Contrasts of ADN and BSN Education and Practice

Terrance Thomas RN

NRS-430V Nursing History, Theories, and Conceptual Models

September 27, 2015

Tish Dorman

Grand Canyon University

School of Nursing

A Baccalaureate nursing program incorporates all of the course work that a three year diploma and a two year associate degree contain in their programs. A Baccalaureate degree program delves deeper into the physical and social sciences, nursing research, public and community health, nursing management, and the humanities. The Baccalaureate degree provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patients and influence health care.

One of the most striking differences between the Associate Degree and the Baccalaureate degree nurse is the research shown towards quality patient care. The American Association for Colleges of Nursing (AACN) has stated that a Baccalaureate degree nurse has lower mortality rates, fewer medication errors, and positive patient outcomes. (AACN 2013). There is no argument. If research shows that fewer people die with a higher educated nursing work force, the case is closed. Life preservation is the number one priority.

The ADN nurse who passes the licensing exam meets the minimum technical competency of the entry level nurse. This is the bare bones of what is acceptable in the nursing medical workplace.

An ADN nurse is task oriented. The Baccalaureate nurse utilizes the nursing metaparadigm in her patient care. The Baccalaureate nurse takes in account a more broad picture of the patients care by understanding all of the person, environment, health/illness, and nursing needs. In my own nursing practice, I have found little difference between an ADN nurse and a baccalaureate nurse. My experiences show poor critical thinking skills on both levels of education. In studies we speak in generalities while in reality we look at the individual. I have witnessed some of the worst bedside care by individuals with the BSN letters on their nametag.

There have been many studies have shown that by increasing the number of Baccalaureate degree nurses in the health care setting have improved patient outcomes. In the issue of Medical Care (October 2014), researcher Olga Yakusheva from the University of Michigan and her colleagues discovered that a 10% increase in baccalaureate degree nurses decreased the odds of patient mortality by 10.9%. The authors also showed that increasing BSN level nurses to 80% would result in lower readmission rates and shorter lengths of stay. This translates to overall better health care as well as increasing the cost savings per patient. This knowledge was unknown to me. I am shocked to learn this major difference in patient care related to increased education. It has changed the way I look at the advancement of my nursing education.

According to another study, Associate degree nurses who returned for their Baccalaureate reported that having the increased education changed the way they practice and perceive their profession. These nurses felt returning back to school for a Baccalaureate of science degree in nursing (BSN) directly benefited their patients (Delaney & Piscopo,2007). I could see where gaining a greater education would provide a nurse with more confidence in their knowledge base. Carrying that increased confidence into the workplace would naturally move into providing improvement in the patient’s health care.

A study published by Dr. Betty Rambur and her colleagues in the July/August 2003 issue of Nursing Outlook showed that “increasing the proportion of Baccalaureate prepared nurses in the nursing population may be essential to stabilizing the nursing workforce. Nurses prepared at the BSN level were found to have higher levels of job satisfaction which is key to nurse retention.“

My hospital and the CNA are in contract negotiations and the latest proposal by the administration is changing the career ladder. Our hospital has a poor record of nurse retention. The hospital proposal states that if an RN with an ADN does not receive their BSN degree within two years, regardless of their years of service, they will return to a Staff Level I nurse. This is the level of a new graduate nurse. I have been with my hospital for 28 years. I am currently at a Staff Level IV position. When I do obtain my BSN degree, I will still be placed at the Staff Level III position. This would mean that although I will have spent over 16k dollars and considerable time and effort to obtain my BSN degree, I would get a pay cut! The proposal states I would need to achieve my Masters degree within 2 years if I am to retain my current staff level pay. This is punitive and an effort to rid the hospital of the higher paid, more experienced nurses. There is no effort towards quality patient care, only increasing the bottom line. While all other hospitals encourage education by promotions and pay increases, my hospital has only disrespect for nurses. There is no effort to help financially or encourage the staff nurse to improve their education. There will be no nurse retention, only a mass exodus of fine quality nurses.

I am pursuing my BSN degree out of an effort to improve my knowledge and education regarding patient care. From the articles and studies I have read during the research for this paper, I have learned that a BSN degree will soon be the minimum entry level requirement for any nursing position. The studies show a higher educated workforce means saving lives. There is no greater purpose for higher learning.

References

Delaney, C., & Piscopo, B. (n.d.). There Really is a Difference: Nurses' Experiences With Transitioning From RNs to BSNs. Journal of Professional Nursing, 167-173.

O'connor, B. (n.d.). New American Association of Colleges of Nursing Data Show Enrollment Surge in Baccalaureate and Graduate Programs Amid Calls for More Highly Educated Nurses. Journal of Professional Nursing, 137-138.

Rambur, B., Palumbo, M., Mcintosh, B., & Mongeon, J. (n.d.). A statewide analysis of RNs' intention to leave their position. Nursing Outlook, 182-188.

Yakusheva, O., Lindrooth, R., & Weiss, M. (n.d.). Economic Evaluation of the 80% Baccalaureate Nurse Workforce Recommendation. Medical Care, 864-869.