Differences In Competencies between ADN and BSN

NRS-430v

July 14, 2013

Differences in Competencies between ADN and BSN

Over the past few decades, many drastic changes occurred in U.S health care delivery. Our current healthcare trends demand nurses to take more active role in the health care decisions in hospital setting, long term care setting and in community healthcare setting. Since “nursing is based upon a body of knowledge that is always changing with new discoveries and innovation” Potter and Perry (2005), nursing profession is compelled to grow from being just a traditional bedside nurse. IOM’s future of nursing report which is released in 2010 calls nurses to be “more highly educated, diverse nursing workforce”. There are two educational routes for becoming a professional registered nurse in U.S. One of the educational routes is be Associate Degree in Nursing (ADN) and another one is obtaining Bachelors in Nursing (BSN) or Bachelors of Science in Nursing. Although, both degrees enable nurses to get licensed as a Registered Professional Nurse, there are differences among Associate level prepared nurses and Baccalaureate level prepared nurses. In order to meet the requirements and demands of our changing health care system, nurses have to be least Baccalaureate level prepared.
First of all, Associate degree program is a two year program that is usually offered by community college or junior college. Upon graduation, ADN student’s earn70 credits. The BSN program is usually four year of study in a college or university with at least 120 credits upon completion of the degree. While both ADN and BSN degree, teach nursing students the basic nursing curriculum such as anatomy, physiology, nutrition, behavioral sciences, medical surgical nursing, maternity, psychiatry, pediatrics and community health etc. “Bachelor’s degree in Nursing offers more classes that focus on evidence-based clinical practices and leadership” Moore(2009). Additional coursework included in BSN degree are in research, statistics, critical thinking and emphasize on public health/community health. The additional classes a BSN have to take are very significant because it broaden nurse’s knowledge and broaden their scope and enable them to become well ground nurse who treat their patient as a whole person and not just the disease or diagnosis.
While there is no skill and competency differences among Associate degree prepared nurse and Baccalaureate level prepared nurse, the BSN degree nurses have more critical thinking skills that equip them for evidence based practice in clinical setting. The article by Moore (2009) states that “Students entering associate degree nursing programs are focused on learning the technical aspects of nursing appropriate to providing direct care to patients and families, mostly in acute care settings.” Client care requires more than just application of scientific knowledge. It requires the nurse to apply critical thinking and clinical decision making effectively. Bachelor’s prepared nurses use critical thinking effectively than Associate prepared Nurse since the BSN curriculum emphasize the need for critical thinking. The first component of critical thinking is a nurse’s specific knowledge base. This varies according to a nurse’s educational experience. "Numerous research studies have demonstrated that the ADN and BSN nurses are not different in skill competency when they graduate, but within a year, the BSN nurses show greater critical thinking skills, better problem solving, and the development of clinical judgment". Moore (2009). Nurse’s broad knowledge base gives the nurse a more holistic view of clients and their health care needs. The depth and extend of knowledge influence the nurse’s ability to think critically about nursing problems. Nurses are responsible for making accurate and appropriate clinical decisions. As a Bachelor’s prepared nurse enters the health care system since he/ she is trained in school they are able to use the critical thinking skill and problem solving better than Associate prepared nurse.
Bachelor’s prepared nurses are better equipped to make clinical decision more effectively and efficiently. Nurses have to make clinical decisions all the time to improve a client’s health and to maintain wellness. For example, it is the nurse who usually takes immediate action when a client's clinical condition deteriorates, who decides if a client is experiencing complications that warrant notification of the physician. A nurse must be able to think critically, solve problems and find the best solution for client's need to assist clients in maintaining or improving their health. For instance, if an elderly patient status post hip replacement, bed-bound complains of pain in the affected leg and swelling, an ADN prepared nurse might carry out the order for pain management and will elevate the leg to subside swelling. On the other hand, a baccalaureate prepared nurse will critically think about the potential complication status post hip replacement surgery and will take the clinical manifestation of swelling of the leg might be secondary to DVT and will notify the Medical Provider immediately in order to prevent complication. “Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels” Rosseter (2012)
Nursing must reflects the needs and values of society through implementing the standards of professional performance and the standards of care. Baccalaureate level prepared nurses are more prepared to incorporate the science and art of nursing into their practice and consequently the quality of care provided to clients is at a level of excellence that benefits clients in innumerable ways. As the IOM: Future of nursing report states, nurses have to be Baccalaureate prepared in order to address the various issues face our healthcare via nursing research, leadership, management and health promotion.

References
Moore, D. S. (2009). The Differences between Associate Degree Nurses and the Baccalaureate Degree Nurses. Retrieved from www.westcoastuniversity.net/deanscorner
Potter, P. A., & Perry, A. G. (2005). Fundamentals of Nursing (6 ed.). Missouri: St. Louis, Mosby.
Rosseter, R. J. (2012). Creating a More Highly Qualifed Working Force. Retrieved from http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf
The National Acadamey of Science. (2010). The future of nursing, Leading change, Advancing health. Retrieved from http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf