Roxanne M Hart
Grand Canyon University:
NVR-430 Professional Dynamics
June 16th, 2013

According to the research that has been conducted by the American Association of Colleges of Nursing, when you compare a nurse with an associate’s degree to a nurse who has a bachelorette degree, the nurse that is prepared with the bachelorette is more prepared clinically and has shown to have lower mortality rates, fewer medication errors, and more positive outcomes for patients. I have read over and compared the Grand Canyon University’s philosophy to the College of Southern Nevada’s nursing programs mission statement. It is not hard to see why research shows that a nurse with a bachelorettes degree is more prepared and knowledgeable to care for patients than a nurse holding an associate’s degree. The College of Southern Nevada’s mission statement states to graduate competent, compassionate, and caring nurses who strive for excellence in their delivery of care to meet the health needs of the community and to contribute to the profession of nursing. The goals of the program are to assist the nurse to be caring, competent, be creative by using their critical thinking skills for decision making while caring for patients, to assist the nurse with communications skills that allow them to collaborate with other disciplines, and professionalism to teach the nurse to continue lifelong learning, accountability, and to be a patient advocate. The 2 year program offered by College of Southern Nevada believes in preparing a nurse to be able to care for a patient safely and to the pass NCLEX, which proves that the student is safe for practice. The associate’s degree program teaches the student just enough information to be able to do this and to pass the NCLEX. The Grand Canyon University Philosophy goes more in-depth it’s more than just preparing a student to practice safely and pass the NCLEX, Grand Canyon University’s philosophy statement states to prepare the student to provide excellent holistic care while encouraging a passion for achievement and a lifelong curiosity for knowledge and pursuit of advanced professional degrees. There are four focuses that Grand Canyon University philosophy also states that the nursing education experiences is planned to meet the needs of the student and client it incorporates professionalism, ethical decision making, critical thinking, and effective communication. These are all part of the curriculum. The four year bachelorette program uses liberal arts, science, health and nursing theories. Along with these, evidence based practices to guide the programs teaching, which incorporates required classes that are not required with an associate’s degree program. The classes that are required for a bachelorette degree offer the student knowledge that is needed for clinical decision making. For example pathophysiology is not a requirement for an associate’s degree, but is required for a bachelorette degree. In this class the student is learning about disease processes and what is normal so that the nurse can recognize when something is not normal and make a clinical decision to help the patient get the proper care and treatment. Another course that is a requirement in a bachelorette degree but not in an associate’s degree program is critical thinking. This is very important for the nurse, because as nurses every decision we make for our patients starts with critical thinking by gathering information and analyzing that information. Using this and also the knowledge that we have learned in our nursing programs we can make the right clinical decisions for our patients. I picked these two courses as examples because of the research showing that there are lower mortality rates, less medication errors, and positive outcomes for patients when nurses are better prepared and educated with a bachelors program. I believe that these two courses that are not required to earn your associates degree could be one of the key factors for the results of the research. These two classes start to build on the foundation for the student nurse, giving them the knowledge needed to make those clinical decisions which are needed for positive outcomes and less errors in care. Maybe if the colleges added these two classes as required course work for an associate’s degree program, this could change some of results from the research performed over the years and better prepare associate degree nurses when they begin their first nursing position. When I was taking my prerequisites before entering my nursing program at the college of southern Nevada I decided to take pathophysiology classes, which I feel has helped me in school and in my career in nursing. I feel that I have a greater understanding of disease processes and their treatments. The reason I feel this way is because during school when I would study with my study group I seemed to have a better understanding of the pathophysiology portion of lecture. Another thing I noticed is that when I began my first nursing job as a new grad on a medical surgical floor, I was working along with new grads that had graduated with a bachelor’s degree that would come to me with questions and guidance with their patients when they were not sure what to do. At times I found this puzzling but I also took it as a compliment from my peers that they trusted my knowledge enough to ask for my opinion and help. I also noticed that the nurses with bachelor’s degrees had more knowledge than me. For example pharmacology, I always felt that my pharmacology class lacked curriculum that I needed to know once I started my nursing career. I would at times have to ask my fellow nurses for assistance about medications. Research has shown that nurses with bachelor’s degrees have fewer medication errors. (American Associations of Colleges of Nursing 2012) I currently hold an associate’s degree and have made one medication error that I am aware of during my first three months of being a bedside nurse, so if you added me to that research it would prove as being accurate. I gave a medication that was supposed to of been injected subcutaneously, but instead I pushed the dose in the patients running I.V. The patient immediately had a reaction and his blood pressure became critically high. I had to call a rapid response, move the patient to intermediate care, and he was started on blood pressure drip medications via his I.V. to counter act the medication that I had given by the wrong route. I violated one of the patients 5 medications rights to safe medication administration. As I mentioned before I feel that my pharmacology class lacked the materials and education to provide me with the knowledge to avoid an error in the task of giving medications to my patients. The syringe was preloaded by pharmacy with no instructions on the label on the route the medication was supposed to be given to the patient. I had looked up the medication in the drug book it listed that the medication could be given subcutaneously, and IV. Usually when the syringe is preloaded by our pharmacy the route of the drug would be IV. I lacked the critical thinking skills need to realize I could have called pharmacy to verify how the medication should have been given prior to administration. I believe that a nurse with a bachelor’s degree has a stronger base of knowledge, stronger critical thinking skills, and stronger clinical background. I discussed my error with a couple of the nurses who also were new grads that held a bachelor’s degree. The first question that they asked was did I call pharmacy to verify how the drug was supposed to be given? That’s what I would have done in that situation. That’s when the light bulb went off why I didn’t I call pharmacy? This is a perfect example how differently a nurse with a bachelor’s degree versus an associate’s degree might think critically and clinically when making decision on how to perform a patient task such as giving medications. Another thing that seems to be apparent by fellow nurses with a bachelor’s degree is the ability to communicate and express opinions more efficiently. This is probably due to the extra courses that are required for a bachelor’s degree, with more knowledge comes more confidence to be able to express and show your knowledge. With the changes in healthcare and hospitals wanting to have a magnet status there could soon be a change in requirements in hiring nursing staff. Most hospitals might decide to change the lowest level of education accepted to be a bachelorettes degree program. If hospitals elect to change this hiring criteria that would force colleges to no longer offer an associate’s degree program, and force nurses with an associate’s degree to continue with their education to earn a bachelor’s degree, so that they are able to obtain employment, and or keep their current employment. If this was to eventually happen it could only help to improve the care, safety and outcomes for all patients mentioned before I feel that my pharmacology class lacked the materials and education to provide me with the knowledge to avoid an error in the task of giving medications to my patients

References

http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf
NRS430V.v10R.GrandCanyonUniversityCollegeofNursingPhilosophy_Student.docx
GCU.EDU
CSN.EDU
Joan L Creasia, Elizabeth E Friberg. (2011). Conceptual Foundations. The Bridge to Professional Nursing Practice, (5th. ED.). ST Louis: Mosby Inc, an affiliate of Elsevier Inc.