Differences between Nurses with Associate-Degree and Baccalaureate-Degree
Imagine this scenario. Two nurses apply for a position in labor and delivery. One of the nurses that interviewed has an associate’s degree with 3 years of clinical practice. With one year spent in labor and delivery at a hospital 45 miles away and has applied for this position because it is only 5 miles from her home which would be ideal for her growing family. The other nurse that interviewed for the same position has recently graduated with her baccalaureate in nursing and only has 6 months experience on a medical-surgical unit. The director calls back the first nurse shortly after they are both interviewed and lets her know that the position was filled with a more qualified nurse with a baccalaureate degree. The nurse mentions that she has experience in labor and delivery and is rather baffled and a little disappointed that experience was overshadowed by baccalaureates degree. A little curious about why exactly this degree is preferred she does some research and is surprised by her findings.
There are many substantial differences in both degrees yet there are only a few worth mentioning. The most important of the differences is as simple as the quality of care the patients are receiving which cannot be compromised. Everything depends on the level of education the nurse has received and the quality of care the nurse can give based on the education route chosen. Years of research has proven that a nurse with a baccalaureate degree has lower mortality rate amongst their patients. “Nurse researcher Ann Kutney-Lee and colleagues found that a 10-point increase in the percentage of nurses holding a BSN within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients—and for a subset of patients with complications, an average reduction of 7.47 deaths per 1,000 patients” (Rosseter, 2013, p.2). Other studies have similar data finding with the conclusion that can be clearly drawn to higher education equals quality of care. There are hospitals nation-wide that have based their staffing ratios on research on the difference of quality in care of a nurse with an ADN versus a nurse with a BSN. Magnet hospital are mainly comprised of nurses with baccalaureate degrees because of the understanding that nurses who are a higher investment also have higher qualification and in studies have shown to have14% less deaths with inpatients then those hospitals who have not primarily invested in nursed with baccalaureate degrees (Matthew et al, 2013, p.4)
Certainly saving patients’ life is the most important reason why a baccalaureate degree outweighs an associate degree. In order for nurses to be pro-active in patient care and responsive to life threatening situations they must first know exactly where and what to look for. Another important point in which a nurse with a BSN is a valuable asset to a hospital is that they have a greater sense of self-direction. With self-direction comes the ability to anticipate patient needs not only physical but also emotional as well as the skill to act accordingly so the patient’s recovery time is shortened (Waters, 1972, p. 461). A study done in the late 1980’s set forth to show the differences in degrees. Their findings showed that the nurses with a baccalaureate degree worked and acted more independently in the advocacy of the patient and would take responsibility for their actions and critical thinking judgment. Unfortunately, the associate degree nurses had difficulty intellectualizing and recognizing concepts and relevant relationships with previous experiences that in turn negatively affected the patient (Deback & Mentkowski, 1986, p. 275-285).
This data affects all patients who come in contact with any nurse. From day one nurses are taught that the moment a patient comes on to the units they are to teach, teach, teach. Let us take the data and put it into an everyday occurrence on a medical floor. A patient comes in with a new diagnosis of hyperglycemia. The task at hand is to keep the patient’s blood sugar within normal limitations. A nurse with an ADN does her job and administers insulin per protocol, gives the patient a brochure about their new diagnosis but has to my coaxed to do teaching about sign and symptoms of hyperglycemia prior to discharge. On the other hand there is the baccalaureate trained nurse who does the same however takes initiative to present the patient with written information to review at home once anxiety levels have subsided. They also makes it a point to have the patient recall the information in their own words this way the nurse is assured that the patient has understood the teaching. The nurse goes a step further to get a consults for diabetic teaching and out-patient diet control classes once the patient is discharged and makes it a priority to teach the family as well, for the nurse knows that once the patient goes home the family will be their support system. This nurse with her BSN does not only teach the sign and symptoms of hyper and hypoglycemia but also teaches the importance of correct medication administration and adverse reaction of non-compliance to reduce the chances of readmission. This is a demonstration of self-direction and being an efficient patient advocate.
After the nurse with the associates degree finished her research on why the nurse with the baccalaureate degree was hired she reflects and knows she needs to return to school. She needs to become a nurse that is more pro-active and responsive to patients in life threating situations to reduce the mortality rate of the patients she cares for. A nurse that is self-directed to anticipate her patient’s physical and emotional needs with critical thinking skills that promote patient wellness. She wants to become a stronger patient advocate who can take responsibility for her nursing interventions and actions.

References
DeBack, V., & Mentkowski, M. (1986). Does the baccalaureate make a difference?: differentiating nurse performance by education and experience. Journal Of Nursing Education, 25(7), 275-285
Matthew D. McHugh, PhD, JD, MPH, RN, Lesly A. Kelly, PhD, RN, Herbert L. Smith, PhD, Evan S. Wu, BA, Jill M. Vanak, MSN, RN, and Linda H. Aiken, PhD, RN (2013). Lower Mortality in Magnet Hospitals. Medical Care, 43(10), 4-7. Retrieved from www.lww-medicalcare.com
Rosseter, R. J. (2013, January 21). Retrieved from http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf
Waters V, Chater S S & Vivier M L (1972) Technical and Professional Nursing an Exploratory study Nursing Research 23(6), 461-462 21(2), 126-131