Educational Preparation Essay

Difference in Competencies Between Associate and Baccalaureate Degree Nurses There is much controversy surrounding the issue of the difference in competencies between nurses educated at the Associate (ADN) and Baccalaureate (BSN) level. This paper will discuss those differences in relation to Professional values, and risk-taking propensity. This paper will discuss how, even though numerous studies have been done that show there is little difference between the competencies of ADNs and BSNs, there is, in fact, a distinct difference. No one can deny that the health care industry has come a long way. This does not exclude the nursing field. There is a huge push by the Magnet hospitals to maintain that 80% of their nursing staff carry baccalaureate degrees by the year 2020. This is due to changes in the healthcare delivery system, as well as cost-containment (Masters, 1989). While baccalaureate prepared nurses have better access to jobs as new graduates and are looked at as being better prepared for the clinical workforce, until they have been working in the clinical sector there is really no difference between the experience level of an associate or baccalaureate prepared nurse.

There is also a gray area, because graduates of both levels of education take the same licensing exam, and also have the same legal responsibilities (Masters, 1989). In the article “Analysis of Differences in Entry-Level RN Practice by Educational Preparation”, June E. Smith states that there was a very close relationship in pattern of practice between recently graduated Associate and Baccalaureate nurses (2002). She also wrote that “Within the first 6 months of practice, ADN and BSN graduates performed activities with remarkably similar frequencies” (Smith, 2002, p. 494). It is shown in the article “Professional Values Held by Baccalaureate and Associate Degree Nursing Students”, that there have been “no significant differences found between the two groups” (Martin, 2003, P. 292).

This particular study was done out of a random selection of graduating students from a number of baccalaureate and associate degree programs in the state of Texas. These nurses rated their professional values using the Nurses Professional Values Scale (NPVS), as taken from the 1985 American Nurses Association Code of Nursing (Martin, 2003). Findings of this study concluded that “senior nursing students in ADN programs did not differ significantly from their counterparts in BSN programs” (Martin, 2003, p. 293). According to Marcia L Masters, role differentiation between ADNs and BSNs is not “clearly defined in terms of decision making responsibility” (1989, p. 391).

In this same article, Masters quotes W. Weiss (1985), “Taking risks means different things to different people.” One person may look at a situation as a challenge for success, where another will look at it as a threat of failure. Through the course of this study, it was found that nurses had a higher risk taking propensity than the normal population, but there were no significant differences in risk taking propensity noted between the ADNs and BSNs studied. This includes both education and experience.

“Although in practice, BSNs may be given more opportunities for decision making, this study indicated the willingness to take the risk in making decisions is fairly evenly distributed between ADNs and BSNs” (Masters, 1989, p. 394). Contrary to what these studies have shown, there is a distinct difference in the competencies of ADNs and BSNs. According to the National League of Nursing (NLN, 2011), a baccalaureate degree expands on the knowledge and capabilities acquired in an associate program. Where associate programs focus on the patient and their family, baccalaureate programs tend to focus more on community nursing and leadership. There is a broader context of nursing that is learned in a baccalaureate program. In the article “The Differences Between Associate Degree Nurses and the Baccalaureate Degree Nurses”, The author states “a nurse with a BSN has more opportunities to work in a variety of health care settings that offer an extensive array of opportunities for professional growth. Baccalaureate-prepared nurses can be bedside nurses, educators, case managers, discharge planners, administrators, and work in public health, home health, and community clinics” (Moore, 2009).

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She continues to explain how associate prepared nurses are focused more on the technical aspects of care, where Baccalaureate prepared nurses are focused more on “evidenced-based clinical practice and leadership” (Moore, 2009). Moore also agrees that in skill competency, there is not much difference between ADNs and BSNs, but that “BSN nurses show greater critical thinking skills, better problem solving, and the development of clinical judgment; three skills of increasing importance for the increase in acuity of patients in hospitals and other health care settings” (2009). As a new graduate ADN, the author of this paper has insufficient experience to identify a specific patient care situation in which approaches to decision making may differ between associate and baccalaureate prepared nurses.

It comes to light from research, however, that a baccalaureate prepared nurse is more competent in thinking on the fly. As stated earlier, baccalaureate prepared nurses have improved clinical judgement and problem solving skills, which are crucial in an emergency or trauma situation, where the patients have a higher acuity level. It seems that as far as newly graduated nurses are concerned, there is not much of a difference in bedside skill competencies between ADNs and BSNs. A baccalaureate degree, however, better prepares the newly graduated nurse for critical thinking, problem solving and better judgment in emergency situations. A baccalaureate degree gives the nurse more opportunities for advancement and movement within the nursing field, and also prepares the BSN for graduate study. This is important especially when it comes to the nation’s hospitals movement toward Magnet Status.

References

1. Martin, P., Yarbrough, S., & Alfred, D. (2003). Professional Values Held by Baccalaureate and Associate Degree Nursing Students. Journal of Nursing Scholarship, Third Quarter, 291-296. Retrieved January 19, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=14562499&site=eds-live&scope=site

2. Masters, M., & Masters, R. (1989). Risk-Taking Propensity of Nurses: ADN and BSN. Journal of Nursing Education, 28(9), 391-396. Retrieved January 14, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=1990100566&site=eds-live&scope=site

3. Moore, D. S., PhD., RN., CNM., MN., & MPH. (n.d.). West Coast University: Dean’s Corner – The Differences Between Associate Degree Nurses and the Baccalaureate Degree Nurses. West Coast University – Nursing Programs – Los Angeles, Orange County, Inland Empire. Retrieved January 20, 2013, from http://www.westcoastuniversity.net/deanscorner/print.php?article=22

4. Ridley, R. (2008). The Relationship Between Nurse Education Level and Patient Safety: An Integrative Review. Journal of Nursing Education, 47(4), 149-156. Retrieved January 15, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009885996&site=eds-live&scope=site

5. Smith, J. (2002). Analysis of Differences in Entry-Level RN Practice by Educational Preparation. Journal of Nursing Education, 41(11), 491-494. Retrieved January 18, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2003013823&site=eds-live&scope=site

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Educational Preparation Essay

There are many differences in the competencies of Associate Degree in Nursing (ADN) and Bachelor’s of Science in Nursing (BSN) graduates. To start, I think it is best to look at the through the perspective student’s eyes when they are deciding which type of program to attend. The first question one may ask is “How long is this going to take?” On average, an ADN program takes 3 years to complete, the BSN requires a minimum of 4 yeas. The difference in the length of programs is first based on the amount of prerequisites required. “While Associate Degree in Nursing students do need to take science prerequisites and some liberal arts classes, they don’t have to earn nearly as many credits in this area as BSN students do.” (ADN vs BSN Debate I Difference in Competencies, Salary & Education.2013)

“Instead of the sixty-six nursing credits that a BSN student must complete, the student in the associate degree program needs forty-nine nursing credits” (ADN vs BSN Debate I Difference in Competencies, Salary & Education.2013) Therefore, the ADN program takes less time to complete, is more condensed, and is more focuses on clinical skills. BSN programs have a direct goal of not only graduating clinically competent nurses, but nurses that understand that this profession is deeply rooted in science and theory. The differences in competencies between the ADN and BSN nurse is based on this understanding of science.

If you had to explain what science is in one word that word would be “why”. BSN programs are typically centered around critical thinking and evidence based practice – they “why” of nursing. “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; three skills of increasing importance for the increase in acuity of patients in hospitals and other health care settings.” (West Coast University: Dean’s Corner – The Differences Between Associate Degree Nurses and the Baccalaureate Degree Nurses.2009)

The ability to use critical thinking when caring for a patient is what defines all other competencies. Competencies aren’t based on just the task the nurse is about to complete, but knowing why she is working towards completing this task. Without that training in understanding the “why”, her competencies are limited to just tasks.

A fast growing trend in nursing today is complex technology used in patient care. Often times the nurse finds herself faced with not only caring for the patient, but managing high-tech equipment involved in that patient care. Being a resourceful nurse is not just beneficial, but crucial to patient care. BSN prepared graduates are experts in research due to the expectations in the BSN curriculum. “A major concern in an era of evidence-based practice is that the majority of practicing nurses have not experienced a formal research course. These classes are generally lacking outside of the baccalaureate curriculum. It would seem that an understanding of the research process would be necessary to deliver optimal patient care” (Ayers & Coeling, 2006; Thorpe & Smutko, 1998). The ability to conduct research appropriately is a skill that is taught. We live in an age where information is just a click away. If a nurse isn’t using the correct resources, the patient is the one that suffers.

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The push for continuing education in nursing is one of the many forces that shaped what nursing is today. The BSN prepared nurse encompasses the ability to be resourceful, a bold and capable critical thinker, and one that will lead the profession into a strong future. As a nurse, we should never settle for just the standards put in front of us. We should always be looking for a way to improve patient care for the individual patient, as well as the practice of nursing as a whole. To settle for just the minimal requirements and standards of nursing is to just complete the tasks assigned to us.

Developing critical thinking is what brings us to better patient outcomes. Learning to think ahead – planning for the worst, expecting the best is what restores patient health. The human body is a dynamic, complex integration of systems working in unison to maintain life. If one of those systems is not working correctly the nurse is cued in because of our critical thinking skills. It is what keeps the nurse’s brain “on”, assessing at a constant. It’s not always the system we’re “caring for” that tells us what is wrong. This is where the critical thinking comes in. We should always be asking “why” as a nurse.

References

ADN vs BSN Debate I Difference in Competencies, Salary & Education. (2013). Best

Nursing Schools, Degrees & Online Nursing Programs. Retrieved January 13, 2013,

from http://www.bestonlinenursingprograms.com/3356/adn-vs-bsn-debate

Ayers, D., & Coeling, H. (2006). Incorporating research into associate degree nursing

curricula. Journal of Nursing Education, 44(11), 515-518.

West Coast University: Dean’s Corner – The Differences Between Associate Degree

Nurses and the Baccalaureate Degree Nurses. (2009, February). West Coast University –

Nursing Programs – Los Angeles, Orange County, Inland Empire. Retrieved January 13,

2013, from http://www.westcoastuniversity.net/deanscorner/print.php?article=22

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