According to recent reports and studies it has been determined that advanced nursing care and quality care requires nurses with higher level of education. Baccalaureate program does provide a detailed and more efficient way for nurses who have completed associate degree in nursing. It prepares for a broader scope of practice and provides a better analytical and clinical skills. It helps understand the cultural, political, economic and social issues that affect patients and influence care delivery. (AACN)
Associate Degree Nurse
An associate degree was first introduced by Mildred Montag and it takes two to three years of nursing education. This program was first started to address the shortage of nursing and it is still preferred nursing program all over the world. The main advantages of ADN degree program is that it is less expensive and less time consuming and learns nursing skills and experience faster. After completing the education and passing the state board exam (NCLEX) practice can be started as a registered nurse. An associate degree nurse will do simple nursing care, such as recording patient symptoms, administer medicine working with simple medical equipment, educating patients on diseases and illnesses and working under the supervision of baccalaureate degree nurses and physicians.
Baccalaureate Degree Nurse
Baccalaureate degree nurses require 4 to 5 years of nursing education. This program gives nurses well rounded education and preparing them to successfully enter in the nursing field. After graduating and passing NCELX one can practice as a registered nurse. Nurse who is already working as a registered nurse can also join RN to BSN bridge program and complete Baccalaureate degree in 12 months or in 3 semesters. (Nightingale College) Nurse with baccalaureate degree have an advantage of advancing his/her career in various fields including management, teaching and as a nurse practitioner.
Differences in competencies between nurses prepared at the associate degree level versus the baccalaureate degree level
Both associate and bacccalureate degree nurses work as a Registered nurse after completion the education and registration requirements. Most of the nurses in nursing practice start their career as an associate degree nurse as it has lighter requirements as compare to BSN program. An associate degree nurse provides bed side nursing and communicate with families, doctors and other staff members while bacccalureate degree nursing program includes evidence based practice, critical thinking, assessing, communicating and providing care. (GCU nursing philosphy)
BSN nurse have better understanding of cultural, economic and social issues and it does make a difference to provide best care.
Report shows that 10 percent increase in BSN degree nurses in the hospital reduces 2.12 mortalities per 1000 patients and subsequent complications mortality rate reduces by 7.47 mortalities per 1000 patients. (March 2013, Issue of heath affairs).
BSN nurse can modify care plan according to the patient requirements and provide care from admissions to discharges. Associate degree nurses have few oppurtunities of working in nursing home, long term care hospital and home health care. BSN nurses gets more oppurtunities to work in different hospital as they can get job easily in management and teaching career. Another report shows that approximately 44.68% has BSN degree and 33.62 has an associate degree. (state of nursing, 2016-17). In the nutshell BSN degree nurses with better education tackle situations better as compare to associate degree nurses.
Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse
(BSN versus a diploma or ADN degree).
A 79 years old female patient has been living in long term care facility.
Most of the time she is in good mood, take medicine on time and participate in all type of activities. One day in the morning this patient refuses to get out of the bed and ate only 25% of her breakfast. The associate degree nurse who is taking care of this patients when gave her morning medicine, patient refused to take the medicine as she is having a lower abdominal pain. She also asked for her deceased husband if he is coming to see her today. ADN degree nurse will give her prn pain medicine take a set of vital signs and document about behavior, pain and given prn medicine without assessing patient properly. Then unit manager of that floor who is BSN, noticed patient is in bed after breakfast she approach the patient who appears to be little bit confused. Based upon critical thinking and evidence based practice education she will do proper assessment. During investigation BSN degree nurse finds out that this patient is using bathroom more often than usual and having a lower abdominal pain for last few days. BSN degree nurse perform dip stick urinalysis, notified to the doctor about positive results of urinary tract infection take order and send stat urine to the labortary for cultural and sensitivity. She re-orient the patients to the time, place and environment. She educates the patient to take more fluids and aslo advise to the kitchen staff to give her extra fluids with all meals. By using her skills and critical thinking this BSN degree nurse figured out possible Urinary tract infection which is common in elders and saved this patient from complication of urinary tract infection. This situation make it clear that bacccalureate degree nurse are more knowlegable good decision maker and better understand situation to provide best care to the patient.
AACN’s (Oct. 2014) survey shows that more then 79% of employers preferred to hire baccalaureate degree nurses as compared the ADN nurses. The instituete of medicine strongly suggested that 80% nurses to obtain BSN degree by 2020 ( (Future of Nursing 2010).