Differences in Competencies: The Associate-Degree Level versus the Baccalaureate-Degree Level in Nursing

Through my research for this paper I have found that RNs who have an associate degree or diploma are more likely to make errors during clinical practice. Nurses who hold Bachelor of Science in Nursing (BSN) degrees have a stronger foundation in which to build better communication, leadership, critical thinking and problem solving skills. The high demands placed on today's nurses really challenge all of these skills on a daily basis. Nurses with Bachelor of Science in Nursing degrees have a better understanding of the importance to be proficient in these skills. In a study of RN-to-BSN degree graduates from 1995 to

An ongoing debate for the requirements to become a Registered Nurse (RN) has been unsettled. Several different educational pathways lead to an RN licensure; however, the minimum educational requirements must be standardized at the baccalaureate level for several reasons. Spetz and Bates (2013) published that a growing number of hospitals prefer hiring nurses with a Bachelor Science in Nursing (BSN) as this increases the status of the nursing profession (p. 1). Associate Degree in Nursing (ADN), as well as a certificate on-the-job training Diploma are two other educational pathways to become an RN, which can be disadvantageous to the nursing profession in several ways (Tollick 2013; Spetz and Bates 2013). If entry-level nurses

The researchers determined that for every 10% increase in nurses at the BSN level, there was a 4% decrease in patient death ("AACN Fact Sheet," 2012). From this study it can be ascertained that a BSN nurse can perform at a more competent and safe level for patients. The amount of knowledge regarding patient care and skills between ADN and BSN prepared nurses is very similar. The BSN however has supplemental skills in critical thinking and communication that allow them to look at and solve problems differently. A BSN is more likely to utilize evidence based practice and team problem solving to minimize their margin of error.

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

This “incorporates the roles of assessing, critical thinking, communicating, providing care, teaching and leading” (Grand Canyon University, para. 7). I also believe that an individual’s maturity over a four-year period has time to evolve with the concepts of critical thinking and decision making the BSN framework offers. The difference in cost and time from ADN to BSN programs is a deciding factor in many educational decisions. The economy and decrease in job opportunities has driven many into the nursing profession that may not have initially considered it a career option. Sadly, I believe that has contributed to the lack of interest in pursing an advanced education. The professional choice wasn’t driven out of a motivation to help humanity or a sense of altruism; it was merely an employment opportunity.

The purpose of this paper is to compare and contrast the differences in the scope of practice between Associates Degree in Nursing (ADN) and Baccalaureate of Science in Nursing (BSN) nurses. There are numerous variances and similarities identified. These variances will be explored to show distinction between the two educational preparedness expectations by the Board of Nurse Examiners (BON).

For years now it has been well know and documented that there is a brutal disconnect between what school prepares NGRN for and the reality they find once they begin working.(Duchscher, 2009) This stark difference found between school and reality sets new graduates (NG) up for a hard fall and the disillusionment they are under when entering the professional practice can lead them to exit nursing altogether.(Duchscher, 2009) The problem then of course becomes recruitment and retention, and the cost of training new nurses back in 2007 was recorded to be as much as 82,000 to 88,000 each.(Ulrich et al., 2010)

Bachelor degree nursing programs are highly regarded for the skilled, clinical thinking, and professionalism of nurses they provide for the community. Obtaining a baccalaureate in nursing provides the same skills and knowledge encompassed in most associate’s programs, while allowing a broadened look into research, public health, management, and humanities (AACN IENP, 2012). Many facilities are now providing incentives for nursing staff to continue their education; from tuition reimbursement, an increase in pay, and played time off for the sole purpose of education. Research has proven that with a more educated

This focus is adapted to primarily prepare the ADN student for more day to day nursing activities. In 1952, Mildred Montag, in response to the nursing shortage, designed a program to counter the college level nursing programs. An associate degree was the end result. (Haase, 2006, p. 1)

The Carnegie Foundation reports that nurses today “are undereducated for the demands of practice” (Benner, Sutphen, Leonard, & Day, 2009, ¶ 17). Education of the ADN centers around the hands-on skills needed to care for a patient at bedside and less on the scientific theories that allow the holistic treatment of a patient. A report by the Milbank Memorial Fund in 2001 reports that nurses educated at the ADN level have a higher incidence of mistakes made while performing their duties (Rosseter, 2011, ¶ 24). Registered nurses who graduate with the two year degree lack research skills, leadership and managerial skills as well as informatics needed to deliver quality medical care within today’s health care system (Orsolini-Hain & Waters, 2009, p. 269).

The implications for BSN-prepared nurses in addition to those of RNs with an associate degree

Discussing the Differences in Competencies between nurses prepared at the Associate-Degree level versus the Baccalaureate-Degree level in Nursing.

There is an increasingly high demand for students going into nursing careers in our society, but there are also varying educational pathways for these students to get into these careers. Are the three educational pathways (Diploma, Associate Degree, and Baccalaureate Degree) preparing prospective nurses to be at the same competency level after schooling? Advancement in education has become an increasingly important topic amongst health care organizations. Educational preparation can indeed affect nursing care and the decision making of nurses. In this paper, an analysis of nursing history and the degree programs themselves will provide evidence of an increased level of patient care by BSN nurses vs. ADN nurses.

“Throughout the last decade, policymakers and practice leaders have recognized that education makes a difference” (Impact of Education, n.d.). Hospitals are also trending towards preferred hiring of bachelors prepared nurses for their workforce. Even national organizations are jumping on the bandwagon requiring “all nurse managers and nurse leaders to hold a baccalaureate or graduate degree in nursing by 2013” (Impact of Education, n.d.), likewise the Institute of Medicine has also recommended that all hospitals have at least 80% of their nursing staff with a BSN or higher by the year 2020 (Impact of Education, n.d.).