Competencies Differences Between ADN and BSN Essay

Florence Nightingale was a nurse who started the nursing training programme in 1860 after the Crimean War. During that war, a lot of women committed themselves to give care for the sick and dying soldiers. The success in their work was evidenced by reduction in mortality and improved prognosis among those injured in the war. Nurses became an indispensable part of the military during that time due to their life-saving work. After the war, nurse training schools were established under the Florence Nightingale model in order to use nurses throughout society (Woolsey, 1950; Dock, 1907). In 1873 the first three training schools were established in New York, New Haven, and Boston. Students were able to attain their nursing education and skills training in two to three years. Society began to refer to these nurses as trained nurses as they were among the first to undergo formal schooling for nursing care. In 1912 the American Nurses Association (ANA) focused on obtaining legal recognition for trained nurses. In 1951, nurse educator Mildred Montag started a new two year associates degree program in nursing in order to produce trained nurses who would assist professional, baccalaureate prepared nurses. Her aim was not to replace the baccalaureate degree program with the associate degree program. The American Association of College of Nursing (AACN) believes that education has a significant impact on the knowledge competencies of nurse clinicians. Nurses with bachelors degrees in nursing are well equipped to meet the demand placed on today’s nurse especially because their curriculum places great emphasis on critical thinking. BSN nurses are also trained in case management, health promotion, and this in depth learning makes them highly versatile in that they are able to practice across a variety of inpatient and outpatient settings. Recent studies have indicated that, in the acute care setting, the mortality rate is reduced by the presence of greater numbers of baccalaureate prepared nurses (Aiken, Clarke, Cheung, Sloane & Sliber, 2003; Estabrooks, Midodzi, Cummings, Ricker & Giovanetti, 2005; Tourangeau et al. 2006). The BSN programme curriculum incorporates â€Å"clinical, scientific decision making and humanistic skill† (Vande Mortel and Bird 2010). The ADN can give efficient bedside care to the patient with their clinical experience, however these nurses are not exposed to the broad spectrum education that baccaulareate nurses experience. Thus, ADNs do not have a basis on which to implement wholistic care measures, and their knowledge base for critical thinking is limited—not due to their mental capacity, but because of the width and depth of their accelerated curriculum. In these days the health care is expanding and globalizing, thus, the demands placed on the nurse have grown and become more complex. Nurses therefore must have the appropriate knowledge base to bring about optimal outcomes in their patients. The American Association of colleges of nursing (AACN) recognizes the â€Å"bachelor of science degree in nursing as the minimum educational requirement for professional nursing practice† (AACN 2000, para 2). BSN prepared nurses are prepared in assertive and professional communication, patient/family education, critical thinking, and implementing measures based on a wholistic perspective. BSN focuses on a broader picture and thus an approach to nursing that places more emphasis on critical thinking. In the United States, associate degree graduates are working in a health care system that is rapidly growing and changing. So they can study while working in order to improve their degree standing to a bachelors or masters degree. This would advance not only their knowledge base, but their competency in nursing practice. Thus, patient outcomes could improve in their nursing setting. Moreover, many institutions have financial support in place to assist the working student nurse. This lessens the burden of attending school and benefits the institution. According to a study published by Dr. Betty Rambur and her colleagues, in the July/August 2003 issue of Nursing Outlook, increasing the proportion of baccalaureate prepared nurses in the registered nursing population may be essential to stabilizing the nursing workforce. Nurses prepared at the BSN level were also found to have higher levels of job satisfaction which is key to nursing retention. Effective clinical decision making is the important factor in quality of care. For example, in the clinical area, if we order labs for the patient, a skilled BSN nurse can identify the normal and abnormal lab result and this nurse can critically evaluate what may be wrong with the patient, based not only on the lab result, but much of the information in the patient’s chart. This information would include admission diagnoses, past medical history, family medical history, new complaints, medication effects, etc. A BSN would utilize his or her knowledge of biology, chemistry, psychology, faith and spirituality, etc. in a way that best advocates wholistic care of the patient. So, a patient with a past medical history of a heart attack, current diagnosis of congestive heart failure (CHF) and an abnormal lab result showing an elevated troponin level is can assess for signs and symptoms of a heart attack, provide nitroglycerine and make arrangements to have the patient placed on telemetry monitoring and/or transferred to a cardiac care unit. This will provide that patient with specialized care that will focus on his risk for myocardial infarction and try to improve his health outcomes. In this same situation, an ADN may not pick up on these cues as quickly and this may delay in good decision making that would affect the patient’s condition. This patient needs care that is intuitive and careful; a critically thinking nurse will be the best person to provide this life-sensitive care. Again, professional knowledge, keen assessment, and critical thinking assist the nurse in making an effective decision. A baccalaureate program in nursing would be well able to equip a nurse for this kind of care. I agree things can be done to improve the professional status of nurses ,but requiring a BSN is not one of them. Its upto all nurses that keep doing continuing education as a part of our practice. Any one can take nursing classes, pass those exams and even they can pass NCLEX exam, but not anyone can be a good nurse.