Differences in Competencies between nurses at ADN vs BSN level in nursing
Nurses comprise the largest profession in the health care industry. There are more than 3 million registered nurses in the United States. According to surveys, 50% of the RN workforce has a baccalaureate degree, 36.1% of nurses hold an associate degree, and 13.9% have a diploma in nursing (AACN fact sheet). The associate degree of nursing (ADN) actually began due to a shortage of nursing in the 1950’s. The ADN programs also allowed for more diverse groups of people to become nurses. Students who may not have been able to choose nursing were able to do so, people including men, married women that had children, and older undergraduates.
Whether a nurse holds an associate degree of nursing (ADN) or a bachelor's degree in nursing (BSN) their scope of practice is still the same. The difference can be found in their skills of delivering quality patient care. A baccalaureate nurse possess a higher level of skills in leadership, critical thinking, and in overall health promotion. A BSN prepares the nurse for a role not only at the bedside, but in all health care settings. They are taught to have a higher understanding of patient care both with the inpatient and outpatient settings. That is why most management positions require a BSN. Opportunities in advancement come with advanced education. A BSN is also a prerequisite in obtaining a master’s degree or even becoming a nurse practitioner. A BSN allows opportunities in teaching and research also, and these areas are needed to help with the improvement and advancement for delivering professional and safe quality patient care.
Because a baccalaureate nurse is taught the skills of critical thinking, leadership, and communication with all members of the health care team they are able to look at the overall health wellness and promotion in each situation. They look at the overall picture in every situation and the other roles that impact the patient’s care.
For example, in a chronic dialysis center there are dieticians, social workers, dialysis technicians, licensed vocational nurses (LVN), and ADN nurses. They are what consist of a particular unit to provide outpatient dialysis treatments to those with chronic kidney disease. The ADN nurse oversees the dialysis technicians and the LVNs who are delivering the direct patient care. The ADN nurse is responsible for assessing each patient that comes in for their dialysis treatment and administering medications. The director/manager of the unit is a registered nurse also, but a bachelor’s degree in nursing is a requirement.
The baccalaureate nurse oversees not only the quality of the patient care being delivered, but also the plan of care for each patient. They hold weekly meetings with the patients as well as with the nephrologist to improve patient care. They must look at each patient situation, and must communicate the needs of the patient with the doctor and the floor RN delivering the care.
The baccalaureate nurse also leads and connects with the different departments that comprise the unit. The dieticians and social workers are also supervised by the baccalaureate nurse. Looking at every aspect that affects the quality of patient care and overall health wellness is the responsibility of the BSN nurse. The BSN nurse holds a great deal of responsibility; however they are prepared in handling these responsibilities due to the competencies they were taught in their educational program. Nursing is a profession where flexibility and agility are required. In the medical field, things are always changing and nurses need to be able to adapt to those changes. There are more diverse patients in our world today, and the health care needs are greater. A baccalaureate nurse is able to easily adjust to the ever-changing conditions. They possess a higher understanding and skill of health promotion, leadership, and above all critical thinking. Because a more educated nurse will be better equipped to adapt to the demands of an ever-changing health care system (The Future of Nursing: Focus on Education).

References
American Association of Colleges of Nursing (AACN) Fact Sheet: Creating a More Highly
Qualified Nursing Workforce. http:www.aacn.nche.edu/media-relations/ nursingworkforce.pdf

Cresaia, J., & Friberg, E. (2010) Conceptual Foundations: The Bridge to Professional Nursing
Practice (5th ed). St. Louis, MO: Elsevier.

Institute of Medicine. The Future of Nursing: Focus on Education. Released 1/26/2011, from
http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health/Report-Brief-Education.aspx?page=1