The profession of nursing has established its glory in human history through overcoming various challenges in last two centuries. Started as a small group of people with compassion and courage to care for sick during the dark ages of 19th century, nursing has come to a point where it is renowned as a profession having strong body of knowledge that integrated in day to day practice. During the process of natural evolution, nurses had to go through a series of transformations from mere ‘nursing job’ to distinguished profession where the members not only involve in medical care of the patient ,but also in helping the patient as a person and member of a family and society to steer through difficult times. As mentioned in American Association of College of Nursing (AACN) facts sheet : Creating a more quality nursing workforce (AACN, 2012) this elegant approach is implemented nationwide through the hands of more than three million registered nurses.
Professional preparedness of nurses who are working today mainly falls in to two categories; Associate degree (AD) and Baccalaureate degree(BS) prepared. Associate degree programs were the answer for nursing shortage that our country experienced in last century especially in the post second world war era. Associate degree programs are usually two years in duration. They prepare nurses to function at bedside based on the core concept of patient safety. These nurses were extremely successful in caring for patients in a setting were physicians took the entire responsibility of medical decision making. Advantage of Associate degree programs are that they prepare nurses in a short span of time and are more widely available compared to bachelor degree programs. They also come with less financial liability at the end of study process because of their shorter duration. These accessibility and affordability factors made associate degree programs an attractive opportunity for beginners in this profession.
Even though AD nurses were successful in doing patient care when nursing care was more task oriented, advanced concepts in medical and nursing care especially ‘ holistic approach on patient care’ demanded a newer identity and role for new generation nurses. New challenges along with availability of better knowledge on ‘complex human interaction and symbiosis with the world he or she lives in’ brought the origin of baccalaureate degree programs for nurses. These nurses are prepared with better understanding of advanced concepts of human behavior. They are also trained to apply critical thinking and communication skills in various complex clinical situations they come across in day to day professional life. In effect, these nurses are professionally carved to respond to the similar situation in a different and more effective manner than an AD nurse. Through critical thinking and problem solving capabilities integrated in their advanced knowledge, these nurses are more effective in creating better patient outcomes than AD prepared nurses (AACN, 2012). However, the most perceived disadvantages of BS programs are its longer duration, higher financial liability and less availability of training programs compared to that of AD programs.
Because of the inherent difference in preparedness, higher quality of patient care and outcomes are expected from baccalaureate degree prepared nurses in clinical situations. This outcome difference was scientifically proven through research studies and their analysis in the past. According to Johnson (1988), a meta-analysis of 139 studies related to AD and BS nurses showed that there is significant difference between professional (BS) and technical (AD)nurses on measure of nursing performance (Johnson, 1988). There were substantial difference in communication skill, knowledge, problem solving and professional role among these two groups of nurses. Critical thinking and problem solving abilities, skills to facilitate inter personal communication and increased knowledge base empowered BS prepared nurses to have more vital role in current health care settings.
In real life, I had experience with one of my fellow nurses who is baccalaureate prepared and had opportunity to learn firsthand regarding the merits of advanced learning in nursing. Being an Oncology nurse for years, I never understood why some of my patients with newly diagnosed cancer were very rude and disrespectful to the nurses who took care of them in their crisis situation. I had seen incidence where my experienced coworkers got burned out and requesting transfer to different units. I had a similar incident where one of the newly diagnosed cancer patients was very angry with me when I asked him to consume his prescribed medications. I was very confused about the dynamics of the situation and how to approach it. I could not understand why the patient was angry with me when I was trying to help him managing his disease condition.
This situation brought me in to discussing my concern with the above mentioned nurse who was baccalaureate prepared. From her advanced knowledge regarding human behavior at the time of crisis, she explained this particular patient’s behavior in terms of stages of grief. She showed me the Kubler Ross classification of stages of grief process and made it clear that the patient is going through the state of anger, which is the immediate reaction of the patient to cope with a life changing diagnosis (Kubler- Ross 1969). From her advanced knowledge, she also explained how to interact not only with the patient, but also his family who were going through the same crisis situation. I was so impressed with my coworker’s knowledge and understanding of the complex situation and her problem solving capabilities that she acquired through her bachelors education.
The difference that BS prepared nurses make in real life on a day to day basis is transformed in to better clinical outcomes and is clearly reflecting on all aspects of health care system. There has been a broader consensus among academic scholars regarding the fact that advancement in education of the nursing workforce is the corner stone in improving quality of care and better clinical outcomes (AACN, 2012). Currently, educational institutions are embracing the commitment of preparing nurses in to more advanced clinicians with the power of strong critical thinking and problem solving capabilities. This is evidenced in the philosophy of Grant Canyon University College of Nursing and is stated as “the nursing programs prepare graduates to provide excellent, holistic care while encouraging a passion for achievement, a lifelong curiosity for knowledge, and pursuit of advanced professional degrees”. This statement consolidates the core concepts as well as the academic pathway employed in developing and nurturing future graduates for the professional advancement.

References 1. Kubler-Ross, E. (1969). On the Fear of Death. Tavistock publications, Oxon. 2009 2. Johnson, J. H. (1988), Differences in the performances of baccalaureate, associate degree, and diploma nurses: A meta-analysis. Res. Nurs. Health, 11: 183–197. Electronic data recovered from http://onlinelibrary.wiley.com/doi/10.1002/nur.4770110307/abstract. 3. American Association of College of Nursing (AACN) (2012). Fact Sheet: Creating a More Highly Qualified Nursing Workforce. American Association of College of Nursing, 2012. Electronic data recovered from http://www.aacn.nche.edu/media-relations/nursingworkforce.pdf on 23rd September 23, 2012. 4. Philosophy- Grant Canyon University College of Nursing (2012). Electronic data recovered from http://www.gcu.edu/College-of-Nursing/Philosophy.php on 23 September 2012.