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Adn vs Bsn

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Running head: THE DIFFERENCE IN COMPETENCIES OF AN ADN AND A BSN 1

The Difference in Competencies of a Nurse with an ADN versus a Nurse with a BSN

Stacey M. Kestler

Grand Canyon University

THE DIFFERENCE IN COMPETENCIES OF AN ADN AND A BSN 2

Abstract

According to American Association of Colleges of Nursing fact sheet: Creating a More Highly Qualified Nursing Workforce, there are 2.8 million registered nurses currently active and practicing, of these 55% hold a bachelor’s degree, and by 2020 they estimate that number will increase to 80%. This is important because what will happen to the nurses that currently have an ADN or are about to enter into the ADN program? What is the difference between a nurse with an ADN and a nurse with a BSN, and is one better than the other? Nurses make the decisions to get their ADN or BSN for many different reasons, but there are many journals and articles in publication that statically show that having a BSN is safer for patients. In the October 2014 issue of Medical Care, it published that having a 10% increase in the proportion of bachelor educated nurses decreased mortality rates by 10.9%. In the May 2014 issue of The Lancet, it published that European hospitals with a higher number of BSN nurses showed that patients were more likely to live after facing complications due to surgery. In conclusion Nancy Burgess states in her article ADN versus BSN Nursing Degree…Which will it be?, that the United States Bureau of Labor Statics estimates that by 2020 the nursing work force will increase by 26%. With a demand for nurses that seems to only be increasing it is imperative that both ADN and BSN programs keep producing entry level new graduates that are competent to practice safe nursing.

THE DIFFERENCE IN COMPETENCIES OF AN ADN AND A BSN 3 There has been unresolved debate in the nursing world over the competencies of nurse with an ADN, Associate degree in nursing, and a BSN, Bachelor degree in nursing, since the ADN program was established in 1952 by Mildred Montag. Do nurses with an ADN have enough education to perform the same tasks as a nurse with a BSN? According to Associates of College of Nursing, nurses with an ADN pass the NCLEX, the licensing examination, at the same rate as the nurses with a BSN, but they also go on to say that this is because the examination only test for “minimum technical competency for safe entry into basic nursing practice.” This paper will look at the difference between the two programs, and the different way a nurse with an ADN may approach a clinical situation versus a nurse with a BSN. The Associate degree in nursing is a two year program. It was established as a program to produce a “technical” nurse, a nurse that had enough education to perform bedside care safely, and these nurses were to work under the supervision of a nurse with a Bachelors. (Cressaia & Friberg, 2010) This however is not how it played out. A nurse with an associates degree has the same licenses as a nurse with a bachelors degree. They can perform the same tasks with the exception of management duties. The article ADN vs. BSN: Which should you choose?, explains the core curriculum for ADN program is adult health, maternal and newborn health, pediatric health, psychiatric health, gerontological nursing and sometimes community health. Nurses with associate degrees have excellent bedside care because the program is designed to have more clinical experience providing direct patient care. The associate program also opened doors for a population that would not have been able to become nurses because it’s cheaper, the program is only 2 years and can start earning an income quicker. The down side is there is no real THE DIFFERENCE IN COMPETENCIES OF AN ADN AND A BSN 4 opportunities for career advancement since the program is focused on the technical skills and not the critical thinking portion of nursing. The Bachelors degree in nursing is a 4 year degree. Along with core curriculum mentioned above, the BSN program includes a liberal education, quality and patient safety, evidence based practice, informatics, management, health care policy and finance, communication and collaboration, clinical prevention and population health, and professional values, (Cressaia & Friberg, 2010) and the article ADN versus BSN Nursing Degree… Which Will it BE? includes case management, public health, nursing theory and nursing research to the list. This opens many doors for nurses. Not only can they do direct patient care but now they qualify for entry level management positions, education position, case management positions and public health positions, they also have the ability to earn higher wages and can enter into an MSN program if they choose to further their education. When comparing how a nurse with an ADN may approach a clinical situation versus a nurse with a BSN I have conflicting emotions. I received my ADN in 2009. In the beginning I may have walked into a room and treated a patient not really understanding the “why”. What I mean by this is a patient may have a high blood pressure and my first thought would have been what medication is ordered that I can give to lower it, but now when I walk into a room I think is this patient having pain, did they not take their daily home medications before surgery, or do they have something else going on like withdrawal from alcohol. I did not learn how to think this way in school, but by experience. We have new graduates on the floor with a BSN that think the same way I did in the beginning. I think sometimes no matter if you have a BSN or ADN the critical thinking portion of the job will just come with experience. THE DIFFERENCE IN COMPETENCIES OF AN ADN AND A BSN 5
For the purpose of this paper, given the situation I mentioned above about high blood pressure, the nurse with an ADN would treat the patient with medication like hydralazine or Lopressor. The ADN nurse would treat the symptoms without trying to find the underlying cause. The nurse with the BSN would go into the room and ask the patient to rate his or her pain, ask if they took their normal dose of blood pressure medicine before surgery or ask if they drink alcohol or use drugs. Then the nurse would either give pain medication, give blood pressure medication or may need to get orders for a substance abuse protocol and treat the patient per the protocol.
In conclusion, the nurse with and ADN has created a foundation that can be built upon. The article, The Impact of Education on Nursing Practice, states “research shows that RN’s prepared at the associate degree and diploma levels develop stronger professional – level skills after completing a BSN program and that RN-to-BSN students demonstrated higher competency in nursing practice, communication, leadership, professional integration, and research/evaluation. The article also states that Robert Wood Foundation states that “to respond to the demands of an evolving health care system and meet the changing needs of patients, nurses must achieve higher levels of education”, and the tri- council of nursing states “without a more educated nursing workforce, the nation’s health will be at risk.” Over all, I agree. I think that as a nurse we should have the most to update education, and skills to care for the patient, and if statistically that means having a BSN makes it safer for the patient then we as nurses should all strive to get our BSN.

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