Over the last decade, healthcare has evolved and nursing practice has become broader requiring the need for baccalaureate degree in nursing as the minimal standard for Registered Nurse (RN) license. Although also accepted, the associate’s degree in nursing is granted at the technical level rather than at the professional level. (ANA, 1965). In this paper I would like to discuss the differences in competencies between nurses that have been prepared at a BSN vs ADN level of nursing. In addition I would like to discuss a situation in which patient-care shows approaches and decision-making and care based on educational preparation of a BSN RN versus a diploma or ADN degree nurse.
Many studies have been done in Nursing Education. The research is based on today's Nursing preparedness. There are three different pathways to reach a Registered Nurse degree. All three pathways 1) Diploma nursing, 2) An associate's degree in nursing, and 3) A bachelor's degree in nursing are required to pass the NCLEX licensing examination. The NCLEX stands for National Council licensure examination. This test is geared for the minimal entry level of competency that is required.
Associates Degree Nursing:
To achieve this degree from start to completion usually takes 2 to 3 years within the community college or some technical school where the students at the end of their graduation may challenge the NCLEX-RN examination.
The associate degree in nursing was first started in the 1960s in the United States at the community college level. Mildred Montag was the director as well as the founder of this technical degree. This was due to the shortage that the nursing community was experiencing. Nursing students are given the foundation of the anatomy and physiology, as well as microbiology. This along with chemistry, are the sciences that are required by this group. There is some community service involved during school, however the research required and experience is minimal, not preparing the RN’s for higher levels of knowledge on the needs of the community. Another area is Critical thinking. This is also another important factor that is not well developed during nursing school. This creates nurses going to the workforce prematurely and having to learn to think critically while on the job. Nursing ethics and leadership is another area not strong in ADN programs furthering to create limited knowledge on work ethics and lack of leadership. Not enough research on disease and disease prevention standing under ADN’s graduates. This also contributes to affecting the development of stronger patient and community educators. Nurses graduating from these programs are more geared towards clinical experience, hands on training and focuses more on technical skills.

In 1965, the American Nurses Association (ANA) made recommendations for the bachelors program to be the minimum preparation for nurse’s practice at the professional level. This program curriculum is comprehensive and founded on the demands on today's nursing. According to the American Association of Colleges of Nursing (AACN) education and preparation of baccalaureate in Nursing Science requires aside from the same science classes required by the ADN, other educational components which are the development of stronger communication abilities, decision making, clinical and scientific thinking skills, which are critical in nursing. There is also a strong emphasis on instilling leadership and Nurse Management in the nursing students. Humanistic skills is also another area in nursing that is integrated to BSN curriculum students. These students are also better prepared for patient and community service education. American Medical Association commented on a study that provides evidence that institutions with BSN degrees or higher are associated with improved patient outcomes.

I would like to further discuss a situation in which I was involved in which I acknowledge the differentiation between the AND manager and BSN manager. I was in a managers meeting sitting next to another RN manager who holds a BSN. The meeting was about interdisciplinary work and leadership and required participation from the staff present. I am new to management and I truly felt unprepared with so little knowledge in the subject and no schooling that I could refer too. I held back in participation. The BSN nurse manager from my department was very knowledgeable and made several suggestions on preparation strategies. She was more confident, knowledgeable and prepared than I was and a better asset altogether in the meeting.
With that, I would like to express that with no doubt in my heart, I like to have that knowledge and confidence in me. Although my bedside experience as a previous ICU RN is my strength, I am now in management and my goal is to strengthen my leadership skills and expand my knowledge to be the best that I can possibly be.
As mentioned earlier there are journals and articles referring to research on the better preparedness provided to RN’s by BSN programs throughout the US. This information gives lot of emphasis on how institutions are preferring to hire nurses that already have a BSN degree vs ADN, also many hospitals are offering assistance to nurses with ADN to further their education. On that note, I would like to say that I am inspired by some of the research I’ve done and am looking to further my own knowledge.