While the Registered Nurse, be it ADN or BSN, provides similar care as regards skill level, medicine administration, and composition of care plans, the LVN is more limited in scope. The LVN is not permitted to hang or push IV medications, perform admission assessments, write nursing care plans, or flush PICC/Central lines. Differences between ADN and BSN are often more subtle as regards both learning and application. Bachelor level nurses typically demonstrate a higher level of competency when dealing with patients of greater comorbidity and acuity as well as a more sophisticated approach to decision making.
Medical terminology indicates comorbidity as multiple system diagnosis of disease, such as a patient with both acute renal failure and congestive heart failure. Such an individual presents a unique challenge in that blood pressure control is at risk via both systems. While both ADN and BSN may approach the nephrologist regarding use of a diuretic, the BSN will have a superior understanding regarding risks/side-affects as pertains to each system, ideal length of use, and related laboratory results to communicate to each physician specialist. This difference in ability stems, in part, from additional hours exposing them to extensive pathophysiology, pharmacology, and research involving all aspects of the profession. Acuity reflects patient stability and while list of diagnosis, patient history, and physical may contribute a more intimate knowledge of client needs, the ADN will have fewer clinical experience hours upon which to draw and apply to care. For example, an ADN minimum clinical hours stands at 470 while the minimum BSN clinical hours rank in at 970. Additionally, most BSN programs prepare the graduate for rapid decision making as regards prioritization for client care and designation of staff assignments. In Marilyn H. Oermann’s Clinical