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Educational Prep

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Historically nursing and nursing education continues to grow and change. The first nursing program started with Florence Nightingale who laid the foundation of professional nursing with the diploma program. Today, there are three different pathways to become a registered nurse. The three pathways include; the baccalaureate degree program, associate degree program, and the diploma program. All of these pathways allow the student to take the NCLEX-RN and become a registered nurse. What is the difference between the programs and student outcomes if all the students end up with the same licensure? The difference is the technical nurse versus the professional nurse. This paper will focus on the difference in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level in nursing. "The existence of multiple pathways contributes to a confusing landscape of nursing education and creates challenges for aspiring nurses as they try to choose the most appropriate type of program in which to enter the profession" (book reference). The associate and baccalaureate programs are available to anyone who wishes to pursue a career in nursing, but the two programs prepare two different types of nurses. The associate degree level nurse is more focused on task oriented practice and are more technical driven and clinically competent. On the other hand, the baccalaureate degree level nurse is more professional and use evidence based practice and advanced critical thinking skills. Also, the baccalaureate degree level nurse is prepared to be in a leadership and management role versus the associate degree level nurse who is more geared towards bedside care. “Baccalaureate nursing programs encompass all of the course work taught in associate degree and diploma programs plus a more in-depth treatment of the physical and social sciences, nursing research, public and community health, nursing management, and the humanities" (AACN impact). The baccalaureate degree nurse will be better prepared in the ever changing world of healthcare, and they will have the skills to deliver overall better quality of care. "The additional course work enhances the student’s professional development, prepares the new nurse for a broader scope of practice, and provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patients and influence health care delivery" (AACN impact). According to the American Association of Colleges of Nursing, "Quality patient care hinges on having a well-educated nursing workforce. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels" (fact sheet). Since the baccalaureate program offers a more in-depth course, this allows the nursing student to have a better understanding of all the various sciences, health, research, and management roles. With this better understanding comes better patient care followed by improved patient outcomes. Nurses tend to be viewed as the main caregiver of a patient in an acute care setting, and they should possess a higher level degree to help protect the continuously growing and challenging patient. Studies have proven that nurses with higher educations do make a difference in patients outcomes as stated in the AACN fact sheet, "A 10% increase in the proportion of nurses holding BSN degrees decreased the risk of patient death and failure to rescue by 5%" (as cited in...). Certain areas in healthcare that are more complex require a higher level educated workforce. An example of a complex area of care is palliative care. The World Health Organization defined palliative care as, "Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual" (who). The care of a patient on palliative care requires a better understanding of complex and serious health conditions. The BSN vs. the ADN would perform better in this situation because they have a broader knowledge of sciences, humanities, and community and public health. This broader knowledge would allow them to benefit the patient's overall health. The AACN's website addresses the BSN versus ADN education and practice by stating, "The increased complexity of the scope of practice for RNs requires a workforce that has the capacity to adapt to change. It requires critical thinking and problem solving skills; a sound foundation in a broad range of basic sciences; knowledge of behavioral, social and management sciences; and the ability to analyze and communicate data. Among the three types of entry-level nursing education programs, NACNEP found that baccalaureate education with its broader and stronger scientific curriculum best fulfills these requirements and provides a sound foundation for addressing the complex health care needs of today in a variety of nursing positions. Baccalaureate education provides a base from which nurses move into graduate education and advanced nursing roles" (aacn impact). In conclusion, there are three different pathways to prepare a nurse, but the baccalaureate degree level nurse has a more professional and diverse competency level. According to the American Association of Colleges of Nursing, “the fact that new nurses pass the licensing exam at the same rate does not mean that all entry-level nurses are equally prepared for practice” (aacn). Studies have shown that while associate degree level nurses may provide quality patient care, results have determined that the baccalaureate degree level nurse has a broader knowledge base that improves patient outcomes.

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