EDUCATIONAL PREPARATION

Associate Degree Nurses Versus Baccalaureate Degree Nurses

Madelyn Bearden

Grand Canyon University: NRS-430V

July 5th, 2014

EDUCATIONAL PREPARATION Associate Degree Versus Bachelor Degree Nurses

Education has played an increasingly important role in the development of the nursing profession throughout the years, and one should be able to use learning in order to move forward in daily practice. This paper will discuss the differences in competencies, education, and practice between Associate Degree Nurses (ADNs) and Baccalaureate Degree Nurses (BSNs).
This paper will also discuss the roles that skills and clinical versus academic experience play in practice decisions made by both BSN & ADN nurses.

Associate Degree Nurses

In 1952 Mildred Montag designed the Associate Nursing Program as a response to the critical national nursing shortage after the war. (Creasia, 2011) The shortened length of the program, two years, made it an ideal “collegiate alternative for the preparation of technical nurses” (Creasia, 2011) but Montag’s original intent of having ADNs work under the direction of BSNs became clouded along the way and the inclusion of core general nursing courses and clinical instruction led to the declaration of eligibility for RN licensure exams after graduation for these ADN nurses.

The program was piloted in 1958 (Creasia, 2011) and proved to be an enormous success, producing clinically skilled RNs who could pass the National Clinical Licensure Exam (NCLEX) and were able to successfully enter the nursing workforce after a shortened educational course.

Baccalaureate Degree Nurses

The Baccalaureate program was also founded after the war in the midst of the nursing shortage, but was not as popular nor as immediately successful as the shorter ADN program. The early BSN
EDUCATIONAL PREPARATION

programs were five years of study, two years of general education followed by three years of nursing courses. (Creasia, 2011)Today Baccalaureate programs are typically four years in length and consist of preparation to “practice in beginning leadership positions in a variety of settings.” (Creasia, 2011) Several of the key components to BSN preparation quality and patient safety, evidence-based practice, information management, health care policy/finance, and professional values. (American Association of
Colleges of Nursing [AACN], 2008a)

Differences in Competencies between ADN versus BSN nurses

An educated workforce drives the quality of patient care. Evidence-based research has shown that better patient outcomes are associated with nurses prepared at the baccalaureate level. (AACN,
2013) Nurse researchers have found that a 10 point increase in the percentage of BSN nurses within a hospital setting has been associated with an average reduction of 2.12 deaths for every 1000 patients and in a study published in the September 24, 2003 Journal of the American Medical Association researchers at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. (AACN, 2013) BSN prepared nurses have also been linked with lower rates of post-operative complications and lower rates of inpatient deaths in Magnet hospitals.
(AACN, 2013)

Other studies have shown that the educational level of practicing nurses in the clinical setting has a direct and important impact on patient outcomes. Higher levels of education have a direct correlation with reduced mortality rates and lower rates of failure-to-rescue. (McHugh et al.,
2012).

Associate Nurse versus Baccalaureate Nurse

EDUCATIONAL PREPARATION

Patient Care Situation

Using a patient care situation, a known female heart failure patient on a telemetry floor may present with a blood pressure of 106/66 as reported by the nurse aide. The ADN may choose to hold the patient’s beta blocker in response to what she views as a “soft” or borderline low blood pressure, while the BSN may choose to give the medication in spite of the low reading as she is aware of the beta blockers’ mechanism of action & primary function to protect the heart rather than lower the blood pressure. Although ADNs are unquestionably skilled clinicians and have the required knowledge to pass the NCLEX exam, associate programs generally seem to focus on giving the student the minimum of what is necessary for practice in the clinical setting, encouraging the ADN to rely heavily on experience to gain the knowledge necessary for well-rounded and comprehensive care. Education in leadership roles and nursing theory is inadequate if not non-existent in associate programs, a serious oversight in modern nursing which is accepting more responsibility daily.

In conclusion, although the role that the ADN plays in today’s nursing practice cannot be discounted, nursing is an ever-changing, ever-evolving science, and in order to keep up, nursing education must change and evolve with it. The entity of the bedside nurse embodies dedication by her very existence, and that dedication must also extend to achieving the highest level of education mandated by experts in order to deliver quality, safe, effective clinical practice and obtain best patient outcomes. The people in the beds deserve no less.

REFERENCES

McHugh, M.D., Kelly, L.A., Smith, H.L., Wu, E.S., Vanak, J.M. & Aiken, L.H. (2012). Lower Mortality in Magnet Hospitals. Creasia, Joan L., & Friberg, Elizabeth E. (2011). Conceptual Foundations: The Bridge of Professional Nursing (5th ed.). St. Louis, MO: Mosby/Elsevier

Retrieved from http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf