A Bachelor's Degree as a Requirement of Medical Practice Essay

“Programs provide a solid liberal education and substantive upper division nursing major. Both components are combined in ways that prepare a nurse generalist who is able to provide professional nursing services in beginning leadership positions in a variety of settings” (Friberg, 2011, p. 87-88). Obtaining a BSN can open up more job opportunities for a person and in most cases makes you more desirable to employers. Many nurses get burnt out from being floor nurses so if you have your BSN you have the option to move into management or many other areas like insurance companies, pharmaceutical companies, research jobs or even a clinical instructor. “Research shows they use evidence based practice for better patient outcomes.” (Moore, n.d.) “ As also stated in the same article “numerous research studies have demonstrated that the ADN and BSN nurses are not different in skill competency when they graduate, but within a year, the BSN nurses show greater critical thinking skills better problem solving, and the development of clinical judgment; three skills of increasing importance for the increase in acuity of patients in hospitals and other health care settings.” (Moore, n.d.)

They determined that patients needing surgery have a "substantial survival advantage" (Aiken, Clark, Cheung, Sloan, & Silber, 2003) if treated in hospitals with higher ratios of nurses educated at the baccalaureate degree level. They too determined through this research that the more nurses holding BSN degrees help decrease the risk of patients dying and the ability to determine the patient is in distress. This research provides the evidence that nurses with a BSN degree have a better comprehension in their ability to formulate nursing diagnoses and evaluate nursing interventions. (Giger & Davidhizar, 1990) BSN degree nurses also demonstrate improved professional integration and research/evaluation skills. (The Future of Nursing:Leading Change, Advancing Health, 2012)

An ongoing debate for the requirements to become a Registered Nurse (RN) has been unsettled. Several different educational pathways lead to an RN licensure; however, the minimum educational requirements must be standardized at the baccalaureate level for several reasons. Spetz and Bates (2013) published that a growing number of hospitals prefer hiring nurses with a Bachelor Science in Nursing (BSN) as this increases the status of the nursing profession (p. 1). Associate Degree in Nursing (ADN), as well as a certificate on-the-job training Diploma are two other educational pathways to become an RN, which can be disadvantageous to the nursing profession in several ways (Tollick 2013; Spetz and Bates 2013). If entry-level nurses

In addition to the content taught in ADN programs, the humanistic BSN education encompasses more of the physical and social sciences (Impact of Education, 2011). The BSN nurse is better prepared to work more independently, therefore is well qualified to practice in healthcare systems outside of the hospital. Bachelor programs “prepare professional nurse generalists for acute care settings, community-based practice, and beginning leadership /management positions” (Creasia & Friberg, 2011, p. 32). This course of study is crucial to the delivery of good, safe, quality patient care. There have been several research studies completed to see if there is a correlation between higher RN education level and better patient outcomes. Several studies concluded there is decrease in mortality rates within hospitals that employee a greater percentage of bachelor prepared nurses (Creating a More, 2011).

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

The purpose of this paper is to compare and contrast the differences in the scope of practice between Associates Degree in Nursing (ADN) and Baccalaureate of Science in Nursing (BSN) nurses. There are numerous variances and similarities identified. These variances will be explored to show distinction between the two educational preparedness expectations by the Board of Nurse Examiners (BON).

Education increases both clinical competency and quality care. Associate degree in Nursing can be completed in three years. It was initially started to fill the shortage of nurses. BSN degree is four year nursing education and it helps the nurses to be well- rounded academically. ADN versus BSN have been in discussion for some time now. According to “HRSA’s 2013 report, titled The U.S. Nursing Workforce, found that 55% of the RN workforce held BSN or higher degree. In a separate study conducted by National Council of State Boards of Nursing found that 61% of RN workforce in U.S. was BSN or Higher degree”

According to Creasia (2010), “The first baccalaureate nursing program was established in the United States at the University of Minnesota in 1909” and many programs were 5 years long (p. 4). Today, the BSN program is a 4-year college degree offered at universities, private schools and community colleges throughout our nation. The BSN degree graduate has many advantages over an ADN degree graduate and these might include: career paths that are only open to nurses with a BSN degree including administrative positions and minimum requirement for advanced practice nursing (APN). Furthermore, the BSN graduates get extensive training in components that might include: quality and patient safety, evidence-based practice, information management, clinical prevention/population health, and professional values, all of which are essential as nursing care becomes more complex (Creasia, 2010, p. 4). One of the biggest disadvantages of having a BSN degree is that the legal scope of practice is undifferentiated due to being awarded the same license as an ADN graduate “hindering the reward system for leadership responsibilities” (Creasia, 2010, p. 16).

To practice evidence-based nursing, one must understand the concept of research and how to precisely evaluate research. ADN programs are primarily geared towards the basic nursing skills and lack exposure to this type of research. The BSN programs will cover a broader range of theory-based practice, as well as encourage more developed adaptation skills. The result will be an overall better patient outcome, due to the higher level of education.

Bachelor degree nursing programs are highly regarded for the skilled, clinical thinking, and professionalism of nurses they provide for the community. Obtaining a baccalaureate in nursing provides the same skills and knowledge encompassed in most associate’s programs, while allowing a broadened look into research, public health, management, and humanities (AACN IENP, 2012). Many facilities are now providing incentives for nursing staff to continue their education; from tuition reimbursement, an increase in pay, and played time off for the sole purpose of education. Research has proven that with a more educated

The Carnegie Foundation reports that nurses today “are undereducated for the demands of practice” (Benner, Sutphen, Leonard, & Day, 2009, ¶ 17). Education of the ADN centers around the hands-on skills needed to care for a patient at bedside and less on the scientific theories that allow the holistic treatment of a patient. A report by the Milbank Memorial Fund in 2001 reports that nurses educated at the ADN level have a higher incidence of mistakes made while performing their duties (Rosseter, 2011, ¶ 24). Registered nurses who graduate with the two year degree lack research skills, leadership and managerial skills as well as informatics needed to deliver quality medical care within today’s health care system (Orsolini-Hain & Waters, 2009, p. 269).

The need for expansion in their roles for higher levels of education and an improved system of education are required for nurses now for meeting the diverse needs of the patients and to provide better care. Improving the education system and achieving a more educated work force is increasing with nurses having baccalaureate degrees , that is, a traditional Registered Nurse to Bachelor of Nursing program or a traditional 4 year Bachelor of Nursing program or a program that allows seamless transition from Associate in Diploma Nursing to Bachelor of Nursing.

The implications for BSN-prepared nurses in addition to those of RNs with an associate degree

Attaining a high level of education will improve the healthcare system only if nurses are fully utilizing their knowledge and abilities. Many times nurses face challenges in exercising their abilities and knowledge due to institutional policies or government regulations,

(Friberg 26) When ADN programs were started they were only meant to be short term. If a nurse had ADN they were team up with and BSN nurse. In the past the ADN degree was used for nursing shortage, they need nurses. Not to say that having an ADN is a not expectable. As the federal, state and many hospitals combine together the percentage and numbers of how the nurse caring for patient should have a higher education. I have an Associate degree. I have been a floor nurse for about five year. Our hospital became Magnet in 2011, with this award we have to have certain percentage of bachelors’ nurses by next designation. This is not why I am getting my bachelors to be a percentage but to have more windows of opportunities in having my BSN. I am planning on continuing on to get my Masters.