ANA Nursing Standards

Bachelor of Science degree in Nursing is Four year Program accredited by a university or a college. Having bachelor’s degree in the science of nursing (BSN) can lead us in many direction in the carrier. It is a steppingstone. Like ADN the BSN program also follows their core curriculum, adult health, maternal and newborn nursing, pediatric nursing and community health nursing. In generally speaking many advance nursing positions requires a BSN. BSN nurses are prized to their skills in critical thinking, leadership, case management and health promotion. Studies also have found that the nurses prepared at the baccalaureate level have stronger communication and problem solving skills.

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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

Associates prepared nurses are able to sit for the NCLEX as well as bachelors prepared nurses. They are both able to practice and perform many of the same skills and procedures. Their differences in clinical competencies are few, but their differences in critical thinking, decision making, communication, leadership, and management techniques and abilities, are many. The bachelors prepared nurse has received a higher and more in depth level of education in their field. This additional study and preparedness gives the bachelors prepared nurse the ability to understand not only the “what” and “how” of their clinical procedures, but also the

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these

Nurses a with Bachelor of Science in Nursing Degree (BSN) are known for their skills in critical thinking, leadership, case management, health promotion, and for their ability to practice across a variety of inpatient and outpatient healthcare settings. These nurses are well-prepared to meet the demands placed on today's nurse.

There are numerous studies depicting the correlation between the four-year degree nursing education and improved patient outcomes. In the August 2008 edition of Health Services Research, Dr. Christopher Friese and associates identified a link between patient outcomes and nursing education level. They determined that moving to a nursing practice environment with a higher proportion of baccalaureate prepared nurses led to a significant decrease in the mortality of hospitalized cancer patients who underwent surgery. In addition to lowered mortality rates, patients also experienced lower failure to rescue rates. In a separate study published by the Journal of Advanced Nursing, researchers at the University of Toronto resolved that facilities with a greater number of BSN prepared nurses had lower 30-day mortality rates. For every 1,000 patients discharged, a 10% increase in the number of baccalaureate degree nurses resulted in 9 fewer deaths (Rosster,

Furthermore according to American Association of College of Nursing, “the baccalaureate degree is designed to prepare nurses for work within the growing and changing health care environment. With nurses taking more active role in the health care, they are expected to develop critical thinking and communication skills in addition to receiving training in clinics and hospital”(American Association of College of Nursing) .

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).

In an article published in Health Services Research in August 2008 that examined the effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery, Dr. Christopher Friese and colleagues found that nursing education level was significantly associated with patient outcomes. Nurses prepared at the baccalaureate-level were linked with lower mortality and failure-to-rescue rates. The authors conclude that “moving to a nurse workforce in which a higher proportion of staff nurses have at least a baccalaureate-level education would result in substantially fewer adverse outcomes for patients.”

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 battle between Associate vs. Bachelors have been raging over years. The debate seems to be heavily to receive in BSN and or higher education. The American Nurses Association (ANA), American Association of College of Nursing and Institute of Medicine (IOM) have published many articles, facts and book about the important of a nurse to become BSN or higher educations. Just by researching between the ADN and BSN the developments and growth are very different. Using the description from Grand Canyon University College of Nursing Philosophy, “Baccalaureate nursing practice incorporates

According to the ANA (Nursing World, 2000) has reaffirmed its position that a baccalaureate education should be the standard level of education for entry level nursing. There is a new approach to the certification of the RN, that being exams that distinguish the BSN candidate from the diploma or associate trained nurse. The accreditations would indicate that a BSN nurse would earn the “board certified” designation while the diploma and associate nurse would be “certified.” At present this student does not agree with the ANA recommendations. While only 47.2% of the nursing workforce holds degrees at the baccalaureate level or above (AACN, 2008b) standardized testing should still exist. The decision to administer different exams and define