Essay on Associates vs Bachelor Degree in Nursing

Current trends in healthcare are leading to more complex, advanced patient care and needs. Hospitals and patient services are now in need of highly skilled, trained, and educated professionals to deliver this care. The impact of these trends extend into the profession of nursing, where employers are taking a closer look at the outcomes of patient care delivered by ADN graduates vs. BSN prepared nurses. Although

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

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 people’s life expectancy increases, the nursing field needs to keep pace with the rapid changes. There’s increased needs for nurses in many different field as well such as nursing home, hospitals, ambulatory cares, palliative care, and hospices. Therefore, an expectation of a role as a nurse has been rise. Nursing skills and knowledge cannot remain limited, but need to utilize in more various setting. In order to provide better care in various nursing field, continuing education is essential. For example, as population and their lifespan increases there’s also new diseases and new treatment has been developed. A competence nurse must embrace old and new skills and thorough knowledge to achieve best quality of care and optimum patient’s overall outcome. The quality of patient care heavily depends on nurses’ level of education. One research proves that nurses who received higher level of education showed lower mortality rate, less medical errors, and higher patient satisfaction. This outcome is related to higher education which prepared nurses to handle various circumstances with appropriate answers. Nurses are people who spend most of time with ill individuals at the bed side. Nursing education will provide new demanding roles of nurses’ requirement such as seeing the patient as a whole, providing appropriate response to patient’s condition, and integrating knowledge and skills accordingly.

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.

There is much debate on whether there is a benefit to obtaining a Baccalaureate in Nursing. Since it is only my second week in the RN to BSN program, I don’t have a lot to base my opinion on. This paper will summarize the differences between Associates a Baccalaureate Degree in Nursing based on what I’ve been told, research I have done, and my own experiences.

This “incorporates the roles of assessing, critical thinking, communicating, providing care, teaching and leading” (Grand Canyon University, para. 7). I also believe that an individual’s maturity over a four-year period has time to evolve with the concepts of critical thinking and decision making the BSN framework offers. The difference in cost and time from ADN to BSN programs is a deciding factor in many educational decisions. The economy and decrease in job opportunities has driven many into the nursing profession that may not have initially considered it a career option. Sadly, I believe that has contributed to the lack of interest in pursing an advanced education. The professional choice wasn’t driven out of a motivation to help humanity or a sense of altruism; it was merely an employment opportunity.

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) .

A survey was conducted with 102 graduates from an associate degree program. The data analysis discussed the graduates’ perception of their comfort level with leadership, delegation skills, management, professional identity and teamwork (Jones & Mbewe, 2011). This paper will focus on the areas that the graduates felt inadequate and compare these areas to the focus and content of each program. It will also look at differences in nursing care approaches based on educational background.

To answer the question posed: Is the nursing education level a contributing issue in the deliverance of quality care and patient safety? "The American Association of Colleges of Nursing believes that baccalaureate prepared nurses like other health care providers, practice at a higher level. Nurses processing a Bachelor's Degree are molded to adapt to the changing health care environment and its demands. This can be accomplished by leadership development, as well as critical thinking emphasizing health promotion and disease prevention across all environments of care". (American Association of Colleges of Nursing [AACN], 2012, p. 1)

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.

Reasons that some nurses stated for not obtaining a baccalaureate had to do with finances, time, and age. Another common barrier that was stated had to do with a lack of differentiation among nurses with varying degrees (Warshawsky, Brandford, Barnum, & Westneat, 2015). Some mentioned that there is no observable difference in the nursing care provided in other baccalaureate nurses. Thus, stating that baccalaureate nurses do not hold a higher level of competence. However, multiple studies conducted previously have shown significant importance in the quality of healthcare from nurses that have a baccalaureate (Winokur, Rutledge, & Hayes, 2016). Some report improvement in patient care quality including, lower mortality rates, lower readmissions, and shorter hospital stays. On the other hand, reasons for pursuing a baccalaureate degree were largely contributed to peer encouragement. Another large facilitator was for career advancement and those that had goals in mind for eventually obtaining their masters (Warshawsky, Brandford, Barnum, & Westneat,

“Throughout the last decade, policymakers and practice leaders have recognized that education makes a difference” (Impact of Education, n.d.). Hospitals are also trending towards preferred hiring of bachelors prepared nurses for their workforce. Even national organizations are jumping on the bandwagon requiring “all nurse managers and nurse leaders to hold a baccalaureate or graduate degree in nursing by 2013” (Impact of Education, n.d.), likewise the Institute of Medicine has also recommended that all hospitals have at least 80% of their nursing staff with a BSN or higher by the year 2020 (Impact of Education, n.d.).