BSN vs. ADN in Nursing Essay

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

The researchers determined that for every 10% increase in nurses at the BSN level, there was a 4% decrease in patient death ("AACN Fact Sheet," 2012). From this study it can be ascertained that a BSN nurse can perform at a more competent and safe level for patients. The amount of knowledge regarding patient care and skills between ADN and BSN prepared nurses is very similar. The BSN however has supplemental skills in critical thinking and communication that allow them to look at and solve problems differently. A BSN is more likely to utilize evidence based practice and team problem solving to minimize their margin of error.

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).

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

Current nurse-to-patient ratios is a topic that has constant focus on today’s patient outcomes and safety. There have be many studies and there continues to be studies done on how a higher nurse to patient ratio effects not only patient and nurse safety and patient outcomes once they leave the hospital, but also patient mortality rates as well. When a nurse has been assigned more of a patient load than they can safely handle, whether it be because of a large patient volume or patient acuity, patients suffer and the quality of care declines. With the higher ratio,

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

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

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.

One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,

Nursing education encompasses a vast continuum. Within the undergraduate subdivision, there are two preparatory levels of nursing education: Associates Degree in Nursing (ADN) and Baccalaureate Degree in Nursing (BSN). Although the underlying philosophies of patient-centered care and compassion remain consistent between both degree-levels, there are distinctions pertaining to clinical decision-making and care delivery. Major differences in competency of critical thinking and problem solving skills, evidence-based practice and clinical judgment, exist between nurses prepared at the associate-degree level and baccalaureate degree level, thus

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 BSN program of nursing concentrates on studies that affect the patient as a whole. They are able to perceive and comprehend the nature and significance of each individual in their care. Nurses with their BSN degree are trained in skills to include case management, leadership, critical thinking and health promotion for the betterment of the patient. They are able to apply the skills acquired during their education to both inpatient and outpatient scenarios (Rosseter, 2011, ¶ 1). Having nurses with a BSN degree will benefit patients across the spectrum due

BSN nurses not only provide more complex aspects of daily care and patient education, but also design and coordinate a comprehensive plan of nursing care for the entire length of a patient's stay from pre-admission to post-discharge, including supervising nurses aides and other unlicensed assistive personnel, designing discharge and teaching plans for patients, and collaborating with patient, physicians, family members, and other hospital departments and resource personnel.

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,

Findings from a study conducted at a university hospital in Thailand showed the importance of nurse staffing to patient outcomes of hospital mortality. The cross sectional observational research design included data of 2531 patients. The study revealed that the ratio of total nurse staffing was significantly related to mortality (Jawad et al. 2003). Nurse staffing ratios have a relationship with reductions in hospital-related mortality in most published studies. A small percentage of hospitalized patients