... Competency Differences of Associate and Bsn Nurses

“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

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).

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.

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.

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.

Under the scope of practice of an RN from the New York State Education Department, an RN can diagnose and treat human responses to actual or potential health problems. To be able to perform those tasks a care plan must be made for each client. An RN manages the health care services such as observing and assessing the health status of clients and implementing/assessing nursing care. This all falls under the initial assessment of a client, which is within the scope of an RN. An RN uses information gathered as part of client assessment, they then have the capacity to assign client care to other members of the nursing team, RNs and LPNs, and assign tasks to other care providers such as nurse’s assistant. Even though there are parts of the nursing process that may be delegated to qualified personnel, the initial assessment is the RNs responsibility. The initial assessment is the basis for safe and appropriate client care, which makes it so vital and why not just anyone can perform it. RNs hold the overall responsibility in the nursing

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.

In order to acquire a degree in nursing, the steps required are having a high school diploma and some form of formal education post high school. There are three different paths available: a Bachelor of Science Degree in Nursing (BSN), an Associate Degree in Nursing (ADN), or a hospital diploma of nursing (Krannich 72). A BSN program includes four years in college with the curriculum consisting of “assessment, disease management, decision making, health promotion and prevention, health care technology and policy, research, quality assurance, leadership, and management.” (Gregory 5). You are also required to complete clinical training, meaning working in a hospital for experience in the field with real people and situations. The ADN program only requires two to three years of education (Gregory 5). However, the ADN program had the most educational opportunities, or universities offering the program. The hospital diploma career path is not offered by every hospital, but only by seventy. The ADN programs available in