Learning from Past Mistakes: The Importance of Experience-Based Education

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

“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.)

A growing number of employers prefer BSN nurses to ADN nurses according to recent reports (Spetz and Bates, 2013). This indicates that hospitals consider nurses with a BSN to be more professional than nurses with an ADN. According to Spetz, there has been a

Nursing has a long history of formal education which moved out of hospitals and into colleges and universities early last century. The associate degree level of nursing was developed out of a need to produce nurses in response to a shortage during and

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).

There is also an increased advantage to having a BSN when attempting to move beyond a staff nurse position. A study conducted by Kearney (1994), on academic advising of RN to BSN students, found that one of the main motivations for returning to school for RNs was the gained potential for promotion. BSN programs will provide more course work focusing on leadership and communication skills, which are essential for advancement within the workforce. Based on the findings by the U.S. Department of Health and Human Services in 2004, BSN prepared nurses only accounted for approximately 30 percent of the workforce, with the majority of practicing registered nurses only holding associate degrees. It’s easy to see how it would significantly improve one’s advantage for promotion by acquiring a BSN, due to the significantly low number of BSNs in comparison to ADNs within the workforce. The BSN might be the only difference to give that slight edge needed for

The American Nurses Association (ANA) is a full-service professional organization that symbolizes the interests of registered nurses through its constituent and state nurses associations. The ANA implements the nursing profession by raising high standards of nursing practice, honoring the rights of nurses in the work field, promoting a positive and realistic view of nursing, and by pushing the Congress and regulatory agencies on health care issues affecting nurses and the public. Their mission statement is, “Nurses advancing our profession to improve health for all.” Some of ANA’s main focuses are reformation of the health care system so that it delivers primary health care in the communities, growing roles for

214) “The ACA and the need for APRNs, nurse faculty, and nurse researchers would have increased dramatically under any scenario.” (L R Cronenwett [RWJF Iniative on the Future of Nursing], 2010, table 1). “Not only must schools of nursing build their capacity to prepare more students. Nursing need to focus on fundamental improvements in the delivery of nursing care to improve patient safety and quality is key.” (IOM, 2010, p. 208)

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

(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.

There is increased evidence that there are differences in the competencies between ADN and BSN. While entry into nursing practice may find all