The Difference Between Associate Degree and Baccalaureate Degree in Nursing

Competency is described as the ability or skill to perform tasks successfully and efficiently. Why do BSN graduates appear to be more competent than their ADN graduate counterparts? Although the answer is not fully understood, research has shown that facilities that have a higher BSN employed staff rate may have less mortality rates and better patient outcomes. According to a study by Linda Aiken in Europe on Nurse staffing and education, and mortality every 10% increase in the proportion of nurses with a bachelor 's degree reduced the likelihood of an inpatient dying within 30 days of admission by 7% (Alspatch JG, 2014, p. 10). This may be due to the fact that BSN graduates are exposed to more extensive and practical information that can be applied in the clinics than an ADN would have received from there program.

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.

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,

Along with the before mentioned competencies of a BSN nurse, they are taught advanced communication skills and are better at educating, making them excellent leaders and resources. Although ADN nurses have been in management positions, I have seen an obvious difference between the two. The BSN managers are far more competent, demonstrating fair practices amongst their employees, they are able to communicate to them in a way that makes them feel like they understand, a way that is not only informative but in no way demeaning. It appears that they take pride in what they do, what they have achieved, and desire to help

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.

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).

The differences can be seen when looking at the responsibilities of these two degrees. For example: “the associates degree graduates are expected to provide safe bedside care to clients with defined and predictable health problems” (Creaisa and Friberg, 2011, pg.26), while nurses with their baccalaureate degrees are expected to treat patients with complicated and unpredictable problems. Another difference between the associate’s degree holders and the baccalaureate degree is that once these graduates get to their workplaces, the ones with the baccalaureate degree are expected to display leadership skills such as teaching and also to focus on the need of not just the patient but also the patient’s families and communities. Like Linda Moore Rosen explains “ADN can assess needs, plan interventions, implement care, and perform evaluations with individuals and families under the supervision of a nurse prepared with a BSN or MSN” (Rosen, 2000, p.236). Baccalaureate nursing practices include working in unstructured settings with little or no kind of established procedures, while associate nursing practices only include secure setting with established procedures.

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).

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)

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).

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

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.

(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