BSN Vs ADN Paper1

Submitted By Sandra-Cuestas
Words: 991
Pages: 4


Differences in clinical practice between Baccalaureate, Associate, and diploma trained nurses.
Sandra Cuestas
Grand Canyon University

Differences in clinical practice between Baccalaureate, Associate, and diploma trained nurses.
For decades there has been an ongoing debate in the field of nursing involving education. The debate focuses around who performs better in clinical practice. The Associate (ADN), Diploma or Baccalaureate (BSN) trained nurse. There has been countless studies trying to put this subject to rest, with very little luck. The debate has only been perpetuated by The Institute of Medicine and its recommendation to make it mandatory that 80 percent of nurses in practice, have a baccalaureate degree, by the year 2020 ( Blegen et. Al, 2013). Nursing is unique in that there are 3 ways of entering the profession. A 2 year associate degree, a 3 year diploma, and a 4 year baccalaureate degree. There is no distinction when sitting for the NCLEX examination, the exam a graduate nurse must pass in order to become a registered nurse. The issue arises in the workforce. Employers prefer hiring BSN trained nurses over ADN and diploma trained nurses. This is due to some studies revealing that the proportion of BSN nurses in hospitals have a direct impact on patient mortality rates and patient safety (Lane, 2010). This paper will examine some differences in clinical practice between associate, diploma, and baccalaureate trained nurses.
A study conducted by researcher Olga Yakusheva from the University of Michigan and her colleagues concluded that in a hospital unit there was a 10.9 percent decrease in patient mortality rates by increasing the proportion of BSN trained nurses by 10 percent (AACN, 2015). Another study by nurse researcher Ann Kutney-Lee and colleagues concluded that in hospitals, a 10 percent increase of BSN trained nurses would decrease the number of deaths by 2.12 for every 1,000 patients (AACN, 2015). Lastly a study conducted by researchers at the University Toronto, involving 46,993 patients, concluded that hospitals with a 10 percent increase in the proportion of BSN trained nurses had a lower 30-day mortality rate (AACN, 2015). Nurses possessing a BSN degree have 1-2 years more of educational preparation than an ADN or diploma prepared nurse. Education that is fundamental in the development of advanced critical thinking skills, leadership, and professionalism (Lane, 2010). Nurses at the associate and diploma level are critical for hospitals because they possess patient care skills, assessment skills, and critical thinking skills. Their skills may be limited though, mainly due to the short educational time frame. ADN nurses and diploma trained nurses also fill the nursing shortage gap, the reason for the 3 way entry into nursing (Spencer, 2008). Nurses having advanced critical thinking skills, leadership skills, and professionalism is of great importance for hospitals. They improve patient mortality rates, medication errors rates, and patient satisfaction rates, although it has always been important, it is even more important now due to the ever-changing insurance industry (Lane, 2010).
A patient care situation that was observed by the nursing student happened when a patient that came in with an acute case of diverticulosis was in the care of an ADN nurse. The patient was experiencing dizziness, slight drop in blood pressure, and slight increase in heart rate. The ADN nurse dismissed it because it was a very slight change. After shift change, a BSN nurse took over the care of the patient. After assessment the nurse decided there was something wrong. She contacted the physician and requested lab work and occult blood studies. The results were consistent with a GI bleed. The advanced assessment and critical thinking skills of the BSN nurse caught the GI bleed before it