February 11th, 2013
In this paper I will briefly explain some of the differences between nurses prepared at the associate-degree level versus the baccalaureate-degree level. Also, I will identify a patient care situation that delineates the different approaches and decision-making between the two levels of nurses.
ADN and BSN degrees are two different degree programs offered for individuals interested in the nursing profession. The Associates Degree of Nursing, also known as the ADN, is usually a two year program. The Bachelor of Science in Nursing Degree, also known as the BSN, is usually a four year program offered by universities and colleges (Friberg, 2010, p. 25).
Anyone who has an associate degree or a baccalaureate degree is eligible to take the same RN licensing examination. BSN program is knowledge, theory and research based; the emphasis is on the entire representation of the nursing field. To prepare nurses for this multidimensional role, several components are essential for all baccalaureate programs. These components are liberal education, quality and patient safety, evidence-based practice, information management, health care policy and finance, communication/collaboration, clinical prevention/population health, and professional values (American Association of Colleges of Nursing [AACN], 2008a). The ADN program is shorter and focuses more on specific clinical skills, and is tasks oriented. It does not study all the theory and science behind nursing as a profession.
In today’s nursing vocation far more is expected from a nurse than to merely follow the doctor’s orders. It is essential that the nurse be able to make critical decisions about a patient’s plan of care. Communicating with physicians when an order seems inappropriate is a required element to nursing. This skill takes an education that is broad based. AACN believes that advanced education has a powerful impact on a nurse’s proficiency. Research has revealed that a decrease in mortality rates and in medication errors, have both been correlated to nurses prepared at the baccalaureate and degree level (AACN fact sheet 2011).
I believe that many BSN nurses are involved in professional advancement. If nurses are not current on the latest best patient practices and evidence based research they are not practicing to their highest level. There is a considerable relationship between educational preparation and degree of adeptness to which the nurse makes nursing diagnosis, implements the nursing process, and evaluates the effects of nursing interventions (Giger & Davidhizar, 1990). Many ADN nurses recognize what needs to be done and when, but sometimes struggle with the why. I currently work in labor and delivery. I have been a preceptor for a few years now. A patient situation that I am faced with almost on a daily basis is regarding fetal heart tones. When training a new nurse it is very apparent to me who has a BSN and who has an ADN. Although I believe the “why” of labor and fetal heart tone interpretation can be taught, it seems to be more challenging for an ADN to comprehend. Many of the associate degree nurses are focused on the tasks at hand, and the interventions needed to fix what they see on the monitor, rather than think about the why it is happening and change that.
There are numerous heart beat deceleration types for a fetus to have while a patient is in labor. Without understanding the reason why each different type happens; the interventions, although they may seem to work for a short period of time, do not correct the reason they are happening. BSN nurses seem to comprehend the reasons why and the next steps that need to be taken. A baccalaureate nurse