Grand Canyon University: NRS 430V
October 18, 2014
This paper will discuss the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level, by using research from different nursing organizations found online. Also identifying a patient care situation in which I will describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse.
Differences in competencies between ADN versus BSN In conducting the research for this paper I was a little biased in my opinions of this topic and had to keep an open mind. I am an associate-degree level nurse, and have been for six years. I feel that my experience has taught me a lot about critical thinking, and helping patients improve their outcomes. I felt pressure in to completing my baccalaureate-degree level of education before I felt that I was ready to complete the education. I now have a better understanding into baccalaureate education as being the accepted minimum requirement for nurses. Much research has been done, relating to BSN versus ADN nurses and better patient outcomes. In Grand Canyon University College of Nursing Philosophy, it states “Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, communicating, providing care, teaching, and leading.” I feel that no matter what education level one has after nursing programs that this is a baseline for nurses. It was hard for me to see that nurses who graduate with their BSN were better at bedside care than one who has their ADN. Looking at the research, and numbers of studies done, I now have an open mind on how having a BSN could affect better patient outcomes. The American Association of Colleges of Nursing refers to the NCLEX-RN examination and states “The fact that new nurses pass the licensing exam at the same rate does not mean that all entry-level nurses are equally prepared for practice.” It later goes on to say “This exam does not test for differences between graduates of different programs, measure performance over time, or test for all of the knowledge and skills developed through a baccalaureate program.” This makes an excellent point about it being an exam that tests for minimum competency for safe entry into basic nursing practice. When a person graduates from a BSN program they have more knowledge of community health, nursing research, ethical decision making, family centered health and trends and issues in today’s health. A person with an ADN level of education comes out of school with the fundamentals and basics of nursing, to include creating care plans and performing everyday nursing skills. With the lack of education at the start of a nursing career it makes sense how patients have better outcomes when then nurse has their BSN. In the October 2014 issue of Medical Care, it shares “that a 10% increase in the proportion of baccalaureate-prepared nurses on hospital units was associated with lowering odds of patient mortality by 10.9%.” That number is a significant amount when considering the lives of patients. In the February 2013 issue of the Journal of Nursing Administration, it states “hospitals with a higher percentage of RNs with baccalaureate or higher degrees have lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay.” With that in mind, thinking about the costs involved when patients have longer stays and/or acquire a decubitus ulcer while in the hospital is a large amount. Being able to prevent those conditions helps with lowering costs. Reimbursement amounts from Medicare are lower than the amount of charges to a patient when adverse outcome happens while a patient is admitted in the hospital. A big focus at the long term acute care hospital where I first started my career was