BSN vs. ADN in Nursing

Through my research for this paper I have found that RNs who have an associate degree or diploma are more likely to make errors during clinical practice. Nurses who hold Bachelor of Science in Nursing (BSN) degrees have a stronger foundation in which to build better communication, leadership, critical thinking and problem solving skills. The high demands placed on today’s nurses really challenge all of these skills on a daily basis. Nurses with Bachelor of Science in Nursing degrees have a better understanding of the importance to be proficient in these skills. In a study of RN-to-BSN degree graduates from 1995 to 1998 (Phillips, Palmer, Zimmerman, & Mayfield, 2002), these students demonstrated higher competency in nursing practice, communication, leadership, professional integration, and research/evaluation.

The added classes enhance the student’s view for a wide scope of practice which will aid the nurse in comprehending the many issues that plague patients and impact health care. A Bachelor of Science in Nursing degree can help a nurse be more confident in his/her ability no matter the patient care setting. Numerous research studies have demonstrated that the ADN and BSN nurses are not different in skill competency when they graduate, but over time, the BSN nurses show greater critical thinking skills, better problem solving, and the development of clinical judgment. For many years, studies have shown through nursing research that education can and does make a difference in clinical practice. Nurses who obtain their Bachelor of Science in Nursing degree have better patient outcomes such as lower mortality.

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In a 2005 issue of Nursing Research, the University of Alberta found that Bachelor of Science in Nursing degree nurses have a definitive influence on mortality rates. (Eastabrooks, Midodzo, Cummings, Ricker, & Giovanetti, 2005) At the University of Pennsylvania, Dr. Linda Aiken and colleagues (Aiken, Clark, Cheung, Sloan, & Silber, 2003) found that the more advanced the nurse’s education the better the patient outcome. 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) Take for instance an associate degree or diploma nurse who checks their laboratory results on their patient.

They find the patient’s potassium level to be high. They call the doctor only to be told that this patient is expected to have high potassium because the patient is on dialysis. If this nurse had done a thorough check on the history and physical documentation from the doctor, she would have determined that this patient is on dialysis. If this nurse had a bachelors of science in nursing degree, she would have the critical thinking skills to identify this to be an expected finding in this type of patient. This is an example of why a nurse prepared at the associate degree or diploma level needs to continue their education to acquire their bachelor of science in nursing degree. In conclusion, I do not believe that an associate degree or diploma nurse makes bad decisions. A nurse with an associate degree or diploma does not have the in-depth insight to have deeper critical thinking.

I do believe if they are prepared better educationally their foundations will be stronger in which to build their assessment skills therefor making them more confident in their ability to take care of the patient and determine the situations where a catastrophic event may be looming. This in turn helps patients achieve the best possible outcome. A nursing staff that is not educated in evidence-based practice cannot provide the most up to date care nor exceed the current and future needs in healthcare. Research points to a necessity for Bachelor of Science in Nursing degree nurses being tantamount to better patient outcomes.


  1. Aiken, L. H., Clark, S. P., Cheung, R. B., Sloan, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290, 1617-1623. Retrieved from
  2. Eastabrooks, C. A., Midodzo, W. K., Cummings, G. C., Ricker, K. L., & Giovanetti, P. (2005, March/April). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), 72-84.
  3. Giger, J. N., & Davidhizar, R. E. (1990). Conceptual and theoretical approaches to patient care: associate versus baccalaureate degree prepared nurses. Journal of Advanced Nursing, 15(9), 1009-1015. Retrieved from
  4. Phillips, C. Y., Palmer, C. V., Zimmerman, B. J., & Mayfield, M. (2002). Professional Development: assuring growth of RN-to-BSN students. Journal of Nursing Education, 41(6), 282-283. Retrieved from
  5. The Future of Nursng: Leading Change, Advancing Health. (2012). Retrieved from

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BSN vs. ADN in Nursing. (2016, Nov 27). Retrieved from