A nurse is a healthcare professional, who in collaboration with other members of a health care team is responsible for the treatment, safety, and recovery of acutely or chronically ill individuals. Nurses are also accountable for the health promotion and maintenance of families, communities, populations, and the treatment of life-threatening emergencies in a wide range of health care settings. Nurses perform a range of clinical and non-clinical functions necessary to the delivery of health care and may also be involved in medical and nursing research.
This paper will reflect the differences in the necessary competencies for nurses prepared at the associate degree (ADN) and baccalaureate of science (BSN) level. Both the ADN and BSN level, allow the individual to sit for the National Council Licensure Examination (NCLEX). After successfully completing the NCLEX, both the ADN and BSN nurse are knowledgeable enough to complete physical assessments, intravenous, and drug administration. Both are also knowledgeable of medical equipment.
ADN’s and BSN’s are competent to demonstrate life-saving practices, like airway management, cardiac monitoring oxygen delivery, drains, and wound care. According to Mahaffey, 2002 the Associate Degree (AD) nursing program originated during a period when the nursing personnel shortage was extensive enough, to prepare a practitioner capable of providing direct and safe nursing care under the supervision of a professional nurse in the acute care setting. With that being a fact of the nursing field, many individuals have been attracted to the two year ADN program, versus the four year BSN program.
According to Mahaffey (2002), the ADN programs were created because of the increase in violence and the ill populations that followed World War II. Though there are similarities between the ADN and BSN, there are distinct differences that also exist. The Baccalaureate nurse has increased knowledge surrounding professional issues such as research leadership, management skills, transcultural, and public health. Baccalaureate nurse’s have an increased opportunity to advance in administration, supervisory, and leadership positions.
After completing the four year program and successfully completing the NCLEX exam, graduates with a BSN can choose from direct patient care, teaching, administration, research, case management, marketing positions in a hospital, community, educational, military, government, industrial, and expanded practice settings. A Baccalaureate nurse practices in a diverse setting, versus a more controlled setting as an Associates nurse. Being currently employed by a well-known hospital in west Phoenix, AZ increases the personal exposure to BSN’s, other ADN’s, and further important personnel that makes up the hospitals team of healthcare professionals.
The hospital is a 32 bed emergency department with two major treatment rooms. On average, the department treats 270-300 patients per day. Included in the team of healthcare professionals are two CM’s (clinical managers), on each shift, who each have BSN degrees. The CM’s accountabilities range from completing the assignment sheet, to rounding, bed counts, huddle, call offs, answering general questions, addressing complaints, answering of the patch phone, and arranging bed assignments. Further accountabilities of the CM include arranging employee evaluations and conducting meetings.
Essentially, the CM’s are positioned to ensure that the flow and cohesiveness of work shifts are as effective as possible for patients among the BSN’s and ADN’s providing care. Floor nurses, who are mostly comprised of AD nurse’s, are considered technical, or hands on nurses. Each AD nurse is assigned to a zone with six-seven rooms. There are two Registered Nurses (RN’s) and an Emergency Room Technician (ERT) in each zone. The patient to nurse ratio is generally a three to one ratio. Further illustration of how the current place of employment operates, the following example is provided.
Suppose there is a patch call with a patient exhibiting chest pain and the ambulance is five minutes out. In this case, the room is equipped and prepared with all the essential needs for the chest pain patient upon their arrival in the ambulance. After the patient has arrived, the primary nurse on duty receives a report from the Emergency Medical Technician (EMT) that accompanied and provided initial care to the patient in the ambulance. At the same time, the secondary nurse and ERT become technical, or hands on.
The patient is administered oxygen, cardiac monitors are placed, an EKG is administered, locks and labs are drawn, normal saline is administered, and a urinalysis is taken along with the patients’ blood glucose level. Each of these tasks is initiated prior to the Emergency Room Medical Doctor (MD) seeing the patient, or at the same time. Emergency rooms around the world operate in similar fashions to ensure that time is of the essence and that a patients recovery from their medical issue is the number one priority for the medical team on duty.
In closing, both the ADN and BSN programs are preparatory tools for an individual to become a nurse. Though differences exist among the accountabilities for each, both positions are essential for the operations of a successful medical organization to exist. Through the pursuit of this BSN curriculum and eventual certification, it will be of personal gratitude, to have the ability of applying current education to the learning process of watching team members closer and asking appropriate questions of each mentioned in this document.
Caruso E. The evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit. Med-surg Nurs. 2007;16(1):17–22. Kerr M. 2002; 37(2):125–134 A qualitative study of shift handover practice And function from a Socio-technical perspective. J Adv Nurse. Mahaffey, E., (2002). The relevance of associate degree nursing education Past, present, future. Online Journal of Issues in Nursing, 7 (2), 1-12. Retrieved March 6, 2011 from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/RelevanceofAssociateDegree.aspx