It began as a 5 year education requirement but as the demand for nurses increased post war, Mildred Montage proposed “a new program to prepare nurse technicians in a 2-year associate degree immunity colleges” (Creaser, J. , & Fibber, E. (2011). Obtaining an DAN became popular because it took a shorter time to complete the educational requirements that allowed entry level nurses. An associate-degree nurse (DAN) is defined as a nurse with a two or three year degree. This training is generally done in a career focused college or a community college.
Competencies that are covered are usually a basic outline of technical and safety training for entry level nursing. Graduates of nursing programs are then allowed to sit for the UNCLE – URN licensing examination. The UNCLE examination tests for “minimal technical impotency for safe entry into basic nursing practice. ” (CAN, Creating a More Highly Qualified Nursing Workforce) Nurses who hold an DAN are usually found in jobs that provide direct and beside care in hospitals, nursing homes, and in clinic settings.
Baccalaureate-Degree Nursing The BBS program was established at the University of Minnesota in 1909.
The difference between an DAN and BBS was incorporating public health nursing and the length of time to obtain these degrees. The BBS program used to take 5 years to complete. It was difficult to get faculty members who were qualified to teach the program. As the baccalaureate program became more of a “norm” in the Universities, now it generally takes 4 years to complete a BBS program. Creaser, J. , & Fibber, E. (2011), Conceptual Foundations, The Bridge to Professional Nursing Practice (p. 25). A Baccalaureate-degree Nurse (BBS) can be defined as a nurse with a four year degree.
BBS education includes additional coursework in nursing and a broader range of studies in other disciplines. BBS graduates will usually have greater opportunities and responsibilities in their career paths. They are equipped with a broad range of theories on which to base their understanding of the psychosocial and physiological behaviors of their patients which is essential for decision making and scope of practice. BBS graduates draw upon their broad-based education for a more comprehensive approach to patient care.
They are prepared for a more in-depth look at nursing research, nursing management, and professional development. As stated in the Grand Canyon University College of Nursing Philosophy (2011), “Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, communicating, providing care, teaching, and leading”. Nursing jobs for a BBS graduate can be found doing the same jobs as a nurse with an DAN however you may also find them in roles such as nursing management, nursing educator, and community health positions as well.
The ever evolving health care system and higher acuity needs of patients, a higher education is imperative to improving patient safety and enhancing nursing care in the hospitals and the community. CAN and other authorities “believe that education has a strong impact on a nurse’s ability to practice” and “show a connection between baccalaureate education and lower mortality rates”. CAN, Research Linking Nursing Education to Patient Outcomes (2014).
Several other studies have been performed whereas the outcome is relatively close to the same; patient outcomes are enhanced, mortality rates are generally lower, and patient safety and quality of care is higher across the health care setting with nursing staff primarily holding a BBS degree or higher. A patient care scenario that may allow us to understand the core difference of the competencies of an DAN and BBS is where a patient has a describes ulcer on his leg. His history includes diabetes, venous stasis and 3+ pitting edema.
The AOL for both nurses is to heal the ulcer, reduce the edema and to prevent the leg from becoming infected. A nurse with an DAN may look at the patient’s history, taking into consideration that he has diabetes and venous stasis and want to treat the leg as the doctor ordered. She will provide wound care as written, educate the patient on how to improve circulation in the leg and provide interventions for the edema by use of diuretics. This is the standard treatment for a patient with this type of diagnosis.
The nurse with the DAN has direct patient care as the main focus in their career (for the most part). The nurse with the BBS may perform all of the same interventions however she will modify his care plan to reflect the interventions that are working and provide information to the doctor for interventions that are not. Example: the patient has diabetes; if the resident has TED hose as an order, the DAN nurse may not take that into consideration. When you’re dealing with a describes ulcer, diabetes, venous stasis, and edema, your main focus is to prevent infection.
You may want to change the care plan from using TED hose at the moment and ask for an Anna tot order, you may want to ask for a prophylactic antibiotic due to the body’s inability to heal with his diabetes DXL. The approach to patient care is the same for both nurses but the nurse with the BBS is trained in leadership, nursing management, and has a broader spectrum of education which allows her to assess the patient’s needs as well as assessing “how did this happen and how can we prevent it from happening again? This does not suggest that the DAN nurse is any less competent that the nurse with the BBS however since the BBS graduate has leadership and management skills as part of their training, the DAN ruse may not have access to changing the plan of care, nor have the desire to collaborate with the physician – she may just be focused on healing the wound rather than taking the whole picture into consideration of how to treat this patient’s medical diagnosis and his illness simultaneously.
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