Differences in Competenties Between Nurses Prepared
There are many differences in the competencies between nurses prepared at the associate’s degree level versus the baccalaureate level in nursing - Differences in Competenties Between Nurses Prepared introduction. The differences in competencies can be seen in the leadership ladder for advancement in the profession of nursing, the ability to provide care, the coordination of patient care, and the membership of an educated interdisciplinary health care team. In my matriculation into Grand Canyon University’s RN-BSN program I previously researched this topic extensively.
In 1965 the American Nurses Association (ANA) took a courageous position in publishing a position paper asking for the baccalaureate degree to be the minimal level of education for the profession of nursing. (“A Position paper. “, 1965). This was the first documented attempt to change the level of education of nurses from a technical based education to a scientific based education. The position that the ANA held had many of the following obstacles to overcome, the interference of government funding of programs, nurses to see beyond just the technical based profession and the perception of nursing as a caregiver.
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The ladder of leadership after obtaining an associate degree in nursing (ADN) is the certifications that can be obtained through their professional organizations and chosen specialty. The ladder of leadership for a bachelor’s degree in the science of nursing (BSN) can lead many directions. Obtaining a BSN a nurse opens doors into management positions, clinical educator positions, a master’s of the science of nursing (MSN), moving forward as an advance practice nurse within your specialty and obtaining a doctorate in nursing (DN), doctorate in nursing science (DNS), and or a doctorate of philosophy (PHD).
Obtaining your BSN offers a ladder with higher levels of opportunities compared to the ADN. The ability to provide care between an ADN and BSN prepared nurse can be distinguished in the evidence based analytical approach versus the technical education ADN prepared nurse receive. A BSN prepared nurse is educated in evidence based theory, where ADN’s are educated with a skill foundation, the ADN program overlooks the use of theoretical analysis of data. Evidence based theory enables a BSN prepared nurse to demonstrate clinical expertise in providing care in an inpatient and outpatient setting.
Applying evidenced based practice BSN’s can develop and implement comprehensive teaching plans to meet the learning needs of the client versus the ADN whose teaching plans are basic and based on the promotion, maintenance and restoration of health. In essence the BSN prepared nurse using evidenced based analytical approach in patient care is able to function as a superior provider of care, where the ADN is limited to basic critical thinking and resources in literature.
In a 2001 survey published by the Journal of Nursing Administration asking various chief nursing officers (CNO) and nursing administrators if they recognized competencies between the two types of education. 72% of CNO’s and nursing administrators stated a difference in stronger critical thinking skills and leadership skills among the BSN prepared nurses. Registered nurses today are the primary care givers and directly responsible for the coordination of care for their patients and work as part of an interdisciplinary team.
Through formal education a BSN prepared nurse is prepared for community education and case management, these areas provide coordination of patient care within and outside the hospital setting. The ADN prepared nurse due to being technical/skill educated lacks community and case management knowledge which is not taught in the degree ADN program. Coordination of care starts at the beginning of providing healthcare to a patient it continues after the patient is released and enters the community which is why there is an importance of education for community and case management nursing.
The membership of an educated interdisciplinary health care team includes doctors, pharmacists, speech pathologist, nutritionists, and countless others professions that require a minimal education of a master’s degree. The ADN prepared nurse in essence provides little with the exception of a trade and skill to the profession of nursing. The government today recognizes the importance of a BSN prepared nurse requiring a formal education for the each branch of the armed forces, Veterans Administration (VA), and government employment .
The interdisciplinary team approaches’ the bedside nurse asking the bedside nurse for updates and suggestions, how can an ADN prepared nurse provide an evidence base theory for the patients condition, progress or decline when lacking the required education? Then we ask ourselves when doctors and other health professionals look upon us as diaper changers, don’t value our opinion or fail to acknowledge nursing as a profession, we can only blame but ourselves for not advancing our own education.
In conclusion I will demonstrate how nursing care would be different with a formal education. An ADN nurse whose name is Gloria has been providing care to patient B for several days she notices that there is a change in the patents behavior but can’t exactly identify the critical change. Using her skills she was educated with and the up to date literature she educates herself she probes a little further to identify the change. Ann a BSN prepared nurse and is working in pod 1 with Gloria, Gloria discusses the change and concerns in her patient with Ann.
Ann who has a light assignment for the afternoon reviews in depth the patients’ charts, progress notes and medication record. She takes her formal education and critical thinking and correlates the information. Ann notices a change in a lab value corresponds to a day that a medication was started and a different MD in the progress note charting. Ann probes a little more through the medication record and sees that the pharmacy was sending 1ml of a medication instead of the 0. 1ml correct dosage that was to be administered.
Ann through her critical thinking realizes that a medication error is being made. Through leadership skills notifies her direct management and informs them of this mistake. Because she is a BSN prepared nurse the education committee for the hospital asks Ann to present to the hospital board at the next committee meeting to propose a initiative to reduce medication errors. Ann through evidence based practice shows a method to reduce medication errors, the committee was so impressed that her theory was put into place and succeeded to reduce medication errors.
Ann was looked upon as an equal through the hospital administration, doctors, pharmacist and other highly degreed team members. When a management position was available Ann applied and was offered this position due to having the basic requirement of a BSN. Where is Gloria today? Gloria is working at the bed grateful that Ann knew how to scientifically break down information and find the a problem. Gloria did apply for the same management position but since she didn’t have the minimal requirement of a BSN she was not a candidate.