Educational Preparation

Educational Preparation: Differences in Nurses Prepared at an Associate-Degree Level Compared to a Baccalaureate-Degree Level
Chiane Valeo
Grand Canyon University: Professional Dynamics
July 24, 2018

Educational Preparation: Differences in Nurses Prepared at an Associate-Degree Level Compared to a Baccalaureate-Degree Level
Nurses have worked in the hospitals for years at different degree levels doing the same tasks. Now there is a strong movement to initiate that hospitals have 80% of their nurses baccalaureate-prepared (Institute of Medicine, 2010). There have been several studies that have attempted this recommendation such as the issue Medical Care published by researcher Olga Yakusheva from the University of Michigan. They implemented this practice and found that with an increase of 10% of nurses obtaining a Bachelor of Science in Nursing (BSN) there was a 10.9% decrease in patient morality (Yakusheva, 2014). As other authors began studying this practice the overall result is for the better, which is increased patient outcome.
Training Associate-Degree Nurses
The associate-degree nurse came around after World War II. With the increase in hospital size, patient demands, chronic illnesses, and children being born the nursing shortage began. A nurse educator, named Mildred Montag, developed a program that trained nurses in a 2-year associate degree curriculum (blank, ebook). The focus was to increase the quantity of nurses by providing the minimum requirements of nursing. While the increased production of having community colleges offer this way into nursing, the level of competency was standard. This caused the focus to be on increasing the shortage of nurses and lacked the attention to evidence-based care and better patient outcomes that a BSN nurse implements (blank, ebook).

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Competency Differences
Entering into a 4-year bachelor degree nursing programs requires a great amount of commitment. Students enrolled in BSN programs have more training and required classes than the Associate Degree in Nursing (ADN). Such classes could impact the professionalism and thought process when applied to their nursing career. The American Association of Colleges of Nursing states that BSN prepared nurses have valued competence in their leadership, critical thinking, and health promotion skills (American Association of Colleges of Nursing AACN, 2017). Both the ADN and BSN nurse sit for the same licensure exam which tests for entry-level nursing practice. In the BSN program, students have additional courses required that provide a more in depth understanding of social, cultural, political, and economical issues that may impact patients and the healthcare they receive (AACN, 2017).
Having this extra knowledge may differ how a BSN nurse handles a conflict at work and may understand the chain of command better from their nursing leadership and nursing management class. The excess of classes allow the BSN nurse to be prepared for a wider scope of practice. They may be more prepared for roles in management for charge nurse or nurse leader as for the ADN is primarily trained to provide basic competent care. ADN nurse is taught how to care for patient at a basic level and enough skill to delegate tasks to others. The BSN nurse has more education in critical thinking, leadership, and evidence-based practice. This allows for greater opportunity in management roles and advancement in their careers. During a critical situation, the BSN nurse will be better prepared and have more educational background and knowledge to assist them in working through the situation.
Patient Care
When educational preparation is applied to patient care, the ADN and BSN nurse may handle things in a similar fashion but with slight differences that can impact care. One scenario would be when an ADN nurse gets a critical patient, who is stable, they may set up their room with supplies the patient may need for their condition. On the other hand the BSN nurse may also set it up the same way except with thinking critically, checking the chart for other predispositions, and preparing for any circumstance, will stock the room in case of a critical event occurrence.
A different approach to patient care and decision making would be how each nurse reacts if a patients begins to desaturate. The ADN nurse may assess the patient, obtain an oxygen saturation reading, and place oxygen on the patient to correct the situation. The BSN will handle the situation with the same approach except they may also fully assess the patient, obtain full vital signs, and check the patients chart. By doing so they will have prepared to inform the doctor if the desaturation continues all without losing vital time. This is the critical thinking process the BSN nurse will implement to navigate through their stressful situation for the best possible outcome.

The rationale for these situations are the more in depth training the BSN nurse gets. Having this excess education will give the BSN nurse more time to establish their critical thinking skills. Two years may seem longer to obtain a degree, but it will allow for better nursing care, opportunities, and patient outcomes.

References
Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press.

Yakusheva, O., Lindrooth, R. & Weiss, M. (2014, October). Economic evaluation of the 80% baccalaureate nurse workforce recommendation: A patient-level analysis. Medical Care, 52(10), 864-869.

American Association of Colleges of Nursing (2017). The Impact of Education on Nursing Practice. Washington, DC: Author. Retrieved from http://www.aacnnursing.org/News-Information/Fact-Sheets/Impact-of-Education
U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. (2003). Managing asthma: A guide for schools (NIH Publication No. 02-2650). Retrieved from http://www.nhlbi.nih.gov/health/prof/asthma/asth_sch.pdf

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