Is having a Baccalaureate Degree in Nursing (BSN) better than an Associate Degree in Nursing (ADN)? Why should nurses get a BSN? Many nurses ask themselves these questions. Hospitals are pushing for nurses to advance their education. If there is an ADN nurse and BSN nurse applying for the same position most likely the BSN nurse will receive the job before the ADN nurse because “ the additional course work enhances the student’s professional development, prepares the new nurse for a broader scope of practice, and provides the nurse with a better understanding of the cultural, political, economic, and social issues that affect patients and influence health care delivery” (“American Association of Colleges of Nursing,” p.1). Different Education Routes for Nurses
Diploma graduates, Associate graduates, and Baccalaureate graduates are the three education routes for licensures of Nurses. Even though all three programs sit for the same National Council Licensure Examination for Registered Nurses (NCLEX-RN), this exam verifies only “minimal competency to provide safe, basic care” (Haverkamp & Ball, 2013, p. 144). ADN vs. BSN Competencies
Many say that Associate nurses are trained strictly on clinical skills, whereas Baccalaureate programs “emphasize evidence-based clinical practice and leadership through course work that includes research, statistics, population-based care, nursing management, and the humanities” (Haverkamp & Ball, 2013, p. 144).
This meaning that, Baccalaureate nurses receive training that allows them to look at the whole picture, like why and how things happen and what they can do to prevent them. Associate nurses as a Member of the Health Care Team, “refer patients and their families to resources that facilitate continuity of care; health promotion, maintenance, and restoration; and ensure confidentiality” (Texas Board of Nursing).
Whereas a Baccalaureate nurse as a Member of Health Care Team, “use multiple referral resources for patients, families, populations, and communities, considering cost; confidentiality; effectiveness and efficiency of care; continuity and continuum of care; and health promotion, maintenance, and restoration” (Texas Board of Nursing). Patient Care Situation
An example in the difference of education between Baccalaureate nurses and Associate nurses is shown here. The patient was admitted for Diabetic Ketoacidosis, not taking home medication because he was homeless and lacked health insurance. Nurse A, admitted this patient and cared for the patient for three days. On the third day the patient was to be discharged, keep in mind this patient came to the hospital because he is a Type 1 diabetic and was admitted for Diabetic Ketoacidosis and was not taking any of his insulin because he could not afford them.
Upon Nurse A telling the patient he was going to be discharge the patient became irritated and started to become angry and stated “I am homeless, how am I suppose to pay for my medications that I need, and I will just come right back to the hospital because I won’t be able to take any of my medications.” Nurse A, being an Associate nurse thought to herself what am I suppose to do? Nurse A then stated to the patient “The doctor has discharged you so you are medically stable to leave.” Nurse A explained to the patient that the doctor wrote prescriptions for him to take and fill so that way the patient would have his medication. Again the patient stated “How am I suppose to pay for my medication if I am homeless and have no money.”
Nurse A was stuck in what she needed to do. So during morning rounds with Case Management Nurses which carry a BSN, Nurse A expressed the patients concerns and their response was well let us take a look at every resource that we have and maybe we can voucher his medication for one month and possible sign him up for some type of health care that will help him with his insulin and other medications that he needed. The next thing the Baccalaureate nurse did was go into the patient’s room asked a variety of questions and came back out of the room and told Nurse A, that the patient qualifies for state health insurance and that she will work on the vouchers for his medication for a month.
The Baccalaureate nurse explained to the Associate nurse that she would have to go further up in the chain of command to get the medications vouchered. The Baccalaureate nurse also gave the patient resources that would help him with his troubles in life, examples were housing for the homeless, churches that donate clothes and food to the homeless. What if the Nurse had a BSN?
If the nurse taking care of this patient had a BSN they would have started to collaborate with the Case Manager about vouchering his medications and helping him find health insurance upon admission. Examples of what the Baccalaureate nurse would do are: find resources for the patient for food, shelter and health insurance on the day the patient was admitted, or have made a case management referral. Whereas the Associate nurse was focused on treating the patients and the illness and verifying and following the doctors orders.
This is an example of how a Baccalaureate nurse was able to apply leadership and critical thinking skills while the Associate nurse was unable to. The Associate nurse struggled with the situation that arisen on the day of discharge. For the three days the Associate nurse had the knowledge base to treat the patient illness; taking blood sugars, administering insulin and bringing the patient back to holistic level of wellness. Conclusion
In conclusion, it is important for all nurses to further their education. Baccalaureate nurses can provide better care for their patients and educate their patients about their disease process in depth and use the resources available to all nurses. They are also able to provide better patient outcomes through their advanced knowledge.
Baccalaureate nurses also have opportunities for career advancement in all sorts of different positions whereas the Associate nurses are most likely staying in patient care areas. Baccalaureate nurses can move up and work as Nurse Managers, Case Managers, Quality Management and Infection Control. The encouragement for all nurses to advance their education is a quality step in the right direction for delivering excellent and safe patient care.
American Association of Colleges of Nursing. The Impact of Education on Nursing Practice. (n.d). Retrieved from
http://www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education Haverkamp, J. J., & Ball, K. (2013, August). BSN 10: What is Your Opinion? AORN Journal, 98(2), 144-152. http://dx.doi.org/10.1016/j.aorn.2013.06.006 Texas Board of Nursing. (December 2011). Differentiated Essential Competencies of Graduates of Texas Nursing Programs. Retrieved from http://www.bon.texas.gov/about/pdfs/delc-2010.pdf
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