The differences between nurses at the associate degree level verses the competencies of a baccalaureate degree level is skill and education. Skills and knowledge are needed to provide safe and competent care regardless of what level of nursing that you are pursuing. According to the journal, Associate degree level nurses are trained more so at the bedside level. The Baccalaureate level nurse are trained to think and critically and solve problems. The Associate level nurse are trained to asses and look for abnormal findings such as abnormal blood pressures, a CHF patient with a significant weight gain in twenty four hours.
The Baccalaureate level nurses are trained to think critically and solve problems. Although both levels are required to use critical thinking skills to pass the state board exam, the baccalaureate level nursing goes more in depth on how to utilize these skills. The Associate Nurse basically provides care for the patient, this includes completing all activities of daily living, assessing the skin, obtaining vital signs, obtaining lab samples, starting peripheral lines or administering intravenous fluids.
The Baccalaureate level nurse educate the patient and attempt to prevent worsening conditions, the baccalaureate level nurse also instructs and educates the patient to monitor their surgical sites for signs and symptoms of infections such as redness, swelling, or drainage and to report the findings immediately. The BSN advises and instructs the patient to report signs and symptoms of pain at the earliest onset. The BSN advises the patient on the importance of reporting these findings. The Baccalaureate Nurse is in most cases a charge nurse who deals with staffing issues and deals with unit emergencies as they may arise.
A senior Associate level nurse may be a charge nurse based on years of experience, knowledge and practice. Although both levels must have clinical competence they have different levels of knowledge used in the practice of nursing. According to the Journal of Professional Nursing Issue in May 2008, the educational preparation of nurses must provide the necessary skills and foundation for graduates to practice at a level of competency and safety (www. library. gcu. edu). This writer has personally witnessed a BSN level urse; actually a couple, that are new graduates who are not competent.
They were obtaining blood pressures and was not sure how to place the cuff on properly or where to place the stethoscope on the patient’s arm and then they asked, “ how do you know which on is the systolic and which is diastolic. This writer was frantic but as an associate level nurse eager to assist these new graduates on the proper way of obtaining a blood pressure and they were very appreciative. In thinking about this question further about entry into practice, I had to do some reflection.
As I come from an AD program, I have to say that for the time (graduated 2007), and for the expectations of entry-level RN practice at that time, I received the most complete and comprehensive education that I could have ever asked for at Florida Gateway College in Lake City, Florida. I knew I was prepared to begin working as a safe, competent professional and I quickly learned as I worked alongside new BSN graduates that I was more clinically prepared in many ways. That being said, I also knew that if I wanted to have more choice with regard to my future, I would have to pursue at minimum a BSN.
So, I find a definitive answered to the question posed to be difficult. Regarding ENTRY into practice, I believe that an AD program prepared nurse can be a huge asset to nursing practice, and in many ways is more prepared now than even I was with regard to some issues (e. g. : critical thinking and competency and skills). In light of the current shortage, as well as other issues, the reality is that AD program graduates are here to stay, due to the fact that they are geared for bedside nursing and the acute care setting is becoming more prominent.
I do believe that if possible, a student should pursue BSN education in the nearest future to advance in knowledge and education, but there are often obstacles to that for some students. This nurse has enjoyed being at the AND level working closely with the patients at the bedside, working closely with the Primary Care Providers and all of the members of the Interdisciplinary team, but now I feel that there are more marketable opportunities as a BSN level nurse.
At the end of the day it does not matter what level nursing you are on, you must keep the patient’s best interest as far as safety and education level at heart. The more you enhance and advance your knowledge the more you can teach your patients about prevention and safety. The health care field is however becoming more demanding as far as medically and requiring employees to be technology savvy. So to summarize, the AND level nurse is trained for the bedside and the BSN level nurse is trained more so to think critically and to solve problems.