Throughout history, a nurse has been defined as “a person caring for the sick”(Merriam-Webster, Inc. , 2004, p. 853). At the completion of school, whether from an Associate Degree in Applied Science or a Bachelor of Science Degree, all candidates must pass the national licensure exam. This enables the new graduate nurse to practice as a registered nurse. This new R. N. graduate is permitted to work in health care facilities in entry level positions. Both begin their career similarly with an extended orientation period being mentored by a “seasoned” colleague.
Orientation is a probation period which grants the new employee time to become acclimated to the new facilities’ policies and procedures, as well as time for the facility to evaluate the new employee’s progress. Close supervision is required, as well as hands-on-hours, to order for the graduate nurse to gain confidence in the new work environment. (Goulette, 2010, p. 2) Is there a difference between the nurse with an associate’s degree and the nurse with a bachelor degree since the RN licensure test is the identical and both begin their employment with an extended orientation, as well as tight supervision?
One difference is the amount of education. ADN programs, offered by junior or community colleges, can be completed in two to three years. BSN programs, college or university offered, take four years to complete. Time is not the only difference in their schooling. The BSN program places emphasis on general education requirements in the first two years. It is the latter two years where nursing is the center of attention. The criteria needed for the baccalaureate program includes liberal arts education, patient safety, quality of care, research based practice, health care funding, collaborative care, and preventive medicine in communities.
(American Association of Colleges of Nursing [AACN], 2008, p. 3) The ADN or technical programs essentially delete some of the generalized educational courses and devote the attention exclusively on nursing which correlates to more hands on experience. This focus is adapted to primarily prepare the ADN student for more day to day nursing activities. In 1952, Mildred Montag, in response to the nursing shortage, designed a program to counter the college level nursing programs. An associate degree was the end result. (Haase, 2006, p.1)
To answer the question posed: Is the nursing education level a contributing issue in the deliverance of quality care and patient safety? “The American Association of Colleges of Nursing believes that baccalaureate prepared nurses like other health care providers, practice at a higher level. Nurses processing a Bachelor’s Degree are molded to adapt to the changing health care environment and its demands. This can be accomplished by leadership development, as well as critical thinking emphasizing health promotion and disease prevention across all environments of care”.
(American Association of Colleges of Nursing [AACN], 2012, p. 1) With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations: 20, Saturation: 94% on room air, Hemoglobin: 7.
0 and trending downward over the last three days. The patient complained of chest pain, mid-sternum radiating to jaw, and shortness of breath. This assessment differs from the initial assessment at the beginning of the shift. The nurse informed the physician, placed the patient on oxygen, administered intravenous fluids, removed any nitrate patches, performed an electrocardiogram, suggested that blood be obtained for type and cross to be sent to the lab. The RN remained at the patient’s bedside, continually monitoring the vital signs and assessing the patient’s condition.
The bedside nurse is exhibiting proficiency in the ability to think critically by making a nursing diagnosis, initiating nursing interventions, and evaluating the results. In the above example of critical thinking, it remains difficult to conclude whether level of education or years of experience are the determining factor in the delivery of patient care. For many years there has been an ongoing debate throughout the nursing community on the importance of knowing that versus knowing how.
What seems clear is that vast general, as well as nursing knowledge can only benefit the profession and the patients we serve. ? References American Association of Colleges of Nursing. (2008). Essentials of baccalaureate education for professional nursing practice. Retrieved from www. aacn. nche. edu American Association of Colleges of Nursing. (2012). The Impact of Education on Nursing Practice. Retrieved from http://www. aacn. nche. edu/media-relations/fact-sheets/impact-of-edcation Creasia, J. L. , & Friberg, E. E. (2011).
CONCEPTUAL FOUNDATIONS: The Bridge to Professional Nursing Practice (5th ed. ). St Louis, MO: Mosby Inc. , an affiliate of Elsevier Inc. Goulette, C. (2010). Nursing (Job) Shortage. New Grads are Finding the Job Hunt Tough. “. Retrieved from nursing. advanceweb. com/ Haase, P. (2006). The origins and rise of associate degree nursing education. Retrieved from www. noadn. org Merriam-Webster, Inc. (2004). Merriam-Webster’s Collegiate Dictionary. In F. C. Mish (Ed. ), Merriam-Webster’s Collegiate Dictionary (Eleventh Edition, p. 853). Springfield, Massachusettes, USA: John M Morse.