Difference in Competencies Between Associate and Baccalaureate Degree Nurses There is much controversy surrounding the issue of the difference in competencies between nurses educated at the Associate (ADN) and Baccalaureate (BSN) level. This paper will discuss those differences in relation to Professional values, and risk-taking propensity. This paper will discuss how, even though numerous studies have been done that show there is little difference between the competencies of ADNs and BSNs, there is, in fact, a distinct difference. No one can deny that the health care industry has come a long way. This does not exclude the nursing field. There is a huge push by the Magnet hospitals to maintain that 80% of their nursing staff carry baccalaureate degrees by the year 2020. This is due to changes in the healthcare delivery system, as well as cost-containment (Masters, 1989). While baccalaureate prepared nurses have better access to jobs as new graduates and are looked at as being better prepared for the clinical workforce, until they have been working in the clinical sector there is really no difference between the experience level of an associate or baccalaureate prepared nurse.
There is also a gray area, because graduates of both levels of education take the same licensing exam, and also have the same legal responsibilities (Masters, 1989). In the article “Analysis of Differences in Entry-Level RN Practice by Educational Preparation”, June E. Smith states that there was a very close relationship in pattern of practice between recently graduated Associate and Baccalaureate nurses (2002). She also wrote that “Within the first 6 months of practice, ADN and BSN graduates performed activities with remarkably similar frequencies” (Smith, 2002, p. 494). It is shown in the article “Professional Values Held by Baccalaureate and Associate Degree Nursing Students”, that there have been “no significant differences found between the two groups” (Martin, 2003, P. 292).
This particular study was done out of a random selection of graduating students from a number of baccalaureate and associate degree programs in the state of Texas. These nurses rated their professional values using the Nurses Professional Values Scale (NPVS), as taken from the 1985 American Nurses Association Code of Nursing (Martin, 2003). Findings of this study concluded that “senior nursing students in ADN programs did not differ significantly from their counterparts in BSN programs” (Martin, 2003, p. 293). According to Marcia L Masters, role differentiation between ADNs and BSNs is not “clearly defined in terms of decision making responsibility” (1989, p. 391).
In this same article, Masters quotes W. Weiss (1985), “Taking risks means different things to different people.” One person may look at a situation as a challenge for success, where another will look at it as a threat of failure. Through the course of this study, it was found that nurses had a higher risk taking propensity than the normal population, but there were no significant differences in risk taking propensity noted between the ADNs and BSNs studied. This includes both education and experience.
“Although in practice, BSNs may be given more opportunities for decision making, this study indicated the willingness to take the risk in making decisions is fairly evenly distributed between ADNs and BSNs” (Masters, 1989, p. 394). Contrary to what these studies have shown, there is a distinct difference in the competencies of ADNs and BSNs. According to the National League of Nursing (NLN, 2011), a baccalaureate degree expands on the knowledge and capabilities acquired in an associate program. Where associate programs focus on the patient and their family, baccalaureate programs tend to focus more on community nursing and leadership. There is a broader context of nursing that is learned in a baccalaureate program. In the article “The Differences Between Associate Degree Nurses and the Baccalaureate Degree Nurses”, The author states “a nurse with a BSN has more opportunities to work in a variety of health care settings that offer an extensive array of opportunities for professional growth. Baccalaureate-prepared nurses can be bedside nurses, educators, case managers, discharge planners, administrators, and work in public health, home health, and community clinics” (Moore, 2009).
She continues to explain how associate prepared nurses are focused more on the technical aspects of care, where Baccalaureate prepared nurses are focused more on “evidenced-based clinical practice and leadership” (Moore, 2009). Moore also agrees that in skill competency, there is not much difference between ADNs and BSNs, but that “BSN nurses show greater critical thinking skills, better problem solving, and the development of clinical judgment; three skills of increasing importance for the increase in acuity of patients in hospitals and other health care settings” (2009). As a new graduate ADN, the author of this paper has insufficient experience to identify a specific patient care situation in which approaches to decision making may differ between associate and baccalaureate prepared nurses.
It comes to light from research, however, that a baccalaureate prepared nurse is more competent in thinking on the fly. As stated earlier, baccalaureate prepared nurses have improved clinical judgement and problem solving skills, which are crucial in an emergency or trauma situation, where the patients have a higher acuity level. It seems that as far as newly graduated nurses are concerned, there is not much of a difference in bedside skill competencies between ADNs and BSNs. A baccalaureate degree, however, better prepares the newly graduated nurse for critical thinking, problem solving and better judgment in emergency situations. A baccalaureate degree gives the nurse more opportunities for advancement and movement within the nursing field, and also prepares the BSN for graduate study. This is important especially when it comes to the nation’s hospitals movement toward Magnet Status.
1. Martin, P., Yarbrough, S., & Alfred, D. (2003). Professional Values Held by Baccalaureate and Associate Degree Nursing Students. Journal of Nursing Scholarship, Third Quarter, 291-296. Retrieved January 19, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=14562499&site=eds-live&scope=site
2. Masters, M., & Masters, R. (1989). Risk-Taking Propensity of Nurses: ADN and BSN. Journal of Nursing Education, 28(9), 391-396. Retrieved January 14, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=1990100566&site=eds-live&scope=site
3. Moore, D. S., PhD., RN., CNM., MN., & MPH. (n.d.). West Coast University: Dean’s Corner – The Differences Between Associate Degree Nurses and the Baccalaureate Degree Nurses. West Coast University – Nursing Programs – Los Angeles, Orange County, Inland Empire. Retrieved January 20, 2013, from http://www.westcoastuniversity.net/deanscorner/print.php?article=22
4. Ridley, R. (2008). The Relationship Between Nurse Education Level and Patient Safety: An Integrative Review. Journal of Nursing Education, 47(4), 149-156. Retrieved January 15, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009885996&site=eds-live&scope=site
5. Smith, J. (2002). Analysis of Differences in Entry-Level RN Practice by Educational Preparation. Journal of Nursing Education, 41(11), 491-494. Retrieved January 18, 2013, from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2003013823&site=eds-live&scope=site