Educational Preparation

Educational Preparation – The Differences in Competencies of Registered Nurses with and Without Baccalaureate Degrees

Educational Preparation – The Differences in Competencies of Registered Nurses with and Without Baccalaureate Degrees Nursing is a profession with great honor and satisfaction. Patients trust nurses in the most difficult times of their lives. Nursing avails itself many opportunities to grow and practice at several different levels. Not only is there the Licensed Practical Nurse (LPN) with only twelve to twenty-four months of education, but there are also different levels of Registered Nurse (RN). One may obtain his or her RN licensure by attending a hospital diploma program, attaining an Associate of Science Degree in Nursing (AND), or attaining a Bachelor of Science in Nursing (BSN). Each designation of nurse has its own similarities and differences. This paper will focus on the differences between and RN with an ADN versus a BSN.
Magnet Hospital Nurses
The American Nurses Credentialing Center (ANCC) has a voluntary recognition and certification program entitled The Magnet Recognition Program which represents high quality nursing by emphasizing that nurses are educated to act as teachers and leaders. Magnet hospitals hold five model components including 1) Transformational Leadership, 2) Structural Empowerment, 3) Exemplary Professional Practice, 4) New Knowledge, Innovation, and Improvements, and 5) Empirical Quality Results. By the year 2020, magnet hospital nurses will have predominantly baccalaureate RNs to facilitate and maintain these components (2013), Retrieved April 28, 2013, from http://nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model. “Quality patient care hinges on having a well educated nursing workforce” states The American Associate of Colleges of Nursing (2012). Nurses with an education level higher than an associate’s degree have proven to have less medication errors and reduce hospital mortality rates within magnet hospitals (Medical Care, 2013).
Education versus Experience There is an ongoing debate over education versus experience; however, experience does not substitute for higher education according to Linda Aiken Ph.D. RN. (2005), Retrieved April 28, 2013, from http://news.nurse.com/apps/pbcs.dll/article?AID=2005505090562. Aiken performed a study of Pennsylvania hospitals comparing outcomes of BSN versus AND nurses which revealed that for every 10% increase in the proportion of nurses with BSNs there would be a 5% decline in mortality and a 5% decline in failure-to-rescue post surgery. “We require a baccalaureate as minimum entry level for other health care professions – social work, pharmacy, dentistry, physical therapy, occupational therapy – why should nursing be any less?” Aiken asks (2005).
Baccalaureate nurses are given instruction to cultivate leadership and decision making skills to promote high quality nursing management skills. “Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, communicating, providing care, teaching, and leading” (2013), Retrieved from http://ccn.aacnjournals.org/content/22/6/12.full.
The following patient care scenario illustrates the difference in the outcome of decisions made between an ADN and a BSN nurse.
Patient Care Scenario
In a patient-focused and family-centered care hospital, an AND staff nurse is tending to a patient in the ICU whose condition is declining. The unit has set visiting times every two hours but the nurses do have the ability to make exceptions. Family members from out-of-town have arrived in the afternoon during non-visiting hours. They wish to visit the patient immediately. The staff nurse had been busy caring for the patient al morning. The staff nurse refused to give exception to the visiting hours and would not allow the family in to see the patient. Quite upset, the family complained to the BSN charge nurse. Asking the family to allow her to speak with the staff nurse privately, the charge nurse responded that she needed the quiet time to catch up on her charting. Understanding the holistic approach to the patient’s and family’s need for information, reassurance, and support the charge nurse coached the staff nurse of her role to meet those needs which takes priority over patient charting. The staff nurse was then able to better understand the hospital’s philosophy of patient-focused family-centered care and invited the family into the patient’s room whereupon the needs of the patient and family were met.
Analysis of the Patient Care Scenario
Not fully understanding the philosophy of patient-focused family-centered care, the AND staff nurse made a decision that did not place the patient as a priority. The result of her decision was angry family members as they were not permitted to have their needs for information met and the patient was prevented from obtaining reassurance and support from the family. As a nurse leader, the BSN charge nurse was able to teach or remind the staff nurse of the hospital’s philosophy that keeps patients’ and families’ health care their priority.
Nurses in Today’s Health Care
Health care today is in need of more nurses to become leaders and managers in their field, requiring them to attain a higher education and receive their BSN. The nursing profession is evolving as “the demands placed on nursing in the emerging health care system are likely to require a greater proportion of RNs who are prepared beyond the associate degree or diploma level” (Pew Health Professions Commission, 1998, p. 64).

References
American Nurses Credentialing Center. (2013). Magnet recognition program model. Retrieved from http://nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model
American Association of College and Nursing. (2012). Fact sheet: Creating a more highly qualified workforce
McHugh, M.D. &Kelly, L.A. (2013). Lower mortality in magnet hospitals. Medical Care, 51, 382-388. Doi:10.1097/MLR.0b013e3182726cc5
Nurse.com (2005). Nurse Leader Speaks on Patient Safety at Stony Brook. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=2005505090562
Henneman, E.A. &Cardin, S. (2013). Family centered critical care: a practical approach to making it happen. Retrieved from http://ccn.aacnjournals.org/content/22/6/12.full
Pew Health Professions Commission, 1998, p. 64

References: American Nurses Credentialing Center. (2013). Magnet recognition program model. Retrieved from http://nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model American Association of College and Nursing. (2012). Fact sheet: Creating a more highly qualified workforce McHugh, M.D. &Kelly, L.A. (2013). Lower mortality in magnet hospitals. Medical Care, 51, 382-388. Doi:10.1097/MLR.0b013e3182726cc5 Nurse.com (2005). Nurse Leader Speaks on Patient Safety at Stony Brook. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=2005505090562 Henneman, E.A. &Cardin, S. (2013). Family centered critical care: a practical approach to making it happen. Retrieved from http://ccn.aacnjournals.org/content/22/6/12.full Pew Health Professions Commission, 1998, p. 64