The Caring Nurse: ADN versus BSN
The Caring Nurse: ADN versus BSN
Caring is the heart of nursing. Most nurses have a quality about them that harbors caring. Caring is defined by Merriam-Webster dictionary as, “effort made to do something correctly, safely, or without causing damage,” or “things that are done to keep someone healthy, safe, etc.” Nurses, whether they are an associate degree educated or baccalaureate educated, want to do a good job. They don’t come to work to intentionally or unintentionally harm their patients. For example, Aiken, Clarke, Sloan, Lake, Cheney (2008) estimate that 40,000 patient deaths a year could be avoided with better staffing and higher educated nurses. Because of the looming nursing shortage and better patient outcomes for baccalaureate degree nurses, all nurses should be required to get their BSN.
To be required to get a BSN instead of an associate degree there must be adequate faculty. According to Aiken, Cheung, and Olds (2009) 40,000 candidates could not enter a baccalaureate or graduate degree program because there was not enough educational capacity. If there is not room for nursing applicants in advanced level degree programs there will not be an adequate amount of instructors later on to teach the baccalaureate programs and then not enough nurses to be in the workforce. Nurses in the baby boomer generation are retiring and that leaves even more jobs available which should be filled with baccalaureate degree nurses. Nurses with a baccalaureate degree have a higher tendency to go on to get graduate degrees and less associate degree nurses get an education past a BSN. For example, Aiken, Cheung, and Olds (2009) calculated that 3 times as many associate degree nurses would be needed to equal the amount baccalaureate degree nurses that go on to get graduate degrees. Those nurses that start off with a BSN and go on to graduate programs could fill faculty positions to educate more BSN nursing students. With more baccalaureate educated nurses the hospitals could be staffed higher and as a side effect of having more BSN nurses their hospitals would have better patient outcomes.
Caring nurses want better outcomes for their patients. Getting a higher education gives the nurse more skills when caring for their patients. For instance, Fagin (2001) reveals that seventy-two percent of nursing directors notice a difference in the performance of BSN nurses and associate degree nurses, mentioning critical thinking skills and leadership abilities. Enhanced skills give the BSN nurse a greater advantage when caring for their patients. The BSN nurse understands the reasons behind the interventions so that they can make a more informed decision, quicker decision, and accurate decision. The BSN nurse may hold a medication where an associate degree nurse may not. A BSN nurse might also notice a patient decline and intervene sooner than an associate educated nurse. According to the American Association of Colleges of Nursing fact sheet (2012) nurses with baccalaureate education and higher have lower incidences of medication errors, they have lower mortality rates, and greater patient outcomes. BSN nurses are also more likely to be in a leadership role and help implement new policies for better patient to nurse ratios. They are also able to be mentors for associate educated nurses and can give advice or be a person to get advice from for a problematic patient. Aiken, Clarke, Sloane, Lake, and Cheney (2008) concluded that nurse staffing ratios and higher educated nurses attained an advanced quality of care for patients.
Baccalaureate educated nurses have higher patient outcomes and lower medication errors because of the more intense program that they went through. According to Cresia and Friberg (2011) a baccalaureate program prepares nurses as generalists so that they can practice nursing in diverse settings as a beginning leader. A baccalaureate degree nurse is well rounded and has greater knowledge of healthcare policy and patient safety. They will also know evidence-based practice to a higher degree than an associate level nurse. An associate degree educated nurse has gone through a 2-year program. In that short period associate nurses received general education and clinical education. According to Cresia and Friberg (2011) the intent of an associate educated nurse would work under the direction of a BSN nurse. Much in the same way a LPN works under an RN. Because the associate program was so successful and the nurses took the same exam and received the same license the distinction became lost. The associate educated nurse knows the clinical signs and how to react but the baccalaureate nurse knows the clinical signs and has a deeper understanding of why the interventions are needed. Both nurses care about the patient but the baccalaureate nurse has a broader understanding of the patient, which leads to improved outcomes and fewer errors.
Nurses care about their patients and do not want to harm them or have medication errors. It is scary and puts a lot of stress on the nurse if a poor outcome occurs. As indicated by Fagin (2008) there is evidence that nurses and their communities are worried about the decline of care their safety in the hospital. More acutely ill patients in the hospital and fewer nurses to take care of them mean that nurses need to do what they can to prevent any injury to the patient. By requiring nurses to receive a BSN over an associate degree improves patient outcomes, makes patients and families feel more cared for, and will help increase the number of nurses that can be educated to BSN or higher degrees.
Aiken, L., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Effects of hospital care environments on patient mortality and nurse outcomes . The Journal of Nursing Administration, 38(5), 223-229. American association of colleges of nursing. (2012). Fact sheet. Retrieved from www.aacn.nche.edu/media-relations/NursingWorkforce.pdf Cresia, J. L., & Friberg, E. (2011). Conceptual foundations: the bridge to professional nursing practice. In M. Iannuzzi, & R. Richman (Eds.), Pathways of nursing education, pp. 22-41). [Pageburst]. Fagin, C. M. (2001). When care becomes a burden: diminishing access to adequate nursing. Retrieved from Millbank Memorial Fund: www.millbank.org care. (n.d.). In Merriam-webster.com. Retrieved from http://www.merriam-webster.com/dictionary/care