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ADN verses BSN

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ADN verses BSN

Nursing has been an evolving profession. It started off with nurses with no formal

education working as caregiver to the present time where they are working as professionals in the

health care industry. Education has a strong impact on how a nurse thinks, use evidence based

practice and makes Clinical judgments which are best for the patient. “A growing body of research

reinforces this belief and shows a connection between baccalaureate education and lower mortality

rate” (Rosseter.2011).

Looking into the history of nursing, nurses were taking care of the sick family members at

home and did not require any formal training. Nurses are now more than caregivers and have

become professionals. Today there are three ways to enter into nursing; one is through a Diploma,

second is through an Associate’s degree and the third is through Baccalaureate in nursing. The

Diploma Program took anywhere from 2-3 years for certification. This was the very first program

to start in the 19th century and was a hospital based program but because, “Nursing students were

increasingly used to meet hospital staffing needs rather than function in the student role.” (Creasia

and Friberg. P.24) and also due to the increased cost to run such program for the hospital, many

closed down with a very few operating. The Associate degree program which takes 2 years for

completion was designed to meet the shortage in nursing in the year in 1952 designed by Mildred

Montag. This program prepared them to work as technical bed side nurses in secondary setting, or

to work under a baccalaureate prepared nurse. (Creasia and Friberg. P.26.)

“Some confusion arose about roles and relationships, so that by the time the first groups of

students had graduated from ADN programs, they were declared eligible for the RN

licensure examination, an eligibility that graduates of these programs retain today.” (Creasia

and Friberg. P.26.)

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ADN verses BSN

And the Baccalaureate degree program which traditionally takes 4 years for completion was

designed to prepare, “Nurse Generalist who is able to provide professional nursing services in

beginning leadership positions in a variety of settings. (Creasia and Friberg. P.36.)

Now let’s look at the differences in the program. “The main difference between the 3 years

of nursing in baccalaureate and diploma programs was the inclusion of public health nursing as

part of the baccalaureate curriculum.” This led to the strengthening and expansion of baccalaureate

programs. (Creasia and Friberg. P.26.) In addition BSN nurses are prepared in liberal education,

quality and patient safety, evidence-based practice, information management, health care policy

and finance, communication/collaboration, clinical prevention/population health, and professional

values. They are prepared to work in acute care setting, community based setting and to take up

leadership and managerial roles. Whereas Diploma nurses are prepared for bedside nursing and

associate’s degree prepares for technical bedside nursing in a secondary care setting. (Creasia and

Friberg. P.31.)

Does educational qualification affect Patient Outcome? Nursing today is more than

bedside care a nurse has to be able to think critically, use evidence based research, make clinical

judgments and act fast to achieve Quality Patient outcomes. With the influx of new research,

technological advancements, comes a complex work situation. Thanks to medical advancement,

“Patients now have a better chance of surviving traumatic injuries, life threatening disease process,

and delicate surgical procedures than ever before.” (Taylor .P.611.) Only a nurse with an advanced

degree or a professional baccalaureate degree is prepared adequately to think critically,

communicate better and respond effectively to a complex situation. In relation to Quality Patient

Outcomes “A study published 2003 that clearly identified a relationship between higher levels of
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ADN verses BSN

nursing education and better patient outcome.” (Taylor .P.613.) In addition many studies have

attributed that lower level of education contributes to increased mortality rate, complications and

failure to rescue. (Estabrooks, Midodzi, Cummings, Ricker, Giovannetti, Phyllis. 2005.) A nurses

prepared at a baccalaureate level looks at the overall picture of the client she starts by addressing

the individual client moving along to looking at the family and the community overall. She takes

up the leadership role to lead the community to a better.

When comparing a patient situation let’s look how an ADN prepare nurse handling a

patient situation is different from that of a BSN prepared nurse. During change of shift a patient is

receiving a blood transfusion. At first hour of transfusion the patient has no complain. While the

oncoming BSN prepared nurse is taking report from Associate’s Degree prepared nurse, the

patient receiving blood transfusion starts complaining of chest pain. The ADN prepared nurse is

busy assessing the patient while the BSN prepared nurse who just learnt during report that the

patient has a history of CHF, stops the transfusion, administers oxygen, obtains stat EKG and calls

the doctor. She performs these tasks as core measures laid down by the hospital for CHF patient.

The way she handled this situation shows how she took up the leadership role and her immediate

decision of stopping the transfusion and administering oxygen stabilized the patient condition.

Looking at the situation, the ADN prepared nurse would have tried to find other causes for chest

pain rather than fluid overload due to blood transfusion before stopping the transfusion and then

called the doctor. This indicates the technical knowledge with which she can work under the direct

supervision of a professional nurse or a physician. Basically she/he can follow the orders, critically

think and make clinical judgments. Whereas a professional nurse, BSN graduate is able to

critically think, look at evidence based research finding and make clinical judgments for quality
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ADN verses BSN

patient outcomes.

In conclusion, it is important for a nurse to get professional degree in order to take up

managerial and leadership role. A professional nurse continues to enhance her knowledge through

research and studies and makes clinical judgments based on evidence based practice for the

community as whole. Patients deserve to have a highly qualified nurse force to advocate for their

healthcare needs. It is very true, if you don’t move forward there will be stagnation. (Taylor.P.619)

References

Creasia, J. L., & Friberg, E. (2011). Conceptual Foundations The Bridge to Professional Nursing

Practice (Fifth ed., pp. 22-33). St. Louis, MO: Elsevier Mosby.

Estabrooks, C. A., Midodzi, W. K., Cummings, G. G., Ricker, K. L., & Giovannetti, P. (2005). The

Impact of Hospital Nursing Characteristics. In Wolters Kluwer Health . Retrieved February

10, 2012, from OvidSP (00006199-200503000-00002.).

Hood, L. J., & Leddy, S. K. (n.d.). Nursing History, Theories, and Conceptual Models. In Module

2. Retrieved February 10, 2012, from

http://angel03.gcu.edu/section/default.asp?id=1289532

Rosseter, R. (2011, April 14). Creating a More Highly Qualified Nursing Workforce. In Media

Relations. Retrieved February 10, 2012, from

http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce

Taylor, D. L. (2008). Should the Entry Into Nursing Practice Be the Baccalaureate Degree

[Electronic version]. Aorn Journal, 87(3), 611-619.