There are three educational pathways for registered nurses. One is a two year community college program, earning a student an associate degree in nursing (ADN), a three year diploma program offered by hospitals and a four year university or college program, earning the student a bachelor’s of science degree in nursing (BSN). The practice of the ADN and Diploma nurse is the same. Each nurse is eligible to sit for the NCLEX-RN licensing exam. This paper will compare the competency levels of BSN and ADN/Diploma nurses.
The American Association of Colleges of Nursing (AACN) believes that education significantly impacts the knowledge base and competencies of nurses (AACN, 2010). BSN and ADN nurses have the same basic skills needed to care for patients, however, the BSN prepared nurse builds upon these skills. ADN/Diploma degrees focus on the technical aspects of caring for patients, demonstrating clinical competence and use of critical thinking skills, knowledge, caring and compassion. These skills are utilized using ethical decisions and following professional standards set forth by the Board of Nursing.ADN/Diploma nurses usually practice within structured settings where policies, procedures and protocols provide guidelines for care (Hood, 2010). ADN/Diploma nurses assess, implement and plan patient care from admission to discharge of a patient.
The Bachelor of Science degree in nursing is usually the minimum requirement for administrative positions, research, consulting and teaching. The curriculum for the BSN degree includes courses to enhance critical thinking, communication and leadership skills. BSN nurses have additional training in obtaining information from multiple disciplines of the care team.They assimilate and analyze this information, and develop the plan of care.
They also receive specialized courses in disease prevention and management. They take an active role in community health nursing, providing holistic care that includes the patient, family and the community the patient resides in. BSN nurses practice within structured and unstructured environments, supervising nursing personnel in a variety of settings including but not limited to hospitals, outpatient centers, assisted living and home care (Hood, 2010).
The variety of settings practiced in and lack of formalized policies and procedures, requires BSN nurses to have excellent problem solving skills and independent decision making. The increase in complexity of patients requires they understand the disease process, assess the patient’s needs and coordinate with other healthcare providers to establish a plan of care. An example of differences in patient care, ADN/Diploma and BSN nurse are as follows: A patient is admitted to hospice care with stage four brain cancer.A BSN case manger is responsible for the coordination of all care provided, after assessing the patient and families needs. She collaborates with the physician, physical therapy, pastoral services, social workers and insurance companies. After the initial assessment, she consults with a physician, then notifies a medical supply company and a hospital bed, bedside commode, patient lift and wheelchair are ordered. A CNA arrives, providing daily care of the patient.
An RN/ADN arrives weekly to monitor vital signs, checks for skin breakdown, administers wound care treatments and evaluates the plan of care.She also sets up medications, obtains blood for labwork and provides teaching of the progression of the disease process to family members. The RN consults with the BSN case manager and additional orders for services are obtained. Both the RN and the BSN provide advice and emotional support to the patient and family. The difference in the role of ADN and BSN are the ADN’s role is comprised primarily with the patient’s daily care.
She assist with teaching the family the changes that occur and communicates to the BSN case manager those changes.The BSN case manager is responsible for collaborating with the patient, physician, RN, CNA, family and other ancillary departments. She is also involved with the more complex aspects of the daily care and establishing a relationship with the patient and family. All nurses, regardless of specialty, treat patients with respect and compassion. The path to BSN is built upon the skills of a ADN/Diploma nurse. The AACN states the road to BSN, prepares the new nurse for a broader scope of practice across a variety of inpatient and outpatient settings (AACN, 2010).With the increase in complexity of today’s patients along with advances in technology, our healthcare system requires more highly educated nurses. We as nurses embrace education that prepares us to provide the best care possible for our patients.
ReferencesAmerican Association of Colleges of Nursing. (2010). The impact of education on nursing practice.
Retrieved from American Association of Colleges of Nursing website: www. aacn. nche.
edu/media/factsheets/impactednp. htm Hood, L. J. (2010). Conceptual Bases of Professional Nursing (7 ed.
). Philadelphia, PA: Lippincott Williams and Wilkins.