Care approaches and decision-making A compare and contrast of associate-degree level verses baccalaureate-degree level in nursing: Heidi Kruger Grand Canyon University: NRS-430 (NRS-430V-O103) Professional Dynamics Feb, 2013 Abstract As an ever-changing health care system continues to evolve our practice becomes more advanced. The healthcare system requires an expanded knowledge base and training in order to deliver safe, comprehensive care. As in-hospital patient stays shorten and patient care moves to a community setting, a greater number of specialized nurses are needed.
Expected to wear new hats, nurses must attain a higher level of education if we are to adequately rise to new challenges and fill the new rolls of our profession. ADN vs BSN: What’s in the alphabet soup Established in the U. S. in 1909, baccalaureate programs provided a comprehensive education for anyone whom desired to become a nurse professional. Generally this education pathway consisted of fives years of formal education, with three years providing a concentration on the nursing practice.
Included in this preparation where courses on public health and education. Later, the preparation was expanded to include courses such as evidence-based practice, clinical prevention, improved patient outcomes and other upper lever critical thinking courses. In the mid 1950’s the U. S. encountered a nursing shortage and the demand for nurses became great. Developed by Mildred Montag in 1952, the associate degree in nursing program (ADN) was developed to fill this demand for nurses during the World War II and post World War II era.
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This program was only two years in length and included a balance of general education and clinical nursing courses. Its purpose was to provide “technical” nurse. These ADN prepared nurses where to assist and work under the supervision of a professional nurse. (Creasia, 2011) As the years progressed and the nursing shortage resolved, the ADN program remained recognized and many prospective nurses chose the two year community college program to its now four year university counterpart as it as more cost effective and granted the same license upon successful completion of the state board exam. Impact on competent patient care Multiple studies indicate that BSN nurses are better prepared to provide health care. As BSN undergo a higher level of education, which include more critical thinking and a deeper understanding of subjects such as rick management. This education is essential in making quick life and death decisions. More over, inpatient stays are becoming shorter with more care being provided in outpatient settings.
Less time in an inpatient setting means a decreased amount of time with which to provide effective, competent care and deliver comprehensive, retainable patient education (American Association of Colleges of Nursing, 2000) As more care is delivered in a community setting i. e. patients homes, it decreases the available support that a lower level ADN may need. For example, there may be more PRN drugs. A nurse would need to understand how these drugs work separately and how they interact with each other without the aid of pharmacy immediately on had.
As “technical” nurses, they are trained more to do. If a patient shows signs of heart attach or respiratory distress, an ADN nurse may immediately give emergency medication. In contrast a BSN may ask. Are you ok? What medication have you taken? What are you feeling? What where you doing when this began? All while assessing non-verbal cues in order to determine the appropriate action to take. BSN prepared nurses are trained to think quickly before acting quickly. If fast critical thinking and a deeper knowledge of disease processes are not combined, it may prove deadly.
Evidenced based Studies Multiple studies show that a higher level of education reflects in patient care. Research at the University of Pennsylvania revealed at one Magnet Hospital that surgical patients had 14 percent lower odds in death and 12 percent lower odds of failure to resituate within a thirty day period compared to there non-Magnet counterparts. A study in 2007 revealed that a 10 percent increase in BSN prepared nurses where associated with 9 fewer deaths for every 1,000 discharged patients (Rosseter, 2012). BSN prepares nurses have a more positive impact on patient outcomes.
Achieve a broader scope of practice and are superior caregivers particularly in emergency situations. By taking advantage of a higher level of preparation, it allows a nurse to practice to his / her full potential. Conclusion Nurses continue to pioneer new fields. Taking on new tittles such as Case Manager, Infection Control, Risk Management and Legal Nurse Consultant, the role of Nursing is quickly moving from one of patient care to that of community educator and resource manager. We are expected to wear new hats on a daily basis.
For this reason, nurses must attain a higher level of education than was accepted in the past. It becomes ever more apparent that an ADN (Associated Degree in Nursing) program is not sufficient to prepare nurses for these new rolls. Many of these new rolls require a specialized certification. A higher degree of academic achievement is required if we are to adequately keep up with the challenges of a ever changing health care system and meet the demands of an increasingly technologically sophisticated society. References Creasia, J. L & Friberg, E (2011).
Conceptual Foundations: The bridge to professional nursing practice. St. Louis Missouri: Elsevier Mosby. Page 25-27. Retrieved from http://pageburstls. elsevier. com/#/books/978-0-323-06869-7 American Association of Colleges of Nursing (2000, October 24). Retrieved February 26, 2012 from http://www. aacn. nche. edu/publications/position/bacc-degree-prep Robert J. Rosseter (2012, October 24). Creating a More High Qualified Nursing Workforce. Retrieved February 25, 2012 from http://www. aacn. nche. edu/media-relations/fact-sheets/nursing-workforce
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