1

The Effects of ADN vs BSN

Baljinder Kaur
Grand Canyon University

Discuss the difference in competencies between nurses prepared at associate degree levels verses
the baccalaureate degree level.
There are three educational pathways for nursing licensures-baccalaureate, associate
degree and diploma programs. 3-year diploma program typically administered in hospitals, a 2-3year associate degree offered at community colleges and a four-year baccalaureate degree offered
at senior colleges and universities. All these programs offer registered nurse degree and they all
work in same hospital setting but still there is some difference in their competencies. The paper
will examine the relationship between having higher educated nurses and the effect they have in
the healthcare setting.
Associate degree programs was started by Mildred Montagas to be collegiate alternative
for preparation of technical nurses and also to deal with nursing shortage after world war

The Effects of ADN vs BSN

.Montags intent was that Associate degree nurses would work under directions of registered
professional nurses who had Baccalaureate degrees but some confusion arouse about roles and
relationships and by the time students graduated from ADN programs they were declared eligible
for RN licensure examination.(book p 22).Although both associate degree level nurses and
baccalaureate degree level nurses take same National Council Licensure Examination ( NCLEX)
and have same passing rate that still does not mean that they deliver the same quality care. There
are differences in competencies of ADN and BSN. Nurses with Bachelor of Science in nursing
degree are well prepared to meet the demands placed on nursing today.
Associate degree nursing takes two years to complete while baccalaureate takes three to
four years. The core curriculum is similar for both programs including pediatrics, adult health,
psychiatric nursing, gerontological, maternity etc. but Baccalaureate degree program has more
theory course work than associate degree. It prepares its graduates generalists to practice nursing
in beginning leadership position in variety of settings. Baccalaureates course work includes in
depth knowledge on physical and social sciences, liberal education, public health, quality and
patient safety, and research. According to Grand Canyon University of nursing philosophy BSN
incorporates the roles of assessing, critical thinking, communicating, providing care, teaching
and leading. They have ability to work efficiently in outpatient and inpatient settings. Associate
degree courses lack research, informatics and nursing technology. Associated degree nurses work
efficiently where there is set protocols and guidelines to follow. They demonstrate competencies
in various aspects of patient care that includes prevention, promotion, rehabilitation, maintenance
and restoration of health of individuals. They are competent to assess the pain level, risk of falls,
neglect or abused patients, those requiring psychological services for alcohol or substance abuse.
They are competent to handle patient data, creating care plans and performing everyday skills.

The Effects of ADN vs BSN

Numerous research studies have demonstrated that the ADN and BSN nurses are not
different in skill competency when they graduate but over time BSN NURSES SHOW higher
level of critical thinking, better problem solving and clinical judgments. The added classes
enhance the students view for wide scope of practice which aids the nurses in comprehending
issues related to patients. Baccalaureate nurses are independent in their decision making, they
use complex communication skills, they participate in the interdisciplinary team to develop care
plans according to patient needs. They apply both technology and nursing while Associate degree
nurses lack nursing.
Essentially, the common phrase that knowledge is power is very true in this case.
More formal education is knowledge in this instance, which can positively impact patient
outcomes. In todays healthcare environment, there is more of a need for critical thinking,
case management, and leadership. Baccalaureate nurses are instrumental in acting as a
liaison between families, doctors, nursing staff, and hospital staff. Baccalaureate nurses are
well equipped to handle their managerial role and collaborative role with the attending
physician while taking care of the patient and dealing with the family. Furthermore, the
NACNEP found that baccalaureate education best fulfills the requirements of todays
healthcare needs and provides the nurse with a strong base in managing the ever changing
complexities of healthcare. Baccalaureate education has a larger scope and stronger
scientific curriculum which is advantageous for todays nurses. Furthermore, higher
education provides nurses with the tools to advance even farther in their graduate studies,
or take up more advanced nursing positions. This point is further proved by an article that
was published in August, 2008 in the Heath Services Research journal, that delved into the

The Effects of ADN vs BSN

relationship between nursing practice environments and the outcome of cancer patients that
were in surgery. The article shows that there is a statistically significant positive correlation
between nursing education level and patient outcomes. Essentially, baccalaureate-educated
nurses had lower mortality and failure to rescue rates. This point is further highlighted by
the August 2014 edition of the International Journal of Nursing Studies. Researchers found
that a 10% increase in baccalaureate-educated nurses led to a 9% decrease in patient
fatalities. This led the researchers to conclude that increasing baccalaureate nurses in a
hospital setting would lead to a significant decline in patient fatality rates.
Baccalaureate nurses are more knowledgeable is also evident from this situation: In
our dialysis unit, we had a patient who supposed to get heparin during dialysis, but patient
was refusing saying no heparin, no pork, patient was not fluent in English so it was hard
for assigned nurse to understand what she meant, but when nurse went to manager to ask
for help, manager told her that in some religions people dont eat pork and heparin is
derived from pig thats why patient is refusing.
Although both baccalaureate nurses and associate degree nurses are capable of
providing efficient care to the patients, but there are some fields that Associate degree
nurses are not as efficient as baccalaureate degree nurses. They are just one step ahead of
associate degree nurses and also one step close to go up in ladder and work in different
fields along with bedside nursing.

The Effects of ADN vs BSN

Bibliography
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008, May). Effects of
Hospital Care Enviornment on Patient Mortality and Nurse Outcomes . Journal of
Nursing Administration , 38(5), 223-229.
Friberg, E. E., & Creasia, J. L. (2015). The Bridge to Professional Nursing Practice (6th Edition
ed.). Cambridge, MA: Elesevier Mosby.
Friese, C. R., Lake, E. T., Aiken, L. H., Silber, J. H., & Sochalski, J. (2005, March/April).
Hospital Nurse Practice Enviormnments and Outcomes for Surgical Oncology Patients .
Health Services Journal , 54(2), 1145-1163.
Health Resouces and Services Administration . (2013, April ). The U.S. Nursing Workforce:
Trends in supply and education. Retrieved May 2016, from National Center for Health
Workforce Analysis :
http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/index.html
Rosseter, R. J. (2014, January 2014). The Impact of Education on Nursing . Retrieved 2016, from
AACN: http://www.aacn.nche.edu/media-relations/EdImpact.pdf
Rosseter, R. J. (2015, March 15). Creating a More Highly Qualified Nursing Workforce.
Retrieved 2016, from AACN: http://www.aacn.nche.edu/mediarelations/NursingWorkforce.pdf