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Nursing Associate and Baccalaureate Education


Education enhances clinical proficiency and the delivery of quality care. As a result, the education level of the nursing workforce determines the overall quality of patient care. Studies indicate that nurses prepared at the baccalaureate and graduate degree levels have contributed to improved patient outcomes as marked by reduced mortality rates, a reduction in medical errors, and hospital readmission rates (Cho et al., 2015; Dellefield, Castle, McGilton, & Spilsbury, 2015). The American Association of Colleges of Nursing is dedicated to creating a highly qualified nursing workforce in collaboration with learning institutions. This paper distinguishes between the proficiencies of nurses who have undergone associate-degree level training versus those who have taken the baccalaureate degree. A case study of different approaches to nursing care based on training is also provided in the paper.

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Differences in Competencies between Nurses Prepared At the Associate-Degree Level versus the Baccalaureate-Degree Level

The Associate Degree in Nursing (ADN) was created to assuage the critical shortage of nurses following World War II by reducing the duration of education to 2 years (Fisher, 2014). The nurses prepared at the Associate degree level are exposed to clinical settings, disease conditions, and bedside nursing. However, they do not conduct nursing research. Upon completion, ADN graduates are expected to sit and pass the NCLEX-RN exam to commence working as registered nurses (RNs). Conversely, the Baccalaureate nursing degree (BSN) is an academic degree that is granted by a certified institution after 4 years of study. The BSN curriculum is devised to train students to cope with the changing health-care setting. The program involves 2 years of general education and 2 years of essential nursing courses (Trinkoff et al., 2015). The nursing courses prepare nurses for different nursing roles and experiences, which enhance their professional roles as well as graduate studies. BSN graduates should also sit for the NCLEX-RN exam to become RNs.

BSN-prepared nurses acquire competencies in various nursing areas such as leadership, management, critical thinking, public health, communication, and social sciences. The leadership preparation provides a stable background for nurses who intend to progress to managerial, research, or teaching roles. BSN training also incorporates nursing informatics, which educates nurses on the use of technology in healthcare settings to improve patient outcomes. Nursing theories and additional courses that are not part of the ADN degree enhance BSN-trained nurses’ capacity to comprehend multiplex problems affecting patients and the healthcare environment. Nursing theories stem from diverse fields, including sciences, humanities, and Biblical concepts. Consequently, nursing knowledge, philosophy, investigations, and health promotion are inspired by spiritual, moral, legal, partisan, historical, and social outlooks. This aspect enables nurses to provide patients with holistic care.

About 10 years ago, the American Nurses Credentialing Center started labeling hospitals as Magnet® organizations based on specific quality and other standards) Nantz, 2015). One prerequisite was that about three-quarters of nurse managers should hold a minimum of a BSN degree by January 2011 (Auerbach, Buerhaus, & Staiger, 2015). As a result, employers have demonstrated the preference of BSN-trained nurses to ADN-prepared nurses. Reports that the proportion of ADN-prepared RNs recruited in many hospitals decreased from 65% to 60%, whereas the fraction of BSN-prepared RNs hired increased from 67% to 72% over the last few years (Auerbach et al., 2015).

An Example of a Patient Situation Where Nursing Care or Approaches to Decision-Making May Differ Based on the Educational Preparation of the Nurse

An example of a patient situation where nursing care or approaches to decision-making differed based on the educational preparation of the nurse was a hospital scenario involving a patient who had received a new diagnosis of diabetes mellitus. The patient, a 44-year-old male who lived alone, was given discharge instructions by the ADN-prepared nurse, and reminded to meet his endocrinologist in 3 weeks’ time. Part of his disease management instruction involved taking the prescribed medications, having regular physical exercise, and changing his diet. However, the patient had a memory problem, and he knew he would have trouble remembering to take his medications as recommended.

Therefore, the patient was reluctant to leave the clinic without additional information. One nurse, a BSN-prepared nurse, noted the patient’s reluctance and offered to find out what the problem was. After that, the nurse advised the patient to set daily reminders on his mobile phone to help him keep up with his medication schedule. The news of the diagnosis came as a shock to the patient because he did not have a family history of diabetes. The BSN nurse looked up community resources within the patients’ residence for people living with diabetes. The patient was advised to attend meetings once a week. At the center, he would meet other people who would form a support system to help him cope with the disease. The nurse responded to the patient’s concerns, after which the patient gladly left the clinic.

This case indicates a major difference in patient care between a BSN-prepared nurse and an ADN-prepared nurse. The BSN nurse demonstrates an understanding of patient needs and proposes appropriate solutions for effective disease management and improved patient outcomes.

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The nursing field is constantly growing as nurses and physicians employ novel technologies to identify and treat diseases. Keeping up with these advancing trends requires hospital managers to change how nurses interrelate with their patients. The breadth and flexibility accorded by BSN program’s curriculum play a significant role in helping nurses to cope with the numerous challenges involved inpatient care.


Auerbach, D. I., Buerhaus, P. I., & Staiger, D. O. (2015). Do associate degree registered nurses fare differently in the nurse labor market compared to baccalaureate-prepared RNs? Nursing Economics, 33(1), 8-13.

Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y.,… Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International Journal of Nursing Studies, 52(2), 535-542.

Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship between registered nurses and nursing home quality: An integrative review (2008-2014). Nursing Economics, 33(2), 95-108.

Fisher, M. (2014). A comparison of professional value development among pre-licensure nursing students in associate degree, diploma, and bachelor of science in nursing programs. Nursing Education Perspectives, 35(1), 37-42.

Nantz, S. (2015). How to increase unit-based shared governance participation and empowerment. American Nurse Today, 10(1), 52-54.

Trinkoff, A. M., Lerner, N. B., Storr, C. L., Han, K., Johantgen, M. E., & Gartrell, K. (2015). Leadership education, certification and resident outcomes in US nursing homes: Cross-sectional secondary data analysis. International Sournal of Nursing Studies, 52(1), 334-344.

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