Educational Preparation

Write a formal paper (750-1,000 words) discussing the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level in nursing. For additional help finding research on this topic, refer to the library tutorial located at in the Student Success Center. Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse (BSN versus a diploma or ADN degree). IntroductionNurses are prepared in two different educational backgrounds, the baccalaureate degree level of nursing and the associate-degree level of nursing. Though they are prepared in two different settings when completion of these programs both sit for NCLEX-RN exam. The NCLEX is the state board to license and RN for competency to work as a registered nurse. There are few differences in competencies between associate- degree nurses and baccalaureate degree level nurses inc luding their level of commitment, leadership skills and their quality of patient care.Education is an infinite process. Every day, new developments emerge and new deceases and remedies discovered. The overall outlook of healthcare professions has dramatically changed in the past few decades. Nursing plays a very critical and important part in efficient care and patient safety. Nurses work shoulder to shoulder with physicians in treatment planning and management. Legal and ethical responsibility of the care provided is also increasingly shared by the Nurses. Nursing profession thus calls for better qualified and well groomed nurses.Even though associate degree programs prepare nurses for patient care in a hospital setting, that training is insufficient for a variety of nursing roles. Comparison Point one-Associate level nursing was established after World War 2 during a nursing shortage. This started at the community colleges; students would have to attend for 2 years to obtain your nursing degree. Community colleges were growing at a fast rate they were able to accept many more students than universities. Associate nurses were taught the skills of nursing to work as an RN.One study showed that when reviewed by managers 86% of ADN nurses met or exceeded their expectation. (EEpg268) Point two Baccalaureate degree programs are help at the Universities, and students would attend these schools for four years to obtain their nursing degree. One study shows that nurses with their BSN are shown to be less task oriented, have critical thinking skills, are more professional in their role, and show more leadership skills. These nurses look at the patient as a whole and not just a list of things they need to accomplish during their day.ADN program is designed to provide the skills and knowledge to become a compliant generalist nurse. In most cases, it is a 20 month program aimed to provide a reasonably good training for the licensure examination (NCLEX-RN) and then an imm ediate, decent staff position in hospitals and inpatient healthcare modern society human being, encompass extensively sophisticated requisites provoking advanced techniques of acquisition directly correlating to health care industry.The health care is intensifying in complexity and observing beneficial amendments. The longevity and expectations have heightened thus nurses are obligate to become educated in higher echelon, the professional baccalaureate level, to comprehensively achieve composite necessities. The professional nurse who graduates with a baccalaureate is primed for broader role in numerous facet of health care in addition to global knowledge of functionality of medical system and diverse methods of application.Enabling the application in daily patient care, the delegation of tasks, independent decision making, secure patient discharge, and numerous other aspects provoking an improvement in quality of care. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. Education for nurses is life long process either at the bedside or school, nurses are continuously learning to meet the competencies of professional practice and growing demand of excellent care.The difference between the nurse prepared at the associate degree level versus the baccalaureate degree level in nursing is the nurse with baccalaureate degree has the more prestigious degree and training in global aspect of health care Learning in complex systems is, itself, complex. Nonlinear systems confound attempts to develop and enforce simple models of cause and effect, and so traditional, hypothetical-deductive methods to explore cause and effect often fail.We know that in the daily life of parenting, marital relationships, and team sports, where â€Å"continual learning and improvement† replaces â€Å"planned experiment† as an approach for gaining knowledge . Even where firm, cause-and-effect knowledge exists in science-based health care the knowledge, for example, that antibiotic A will almost always kill bacterium B the application of that knowledge runs straightaway into the messy world of complex systems.That is, reliably getting the antibiotic safely into the body of a patient with that germ turns out to be a constant challenge as systems fail (the order got lost), unpredicted side effects occur (the patient is on an incompatible other drug), local circumstances become highly relevant (the drug is unfamiliar to the new doctor), and errors multiply (the bacteriological report was on the wrong patient). The fact is frustrating and inescapable: in health care, as in any complex enterprise, the simple, scientific facts lie fallow without continual Adaptation to local contexts.The modern nurse who intends to improve the job effectively needs to be a master of the work So what is the difference and how will it affect the course of a car eer in nursing In today’s nursing world, more is expected from a nurse than following doctor’s orders and starting IVs. The nurse must be able to make critical decisions about a patient’s care, to question the doctor if orders seem inappropriate and to help the patient through, sometimes, difficult life-changing decisions.These skills take an education that is broad based, one that includes critical thinking and exposure to many different people, thought processes, and culture and societal norms. Two year nursing programs do recognize these needs and address them as they can, requiring liberal arts classes to be taken before entering the program and teaching decision making skills along the way. At every level of nursing, the ability to connect with different people, recognize the pressures they face from their personal environment and find value in each is critical.This is a lot to learn against a backdrop of proficiently performed procedures and giving the rig ht medication. BSN  programs offer more education aimed at developing these skills. These programs bolster knowledge about community and public health issues. There is also more attention paid to nursing management, that is, enhancing skills needed to help â€Å"direct reports† do their best work for the patient and the health care organization. Opportunity to refine patient assessment skills and examine more in depth the pathophysiology of diseases, also sets these rograms apart from their two-year program me Nurses who graduate with a BSN degree will find it easier to enter faculty teaching positions, higher level administrative roles in hospitals or other health care environments and State or Federal level government nursing jobs. And for some, these roles are more satisfying, allowing the individual to affect change at a more global level than one-on-one nursing. While it is true an experienced, talented nurse with an AS degree can move â€Å"up the ladder† into management and leadership roles, the Bachelor’s degree can make the climb a little less steep.And, with all this said, there will always be a critical role for the nurse who works directly with the patient, teaching patients about their health care, assuring quality wound management in the hospital setting and observing patients for signs of a worsening condition. Nursing is a huge and welcoming field. It offers a satisfying career path for both AS and  BSN  trained nurses. Whatever path you have chosen in nursing, the essential wisdom is to continue enhancing your skills and education so that your community, your organization and your patients benefit from your broadened view of the world. ConclusionI know personally from being an RN with my associate degree that I do think differently than other RNs. I find myself worrying a lot about the tasks that I need to finish before my shift ends and not looking at the reasons why I am doing things. I watch other RNs getting why they patient is experiencing these symptoms while I am just following orders and treating the patient. I have seen myself start critically thinking on what my patients need and asking the doctors for different things. References Conceptual foundations the bridge to professional nursing practice 5th edition 2011 American Association of college of nursingRobert Rosseter april 2 2012The Future of Nursing: Leading Change, Advancing Health http://www. nap. edu/catalog/12956. html Aiken, L. H. , Cheung, R. B. & Olds, D. M. (2009, June 12). Education policy initiatives to address the nurse shortage in the United States. Health Affairs Web Exclusive. Accessed June 22, 2009 at http://content. healthaffairs. org/cgi/content/abstract/hlthaff. 28. 4. w646 American Association of Colleges of Nursing (2009). 2008-2009 Enrollment and graduations in Baccalaureate and graduate programs in nursing. Washington, DC: Author. Educational Preparation Educational Preparation juli mar Grand Canyon University NRS 430 12-18-11 Educational Preparation There are 2 common, but different, pathways to receiving a RN license. You can earn a bachelor’s degree (BSN) or an associate degree, (ADN). While there are similarities between the two programs, a BSN takes two additional years of college at a university. Both programs teach nursing skills, electives ,science courses, and clinicals. But, the BSN program is a more in-depth study of nursing research, theory, evidence based practice, management, community, and public health nursing. The baccalaureate program gives the individual the added benefit of having more education. â€Å" No matter which type of entry into practice program one chooses, â€Å"the demands placed on nursing in the emerging health care system are likely to require a greater proportion of RNs who are prepared beyond the associate degree or diploma level. (Recreating health professional practice for a new century. , 1998). Even though the BSN has more education, both graduates are held to the same standards of practice. ADN and BSN nurses must pass the NCLEX exam. They have the same patient workload, responsibilities, and the same starting rate of pay. This brings up the often debate, are their competencies any different ? Mildred Montag created the 2 year associate degree after World War II. Several important goals were attained by the AD programs’ success. It helped train registered nurses to help replace baccalaureate nurses in a shorter time. † A new pool of students, including men, married women with children, and older than typical undergraduates, were now able to choose nursing career† (Creasia & Friberg, 2011, p. 1). Montag assumed these nurses would be assistants to the professional nurses, and since there has been a long debate on whether this degree should continue. The conflict is related to the educational level, leadership, and critical thinking skills of the BSN vs. ADN. Many other countries, Canada, Sweden, Portugal, and the Philippines all require a four year BSN degree for entry level RN. I do believe emplo yers in the United States are moving towards a BSN for entry level as they did before the ADN was developed. In 1965, the American Nurses Association (ANA) designated the baccalaureate degree as the educational entry point into professional nursing practice†(Creasia & Friberg, 1965/2011, p. 4). Most employers have a strong preference for hiring a BSN, as nurses continue to expand their roles and are providing more community based care away from the hospital. Society is also changing and patient needs are becoming more complex as they are living longer, have more chronic illness, and technology advancing. These are reasons a BSN is becoming more apparent in our society today. Does having a BSN mean she/he is more competent over the other ADN ? A BSN is better prepared to meet all the patients needs. They can better assist with teaching in the communities, can take a leadership position, function as clinical nurse leaders( charge nurse), has more advanced critical thinking skills, familiar with nursing research, evidence based practice, and theory. Evidence based practice( EBP), means to back up opinions and practices with facts. Basically, the more we think about what we’re doing and why the better nurses we will be. We learned the importance of this from Florence Nightingale, the founder of modern nursing. She used EBP to improve the conditions of hospitals during the Crimean war. She assessed the environment, collected data, identified interventions, and monitored patient outcomes. In less than 6 months her interventions significantly decreased the mortality of soldiers. Nightingale utilized supporting evidence to transform healthcare(Cooper, 2011, p. 1) With her information, evidence based practice became used and appreciated. Nurses need to know what proven techniques and interventions have been found to be most effective. They can only do this by applying evidence based practice, which is better taught at a BSN level. A BSN can continue to expand their role as a RN, using their BSN as a stepping stone towards, nurse practitioner ,nurse midwife, or nurse anesthetist, if they decide to do so. BSN nurses will find it easier to get faculty teaching positions, higher level administrative roles in hospitals and state or federal level government jobs(Forster, 2008, p. 1). In today’s world more is expected from a nurse than ever before. Nursing practice is not just starting IV’s and following doctors’ orders. The public expects care to be delivered by a professional nurse. The RN must be able to make critical decisions about a patients care, to question the doctor if orders seem inappropriate and to help the patient through some times life-changing decisions. This takes an education that is broad based, one that includes critical thinking and exposure to many different people, thought processes, and culture and societal norms. (Forster, 2008, p. 1). ADN usually cost less and takes less time to complete, but isn’t always the best choice if career advancement is wanted. The quality of our patient care is dependent on our education. Both are wonderful paths for anyone pursuing a nursing career and offer excellent pay, job security, and a wide range of work environments and experiences. References References Cooper, C. (2011). Transforming Healthcare through the use of evidence based practice [journal]. Nursing Excellence, 1(1), 1. Retrieved from http://www. childrenscentralcal. org Cooper, C. (2011). Transforming Healthcare through the use of evidence based practice [online newsletter]. Nursing Excellence, 1(1), 1. Retrieved from http://www. childrenscentralcal. rg Creasia, J. L. , & Friberg, E. (2011). Introduction. In E. Mosby (Ed. ), Conceptual Foundations : The Bridge to Professional nursing practice (p. 4). Retrieved from (Original work published 1965) Creasia, J. L. , & Friberg, E. (2011). Nursing in Institutions of Higher Education. In E. Mosby (Ed. ), Conceptual Foundations: The Bridge to Professional Nursing Practice (p. 41). Retrieved from Forster, H. (2008). ADN vs BSN. Retrieved from http://nursinglink. monster. com/education/articles/3842adn-vs-bsn Pew Health Professions Commission. (1998). San Francisco: Author. Educational preparation There are three main avenues for a person to become a Registered Nurse in the United States. There are diploma programs, associate degree programs (AD), and baccalaureate degree (BBS) programs. Graduates from all three of these programs are eligible to take the same licensing exam and obtain the same registered nurse license in their respective states. Many people, nurses included, have often wondered what the difference is in the education these nurses have received.Is it all the same? Is an RAN an RAN no matter what his/her education level? The primary difference between an AD nurse and a BBS nurse lies within the focus of their nursing education. Recent research indicates that baccalaureate programs focus more on care coordination and community health than do associate programs. One source stated that baccalaureate nursing programs historically provide two to three times more clinical training in outpatient settings than associate programs (Feature 2013).Thus, baccalaureate prepar ed nurses are better equipped to work in these alternative healthcare settings and to provide care to patients who eave the hospital and move on to these alternative settings. The associate degree (AD) nurse holds the same license as the BBS nurse. However, the focus of the associate program education is quite different. City University of New York faculty fellow, Maureen Wallace, Deed, RAN, stated, â€Å"Most AD students get an excellent clinical experience but their education has been heavily skills oriented and focused on acute care. (Feature, 2013, p. 3) The associate nurses' education is geared more towards inpatient, hospital based care. Unfortunately for he AD nurses, this puts them at somewhat of a disadvantage in the current healthcare climate. According to Dry. Patricia Banner (2009), more than 50% of all nurses now work outside of the hospital setting. So while AD nurses may have fantastic clinical skills for acute care, they may not possess critical knowledge needed to educate patients on disease prevention, self-care at home, and utilizing community resources.This apparent knowledge deficit and acute care focused training could significantly impact the way an AD RAN responds to a patient need versus how a BBS RAN might respond. This difference could even negatively impact the patient in the future. This can be demonstrated in the fictitious scenario of Mr.. Smith. Mr.. Smith was admitted to the hospital through the emergency room four days ago with complaints of severe abdominal pain and vomiting fecal matter. He was diagnosed with a bowel obstruction secondary to colon cancer and immediately underwent surgery for tumor removal and bowel resection.He was married with two small children. He had lost a significant amount of weight in recent weeks and was extremely weak. Significant differences in the education level between the AD and BBS nurses can be seen in the way each delivered discharge instructions to this patient. Utilizing her skills and a cute care knowledge base, Nurse AD, focused her discharge instructions on post pop pain management, surgical site infection prevention, dietary restrictions, activity limitations, and the importance of keeping follow up appointments with the surgeon and oncologist.She instructed the patient's wife on how to perform the dressing change, and Mrs.. Smith performed a return ministration reluctantly. Mr.. And Mrs.. Smith nodded politely as Nurse AD provided instructions but they did not ask any questions. They both nodded in agreement when she asked if they understood the instructions. Mrs.. Smith signed the discharge instruction form and Nurse AD advised them to let her know when they were ready to leave so she could call for transport downstairs. Mr.. And Mrs.. Smith were very likely completely overwhelmed at this point, having Just received the new diagnosis of cancer.Mr.. Smith was so weak that he could not perform his own Tall's. Mrs.. Smith as wondering how in the world she was goi ng to get him out of the car once they got home let alone how she was going to bathe him and change his dressing with two small children underfoot. This lack of resources, support, and knowledge could put Mr.. Smith at high risk for re-hospitalizing. Since he will not have adequate assistance at home, he is likely to not follow activity restrictions. He may even fall and injure himself due to his weakened condition. Mrs..Smith probably did not retain much of the discharge education and may not be able to consistently perform an septic dressing change. His surgical wound could become infected. If Nurse BBS completes Mr.. Smith's discharge teaching, the scenario could be much different. Nurse BBS also drew from her educational background. However, hers was more focused on care coordination, community health and illness prevention (The impact of education 2014). She began her discharge instructions by assessing the couple's level of understanding and coping as well as the resources ava ilable to them at home.She asked if Mr.. Smith had a wheelchair for transport from his car to his home. She asked if they had a way to raise the head of his bed or if they had a reclining chair that he could sleep in for comfort and ease of movement. Mrs.. Smith responded by replying that she does not have a clue how to operate a wheel chair or where to obtain one and furthermore, she was not sure she was going to be able to take care of him at all. Nurse BBS identified the need for ongoing skilled nursing care and education. She spoke with the surgeon and obtained an order to refer Mr.. Smith to a home health agency.She delayed Mr.. Smith's discharge for several hours until he home health agency could evaluate him and deliver a wheelchair and hospital bed to his home. Mr.. Smith will now receive nursing care at home to manage his wound and to train Mrs.. Smith on aseptic technique for dressing changes. He will also receive education on all aspects of his newly diagnosed cancer and physical therapy to address his weakness and prevent falls. In this scenario, Mr.. Smith is much less likely to return to the hospital because of the nursing education and in home care he received (Beanbag's and Terrain 2000).His wound will likely heal very icily and he will be better prepared to cope with his disease and recovery because he will have received ample education from his home health nurse. He will probably feel less fearful at home because he will still have access to a nurse when he has a need or a question. In both scenarios, the nurses held the same license. They both performed their Job duties well. They both had the patient's best interest at heart. They both utilized the nursing process and interventions to assist the patient during his time of crisis.However, Nurse Abs's interventions were better suited to meet the tangent's needs. Because her nursing education was more focused on community health and outpatient settings, she was better able to assess the patien t holistically and address his immediate and long term needs. Mr.. Smith is much less likely to be re-hospitalized and much more likely to have a good outcome because of Nurse BBS. Educational preparation There are three main avenues for a person to become a Registered Nurse in the United States. There are diploma programs, associate degree programs (AD), and baccalaureate degree (BBS) programs. Graduates from all three of these programs are eligible to take the same licensing exam and obtain the same registered nurse license in their respective states. Many people, nurses included, have often wondered what the difference is in the education these nurses have received.Is it all the same? Is an RAN an RAN no matter what his/her education level? The primary difference between an AD nurse and a BBS nurse lies within the focus of their nursing education. Recent research indicates that baccalaureate programs focus more on care coordination and community health than do associate programs. One source stated that baccalaureate nursing programs historically provide two to three times more clinical training in outpatient settings than associate programs (Feature 2013).Thus, baccalaureate prepar ed nurses are better equipped to work in these alternative healthcare settings and to provide care to patients who eave the hospital and move on to these alternative settings. The associate degree (AD) nurse holds the same license as the BBS nurse. However, the focus of the associate program education is quite different. City University of New York faculty fellow, Maureen Wallace, Deed, RAN, stated, â€Å"Most AD students get an excellent clinical experience but their education has been heavily skills oriented and focused on acute care. (Feature, 2013, p. 3) The associate nurses' education is geared more towards inpatient, hospital based care. Unfortunately for he AD nurses, this puts them at somewhat of a disadvantage in the current healthcare climate. According to Dry. Patricia Banner (2009), more than 50% of all nurses now work outside of the hospital setting. So while AD nurses may have fantastic clinical skills for acute care, they may not possess critical knowledge needed to educate patients on disease prevention, self-care at home, and utilizing community resources.This apparent knowledge deficit and acute care focused training could significantly impact the way an AD RAN responds to a patient need versus how a BBS RAN might respond. This difference could even negatively impact the patient in the future. This can be demonstrated in the fictitious scenario of Mr.. Smith. Mr.. Smith was admitted to the hospital through the emergency room four days ago with complaints of severe abdominal pain and vomiting fecal matter. He was diagnosed with a bowel obstruction secondary to colon cancer and immediately underwent surgery for tumor removal and bowel resection.He was married with two small children. He had lost a significant amount of weight in recent weeks and was extremely weak. Significant differences in the education level between the AD and BBS nurses can be seen in the way each delivered discharge instructions to this patient. Utilizing her skills and a cute care knowledge base, Nurse AD, focused her discharge instructions on post pop pain management, surgical site infection prevention, dietary restrictions, activity limitations, and the importance of keeping follow up appointments with the surgeon and oncologist.She instructed the patient's wife on how to perform the dressing change, and Mrs.. Smith performed a return ministration reluctantly. Mr.. And Mrs.. Smith nodded politely as Nurse AD provided instructions but they did not ask any questions. They both nodded in agreement when she asked if they understood the instructions. Mrs.. Smith signed the discharge instruction form and Nurse AD advised them to let her know when they were ready to leave so she could call for transport downstairs. Mr.. And Mrs.. Smith were very likely completely overwhelmed at this point, having Just received the new diagnosis of cancer.Mr.. Smith was so weak that he could not perform his own Tall's. Mrs.. Smith as wondering how in the world she was goi ng to get him out of the car once they got home let alone how she was going to bathe him and change his dressing with two small children underfoot. This lack of resources, support, and knowledge could put Mr.. Smith at high risk for re-hospitalizing. Since he will not have adequate assistance at home, he is likely to not follow activity restrictions. He may even fall and injure himself due to his weakened condition. Mrs..Smith probably did not retain much of the discharge education and may not be able to consistently perform an septic dressing change. His surgical wound could become infected. If Nurse BBS completes Mr.. Smith's discharge teaching, the scenario could be much different. Nurse BBS also drew from her educational background. However, hers was more focused on care coordination, community health and illness prevention (The impact of education 2014). She began her discharge instructions by assessing the couple's level of understanding and coping as well as the resources ava ilable to them at home.She asked if Mr.. Smith had a wheelchair for transport from his car to his home. She asked if they had a way to raise the head of his bed or if they had a reclining chair that he could sleep in for comfort and ease of movement. Mrs.. Smith responded by replying that she does not have a clue how to operate a wheel chair or where to obtain one and furthermore, she was not sure she was going to be able to take care of him at all. Nurse BBS identified the need for ongoing skilled nursing care and education. She spoke with the surgeon and obtained an order to refer Mr.. Smith to a home health agency.She delayed Mr.. Smith's discharge for several hours until he home health agency could evaluate him and deliver a wheelchair and hospital bed to his home. Mr.. Smith will now receive nursing care at home to manage his wound and to train Mrs.. Smith on aseptic technique for dressing changes. He will also receive education on all aspects of his newly diagnosed cancer and physical therapy to address his weakness and prevent falls. In this scenario, Mr.. Smith is much less likely to return to the hospital because of the nursing education and in home care he received (Beanbag's and Terrain 2000).His wound will likely heal very icily and he will be better prepared to cope with his disease and recovery because he will have received ample education from his home health nurse. He will probably feel less fearful at home because he will still have access to a nurse when he has a need or a question. In both scenarios, the nurses held the same license. They both performed their Job duties well. They both had the patient's best interest at heart. They both utilized the nursing process and interventions to assist the patient during his time of crisis.However, Nurse Abs's interventions were better suited to meet the tangent's needs. Because her nursing education was more focused on community health and outpatient settings, she was better able to assess the patien t holistically and address his immediate and long term needs. Mr.. Smith is much less likely to be re-hospitalized and much more likely to have a good outcome because of Nurse BBS.