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Competency Differences Between Adn And Bsn

1145 words - 5 pages

Competency Differences between Associate and Baccalaureate Nurses
Scott Dickinson R.N.
Grand Canyon University
NRS-430 V
May 12, 2012

Competency Differences between Associate and Baccalaureate Nurses
Becoming a registered nurse involves attending college and graduating from either an Associate’s degree program, taking typically 3 years, or a Baccalaureate program, typically 4 years. Both degrees require the graduate to pass the NCLEX-RN exam. The percentage of nurses passing the NCLEX-RN is statistically insignificant regardless of program type- associates vs. baccalaureate. The NCLEX-RN exam tests for the minimal amount of skills the individual must have for safe practice. It ...view middle of the document...

In the hospital setting, the baccalaureate nurses has had notable impact on lowering patient mortality, failure to rescue rates, and generally are associated with better patient outcomes (Kendall-Gallagher, 2011, January). A study in 2008 shows a significant link between a registered nurses level of schooling and patient outcomes. The study revealed that for every 10 percent increase in the number of baccalaureate nurses on staff, there was a 4 percent decrease in patient deaths (Aiken, 2008, May). The above study is supported by research done at the University of Toronto showing baccalaureate trained nurses having decreased 30 day patient mortality rates. Statistically this worked out as follows: for every 10 percent increase in baccalaureate trained nurses there were 9 fewer deaths for every 1000 discharged patients (Giger, 1990).
In 1996 two individual studies (State of New York and State of Texas) showed marked increases in medication errors when administered by associate degree nurses or diploma nurses. Additionally, more procedural infractions were noted by these two groups when compared to the baccalaureate prepared nurse (Fagin, 2001).
Chief Nurse Officers (CNO) show preference to hiring nurses possessing a baccalaureate degree. Seventy two percent of the CNO’s indicated the baccalaureate nurse has superior critical thinking and leadership skills (Goode, 2001).
For example, I can see the following scenario in my mind regarding the potential differences in the decision/critical thinking aspect between an associate degree trained nurse and a baccalaureate trained nurse. The patient is in his early seventies, hx of hypertension, Type II diabetes, obesity, moderate dementia. Patient was admitted to the hospital for fever of unknown origin x2 days, 101- via temporal scanner, which is responsive to antipyretics that have been ordered. The spouse reports just getting over a viral infection herself that caused her some fever and chills. There is a left shift on the CBC with slightly elevated white blood cell count. The patient’s dementia, per the family, gets worse when his fever increases. The patient frequently moans, but has been poor to vocalize appropriate responses to medical staff questions. The CXR done in the emergency department is not revealing, the other labs tests were essentially negative. Physical exam reveals decreased lung sounds bilaterally in lower lobes but no appreciable adventitious lung sounds. The emergency department attempted to get urine but the patient was incontinent, the floor has an order to obtain urine for UA but per infection control no Foley catheter to be placed as patient is able to...

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