May 22, 2011
There are different routes in becoming a Registered Nurse. There is the 2-3 year Associate degree level (ADN), which can be obtained at a community college, and there is the four year baccalaureate degree (BSN), which can be obtained at a university. In both routes after finishing the program the candidate needs to take the licensing examination test called NCLEX-RN. When making a decision of what route to take the difference in competencies need to be taken into consideration. Differences include level of knowledge, skill preparation, and clinical judgment.
A BSN degree nurse has a more comprehensive knowledge base than those who have an ADN. ...view middle of the document...
Lack of problem solving from the ADN can result in a negative patient outcome. In addition, BSN nurses possess stronger communication skills than ADN nurses which allow them to not only communicate but to listen and interact better with patients, patient’s family, communities, and diverse populations. BSN nurses are able to communicate effectively in a verbal, nonverbal, written, or electronic matter without forgetting to take into consideration culture, level of education, and social environment of the patient and their family (“UMKC “2011). Incorporating problem solving skills and communication skills will help a BSN nurse evaluate patient’s outcome.
One of the big differences between BSN and ADN is that BSN is trained to develop more clinical judgment, which is an essential component to a nurse. It is essential for delivery in nursing care. The website UMKC states that “Professional judgment is the outcome of critical thinking in nursing practice. Which incorporates decision-making processes that involves evidence and reason to facilitate the evaluation of outcomes and goals” (2011). Nowadays clinical judgment is referred to as nursing process model of practice. In this model nurses will solve a problem by using assessment and nursing diagnosis, planning and implementing nursing interactions, and concluding with the evaluation of such interactions (Tanner, 2006). Being able to follow the nursing process model of practice shows how a BSN educational preparation will help the nurse function with more independence in obtaining success when making clinical decisions. It becomes hard for the ADN to incorporate clinical judgment in their practice due to the limitation in their educational preparation.
A few months ago I was involved in a patient care situation where I believe the patient’s outcome was negatively affected due to lack of formal education and critical thinking by the ADN nurses. A 22 year old was admitted to the orthopedic unit from the ED with multiple trauma due to a motorcycle accident. He was found to have fractured ankle, fracture ribs, wound to right hip area, and incidentally found to have new onset diabetes. Patient stayed a few days in the hospital since blood sugar levels were out of control requiring insulin sliding scale. Pain management and ambulation with crutches was also a concern due to rib pain and ankle fracture. Planning for discharge the case manager knew patient was returning to his apartment which he shared with two friends his age. Case manager was concerned about setting up home health for diabetic teaching, dressing changes, physical therapy and also to arrange a taxi voucher since patient stated he had nobody to take him home. The primary care nurse’s concern was that since the diabetic nurse educator was off the day of discharge the patient needed to learn how to inject insulin. Before going home the primary nurse documented...