Differences in Nurse Competencies: Bsn Versus Adn

Differences in Nurse Competencies: BSN versus ADN

Erica J. Peuschold

Grand Canyon University

NRS-430V

Why is there a debate regarding the difference in the educational preparation of nurses?  The professions of medicine, dentistry, law and pharmacy all use the baccalaureate degree as the minimum entry level in to their profession.  It is vital to the progression of nursing as a profession to come together on this emotionally charged debate.  If you walk down the hall of any hospital in the United States and polled the nurses, you would likely find a potpourri of educational levels.  Let’s explore the differences in competencies between nurses based on their degree level.  Aiming for the baccalaureate degree to be the minimum entry in to the profession should be the goal of all nurses currently practicing.  In order to demand respect for all we do, we must all be educated to a higher level.  

The inception of the Associate Degree Nurse (ADN) began in 1952.  According to Creasia (2011), “…intent was that nurses with associate degrees would work under the direction of registered professional nurses who were prepared at the baccalaureate level.”  The associate degree level of nursing was developed out of a need to produce nurses in response to a shortage during and following World War II. The ADN was not intended for long term use by the nation as a stop gap to fill the shortage of Bachelor of Science in Nursing (BSN) prepared nurses.  It is proven that the rate at which the National Council Licensure Examination–Registered Nurse (NCLEX-RN) is passed does not vary greatly among the educational level of the nurse, (Fulcher, R. and Mullen 2011).  The American Association of Colleges of Nursing, Fact Sheet: Creating a More Highly Qualified Nursing Workforce, states “the NCLEX-RN tests for minimum technical competency for safe entry into basic nursing practice”.  Most patients today are highly complex with multiple comorbidities.  They require more than the minimum in competency.  Baccalaureate prepared nurses are more likely to utilize Evidence Based Practice (EBP) to guide their patient care.

The Institute of Medicine writes “The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century.” (page 1).  With the rise in complexity and demands of patient care, it is imperative that baccalaureate prepared nurses are the front line of nursing.  BSN prepared nurses are trained to care for and manage all patient’s across the spectrum of health care settings.  While, ADN nurses are technically competent and have for decades provided excellent nursing care to patients, the need for general nursing beyond the hospital ward is ever present.  ADNs function primarily at the bedside in the modern hospital setting while BSN prepared nurses are being utilized to provide more complex aspects of daily care, leadership and mentoring roles and patient education.