Nursing care of ADN vs BSN

[AKarpi]

Hi everyone! This is my first post and I have question I need help with. I am currently obtaining my BSN, however, have been working as a home care nurse and don't have a lot of experience with the following scenario. Your experiences are greatly appreciated!

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).

Thanks much!

[Angeljho, MSN, NP]

Countries around the world are moving to create a more highly educated nursing workforce. Canada,Sweden, Portugal, Brazil, Iceland, Korea, Greece and the Philippines are just some of the countriesthat require a four-year undergraduate degree to practice as a registered nurse.

I cut and pasted the above excerpt from the article because I wish to point out that while this is true, what this article fails to mention is that in most of these countries, the model for nursing care heavily utilizes what we would call "technical nurses" in their nursing care models. In Canada, LPNs are used far more extensively in acute care than they are in the USA. In most of Europe, their equivalent of our BSN RN preside over teams of "auxiliary nurses" who provide the lions share of bedside nursing care. In Australia, the equivalent of LPN is the "Enrolled Nurse", and these ENs are used extensively in acute care at the bedside, with RNs functioning in a largely supervisory role.

Yes, in most countries, the educational requirement for the actual designation of "registered nurse" has become a four year degree. But this does not necessarily mean that the amount of care patients receive from such degreed individuals has increased, or is higher than currently in the U.S. When the minimum educational requirement for RN becomes a BSN (or equivalent), hospitals eventually adjust by relinquishing duties formerly provided solely by nurses to unlicensed personnel (think: the increased role of "techs" in the US), or by increasing the scope of practice of lesser educated "basic nurses" (think: the expanded scope of LPNs in Canada after the BSN-only became law there).

In other words, what I am trying to say, is that making the BSN the sole entry to practice may not have the results its supporters intend. It may just push the RN role further away from bedside care, and fill the vacuum with unlicensed techs and/or with some sort of practical nurse equivalent.

I wouldn't want the BSN to be the entry-level for RN practice. I received my associates in nursing and then went for my BSN later. That pathway would have not been possible if the BSN was the entry-level for RN practice. I believe ADNs are necessary at this point in time. However, I do not believe ADNs and BSNs are the same. Education matters. Education creates a more well-rounded nurse.

Also, I'm speaking in terms of nurses who soley have their associate or bachelor degree in nursing. Individuals who hold a previous degree in another area and then get their associate or bachelor degree in nursing is a different case entirely.

[BrandonLPN, LPN]

ADN education and BSN education are obviously two different things. One is an bachelor's degree and one isn't.

But the licensure and scope of practice those two educations result in is exactly the same thing. No difference whatsoever. And that's really always been the crux of the issue, hasn't it?

Instead of basing the conversation around the premise of "ADNs are under-educated for their role", perhaps we should shift the conversation to "BSNs are over-educated for theirs". Perhaps it's time for a new tier of professional nursing, and an expanded scope for the BSN prepared RN.

[elkpark]

In other words, what I am trying to say, is that making the BSN the sole entry to practice may not have the results its supporters intend. It may just push the RN role further away from bedside care, and fill the vacuum with unlicensed techs and/or with some sort of practical nurse equivalent.

Or maybe that is the result its supporters intend ...

[Angeljho, MSN, NP]

Instead of basing the conversation around the premise of "ADNs are under-educated for their role", perhaps we should shift the conversation to "BSNs are over-educated for theirs". Perhaps it's time for a new tier of professional nursing, and an expanded scope for the BSN prepared RN.

Now, I can honestly say I have not considered this point of view. You may be on to something Mr. BrandonLPN.

[LadyFree28, BSN, LPN, RN]

You can click 'unlike' whenever you accidentally 'like' a post.

Not on my iPhone app; but thanks for pointing out something I already know. :)

[BrandonLPN, LPN]

Not on my iPhone app; but thanks for pointing out something I already know. :)

I was kind of wondering how you could have been here so long without knowing about that. :)

[smartnurse1982]

The ADN works in a nursing home, and the BSN works in acute care.

I know in MY area,this is becoming a reality.

It seems to be going this way..

Bsn are working in acute care; Adns are being pushed out.

Adn's are working in LTC,home health,and other non-acute care roles.

Lpn's are being pushed out of these places now.

I have seen ads for hospitals with" Must have Bsn".

I have seen ads for LTC wanting Rn's only.

[nursel56]

The funny thing about the acute care-chronic care battle is the pro-BSN group that published a biased jargon-laden report in 2010 makes a big hoopla about how patient care will increasingly be delivered in community-based settings, focused on chronic diseases and geriatrics.

[VANurse2010]

ADN education and BSN education are obviously two different things. One is an bachelor's degree and one isn't.

But the licensure and scope of practice those two educations result in is exactly the same thing. No difference whatsoever. And that's really always been the crux of the issue, hasn't it?

Instead of basing the conversation around the premise of "ADNs are under-educated for their role", perhaps we should shift the conversation to "BSNs are over-educated for theirs". Perhaps it's time for a new tier of professional nursing, and an expanded scope for the BSN prepared RN.

Bingo. You do not need a BSN to assess, give meds, and clean up bodily fluids. I say this as a college-educated person with a degree in something much harder than nursing. the BSN was *never* intended to be the entry level *bedside* degree. That's why I call it degree inflation.

[smartnurse1982]

The funny thing about the acute care-chronic care battle is the pro-BSN group that published a biased jargon-laden report in 2010 makes a big hoopla about how patient care will increasingly be delivered in community-based settings, focused on chronic diseases and geriatrics.

Are the pro Bsn groups also pushing for Bsn educated nurses in non-acute care roles?

I have not found any information yet on this.

[nursel56]

Sorry in advance for the long post!

Are the pro Bsn groups also pushing for Bsn educated nurses in non-acute care roles?

I have not found any information yet on this.

Not yet pushing for it, but mostly I think they included that in their report as a Plan B for when acute-care jobs dry up. This is a little section of the report:

Most health care today relates to chronic conditions, such as diabetes, hypertension, arthritis,cardiovascular disease, and mental health conditions, due in part to the nation's aging population and compounded by increasing obesity levels. While chronic conditions account for most of the care needed today, the U.S. health care system was primarily built around treating acute illnesses and injuries, the predominant health challenges of the early 20th century

Then they said BSNs are needed for patient care in the 21st century, the reason being the increasing complexity of medical technology and new patient information management systems, as opposed to "rote memorization" in non-BSN nursing education today.

In another part of the report they strongly encourage facilities to foot the bill for training that used to be part of nursing programs by way of nurse residencies.

They also strongly encourage the residencies sponsored and paid for by long-term care or other employers who mostly hire ADNs and LPNs these days.

...they (nurse residencies) also need to be developed and evaluated outside of acute care settings to accommodate the coming shift of care from hospital to community-based settings and the need for nursing expertise in chronic illness management, care of older adults in home settings, and transitional services.

I think they're accommodating the coming shift of jobs, not shift of care.

[BostonFNP, APRN]

Instead of basing the conversation around the premise of "ADNs are under-educated for their role", perhaps we should shift the conversation to "BSNs are over-educated for theirs".

If the BSN was "over education" wouldn't the research show that outcomes were the same regardless of the degree?

Sent from my iPhone.