There are two major educational pathways to become a Registered Nurse (RN): an Associate Degree in Nursing (ADN) and a Bachelor’s of Science Degree in Nursing (BSN). Typically, an ADN degree takes 2 years to complete while a BSN degree takes 4 years to complete. Both allow the nursing graduate to take the National Council Licensure Examination (NCLEX) consequently allowing the graduate to enter the field of nursing as a Registered Nurse. It is important to discuss and understand the differences in educational preparation as well as resulting competencies for both degrees. Prospective nursing professionals are advised to weigh the advantages and disadvantages of enrolling in either program of choice. Both degrees are a wonderful path to nursing but with a BSN degree, opportunities for advancement are greater and graduates are better prepared to handle the multifaceted nursing demands in today’s society.
The ADN program was developed due to the severity of the nursing shortage during the postwar years allowing prospective nurses to graduate at a faster rate (Creasia, 2010, p. 15). This program is usually a 2-year program offered by community colleges, technical schools and nursing schools. According to the American Nurses Association (2005), the ADN degree prepares nurses for roles that are based on nursing theory and technical proficiency. What this translates into is a program that focuses more on clinical and technical skills rather than nursing theory. The ADN degree offers several advantages and these include: earning a nursing degree at a faster rate, potential to earn money more quickly and affordable college tuition. The ADN degree has disadvantages and these include: degree can take up to 3 years to complete depending on program requirements, scope of practice is not what original founder had originally envisioned and patient care may be affected due to complexities and co-morbidities in our patient population (Creasia, 2010, p. 16).
According to Creasia (2010), “The first baccalaureate nursing program was established in the United States at the University of Minnesota in 1909” and many programs were 5 years long (p. 4). Today, the BSN program is a 4-year college degree offered at universities, private schools and community colleges throughout our nation. The BSN degree graduate has many advantages over an ADN degree graduate and these might include: career paths that are only open to nurses with a BSN degree including administrative positions and minimum requirement for advanced practice nursing (APN). Furthermore, the BSN graduates get extensive training in components that might include: quality and patient safety, evidence-based practice, information management, clinical prevention/population health, and professional values, all of which are essential as nursing care becomes more complex (Creasia, 2010, p. 4). One of the biggest disadvantages of having a BSN degree is that the legal scope of practice is undifferentiated due to being awarded the same license as an ADN graduate “hindering the reward system for leadership responsibilities” (Creasia, 2010, p. 16).
Conversely, the main difference between an ADN and a BSN degree is the emphasis on leadership and management, wellness, and community nursing. Equally important, as noted by Ellis (2006), “BSN prepared nurses possess greater knowledge of health promotion, disease prevention, and risk reduction as well as illness and disease management and are prepared to assist individuals, groups, and communities to prevent disease and achieve optimum levels of wellness”. As we have seen, studies show that nursing education level plays a factor in patient safety, quality of care, better patient outcome and lower mortality rate (Rosseter, 2005). This validates that nurses with BSN degrees possess greater critical thinking skills, better problem solving skills and advanced clinical judgment skills; three skills of extreme value for the upsurge in acuity of patients in hospitals and other health care settings. Consequently, AACN (2005) is promoting BSN degrees for entry into professional nursing practice to create a highly educated nursing workforce due to the complexities amongst our patient population.
As stated above, differences between ADN degree and BSN degree are relevant in patient care and consequently have an impact in outcome. It is safe to say that an ADN degree will equip the nurse with the fundamental set of skills necessary to provide adequate patient care. The emphasis of patient care for an ADN nurse centers on interventions and goals necessary for recovery while in the acute care setting. On the other hand, BSN degrees prepare nurses more effectively by providing a better understanding of theory and evidence-based practice, all of which translate to better patient care and outcome. It is important to note the emphasis BSN degrees place on community health and how this plays a significant role in bedside patient care. The application of this degree in patient care is evident in the plan of care since it includes goals that are driven by post-discharge and health promotion. Also, the BSN nurse will place priority on patient education, which is key to fostering health amongst diverse communities. Knowledge is a powerful tool in the midst of numerous community-acquired diseases and the role that a BSN nurse plays to lower infection rates is crucial.
In short, nursing is a very dynamic profession and the types of patients that we are seeing in a medical surgical unit would have been in intensive care unit 5 or 10 years ago. Nurses are now required to develop independent clinical judgment for the reason that taking care of patients has become increasingly challenging and the general population is now, more than ever, involved in their care. Moreover, by nurses continuing their education and being proactive on their educational development will help nursing professionals stay up to date with the increased complexity of the healthcare needs of today and even the future. The needs of our patients are constantly changing and we must change to stay current with the increased complexity of the healthcare needs of today and in the years to come in order to better serve those in need. The healthcare industry is currently undergoing a transformation with the healthcare reform and as advances in technology and emphasis on quality care improvements are on our way, this will bring about rapid change. As nurses, having the necessary tools, including higher education, can help provide the best patient care possible along enhanced patient outcomes. This should empower the nursing professional to grow into a career where flexibility, job satisfaction and fascinating field will ensure competent care to culturally diverse patient population.