Modern nursing began with Florence Nightingale, but has evolved over the years to become a rich history that includes advances in education of nurses, thus forming three entry level of nursing, Diploma, Associate and Baccalaureate of nursing. This discussion will address the difference in competencies between the associate degree and Baccalaureate degree nurses. The ADN program was started to facilitate the need of nurses in the post war years.
This is a two years program that teaches the nurse to provide comfort the physiologic stability and peaceful death. (Yoder 2010). This program was also seen as an ideal course for those who prefer a faster and inexpensive route of becoming a registered nurse. Even though the bedside practice of the ADN and BSN nurses are similar, the ADN nurse focuses on the practical assistance more than the theory. The difference in competencies can be seen in the extra two years required for the BSN program.
These graduates are exposed to more prerequisites theory, leadership management, research and community based health courses. (Spensor 2008). They are more prepared for the ever changing heath care field because their main focus, are evidence based practice. They are taught to think independently, use judgment, critical thinking, reasoning and decision making skills, to understand the situation at hand before providing care, and by utilizing these skill they are better able to work within interdisciplinary team and have better patient care outcome.
An example of this was observed in a patient care situation on a med surgical unit, where the ADN nurse was taking care of a patient with history of uncontrolled diabetes and hypertension who was about to be discharged. His blood glucose was regularly monitored, medication was dispensed appropriately and she made sure that he was receiving the appropriate diet tray from the kitchen. However when his call light was answered by the BSN nurse she noticed that he had a packet of potato chips and some cookies on his bedside table that was open.
She addressed his need, then told him that she noticed the cookies and potato chips at his bedside, which he admitted to be snacking on, and added that the cookies were sugar free and chips were not very salty and that was all he could really afford. The BSN nurse was able to address the situation at hand and was able to teach the pt that even though a packet may read sugar free did not mean it was ok to have. Since it can be loaded with carbohydrates, which break down into sugar.
She then collaborated with interdisciplinary team of dietician and social services to prepare this patient for discharge, where this patient and his family were taught how to comply with his diet, by learning how read labels, choose foods, and the important of doing so. Social services ensure that he was provided with the information of community based resources in his neighborhood that will attend to his financial as well as his social needs.
Even though the ADN nurses bedside nursing was appropriate, it was clear that the two extra years of understanding the concept behind the skills separated a nurse that use critical thinking from one that performed task. In response to the ever changing healthcare system a higher degree of nurses are sought. Therefore the nursing programs help to equip graduates to provide excellent and holistic care while encouraging them to achieve lifelong quest for knowledge and the pursuit of advance professional degree.