As a proficient professional, a Registered Nurse (RN) should take responsibility for own personal, educational, and professional growth as a healthcare provider to perform the comprehensive scope of ever-evolving nursing practice for highest patient outcomes. As X. Malcolm stated, “Education is the passport to the future, for tomorrow belongs to those who prepare for it today” (BrainyQuote, n.d.). Correspondingly, the nurses’ educational growth is very crucial to their personal and professional growth. There are two pathways to begin as a registered nurse: Associates Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN). A student can opt for ADN or BSN degree and pass National Council Licensure Examination-RN, but his or her title remains same: Registered Nurse. BSN empowers a student nurse with critical thinking, communication, management, leadership skills as well as a better understanding of a variety of aspects of the patient care like physical, psychological, social, political, economic, cultural, public health, wellness, community nursing to face present and future healthcare demands or challenges.

Associate Degree Education

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            ADN is a two-years nursing program that incorporates a balance between courses in natural, social, behavioral sciences, and nursing. ADN consist of about 70 credit hours with most of the requirements in nursing courses. It equips the student nurses with the fundamental set of technical and clinical skills necessary to provide an adequate bedside patient care in the secondary healthcare settings like skilled nursing facilities, long-term care facilities, and community hospitals. An ADN graduate performs simple nursing care, recording patient symptoms, and medical history, supporting the family, educating patients on diseases or diagnoses, working in close consultation with doctors, or using and managing simple medical equipment (Nightingale College, 2017). This program is beneficial for a student who cannot afford the school or residential expenses for an extended period. An ADN nurse can acquire the BSN degree through an RN-to-BSN program, spending less money and time to enter the nursing workforce.  

Bachelor’s Degree Education

BSN is a four years program from the senior colleges and Universities that incorporates approximately total 120 credit hours from liberal arts and natural, social, and behavioral science courses and nursing courses, with the emphasis on leadership, management, evidence-based practice, nursing research, informatics, quality care and patient safety. BSN graduates are prepared to give and direct care for the patients, families, populations, and communities experiencing complex and volatile health care needs in an organized or unorganized setting.  It is a bigger investment of time and money as compared to ADN, but it opens doors for a wide range of jobs like management positions, insurance carriers, nurse educators, case managers, nursing researchers, and nursing specializations like public health, pediatrics, geriatrics, oncology, etc.

Research on Competencies

There are multiple studies reflects BSN nurses as more competent and versatile nurses who can assume a role of innovator, patient advocate, case manager, patient educator, discharge planner, and collaborative leader.

Mbewe and Jones (2015) presented a study including fifty graduates from the New York City ADN programs to answer the questiones on respondent’s characteristics, educational preparation, perceptions of his or her skills to assume the leadership or management role. Eighty-four percent respondents did not feel comfortable with their leadership skills due to lack of professional identity and preparation for leadership roles in the nursing due to increased nurse-to-patient ratio, patient care complexity and acuity, and shortened clinical rotations (Mbewe & Jones, 2015). 

The second study included twenty-one University Health System Consortium hospitals to analyze the relationship between RN education and patient outcomes, controlling nurse staffing and other hospital factors influencing the patient care, and concluded that the healthcare facilities with a substantial proportion of BSN or higher educational degrees experienced the shorter hospital stay as well as lower rates of postoperative blood clots, pressure ulcers, and congestive heart failure mortality rate (Belgen et al., 2013).

 Another study demonstrated a compelling relationship between RN education level and patient outcomes, claiming that each ten percent increase in the proportion of BSN graduate RN drops the risk of failure to rescue and patient mortality by five percent (Zittel et al., 2016).

Approach to Care

According to Rosseter (2014), BNS provides a better understanding of evidence-based nursing practice and nursing metaparadigm that changes nurses’ approach to care. For example, an Eighty-years-old male patient with a recent diagnosis of liver cancer on Medical-Surgical unit. Both ADN and BSN graduate working on that unit provide symptomatic care for pain, nausea, vomiting, breathing issues, insomnia, or other physical issues related to cancer and its treatment; patient education and support. This patient’s care also includes an age-appropriate care; guidance for making treatment decisions; support for social, emotional, and spiritual needs; support for caregivers, family, and friends; communication with patient’s doctors, social worker, billing department, and other healthcare providers as needed. BSN prepares nurses to assume the role of a case manager, educator, patient advocate, and utilize skills of problem-solving, decision making, evidence-based practice, communication, critical, and analytical thinking in such cases.

Conclusion

ADN and BSN are stepping stones to enter the healthcare field as a registered nurse. BSN opens access to a broad range of career opportunities and advance-nursing programs. As Martin Luther King (BrainyQuote, n.d.) stated, “The function of education is to teach one to think intensively and to think critically. Intelligence plus character – that is the goal of true education.” Similarly, BSN provides knowledge and tools for nurses to achieve nursing goals and manage current and upcoming challenges in the ever-changing and the evolving healthcare system and culturally diverse population with the ever-changing needs. ADN nurses can pursue BSN degree while working and earning as a registered nurse to overcome two major barriers to continuing education and achieving proficient professional identity.