Nursing is a field that has always been about caring for people and doing what’s right by the patient. Nursing’s ethical principles have remained a constant; to do for the good of the patient, to do no harm, to support a patient’s autonomy, and to be faithful, just, and truthful. These principles are the pillars of nursing and will remain a constant over generations of new nurses. But looking back into the history of the most trusted profession, it has come a long way and truly morphed into a job and lifestyle that is almost unrecognizable in every positive sense than when Florence Nightingale laid its foundation.
Dawn Papandrea (2016) with Nurse.org outlined in her article “Nursing Is In Transformation and That’s Good For Nurses” that nursing has transformed through the influence of technology, the growing areas of education, specialization, and independence of each practitioner, the size of a nurse’s knowledge base, and the nurse’s overall role in the care team (Papandrea, 2016).
Nursing has transformed the treatment of patients through empowering and educating them about their health and lifestyle. One could look through the history of how patients in the beginnings of medicine were treated and liken it to a horror film, especially psychiatric patients and in the instances of research conducted on women of color. Nursing has come to support being a powerful patient advocate and built a culture that defends the total autonomy of the individuals we treat.
Nurses are educated and empowered through a knowledge base vaster than ever before and this knowledge is still growing. Yet the formal education of nurses that takes them to the point of being eligible for taking the standardized National Council Licensure Examination could take a few different paths, the Associate of Science in Nursing (ADN) and the Bachelor of Science in Nursing (BSN).
Although a bachelor’s prepared nurse goes through the same clinical hours and takes the same core courses, they have a curriculum that contains more in-depth material pertaining to management, public health, research, and the general education requirements of 4-year institutions.
Kristina Ericksen (2016) writer and researcher with Rasmussen College explored the differences in these pathways in her article “ADN vs. BSN: Your Guide to Help You Decide on a Nursing Degree.” She said BSN programs have an “emphasis on public health, management and leadership, nursing research and physical and social sciences… meant to provide students with more professional development and a heightened understanding of the issues affecting patient care and healthcare delivery” (Ericksen, 2016).
ADN and BSN prepared nurses share the same responsibilities and privileges, and, on the floor, their scope of practice is identical. However, it should be noted that nurses with a BSN degree have more opportunities in leadership, educational, and administrative offices. Ericksen went on to explain that the “BSN also can open doors for leadership and management positions. Some nursing specialties, like public health, nurse education and nurse research also require a BSN” (Ericksen, 2016).
The debate and comparison between ADN and BSN prepared nurses is heated, but one degree is not less than the other. Not many studies have been conducted regarding the differences in patient outcomes of nurses that have one degree vs. the other. One of the few studies was published in The Lancet co-authored by Linda Aiken, PhD (2014). This study concluded that, “patients in hospitals in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients” (Aiken et. al., 2014). At this point in time, researchers are unable to answer the why question regarding the reasons for these differences in outcome to due to lack of data.
A laymen’s conclusion could extrapolate that perhaps the more well-rounded mind of the BSN nurse can think more systematically in crucial moments of care due to the rigorous and intensive curriculum they endured in academia. Perhaps the BSN nurse has been more conditioned and groomed for critical situations.
If one is of the mind that the BSN nurse is better equipped to care for patients based off of the study in The Lancet, this degree could be a new evidence-based requirement for practice in the field of nursing. The BSN nurse’s education in evidence-based practice gives them an advantage over the ADN nurse because of their in-depth understanding of research and its application to promote better patient outcomes. Evidence-based practice is universally understood to be the most effective route of care for all patients, and yet the ADN degree in nursing does not address the topic of research and its application to patient care beyond an elementary understanding. It remains without the rigor and academic exploration provided by the BSN degree.
The imperative contributing to positive patient outcomes and holistic care is interdisciplinary communication. Nurses are the link in this chain of collaboration that see the patient the most over the course of their treatment and the information the nurse provides the rest of the care team is vital to the health and success of the patient. Each piece of the patient care team is as important as the next, without one link, the chain breaks and the care of the patient is compromised. Nurses use their role to keep the entire team up to date on the patient’s status and wishes in a way no other team member can. The nurse is the eyes, ears, and advocate, bringing the patient’s concerns and the big picture overall assessment that offers the clinical data necessary for holistic treatment. The nurse lubricates the operations of each part of the care team machine; informing the provider of a change in condition, assisting laboratory services with a blood draw on a confused patient in order to result critical information in a timely manner, ensuring with pharmacy that all medications are profiled correctly for the patient’s individual needs, and assisting the nursing assistant staff with skin care by turning patients every two hours. The areas of care that the nurse is involved is an endless list with each part no less important to the outcome of the patient than the last.
The evolution of the nursing profession, it’s changes in educational structure and as a consequence, its influence on patient outcomes has transformed the future for patients and their caregivers alike to ensure the only constant will be change and positive change at that. Nursing will ever look to evidence-based practice to guide the transformation of holistic care for the betterment of patients and their care team.
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