The IOM Future of Nursingreport recommends that hospitals have 80% of their RN’s at a BSN level by 2020 (American Nurses Association (ANA), 2019). This recommendation is indicated due to research. Research has shown that there is an improvement in patient outcomes and professionalism when the facility employees more nurses at a BSN level than ADN level (ANA, 2019). Additionally, the report indicated that BSN nurses are more equipped to handle the increasing complexity of nursing (Schneider, 2016). Obtaining a BSN expands upon the education obtained at the ADN level. The BSN program expands upon basic skills and teaches nurses how to practice evidence-based nursing, advanced critical thinking, increased comfortability with autonomy, management and leadership, communication, and additional cultural sensitivities.
According to Blegen, Goode, Park, Vaughn, and Spetz (2013), a study titled “ Baccalaureate Education in Nursing and Patient Outcomes,” used a cross sectional approach from 21 different University Health System Consortium hospitals. The objective of this study was to examine if nurse sensitive outcomes improved in the hospitals where there was a higher proportion of BSN nurses. The results of this study showed that hospitals with BSN or higher level RN’s had lower CHF mortality, postoperative DVT/PE’s, decrease length of stay, failure to rescue, and decreased decubitus ulcers. The recommendation from the Future of Nursing for 80% of nurses BSN by 2020 was supported by this study (Blegen, et al, 2013).
Personally, the writer would agree with the information above. This can of course be different based on experience and the individual nurse. I would always agree with the more education the better prepared the individual will be. The BSN nurses the writer has encountered have been calmer, showed advanced critical thinking and creative intelligent solutions, advanced skills, and better communication with team members.
American Nurses Association, (ANA). (2019). IOM Future of nursing Report. Retrieved from https://www.nursingworld.org/practice-policy/iom-future-of-nursing-report/
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalaureate Education in Nursing and Patient Outcomes. JONA: The Journal of Nursing Administration, 43(2), 89-94. doi:10.1097/nna.0b013e31827f2028
Schneider, A. (2016). Driving Factors Behind the 80% BSN by 2020 Initiative. Retrieved from https://www.rn.com/headlines-in-health/driving-factors-behind-the-80-percent-bsn-by-2020-initiative/
According to a study that gathered data from 21 University Health System hospitals, it was determined that those hospitals that were staffed with a higher percentage of BSN nurses had lower incidences of CHF, HF, decubitus ulcers, failure to rescue, pulmonary embolisms, post-op DVT, and shorter hospital stays (Blegen, 2013). According to another study that collected data from patient care units, results were that units with more BSN nurses had lower patient falls and medication errors (Blegen, 2001).
Based on life experiences, I would have to disagree with this research. Some of the best nurses that I know are ADN nurses, and I would trust them with my life. I believe that ADN nurses are prepared in the more hands on training and skills training and BSN nurses are prepared to be able to manage and supervise others. I feel that RNs, whether ADN or BSN, possess those critical skills needed to make on the spot decisions, that could potentially save lives. So, in my opinion, I do not feel that it is the skills of these nurses that affect patient safety, rather, it is the high number of patients to nurse ratio and burnout that influence the errors, that occur whether the nurse is ADN or BSN prepared.
Blegen, M.A, et al. (2001). Nurse experience and education: effect on quality of care. Journal of Nursing Administration. 31(1) 33-9. Retrieved from https://www.ncbi.nlm.nih.gov
Blegen, M.A, et al. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration. 43(2) 89-94. doi: 10.1097/NNA.0b013e31827f2028.
The IOM’s report agrees with the ANA’s belief that the increasing complexity of nursing care warrants a higher educational standard, and also referred to a growing body of research linking higher levels of RN education with better patient outcomes in acute-care settings(Spetz & Bates, 2013). The National Center for Biotechnology Information has shown that hospitals with a higher percentage of nurses with a BSN degrees have lower mortality and failure-to-rescue rates, especially when it comes to surgical patients (ADN vs BSN Patient Safety Outcomes & Care Situation, 2019). There are a larger number of BSN educated nurses working in Magnet Hospitals which are producing an increase in positive patient outcomes. BSN educated nurses have improved analytical and critical thinking skills, whereas ADN nurses do not. But, I do believe that experience also counts, because I work with nurses that have years of experience and have ADN degrees and their knowledge base is incredible. Therefore, experience has to count for something when it comes to increased positive patient outcomes. Nurses with a BSN are able to apply and move into leadership and management positions, whereas, ADN nurses cannot unless they seek out additional education. As far as being in real life situations with ADN nurses, I will have to answer this with two answers. ADN nurses that are new graduates don’t have the experience or the real-life experiences yet to have increased patient outcomes. Nursing school teaches you one way and then real nursing happens on the job. I feel that ADN nurses that have years of experience do have increased positive patient outcomes, because they have real life and years of experience behind them that has given them the knowledge that they need to save lives. I personally ask ADN experienced nurses daily for advice and help as I can trust their judgment since they have seen and experienced so much based on their years of nursing.
ADN vs BSN Patient Safety Outcomes & Care Situation. (2019, February 13). Retrieved from https://nightingale.edu/blog/adn-vs-bsn-patient-outcomes/
Spetz, J., & Bates, T. (2013, September 16). Is a Baccalaureate in Nursing Worth It? The Return to Education, 2000?2008. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876405/
According to some articles read, some studies done showed evidence that a higher educated nursing workforce with BSN creates better patient outcomes and lower mortality rates (Passmore, 2019).
These associations imply 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 (Passmore, 2019).
The findings of most of these studies when comparing ADNs vs BSNs agree on this fact, but I personally think and know some nurses that only hold an ADN but have a lot of experience dealing with patients, with doctors and know the chain of command. A good nurse that truly cares, focus on the patient’s best interest and is a true patient advocate. Nurses know how to delegate, how to assist or direct patients to other resources as need it. They know how to coordinate care and provide the best care for their patients. I know nurses with the same level of experience, and I see some very good BSN and some good ADNs. I don’t think hospital nurses working as staff nurses are different when taking care of patients. They both do the same job, they passed the same NCLEX, they both need CEUs, they both follow the same regulations, protocols and schedules. I personally think better patient outcomes and less mortality rates have to do with how responsible that nurse is, good assessment and interventions in a timely manner.
I think a degree does not make you better or worse, is the person you are that defines the person, the professional. Your values, your personality, your integrity and even your heart is what makes you be good or bad.
Passmore, S. (2019, March 12). How Does Your Nursing Degree Affect Patient Mortality Rates? Retrieved from https://www.americansentinel.edu/blog/2014/06/04/how-does-your-nursing-degree-affect-patient-mortality-rates/