Nrs 430v Evolution Of Nursing

Evolution of Nursing
Michael Asher
Grand Canyon University: NRS-430V
1/23/2015

The Evolution of Nursing of nursing will continue to change for the improvement of society. At points in the past and in the future, there will be arguments that there is no difference between a nurse having an ADN and a BSN. With this argument there is supporting documentation that nurses having a BSN will be better for the population as a whole. There may be room for both degrees as both have advantages in assisting with the healing processes in the healthcare setting but the ideal will be for all future nurses to have their baccalaureate in the science of nursing. The differences in competencies between Bachelor of Science Nurses and Associate
Degree nurses are many. BSN’s have a higher level of critical thinking, managing cases, promoting health, and leading other medical staff in wide variety of settings. Nurses with BSN have learned theories and studied history of from former nursing situations. A nurse with an ADN may have better time management and nursing skills due to time in nursing clinicals while BSN’s understand the disease process better and are usually looking at the bigger picture of the patient’s problems.
Within the patient care situation, baccalaureate nurses have the critical thinking skills of the patient’s issues. In one situation, I dealt with a repeat patient returning for Urinary Tract infection. I learned from the patient that he quit taking his antibiotics because he started to feel better. I recall the BSN I was shadowing that day stated, “Many nurses don’t educate the patients, that the patients need to finish their entire course of antibiotics for them to be effective on their infections.” I feel this nurse had a greater in depth understanding of the disease process and was able to think through and use more in depth critical thinking by doing a little more educating of the patient. Case management is another area where BSNs have a better record in some studies. In Health Affairs an article from March 2013 titled “An Increase in the Number of Nurses with Baccalaureate Degrees is Linked to Lower Rates of Post-surgery Mortality,” nurse researcher Ann Kutney-Lee found there was a “10-point increase in the percentage of nurses holding a BSN within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients—and for a subset of patients with complications, an average reduction of 7.47 deaths per 1,000 patients.” (Kutney-Lee, March 2013) This study shows that nurses with a BSN have greater case management skills compared to those with nurses with ADNs and shows the decrease of the number of deaths and complication related deaths.
Health promotion is another area where BSN’s can contribute in a greater capacity than ADNs.
By having the theory of disease process, understanding of history within nursing, and in depth patient care, BSNs have an advantage over associate degree nurses. In February 2013, an analysis of 21 University hospitals was done by Mary Blegen and colleagues for the Journal of Nursing Administration. This study looked at the association between RN education and patient outcomes. “The researchers found that hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay.” (Baccalaureate Education in Nursing and Patient Outcomes, 43(2), 89-94) This study found that the nursing practices of advanced degree nurses promoted health greater than those without an advanced
degree. Lastly, by having a baccalaureate science nursing degree the earner of this degree can take greater leadership roles than one that has an ADN.
Of course this can fall back on the hospital director’s preference, but with many hospitals heading in the direction of Magnet Status, the charge nurses or leaders of the hospital will need to have their BSN. By having the critical thinking skills, understanding the theories of nurse processes, the promotion of health, and case management training, BSNs will lead the healthcare organizations of tomorrow. “The IOM report makes a strong case to support that advances in science and increasing patient complexity have accelerated our need for nurses with the skill and knowledge to manage a challenging and increasingly diverse health care environment. Unlike Associate Degree programs, BSN curriculum provides content on evidence-based practice, health policy and finance, inter-professional communication and collaboration, systems leadership, disease prevention and population management. This is program content that nurse leaders need to navigate not only today’s health care environment but also the changes anticipated with health reform.” (The Future of Nursing: Leading Change, Advancing Health, IOM,
2010) There is no argument that there is a shortage of nurses now and in the very near future with the retirement of baby boomers. Due to this great demand of nurses within the healthcare field, there will be a need for nurses with both ADN and BSN. As seen in with examples within this essay, both nurses will play a part in this future, but it will be an ever-reaching goal for the entire nurse population to continue to grow in mind, body and spirit to attain higher education in the hopes of caring for our patients and having better outcomes within these scenarios. By attaining higher education with a BSN, nurses will have a higher level of critical thinking, better case management skills, more thorough promotion of patient’s health, and fill the needed leadership roles within our healthcare setting.

References

Blegen, M.A., Goode, C.J., Park, S.H., Vaughn, T. & Spetz, J. (2013, February). Baccalaureate Education in Nursing and Patient Outcomes. Journal of Nursing Administration, 43(2), 89-94.

Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health. Washington DC: National Academies Press. Future of Nursing 2010 Recommendations

Kutney-lee, A. (2013, March 1). An Increase in the Number of Nurses with Baccalaureate Degrees is Linked to Lower Rates of Post-surgery Mortality. Health Affairs.