Nursing education: Patient Care decision between a BSN and ADN

Nursing Education and Competencies

Nursing education ensures that nurses have the information, skills, and competencies needed to provide high-quality care to patients. Many studies have shown that nurses who have completed the Baccalaureate degree levels have less occurrences of death, medication mistakes, and improved patient outcomes. As a result, there is a need to improve nurse education with the goal of assuring clinical competency during health care delivery. In the nursing profession, nurses must hold either an Associate's Degree in nursing or a Bachelor's Degree in nursing to provide nursing care. It is a requirement that nurses with either of the qualifications pass the required NCLEX exam. Nursing competencies refer to the ability of a professional to provide nursing care efficiently. Mostly, it entails the combination of the knowledge and the skills in order to achieve better patient care outcomes. According to the American Nurses Association (2013), the education level of a nurse determines to a greater extent the delivery of healthcare as well as the health outcomes of the patients. Even though nurses are trained to perform the same duties, the two programs have some differences.

Differences in Associate's Degree in Nursing (ADN) and Bachelor's Degree in Nursing (BSN)

Nurses with an Associate's degree are trained in a two-year program at a community college level with their training focusing more on the nursing theory and the skills (Carter & Welch, 2016). As such, these nurses are educated more on the application of the theoretical knowledge, provision of safe and high-quality care as well as ethical behavior and collaboration with other healthcare professionals. Therefore, ADN nurses are prepared for the provision of bedside nursing care and application of nursing fundamentals with less focus on the leadership, nursing theory and public and community health. The AND nurses have fewer opportunities after completion of their degree and majority end up working in skilled nursing facilities, long-term care homes , psychiatry wards and hospital settings.

On the other hand, nurses trained at a Bachelor's level are prepared in a four-year program at a University level. During their training, nurses undergoing through this training program are taught on the critical thinking skills, leadership, problem-solving as well as professional behavior. Therefore, in the BSCN program, more emphasis is laid on the administration, the vital skills as well as the nursing theory (Wray, 2017). As such, these nurses are prepared more to be in leadership positions. In the BSN program, more emphasis is placed on professional development and therefore a broader scope of practice. Therefore, BSN has more and better opportunities since they have a wide variety of choices they can make when it comes to choosing the employment opportunities (Wojnar & Whelan, 2017).

Competence and Opportunities for BSN Nurses

In spite, the nurses in both the nursing programs, nurses with a BSN are more prepared and are able to provide more competent care since they are able to identify other factors that affect the provision of health care such as the social, economic and cultural factors. They are not only able to provide care to patients within a hospital setting, but also, they are able to provide care in both the public and community setting. As such, they can provide care in community health centers, school environment and can work as clinical instructors. Concurrently, these nurses are able to fill in the roles as case managers, clinical nurse educators as well as nurse managers out of the hospital settings (Matthias & Kim-Godwin, 2016).

Skills and Competencies for Nursing Care

Nurses who have undergone the AND the BSN programs must possess the necessary skills and competencies for the provision of high and safe quality care to the patients. They must work in collaboration with other healthcare professionals for the achievement of the best healthcare outcomes (Wray, 2017). Furthermore, communication skills are critical. The focus must be on the patient and being advocates for the patients with the provision of a safe and quality environment for promoting of healing among these patients.

Patient Care Decision Between a BSN and ADN

In a female surgical ward, Miss X was recovering from surgery when she started experiencing a sudden incident sharp shooting chest pain with shortness of breath. The ADN nurse examined the patient and found that the baseline vital signs were normal and concluded that the patient might have experienced the chest pain due to myocardial infarction. She started the patient on oxygen and got the orders for administering sublingual nitroglycerin, however, the patient continued to complaining of the pain. The ADN informed a BSN who did a thorough physical examination after which he identified a swelling on the left leg of the patient with a positive human sign. She enquired of the possibility of the patient being on any blood thinner for deep vein thrombosis prophylaxis which she was not. The doctor was informed immediately, and an order for chest CT scans for the pulmonary embolism checks. The CT scan confirmed that the patient had a pulmonary embolism and was then transferred to the Intensive care for care.


From the clinical scenario, the BSN was able to identify the actual problem with the patient due to the extensive education theory with more exposure to the various aspects of nursing along with the emphasis on critical thinking. Therefore, it is clear that BSN nurses are more competent in the provision of nursing care through the implementation of the essential skills of thinking and problem-solving skills. Thus, the need for the nurses to acquire a BSN during training so as to ensure provision of high-quality care and achievement of quality patient outcomes.


American Nurses Association. (2013). Public health nursing: Scope and standards of practice. American Nurses Association.

Carter, J. T., & Welch, S. (2016). The Effectiveness of Unfolding Case Studies on ADN Nursing Students' Level of Knowledge and Critical Thinking Skills. Teaching and Learning in Nursing, 11(4), 143-146.

Matthias, A. D., & Kim-Godwin, Y. S. (2016). RN-BSN Students’ Perceptions of the Differences in Practice of the ADN-and BSN-Prepared RN. Nurse educator, 41(4), 208-211.

Wojnar, D. M., & Whelan, E. M. (2017). Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education. Nursing outlook, 65(2), 222-232.

Wray, M. A. (2017). Senior BSN Students’ Confidence, Comfort, and Perception of Readiness for Practice.

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