Adn_vs_Bdn

Running head: DIFFERENCE IN COMPETENCIES Difference in Competencies between Nurses Prepared at the Associate-Degree Level versus the Baccalaureate Degree Level Maureen P. Lydon Grand Canyon University: NRS-430V Professional Dynamics September 4, 2011 Difference in Competencies between Nurses Prepared at the Associate-Degree Level versus the Baccalaureate Degree Level One of the impediments to Nursing becoming a profession is developing a standard education path for entry into the profession, the use of differentiated competencies between associate-degree program nurses (ADN) and baccalaureate degree programs nurses (BDN) should help define a standard education path. An agreed upon characteristics of a profession cited by numerous researchers is a lengthy and required education. (Creasia & Friberg, 2011) Currently, a person who wants to become a registered nurse may enter a diploma program, an associate degree program or a baccalaureate degree program. The existence of these three paths has called into question nursing’s claim as a profession as three different types of education can result in the same designation, a Registered Nurse. To rectify this situation competency statements on differentiated roles for ADN and BDN prepared nurses were developed to establish an educational path and job descriptions for each group. (Primm, 1987) In Primm (1987), the ADN competencies include caring for focal clients, identified as individuals and members of a family, and being responsible for a specified work period that is consistent with the identified goals of care. The ADN is prepared to only function in a structured health care setting with established health care policies, procedures, and protocols and where assistance from more educated and experienced nurses is available. Primm (1987) further stated the BDN competencies included caring for focal clients identified as individuals and families but also included aggregates and community groups. The BDN was responsible from admission to post-discharge, not just a specified work period as the ADN. Finally, the BDN should be prepared to function in structured and unstructured health care settings. The unstructured setting is where there are no healthcare established policies, procedures, and protocols and where there is a potential for unexpected events or conditions that would require the BDN to make independent nursing decisions. Primm (1987) further stated that the ADN competencies should be assumed to be part of the BDN competencies. The differentiated competencies between the ADN and the BDN clearly delineate an educational path for the two different programs. By adding the assumption the ADN would progress to a BDN through further post-ADN education we have one educational path for one profession. Here’s a situation I dealt with at work that could provide an example of how the nursing care approach could differ based on my educational preparation. I should clarify that I did attend a BSN program for approximately 4 years about 20 years ago but did not graduate at that time. The setting I work in is Oncology outpatient clinic. My daily schedule involves follow-up for our chemotherapy and radiation therapy patients as well as perform new patient assessments. It’s a pretty unique model of care that involves supportive care therapies such as Naturopathy, Nutrition, Care Management and various other Complimentary Alternative Medicines (CAM). A unique aspect of our patient population is that there a very few local patients and most patients travel from out of state. Cancer Treatment Centers of America (CTCA) has a Travel Department that is responsible for booking a patient’s travel itinerary. During my first year of work at CTCA I noticed that on occasion a patient was not able to participate in all the care modalities because of time constraints imposed by the Travel Department’s travel itinerary and because the scheduling department was not scheduling desired appointments with the appropriate treatment departments. Patients had symptoms that were not being managed and they had no available time on their schedules to follow-up appropriately. From an ADN perspective the only option would have been to catch missed therapy and reschedule the therapy for a future visit. But our patients travel to our centers because we promise them a holistic approach to treating their cancer with alternative approaches to managing their symptoms. We were not fulfilling our patient model of care as promised and what we had were some disappointed patients. To better understand why this was continually happening and to understand how many patients of the CTCA patient community it impacted I had to research the issue. I found numerous problems with the documentation and communication of order to implement the patient’s care plan. To fix this my team members and I did developed a Patient Care Empowerment Form that contains all the possible CAM follow-ups that the patient can request and all the necessary tests and consults that can be ordered for routine or restaging follow-ups. This form communicated the care plan and the time needed to complete it the entire process. The form was very successful on a number of levels but most importantly patient satisfaction in our team improved significantly. This example demonstrates the difference between a BDN education and an ADN education as the solution involved researching a problem affecting all patients as opposed to just dealing with the bedside care of one patient. REFERENCES References Creasia, Joan L. (Ed.), & Friberg, Elizabeth E. (Ed.). (2011). Conceptual Foundations: The Bridge to Professional Nursing Practice (5th ed.). St. Louis, MO: Mosby, Inc., an affiliate of Elsevier Inc. Primm, Peggy L. (1987). Differentiated practice for ADN- and BSN-prepared nurses. Journal of Professional Nursing, 3(4), July-August 1987, 218-225. Retrieved September 4, 2011 from http://www.sciencedirect.com/science/article/pii/S875572238780008X