Thursday, January 29, 2009
RN Education/Certification
The National Database for Nursing Qualtiy Indicators currently collects data related to RN Education/Certification and the outcomes of nursing care. According to the Dunton (2008), "certificatiion is a measure of nursing specialty knowledge, skills and experience."The lastest research that was done by the NDNQI showed there is a decrease in patient falls on units where there is a higher percent of RNs who are certified. I had the assumption that there was not any difference in a nurse with an Associate Degree and one with Bachelor Degree. After starting back to school for my BSN, I no longer have that assumption. I definitely believe the nurse after receiving the BSN has a greater potential to be leader and has the abiltiy to critically think when it comes to complex situations. Do you agree? What differences do you see between an AD nurse and a BSN nurse?
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I am also seeing a definite difference but I am unsure as to whether this difference is totally education related. I believe that when completing the ADN program, students are focused on passing the course tests, the HESI, the boards and gaining skills. The focus is on THEMSELVES and driven by their confidence level.The ADN generally is either unemployed or working part-time as an unlicensed assistive personnel (UAP)thus concerned about financially paying their bills. Many have limited work experience or limited in the skills they may bring to their new careers as nurse. However, as an EARN student, most are currently working (many fulltime)and generally have extensive careers either in nursing or other professions on which they can draw skills and experience. After working in the nursing field, they are confident in their skills levels and able to realize that the patient is their focus. While the EARN students will enter the EARN program cognizant of a personal gain at graduation, most also know the ultimate reason for their desiring a BSN is to provide the best care to their patients consistently.
ReplyDeleteI would be curious to know any difference witnessed between a traditionally prepared BSN and an EARN.
My experience has shown that ADN nursing have more clinical skills than traditional BSN. That is good in some ways. The ADN lacks the critical thinking that is so important for patient care. I am an example. Some ADN nurses develop critical thinking on their own and some do not. I think most EARN nurses have already developed this is some way and that is why they are returning to school. I can see a big difference in my way of thinking now after being back in school.
ReplyDeleteI agree! I can see a difference in my critical thinking ability during this educational process in the EARN program. I remember when I was getting my ADN and was doing clinicals in the company of BSN students, almost all of the staff nurses said that the technical skills of the ADN students were better than that of the BSN students. Of course, we all know that we learned most of our technical skills at the bedside, but it seemed common that ADN programs focused more on skills completion than a BSN program, but the BSN program had more critical thinking and theoretical courses.
ReplyDeleteJust a question.... when you say, "RNs who are certified" do you mean a nurse with a bachelor's degree or a nurse with a specialty certification beyong the BSN?
Becca, I am sorry. I should have explained that better. I mean a nurse who has certifications in a specific area or certifications such as ACLS or PALS.
ReplyDeleteI am so excited that we are slowly obtaining high level evidence to support that there is a difference in patient outcomes related to higher nurse to patient ratios as well as higher numbers of BSN vs AD nurses. This is not to say that the AD nurse does not provide excellent care as you EARN students know that I was an AD nurse first. I see a difference in critical/analytical thinking and in thinking about client outcomes and not completion of task. I also see it in putting the whole picture together and not looking at pieces only. Lisa, perhaps getting your colleagues who are AD and not in a BSN program would give us a wider perspective.
ReplyDeleteToo often I hear, "I would rather have an ADN prepared nurse than a BSN nurse." They often site technical skills as better, but all they really are concerned with is getting what they perceive to be the work done. Task completion becomes the goal and critical thinking is not valued. Nationwide we suffer from a "failure to rescue" of our patients in trouble.
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ReplyDeleteI am ashamed to say that once was one who thought this way. I believe that there are some ADN nurses who over time and with experience learn to critically think. Only when they are educated that this is actually what they are doing is when it all makes sense. I had a physician come to me requesting a RN to work in his office instead of a LPN. When I asked why, he responded, "Because I need someone who can think on a professional level and recognize potential health problems". Although he did not specify whether ADN or BSN, his concern was not only with the tasks to be performed.
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