Educational Preparation (BSN versus ADN)

Educational Preparation (BSN versus ADN)

In line with the IOM’s recommendation for nurses to engage in lifelong education and goal for increasing the number of nurses with Baccalaureate degree to over 80% by the year 2020, many contemporary nurses (45%) have completed or are actively pursuing the BSN option(Kutney-Lee, Sloane, & Aiken, 2013). Regardless of this trend, a significant proportion of nurses that hold an Associate degree in nursing (ADN) exist. As such, understanding the level of competence of both the BSNs and ADNs is necessary for the proper distinction of the scope of practice. In essence, this paper aims at establishing the differences in competencies between BSNs and ADNs as well as their nursing care or approach to decision making in similar patient care situations. By so doing, a new understanding of the differences between the ADN and BSN is inevitable.

Differences in Competencies

Primarily, BSNs and ADNs differ in competency level in a variety of ways that are worth noting. A befitting example of such variation is apparent when detailing the focus of the curriculums of both ADN and BSN prepared nurse. The ADN’s curriculum mainly focuses on the clinical or technical aspect of nursing practice. Such is the case given that ADNs mainly stay in the clinical areas and their educational preparation enables them to perform at a task-oriented level. Contrary to the ADN’s specialization onthe technical aspects of nursing, the BSN curriculum mainly focuses in modeling nurses that are have critical thinking, leadership and research skills. The BSNs integrate nursing theory in their nursing practice, which is necessary for the justification of the nursing strategies adopted (Huston, 2014). Based on the focus of the training curriculums, it is beyond doubt that the level of competence of ADNs and BSNs differ significantly.

Notwithstanding, the competence levels of both ADNs and BSNs also differbased on the duration of training for individuals in both degree programs. For instance, the duration for full completion of the ADN program is short (two years) and takes place in a community college while studying of the BSN program lasts four years and in a University. Such a difference in the study period translates to variation in the competency levels. That is for surebecause the BSNs have a more intense program that needs moretime to complete compared to the ADNs’ shorter timeframe for completion(Huston, 2014).

Differences in Nursing Care/Approach to Decision-making

The BSN and ADN-prepared nurses also differ in their approach to similar patient care situations given their variations of the competency levels. A befitting example of a patient care situation that depicts this difference in approach to decision-making relates to the maintenance of patient safety. To this effect, many researchers have carried out studies targeting to establish this phenomenon. For instance, Aiken,Cimiotti, Sloane, Smith, Flynn, and Neff, (2011) in their study found out that there is a link between patient safety outcomes and level of nursing education (ADNs and BSNs). Such is the case given the low mortality rates noted in hospitals with high number of nurses with either an ADN or BSN qualification. More specifically, the study established thathospitals with many BSN-prepared nurses performed much betteras compared to those with many ADN-prepared nurses. Such a finding is due to the approach care adopted by both BSNs and ADNs. Precisely, BSNs employ critical thinking skills and develop superior strategies backed by evidence from research, which enable them to influence the care and safety of patients more significantly. On the other hand, ADNs’ reliance on the technical aspects of nursing makes them unable to impact on the patient safety as the BSNs(Huston,2014).  With such an illustration, it is beyond doubt that the ADNs and BSNs approach to decision-making and nursing care varies greatly.


Concisely, this paper aimed at determining the differences in competencies between BSNs and ADNs as well as their nursing care or approach to decision making in similar patient care situations. Largely, the discussion has achieved this objective and several deductions are attainable from this analysis. A case in point of such conclusions is that BSN differ significantly from the ADNs. For instance, an ADN scope of practice is mainly concentrates on the technical aspects of nursing while a BSN’s curriculum incorporates the aspect of critical thinking, which enables them to work in many areas within nursing. Based on this deduction, it is thus important to make a distinction of what an individual, either an ADN or BSN, can do for the avoidance of poor performance and dissatisfaction. However, in the absence of such consideration, poor healthcare outcomes are inevitable given staff dissatisfaction.




Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011). The effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical care49(12), 1047.

Huston, C. J. (2014). Professional issues in nursing: Challenges & opportunities.Baltimore, MD; Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Kutney-Lee, A., Sloane, D. M., & Aiken, L. H. (2013). An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality. Health Affairs32(3), 579-586.


(Visited 2 times, 1 visits today)