ADN vs BSN:

Running head: ADN VS BSN: THE CHANGING WORLD OF HEALTH CARE

ADN vs BSN: The Changing World of Health Care

Kimberly Gray
Grand Canyon University
Professional Dynamics
NRS-430V-0502
Chris Bartholomew
October 30, 2015

ADN vs BSN: The Changing World of Health Care

Health care has always been an ever changing field. Not only has practice changed,
policies, patient safety goals, outcomes and now education. In 1951 Mildred Montag, Ph.D
developed and proposed a nursing program that would help assist the professional nurse and
change the nursing world to this day (Adelphi University, n.d., p. 1). After World War II there
was a shortage of nurses. Mildred Montag looked for a way to expand the nursing field and in
her dissertation wrote out the curriculum for the Education of the Technical Nurse (Grand
Canyon University, 2015). The technical nurse is a nurse with an associate degree. It was
Montags vision that the ADN work under and be supervised by a nurse with a baccalaureate
degree. Today many associate degree nurses work on their own in many homecare setting and in
hospitals. Although the associate degree nurse and the baccalaureate degree nurse are both
registered nurses, their competencies are very different.
The world of healthcare is changing. The American population is getting older. By 2030
nearly 20% of Americans will be age 65 or older (Institute of Medicine, 2010). During this time
the worlds healthcare needs will become more complex. Chronic conditions such as diabetes,
hypertension, arthritis, cardiovascular disease and obesity have changed healthcare from caring
for acute illness and injuries to caring for chronic conditions and multiple co-morbidities.
Because of the preceding, care in the hospital has become more complex. Nursing is now having
to care for sicker patients and use more sophisticated technology to help patients manage their
illness and decrease the disease progression. The Institute of Medicine calls for nurses to
achieve higher levels of educationthat better prepares them to meet the needs of the
population (Institute of Medicine, p. 2).

In 2005 the American Organization of Nurse Executive released a statement, with the
interest of improving and enhancing nursing care and patient safety, which called for all
registered nurses to be educated in baccalaureate programs (American Association of Colleges
of Nursing, March 19, 2015). The Tri-Council for Nursing released a report stating that advanced
nursing degrees will better prepare registered nurses to develop improvements to reduce the
incident of medication errors, and help the nurse to navigate and coordinate the care of patients
while incorporating increasing complexity of technology, medical treatments and more
advancing chronic health conditions that will be seen in all age groups (Tri-Council for Nursing,
2010).
Since the development of the associate degree of nursing it has been a relevant choice for
students entering the nursing profession. The shorter and low-cost price 2 year program has
allowed older students, married students, and minorities to gain an entry level nursing license
(Mahaffey, 2002). The ADN program has had a positive effect on the nursing population. Every
year almost 60% of registered nurses are ADN prepared (Mahaffey). Course curriculum for an
associate prepared is roughly half general education and half nursing courses. These programs
are patient centered and task-based concepts. Nursing courses are based on broad structures of
adult nursing, maternal and child nursing and not considered disease centered. Fundamental
concepts are built on and expanded throughout the program. Graduates of the ADN program gain
an understanding of core nursing concepts to include but are not limited to; patient education,
signs and symptoms of disease, and medication administration. Upon graduation the ADN
prepared nurse can sit for the National Council Licensure Examination of Registered Nurses
(NCLEX-RN). According to The Online Journal of Issues in Nursing (2015), nurses prepared

at the ADN level are caring, competent and committed health care professional who fill a vital
need in local communities.
As baby boomers get older, and their needs get more complex the Institute of Medicine
feels that nurses will need to achieve higher levels of education that better prepares them for the
growing needs and complexity of patients (Institute of Medicine, 2010). Baccalaureate prepared
nurses are trained in more multifaceted competencies such as; leadership, health policy, system
improvements, research, evidence-based practice, team work and collaboration. These
competencies move nursing from task-based to more of a multidimensional care that allows the
nurse to work more independently while making patient focused decisions and working in a
variety of clinical care settings (American Association of Colleges of Nursing, 2015).
In the February 2013 issue of the Journal of Nursing Administrationfound 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(American Association of
Colleges of Nursing, March 19, 2015, p. 2).
It was Mildred Montags vision to create a technical nurse who would assist a
baccalaureate prepared nurse. Associate prepared nurses are still needed to assists patients in
coping with their conditions and to maintain care upon discharge but, as healthcare is changing
to less hospital centered and more community centered care, it has been found that there is a
need for higher education in nursing. Community centered care is teaching people how to
manage their healthcare needs to decrease further decline in health. Baccalaureate prepared
nurses are trained in a higher degrees of competency such as; research, evidence-based practice,

team work and collaboration, that have been shown to decrease chronic disease mortality and
hospital length of stay.

References
Adelphi University (n.d.). We are building on 70 years of success. Retrieved October 30, 2015,
from http://nursing.adelphi.edu/about/who-we-are/history/
American Association of Colleges of Nursing. (2015). The baccalaureate degree in nursing as
minimal preparation for professional practice. Retrieved from
http://www.aacn.nche.edu/publications/positions/bacc-degree-prep
American Association of Colleges of Nursing. (March 19, 2015). Fact sheet: creating a more
highly qualified nursing workforce [Fact sheet]. Retrieved from
http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf
Grand Canyon University (2015). Nursing timeline of historical events. Retrieved October 28,
2015, from
http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs430V_timeline.php
Institute of Medicine (2010, October). The future of nursing: focus on education. Retrieved from
Institute of Medicine: www.iom.edu/nursing
Mahaffey, E. H. (2002). The relevance of associate degree nursing education: past, present,
future. The Online Journal of Issues in Nursing. Retrieved from
http://nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/ojin/
Tri-Council for Nursing (2010, May 14, 2010). Tri-Council for nursing issues new consensus
policy statement on the edicational advancement of registered nurses [White paper].

Retrieved from Tri-Council for Nursing:

http://www.aacn.nche.edu/Education/pdf/TricouncilEdStatement.pdf.