It has been close to 50 years ago, in 1965, since the American Nurse's Association (ANA) released a position paper stating that the "minimum preparation for beginning professional nursing practice should be baccalaureate degree education in nursing" (as cited in American Nurses Association, n.d.), and this statement is consistently reaffirmed by the organization in 1978 and 1985 (American Nurses Association, n.d.). Opponents to this position argue, that graduates of Associate's Degree in Nursing (ADN) programs and Baccalaureate of Science in Nursing (BSN) programs have been shown that they have the same skill levels (Smith, 2002). Is this true? In brief, no. Their basic technical skills upon graduation are the same, but their
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In ADN programs, there is discussion and possibly an assignment related to subjects requiring higher level knowledge and thinking. In a BSN program, the student has entire courses related to higher level thinking. Some examples include having a 45 minute discussion on leadership compared to having an entire course in Nursing Leadership and Management (Grand Canyon University, 2014), or Instructors discussing critical thinking in class and in clinical rotation compared to having a course in Critical Thinking (Grand Canyon University, 2014) that allows a student to work out the mechanics of medical critical thinking over months. Inasmuch as an ADN program touches the same subject matter as a BSN program, it does not let the nursing student engage the material in a meaningful way. That is, nursing students need to be able exchange discourse, contemplate, absorb and finally, integrate higher level nursing concepts in today's complex world of medicine. An ADN program does not provide the time for this level of learning and expertise.
I would like to share with you an example of how skill and competency can affect patient care. I was working as a Charge Nurse on a high acuity post surgical floor at a local hospital. One night I was asked to float to another unit to be a Charge Nurse. It was the Continuous Diagnosis Unit (CDU),