BSN and ADN Nurses


BSNand ADN Nurses

BSNand ADN Nurses

Theeducational level of the nurses is portrayed by their competenciesduring their nursing practice. In the United States, there are twodifferent ways of becoming a registered nurse. These are theassociate-degree level qualification and the baccalaureate-degreelevel qualification. Thecompetencies between the two nursing are different based on theeducation level and the expertise they are prepared to give in ahealth care setting. This paper seeks to explore the differences interms of competencies of the two nursing levels by discussing theirpractices. To put the differences into perspective, this paper willexamine a patient care scenario by describing how each of the twolevels of nursing will approach the situation in decision making.

Oneof the main differences in the competency of these two levels ofnurses is the educational qualification and knowledge acquired duringtheir training. The main focus for the ADN education program is togive the nurses the competency for the entry level to a hospitalsetting (Ridley, 2008). They do not have training for specializedmedical cases or decision making. The ADN qualification requires twoyears of nursing education that covers general courses (Christina,2006). On the other hand, the BSN is prepared for a broader practicescope that involves nursing management and research. The BSNqualification requires four years of formal education that coversin-depth medical, social and physical sciences.

Thecompetence for the ADN is centered on the care of the patient,especially the one involving the bedside care. Therefore, theircompetences are more on the hands-on-skills that are needed to handlepatients in a hospital setting. According to Christina (2006), ADNnurses are equipped with the general knowledge that enables them tocompetently handle patient care. On the other hand, the competence ofthe BSN is centered not only on the patient care, but also on thedecision making procedures that relate to health and clinicalsituations (Pam et al, 2003). A registered nurse will focus on thefacts about the patient, the history and the diagnosis before makingdecisions about the treatment and care.

Inaddition, the two nursing levels receive different responses andresponsibilities in a health care setting. According to the AACN, theBSN nurse will receive more appreciation from the employers becauseof the higher competencies arising from higher education (Rossetter,2010). The decisions made by the BSN are appreciated more andconsidered compared to those of the ADN. At the same time, the BSNwill get higher level responsibilities by the health care employersbecause of the health care skills that they add to the workplace. Onthe other hand, the ADN are given lower responsibilities and areconsidered to be the hands-on professionals in the workplace. Theyare not entrusted with higher responsibilities, especially when theBSN is available.

Thedecision making skills of the two levels of nurses are different andpresent one of the major competence differences between the two. TheBSN nurses are considered to be good at making decisions because oftheir advanced training in management (Ridley, 2008). Their maturitylevel of the two levels of nursing qualification is different.According to Pam et al (2003), the BSN nurses are also considered tobe more competent in terms of clinical skills and their ability tolearn. On the other hand, the ADN are not considered as elitedecision makers in the clinical setting because of their educationallevel. While they are consulted because of their patient care skills,they are not considered for management.


Thepatient case to illustrate the difference of the two levels is thepatient situation I experienced during my short holiday practice.There was a patient in the oncology unit, where I used to carry outmy observation practice. In the inpatient unit, both the ADN and theBSN nurses were involved in the caring of patients and note thechanges in the patients. At the same time, the hospital gave trainingto the two levels of patients on how to deal with patients afteradministration of biotherapy and chemotherapy. For this patient, hestarted shaking and chills, just after receiving a chemotherapydosage. The immediate present nurse had an ADN qualification. Hestarted panicking and could not handle the patient.

Instead,he called the BSN nurse who was in charge for the evening. The BSNwas calm and showed a lot of leadership in the way she handled thesituation. She took time to assess the patient and reviewed theadministrative record for the patient’s medication. After thereview, the ADN nurse gave the patient a morphine dose, whicheventually calmed the patient down. She later talked to the ADN nurseand gave her some advice on how to observe the patients in the unit.


TheADN and the BSN portray the differences in their competencies becauseof the different educational qualifications. While the ADN aretrained to take care of patients in the bed care situations, the BSNnurses are further trained on clinical decision making. As a result,the ADN have hands-on-skills compared with the management anddecision making competencies of the BSN. The review of the patientcase above shows the difference in their competencies as well as thedecision making skills between the two levels.


Christina,M.G. (2006). ADNto BSN:Lessons from Human Capital Theory. NursingEconomics. May/Jun2006,Vol. 24 Issue 3, p135-142

Ridley,R (2008). The relationship between nurse education level and patientsafety: an integrative review. Journalof education,47(4), 149-156

Rosseter,R.J. (2010). Creating a More Highly Qualified Nursing Workforce as aresource. AmericanAssociation of Colleges of Nursing (AACN),Retrieved From, &lt 17, 2015

Pam,M., Yarbrough, S., &amp Danita, A. (2003). Professional Values Heldby Baccalaureate and Associate Degree Nursing Students. Journalof Nursing Scholarship. 20033rd Quarter, Vol. 35 Issue 3, p291-296