future of nursing discussion 3

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Please respond to the discussion questions. Please also respond to the peers discussions.


Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?


Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?

Peer discussion 1

Due to the push for the minimum educational requirement for nurses to
be a baccalaureate degree, research has been performed to determine
whether or not nurses prepared with a baccalaureate degree actually
perform better in practice and improve patient outcomes. Haskins and
Pierson (2016) analyzed the results of nine studies. Overall, the
results of this analysis were largely in favor of
baccalaureate-prepared nurses.

Results showed that when patients were cared for by a greater number
of nurses who had completed baccalaureate programs, they showed a
lower risk of 30-day mortality. One of the individual studies actually
showed that for every 10% increase in the nurses who held a
baccalaureate degree, the 30-day mortality rate reduced by 7% (Haskins
& Pierson, 2016).

The authors also examined studies that looked at failure-to-rescue
and BSN-prepared nurses. Hospitals with 20-29% and 30-39%
baccalaureate degree nurses saw a reduction in failure-to-rescue by 9%
and 8%, respectively. When hospitals had >40% baccalaureate nurses,
there was a reduction of 18% seen in failure-to rescue (Haskins &
Pierson, 2016). These results demonstrate that a baccalaureate degree
in nursing has a positive effect on patient outcomes, specifically
30-day mortality and failure-to-rescue (Haskins & Pierson, 2016).

In my personal experience, I do not agree with this research. I
don’t agree that a BSN is necessarily better than an ADN degree.
I think that it matters more how dedicated the nurse is to learning
and preparing him or herself. When I was in my clinical for nursing
school and as a new graduate nurse, I was frequently told by nurses at
the hospitals I was at that they actually preferred the ADN students
over the BSN students because the ADNs were more dedicated to learning
and working. I also work with many ADN nurses whom I would trust to
care for my family members or myself, and I’ve worked with BSN
nurses that I would not give the same trust to. Obviously, that can be
reversed also. However, the bottom line is that it cannot always be
chalked up to a more expensive degree that makes a person a more
competent nurse.

Haskins, S. and Pierson, K. (2016). The impact of the Bachelor of
Science in nursing (BSN) degree on patient outcomes: A systematic
review. Journal of Nursing Practice Applications & Reviews of
6(1): 40-49. doi: http://dx.doi.org.lopes.idm.oclc.org/10.13178/jnpa…

Peer discussion 2

There are many paths to becoming a nurse whether it is
an associate’s degree or a bachelor’s
degree. Whether you obtain an ADN or BSN
you would start off in
the same level of practice within the nursing field and
have the
same patient responsibility, although some hospitals are
to only hiring BSN nurses as studies show having a
higher level of education
such as a BSN correlates to improved
patient care and health outcomes. In
research done at a hospital
in Pennsylvania, there was a link showing BSN
nurses were a 10%
increase in proportion of nurses and this resulted in a
of patient deaths by 5% (Robert Wood Johnson Foundation, 2014).

Based on my real life experiences, I do not agree with

findings. Additionally, going through the BSN program and
almost being done, I
know for a fact what I am learning here is
not going to improve my patient
care. Being educated does not
improve common sense and I feel like many nurses
who potentially
injure patients do so because they are careless or have no
sense and considering book smarts are different then common sense,
is no correlation between patient safety and having a BSN.

Robert Wood Johnson Foundation. (2014). Building the Case

More Highly Educated Nurses. Retrieved from: https://www.rwjf.org/en/library/articles-and-news/…

Peer discussion 3

A cross-sectional study dating back to
2013 found that RNs with BSN had better patient outcomes and a lower
mortality rates in patients with CHF than nurses without a BSN.
Another study in 2017 supports the idea that when comparing nurses
with an associate against nurses with a bachelors their ideas on
effective patient outcomes are different. Associate nurses focus
more on the local bedside level where as bachelor nurses focus more
at the systemic level including health care system factors like
policy and staffing when it comes to patient safety.

When it comes to my real-life
experience I have noticed that nurses with BSN or MSN degrees are on
the unit they tend to spend more time in the chart or sitting behind
the desk rather than at the bedside. Now this comes down to the
individual I do not link a BSN/MSN to desk jobs, but I have noticed
as of late new graduate RN’s who came from university do not
thrive in the bed side setting like associate level nurses. I also
want to point out that every associate level nurse I work with is
currently enrolled to get their BSN myself included. So, while only
holding an associate we are currently educating ourselves further to
that level of BSN. I truly do not see any correlation between the
degree being held and the level of care being provided to patients.
If anything, personally these types of studies just divide nurses on
the unit as some many get attitudes with others due to level of
education achieved. I truly believe that when it comes down to
patient safety as long as your heart and mind are in the right place
patient desired patient outcomes will be achieved regardless of degrees.


Anbari, A. B., Vogelsmeier, A., &
Dougherty, D. S. (2017). Patient safety communication among
differently educated nurses: Converging and diverging meaning
systems. Western Journal of Nursing Research. https://doi.org/10.1177%2F0193945917747600

Blegen, M. A., Goode, C. J., Park, S.
H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in
nursing and patient outcomes. JONA: Journal of Nursing
Administration, 43(2). https://doi.org/10.1097/NNA.0b013e31827f2028

Peer discussion 4

There are multiple paths you can take to become a RN, which is pretty
unique in health care. In 2010 the IOM released a report in which
called for 80 percent of RNs to have their BSN by 2020. This has been
a huge push in hospitals and is part of the gaining magnet
recognition. Research does support the claim that RNs with their BSN
lead to improved patient outcomes, as opposed to ADNs. One study found
that a 10 percent increase in proportion of RNs with BSNs was
connected to a 7 percent decrease in patient deaths (RWJF, 2014).
Research has supported this association and I do agree with this. BSN
programs better prepare nurses to care for the increasingly complex
health care demands, with patients that are living longer, are sicker,
and a lot have multiple comorbidities. BSN education includes much
more critical thinking, complex problem solving, and leadership which
ADN programs aren’t necessarily able to provide the students.
Another study, which looked at more individual effect of patients
rather than the overall hospital numbers, found that “patients
who are cared for by a higher proportion of BSN-prepared nurses were
less likely to die, stayed in the hospital for shorter periods, and
faced lower health care costs” (RWJF, 2014). I know many
hospitals are willing to hire nurses with ADNs, but they do expect you
to obtain your BSN within a few years, as well as most offering
tuition reimbursement after being employed there for so long. These
are terms that are aimed to increase the number of employees with
their BSN and promote the fulfillment of the IOMs goal and result in
improved patient outcomes.


Robert Wood Johnson Foundation (RWJF). (2014). Building the Case for
More Highly Educated Nurses. Retrieved from https://www.rwjf.org/en/library/articles-and-news/…

Peer discussion 5

Recent research studies have proven that obtaining a
bachelor’s degree in nursing is beneficial to the health and
mortality of the patients entrusted to our care. Higher education
levels significantly decrease patient mortality rates (Aiken,2010),
and the American Association of Colleges of Nursing recently suggested
a higher level of education, “enhances both clinical competency
and care delivery” (AACN,2015). A higher level of
education decreases the risk for error, diminishes the possibility of
missed care and promotes stronger critical thinking skills (Aiken,
2010). Higher education also promotes confidence in nurses and this
confidence is recognized by our patients.

Advancement is a great opportunity for registered nurses. ADN
graduates in acute care settings rarely advance to the role of nurse
manager, nurse educator, or administration. These superior roles
generally require a higher level of education. The skills learned
during the associates degree program do not focus on management. For
instance, organizing the unit budget and cost effectiveness are not
included in the ADN curriculum. Management skills are learned through
a BSN approach, and these skills are only briefly mentioned during the
ADN program. Effective management is essential to quality patient care
and unit survival. A productive work environment should be empowering
and capable of increasing morale among peers.

BSN education intensifies the understanding of patient-centered care
and communication. A BSN nurse is more likely to be chosen as a
resource nurse on any acute care unit. This is because a higher level
of education is desired and respected by upper management, patients,
and peers. A resource nurse should knowledgeable, and capable of
coming up with answers to difficult questions in a short period of
time. For example, one BSN nurse on my Palliative care unit, planned a
beautiful wedding for a dying patient upon request. This nurse found
the resources required to decorate the waiting room like a chapel,
prepare a wedding cake, and locate a pastor who was willing to perform
the ceremony. The couple wed three hours after the fiancé
approached nursing with their desire to marry before the patient
passed away. Leadership skills are the result of a higher
education. Effective leadership skills must be learned, and a leader
uses their skills to transform healthcare. Positive BSN leadership
creates a caring foundation that accepts change and thrives on a challenge.

I agree that higher education enhances patient safety and decreases
mortality, but I believe we are overlooking one thing. ADN nurses are
placed under tremendous pressure to obtain their BSN. Most facilities
who hire ADN nurses have them sign a contract which gives the nurse a
deadline to complete their BSN. The push is for BSN nurses, so
everything is centered around the BSN nurse. As a profession, with the
push for BSN nursing, I think we often take the ADN nurse for granted.
The associates degree is a stepping stone to the next level. I have
sat in meetings where I have heard, “I will no longer hire ADN
nurses”, or “ADN’s are not educated to understand
research” or “ADN’s do not have the skills to
precept Capstone students”. This sends the message that
ADN’s are suboptimal and can be traumatizing to the ADN nurse.
ADN’s are far from suboptimal but if one hears this daily they
will begin to feel inferior and this will hinder patient care. As we
grow in our careers and earn higher education we need to remember our
roots. The pressure we place on each other is one of the greatest
barriers to effective patient care, and that is what we are
overlooking. As a BSN nurse we should guide our peers with associates
degrees. We should encourage them and build up their confidence, so
they too will feel successful and earn their BSN willfully and without delay.

Aiken, L. Nurses for the future. (2010). N Engl J
, 364 (3): pp 196-98.

American Association of Colleges of Nursing (2015). Creating a more
highly qualified nursing

work force. Retrieved from http://www.aacnnursing.org/News-Information/Fact-S…

Peer discussion 6

Time and
time again, research has shown that those who possess a
bachelor’s of science degree in nursing (BSN) improves
patient health and expected goal outcomes. shown that
pathways that lead to the bachelor’s degree in nursing
(BSN) and higher may improve patient outcomes.According
to Robert Wood Johnson Foundation, hospitals that employ larger
numbers of BSN-prepared nurses have lower patient mortality rates;
reducing the probability of death by 5%. The link between nurse
education and patient outcomes was confirmed in 2011(RWJF, 2014).
I feel as though the research is biased in that it only supports
BSN nurses but it doesn’t state ‘why’ the
difference in rates. Do I believe that I am incapable of learning
what a nurse with a BSN knows, the answer is no; but, I am aware
that society has placed emphasis on the continuance of education;
therefore, the need for a BSN is imperative to me being merely
considered competent even before my skill is observed. I feel as
though if a nurse is dedicated to learning a trade and, or
enhancing their skill that is what sets them apart and saves
think that ADN nurses are not given the opportunity, especially at
this time, as a nurse who advances their degree; thus, they will
not be as knowledgeable as a BSN prepared nurse. However, if
taught and permitted to retain their current degree status, I
think that they will be just as effective as the nurse who
possesses a BSN. I admit I have learned more in this program,
however, the material was presented to me for me to learn. I think
it is a matter of semantics – if the programs provided for ADN
degrees were widely accepted, then level of the degree would not
matter. Nurses are more and more being held at a higher standard
and expected to perform at the highest level of their skill set.
At times the duties fulfilled overlap and the practice of the
nurse becomes more advanced. I truly believe the stipulations
being placed on delivery of patient care, as it relates to nurses
overall, is what has changed the mortality rate; it just so
happens that the nurses, because of requirements, were BSN nurses.


Wood Johnson Foundation. (2014, April 18). Building the Case
for More Highly Educated Nurses
. Retrieved from Robert Wood
Johnson Foundation: https://www.rwjf.org/en/library/articles-and-news/…


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