There are three different paths to entry into a career as a Registered Nurse. Hospital based diploma programs where started in 1873 and were the first formal education for nursing. Baccalaureate nursing programs began in the 1950’s. However , these programs weren’t able to train enough new nurses to meet the needs after World War II so entry level 2 year associate degree programs where created and after a 5 year study of the competency level of these nurses they were employed as graduate nurses. ADN programs prepare more nursing graduates today than BSN and diploma programs combined.
The three types of entry level nursing program have helped meet nursing shortages and also opened the profession to nontraditional students. It has also created confusion among the public as well as the professions as to the exact educational requirements of a professional nurse (Creasia, J. L. , & Friberg, E. E. 2011). A survey showed that Baccalaureate or Master’s prepared nurses make up approximately 50% of the workforce with Associates prepared and Diploma prepared nurses making up approximately 36. 1% and 13.
9% of the work force respectively. All graduates of entry- level nursing programs are required to take the NCLEX-RN examination to obtain licensure as an RN. However, according to the AACN, even though graduates from the different programs enjoy the same pass rate on the examination this does not mean that these programs are equal since the NCLEX-RN only tests “minimum technical competency for safe entry into basic nursing practice and does not measure all the skills and knowledge developed” (Rosseter, R. J. 2012).
There are many studies relating patient outcomes to nursing education level that show that a higher number of baccalaureate prepared nurses leads to better patient outcomes. A study published in the September 24th, 2003 Journal of the American Medical Association found that surgical patients have a “substantial survival advantage” if treated in hospitals with higher proportions of nurses educated with baccalaureate or higher degree level. It went on to state that a 10% increase in the proportion of nurses holding a BSN decreased the risk of patient death and failure to rescue by 5%.
A second study published in the January 2007 Journal of Advanced Nursing confirmed this, stating that a 10% increase in the proportion BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death (Rosseter, R. J. 2012). I chose the ADN route as my entry into the nursing profession for several reasons. First of all, when I first attempted college at the age of 18 I was less than motivated and was easily influenced by the temptations of going to school in a large city. My studies where not my top priority and my grades suffered.
I was eventually kicked out of school with a 1. 8 GPA average. For this reason I was not eligible for the highly competitive BSN programs. Also, when I decided to return to school to pursue my RN license I was married with a 4 year old son and a daughter on the way. The ADN program had a waiting list which guaranteed eventual placement despite my GPA at the time, was faster which allowed me to enter the profession and provide a better life for my family in less time, and cost substantially less than the university based BSN programs which meant less debt once I graduated.
With that said I quickly noticed I was less than prepared for all the challenges I would face as an RN. My first job after graduation was as a Circulating Nurse in the Operating Room. Trying to combine all the aspects of nursing in this fast paced setting was very challenging. As a circulating nurse you need to be able to communicate with your patient and there family in the brief 5 minutes you have with them before wheeling back for surgery, answering all their questions and concerns and instilling confidence in your abilities.
Then assist the anesthesia provider with the induction of the patient, dealing with situations that may arise from difficult airways and adverse reactions to the anesthetic. Apply knowledge of anatomy while positioning the patent taking into consideration factors such as age and disability that my affect your ability to position them properly for the procedure. Communicate with the surgical tech, who may not have the knowledge of anatomy, physiology or pharmacology but will be the person assisting the surgeon during the surgery and will be passing the medications to them.
As well as communicating potential difficulties based on my assessment to the surgeon that may cause them to have to alter their plans for the procedure. I found this very difficult having no experience and only 2 years of school. I have no doubt that had I entered into the profession with a BSN, and the advanced knowledge of therapeutic communication, assessment, pharmacology, and anatomy and physiology it would have provided, I would have been able to handle these situations better and that even though I have grown a lot since I’ve started my pursuit of a BSN is going to better equip me to handle situations in the future.