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Running Title: NURSING DEGREES



A 20 Pages Term Paper on Nursing Degrees


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Introduction

           The Schools 0f Nursing and many such like institutes declare their commitment to the highest standards of lifelong learning and excellence in the helping tradition. They all are committed to prepare men and women for compassionate practice as competent professionals through scholarship, leadership in service to the community, the nursing profession, and personal growth. With the present disciplines and credits, the curriculum is designed in such a fashion that they encourage close student-teacher relationships in preparing nurses who exemplify the highest ethical standards, integrity, and passion for justice in health care. They are dedicated to developing critical reasoning vital to judgment and ethical decision-making in professional practice. In the tradition of Jesuit education, they claim to provide a foundation for nursing knowledge and a spirit of inquiry. They also claim to foster the search for human and ethical alternatives to solve contemporary nursing and health care problems through applied clinical research. The faculty all students act as full partners in learning, who create an environment that celebrates a multicultural society through sensitivity, compassion, respect, and creativity. They motivate students to eloquently advocate for patient needs and high quality care, balancing technology with a humanistic approach. The emphasis is on holistic view and integration of the intellectual, psychological, and social aspects of personhood in the promotion and maintenance of health and in the provision of nursing and health care.  They see a perspective that considers the ecological influence on human needs and health for nursing and health care in the 21st century.

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           Some of the institutes are offering distance learning for nurses, to help them m earn a fully accredited nursing degree. Now they can earn their ADN or BSN while studying at their convenience from anywhere. The institutes also don’t require binding contracts; features affordably priced study materials, include self-help evaluations and most importantly, provide great support to guide through the process of earning the degree.  The question arises whether the degrees being awarded for different courses are the same in their usefulness? [Miller, B., Adams, D., and Beck, L. (1993)]

The Curriculums

           If a deeper look is made over the syllabi of different courses we find that there is not much difference in them rather with little amendments the curriculum is modified. There are several paths a person can take once he or she decides to become a registered nurse. Nursing students receive their basic education in a variety of settings and attain different degrees. All new graduates must pass the same RN licensure exam (NCLEX-RN). The bachelor’s degree is a step ahead of ADN called BSN. Lets have a look over their requirements.

High School Preparation

For the Associate Degree in Nursing:

            Recommended high school preparation includes study for two years of algebra, one year of biology, and one year of chemistry. However, students who do not complete the recommended preparation may do the ADN and BSN programs by successfully completing the prerequisite and non-nursing classes.

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For the Bachelors of Science in Nursing

The minimum requirements for admission include:

  • Two years of high school algebra, or intermediate algebra in college (with a 2.0 or higher)

Two years of a single foreign language in high school, or two quarters in college

ADN Requirements

           Associate Degree in Nursing (ADN) Program admits students through The Nursing Admissions Committee to consider for admission, students who meet the following minimum prerequisites:

  • Satisfactory completion of high school or equivalent (GED);
  • 2.0 GPA in each non-nursing academic course taken to meet graduation requirements for the AAS in Nursing;
  • Completion of the following prerequisite courses:
    • Bio- Human Anatomy & Physiology I & II;
    • English - English Composition;
    • Chem. - Introduction to Chemistry;
    • Psych - Survey of Psychology;
    • Psych - Life Span Development;
    • Social Science elective.

           Students must have completed or be enrolled in pre-requisite courses. The AND is an associate nursing degree, which has a curriculum, designed to prepare the nurses in bachelors: -

Nursing Concepts 1,
Nursing Concepts 2
Nursing Concepts 3
Differences A
Differences B
Differences C
Occupational Strategies

Students, who attend a two-years community college that offers an ADN program, receive an associate degree in nursing.

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Pre-Professional Admission

           Students are also admitted to a Pre-Professional prior to beginning the BSN Program in some institutes.  Students who have completed or are in their second year of the ADN Program may consider this option. Students may utilize parallel tracking while completing the ADN Program and in the Pre-Professional status. Parallel tracking means that students enrolled in the ADN Program and as a Pre-Professional may make academic progress in both programs concurrently. As Pre-Professional Nursing student a student may enroll in upper division courses such as statistics or other Liberal Studies courses in order to:

  • Meet the prerequisite requirement in statistics and/or intermediate algebra; and
  • Count the credits as part of the 10 required credits in Liberal Studies and/or the remaining 3 elective credits, if needed, required to complete the BSN Program.

           Completion of the credits prior to beginning the BSN Program means that students have more flexibility for work, school and personal activities as well as decrease stress during completion of either the full or part-time program.

BSN Requirements

The students who attend the BSN program are taught following disciplines: -

Health Restoration I
Health Restoration II
Health Support A
Health Support B
Professional Strategies
Research in Nursing

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Students who complete a four-year program at a college or university receive a bachelor of science in nursing. In addition, many schools offer RN-to-BSN programs tailored to nurses who are already practicing with their associate degree.

Generic BSN programs:

        Citing the need for nurses to take on more responsibility in an increasingly complex health system, an advisory panel to the federal Division of Nursing has recommended that at least two thirds of the basic nursing workforce hold baccalaureate or higher degrees in nursing by 2010. According to the American Association of Colleges of Nursing the 10 largest generic BSN programs by enrollment are:

Regents College New York

Texas Woman's University
University of Wisconsin-Oshkosh
Kent State University Ohio
Hawaii Pacific University
University of Illinois at Chicago
University of South Carolina
Northwestern State University, Louisiana

Hospital Diploma

            A small percentage of RNs go through a three-year hospital training program, receiving a hospital diploma. Such programs were common in the past but have become rare.

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RN-to-BSN programs

            Many RN-to-BSN programs are tailored to working adults. The programs may offer evening and weekend classes, and "distance learning" opportunities, which enable students to complete coursework from home or via the Internet rather than attending classes’ onsite. According to the American Association of Colleges of Nursing the 10 largest RN-to-BSN programs by enrollment are:

Regents College (a "virtual university") in New York
University of Phoenix
Grace land College Missouri
Carlow College Pennsylvania
Saint Joseph's College Maine
Wilmington College Delaware
State University of New York - Institute of Technology at Utica/Rome
Florida International University
Pennsylvania State University
Indiana Wesleyan University
University of Southwestern Louisiana
Southeastern Louisiana University

Previously regent’s tests were conducted but now the Regents Exams are no longer required for the BSN Program.

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The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is taken after completion of the ADN Program. Licensure as a Registered Nurse in the state of Washington requires successful completion of the NCLEX-RN.

The institutes also grant credits toward the BSN Program for a student who successfully passes the NCLEX-RN. A student is required to provide proof of current licensure for practice as a Registered Nurse in Washington prior to the end of the first quarter of the BSN Program.

Master's and doctoral degree

           According to the American Association of Colleges of Nursing the number of master's nursing students has climbed over the past decade in response to rising demand for nurse practitioners, clinical specialists and other RNs with advanced practice skills. In 1996, 9% of nurses had master's degrees and 0.6% had doctoral degrees. According to the AACN there are 10 largest master's programs by enrollment offered at various universities.

ADN to BSN Program

Four Years Model Program of Studies for Excellence in Nursing in Education is based on the:

  • Courses students are recommended and/or required to complete in high school are for them to qualify for admission to the ADN and BSN Programs;
  • Associate Degree in Nursing (ADN) Program.
  • National Council Licensure Examination for Registered Nurses (NCLEX-RN).
  • One year full-time Bachelor of Science in Nursing (BSN) Program  (or the seven-quarter part-time BSN Program).

The Four Year Model Program of Studies features:

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  • One year of prerequisite and non-nursing courses required prior to entering the ADN Program (most of these classes also are required for admission to the BSN Program);
  • The two year ADN Program with additional prerequisite courses required for admission to the BSN;
  • Completion, if needed, of remaining Humanities (VLPA) and Social Sciences (I&S) in the BSN; and
  • The one-year BSN Program from the NCLEX-RN exams applying to the BSN degree.
    There are yet more institutes, which offer further training of nurses at Masters level. The School of Nursing for example offers two degrees:
    • Bachelor of Science in Nursing (BSN)
    • Master of Science in Nursing (MSN)

The Bachelor of Science in nursing degree program includes a four-year Baccalaureate degree program in Nursing (BSN) and an ADN to BSN Completion Program.

The Master of Science in nursing degree program

            The Master of Science in Nursing (MSN) in advanced practice and clinical systems management, a Masters Entry Option (MEO), a joint Master of Science in Nursing and Master of Business Administration (MSN/MBA), a dual degree Master of Science in Nursing and Master of Public Administration (MSN/MPA), and non-degree programs such as continuing education programs and a Post-Masters FNP Certificate Program.

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            The California Board of Registered Nursing accredits the baccalaureate degree program and the Nurse Practitioner programs. The baccalaureate and masters programs are both accredited by the National League for Nursing. The curriculum includes: -

Philosophy of the School of Nursing
Bachelor of Science in Nursing Program
ADN to BSN Completion Program
LVN 30 unit Option
Associate Degree to Bachelors Degree Completion Program
National Council License Examination (NCLEX)
Public Health Certificate
Undergraduate Outcomes
Policies and Procedures
Undergraduate Course School of Nursing
[University of California San Francisco]

Nursing Education Analysis

           Formal nursing education in the United States had its antecedents in Europe and England. Pastor Theodor Fliedner for the Order of Deaconesses began one of the first formal training programs for nurses in 1836 in Kaiserswerth, Germany. Other religious orders were also providing formalized training for nurses in Europe at that time, but Fliedner's school is noteworthy for having given the British nursing reformer Florence Nightingale her formal training. Her experience at Kaiserswerth gave her the impetus to organize nursing care on the battlefields of the Crimean War and, later, to establish a nurse training program at Saint Thomas's Hospital in London. In the late 1800s training schools patterned after this model were established in the United States.

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           Originally, nurses received little or no classroom preparation. Most of the training was based on apprenticeship, with older students teaching the younger ones how to care for patients. All programs were directed by hospitals, and nursing students provided low-cost service to the institutions; upon graduation, most of them worked as private-duty nurses in patients' homes. Hospital-based programs still exist today and are known as diploma schools of nursing. They offer a sound educational background for nursing practice in a program that contains both theoretical information and practical experience, but the diploma they grant is not an academic degree. Most diploma schools, however, are affiliated with a college where the nursing students can take courses for academic credit. In recent years, some hospitals have applied to their state boards of higher education for permission to award an associate degree in nursing. This trend has sparked debate within the nursing profession over the question of whether a hospital can qualify as an institution of higher education. The major focus of diploma education is to prepare nurses to give direct bedside care in hospitals, nursing homes, and other institutional settings. Graduates of these programs are eligible to take the licensing examination in the state in which they wish to practice. Upon passing, they may legally practice nursing and are allowed to use the initials RN (registered nurse) after their names. [:  F.A. Davis, 1997]

           Many diploma schools closed after 1965, when the American Nurses' Association (ANA) published a position paper stating that all nursing education should take place in institutions of higher learning. The organization also recommended two levels of nursing practice: professional and technical; the professional nurse would have a baccalaureate or higher degree, the technical nurse would have an associate degree, and the technical nurse would work under the direct supervision of the professional nurse.

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           Associate degree nursing programs were introduced in the United States in 1952. They are primarily offered by community colleges, although a number can be found in four-year institutions. It is a two-year program that strongly emphasizes technical skills supported by a basic foundation in biological and behavioral sciences. The associate degree graduate also takes the state licensing examination and can practice nursing using the initials RN. Baccalaureate degree programs in nursing are found in colleges and universities throughout the United States. The program takes four years to complete and provides a strong base of liberal education in the arts, sciences, and humanities. These programs also emphasize bedside patient care, and provide courses in community health nursing, leadership and management, and nursing research. Graduates take the same licensing examination as other graduates and also receive the RN designation.

           Master's and doctoral degrees in nursing usually require the applicant to be a graduate of an accredited baccalaureate-nursing program. The emphasis of graduate programs is primarily on research, advanced clinical practice, and the preparation of nursing educators and administrators.

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           The practical nurse has an education and license very different from that of the registered nurse. The program for practical nurses takes approximately one year and includes classroom work and practical training in a hospital. Such programs are usually offered through vocational or technical schools, and graduates must also take a licensing examination in order to practice. The test, however, is different from that taken by RNs. After passing the examination, these graduates may use the initials LPN (licensed practical nurse) or LVN (licensed vocational nurse) after their names. These nurses practice under the supervision of the registered nurse.

           One of the on going challenges is receiving the respect the nurses deserve, from other professionals and from the public.  Nursing has earned the right to call itself a profession; it is a unique discipline and in no way inferior to other disciplines. [Dickson G,]

            Can they demonstrate this through receipt of degrees AND or BSN or other courses?  What are the characteristics of their "profession"?  The behaviors contribute to professionalism, as follows:

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  • There is an educational background required to ensure safe and effective practice.
  • All have been through nursing school with required degrees.        
  • Members of the profession adhere to a code of ethics.
  • The ANA Code with its eleven standards defines the profession’s ethical practice.
  • Members participate in professional organizations.
  • There are hundreds of professional organizations; many nurses choose to belong to one or more.  The largest is the ANA but there are specialty organizations centered on areas of practice.
  • Members are accountable for continuing education and competency.
  • The nursing professional keeps his or her knowledge base current by formal and informal ongoing education, and can demonstrate that competency when required.
  • Professionals publish and communicate their knowledge and advances in their profession.
  • This can occur formally, as in nursing publications, less formally, as on the Web, or informally, in one-to-one communication.
  • Members of the profession are autonomous and self-regulating.
  • Nurses make independent decisions within their scope of practice and are responsible for the results and consequences of those decisions.
  • Professionals are involved in community service.
  • Nurses formally and informally disseminate health promotion information in their communities.
  • A profession develops, evaluates and uses theory as a basis for practice.
  • Nursing has been based on theory since the time of Florence Nightingale, and has incorporated the work of such notables as Imogene King, Virginia Henderson, Dorothea Orem, Jean Watson and others into models for practice.
  • Members of the profession are involved in research.
  • Nursing as a profession and individual nurses are integrally involved in research   and expanding the knowledge base to ensure the most up-to-date, safe and effective practice.

The profession is unique, vital and worthy of respect. They hold patient's lives in their hands, and have earned the right to the esteem of the public and other disciplines.

Conclusion

           Having known the educational requirements of both nursing associate and baccalaureate degrees it is found that they teach almost the same curriculum. There is not a big difference in the course program and description. The influences/correlations the degrees have on the   nursing practice today. It is evident that there is no difference in the ADN and BSN degrees. The students from both programs must take the same licensure exam in order to be certified. Therefore, the knowledge base for both the ADN and BSN programs are the same. The only difference is that one goes to school for a total of four years to obtain a BSN, and a total of two years for an ADN. This means that the baccalaureate grad has no more knowledge then the associate grad does.

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References

Miller, B., Adams, D., and Beck, L. (1993). A Behavioral Inventory for Professionalism in Nursing- Originally published in the Journal of Professional Nursing; cited in Nunnery, R., Advancing Your Career:

Concepts of Professional Nursing.  Philadelphia:  F.A. Davis, 1997

School of Nursing University of California San Francisco

http://nurseweb.ucsf.edu

Washington university Bothell http://www.bothel.washington.edu./nursing/

Dickson G, et al. New Jersey Nursing Shortage Fact Sheet- December 2001. New Jersey Colleagues in Caring, A Collaborative Nursing Workforce Project

Dickson, G. The Scope of the New Jersey Nursing Shortage and Recommendations to Address

 
 


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