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The delivery of healthcare system has transformed radically since the certification and introduction of the Essentials of Baccalaureate Education for Professional Nursing Practice by the American Association of Colleges of Nursing (AACN, 2008). The baccalaureate education essentials provide a curriculum for nursing education that is suitable for the 21st century (AACN, 2008). It offers the core knowledge and skills necessary by all healthcare nursing professionals with focus on patient-centeredness, interpersonal team relations, evidence centered practices, quality improvement and the patient’s safety, informatics, and clinical thinking. The contemporary nursing profession necessitates supplementary knowledge in genetics, cultural understanding, professionalism, and many other ever-changing issues in the health-care environment (Aacn.nche.edu). However, there has been controversy concerning the non-standardized nursing education that currently exists and confuses the community where some nursing professionals are viewed by others as less educated while common people view them as servants, thus creating a negative environment to the nursing community and constantly argue on who is most qualified.

Background Information and Significance of the Problem

The focus of several health professions, as evidenced by the numerous reports from the Institute of Medicine (IOM, 2004), shows that developing a benign healthcare system has become a major priority in the sector. Nursing has been recognized to have the biggest influence on the healthcare transformation of provision to a higher quality, safer and more cost-effective system (Bosher & Pharris, 2009). In addition to the apprehension over healthcare results, the US and the global market are facing a nursing deficit that is projected to increase because of the rise in demand for various nursing services. This has led to the rise in number of baccalaureate-equipped nurses with different qualification levels to try addressing the need.

The AACN, which oversees the baccalaureate nursing programs, considers that education plays a substantial role in the knowledge and proficiencies of the nurse clinicians and all health care providers. According to AACN (2008), nurses holding BSN degrees are considered better equipped to meet the present nursing demands. BSN nurses are valued for their skills in leadership, management, critical thinking, health promotion (Aacn.nche.edu) and for their capability to efficiently practice across a range of inpatient and outpatient situations including federal agencies, top nursing organizations, military health care foundations, marginal nurse advocacy groups and magnet hospitals that collectively recognize the distinctive value that baccalaureate-prepared nurses offer (Blais & Hayes, 2011).

AACN also encourages employers to exploit the knowledge and experience offered by the diverse educational programs that end up to the registered nurse (RN) certification. They also encourage BSN graduates to pursue the employers who value their high level of education and unique competencies (Aacn.nche.edu).

Approaches to Nursing Education

There are three methods that can be used to become a registered nurse: (1) by going through a 3-year diploma course that is administered in hospitals, (2) a 3-year associate degree course generally offered at community colleges, (3) a 4-year baccalaureate degree administered in the senior colleges and universities (www.nursetogether.com). Graduates from these three programs must then pass National Council Licensure Examination for Registered Nurses (NCLEX-RN) (www.nursetogether.com) licensing examination before they are allowed to practice.

Nurses Should Undergo Four Years Degree Program

Baccalaureate customized BSN nursing programs incorporate all the coursework covered in diploma and associate degree programs and an additional more comprehensive study of nursing research, public health, social sciences, community health, humanities, physical sciences and nursing management (Aacn.nche.edu). The supplementary coursework the BSN go through enriches the student’s professional advancement, prepares the student nurses for a wider scope of practice, and gives the nurses a clearer understanding of the social needs, political influences, cultural background, and economic concerns (Blais & Hayes, 2011), that affect patients and influence the quality delivery of health care. The comprehensive coverage of miscellaneous subjects like math, social sciences and community health among others make BSN nurses have better analytical and pubic relation skills that are rather essential in handling patients. The study of nursing research also gives the BSN degree nurses knowledge and skills to research on a pandemic and make recommendations on best practices to handle the widespread outbreaks. Equally, the research helps the nurses understand the history of the diseases in a particular region, which makes a strong point for illnesses treatment. This wider scope of application makes the 4 year BSN degree program superior to the diploma and associate course since the nurses can professionally and efficiently handle more situations than their counterparts (www.nursetogether.com), and, therefore, should be embraced by all. This provision of different nurses standards in the three programs has left more questions than answers on the competencies of the diploma and associate nurses compared to the nurses holding BSN degrees who are presented to be more qualified. Despite the fact that the three groups of nurses pass the licensing exam before they are allowed to practice, BSN graduates are more qualified and need to be treated as high grade specialists because of the higher number of units taken.

Strategies to be Employed to Promote BSN

To make the students appreciate BSN as an advanced nursing course and to persuade the students to see the essence of taking the abovesaid program, the BSN examinations should be administered by separate exam boards in order to create the distinction. They should also be given different titles from the commonly used ones which collectively identify all as equal upon graduation, despite the BSN graduates studying longer in the universities and paying bigger fees to earn their degrees. Similarly, the BSN graduates need to enter the job market at a higher job group level that attracts more work benefits than the nurses from diploma programs. When these strategies are they will encourage more students to prefer the BSN to the nursing certificate qualifications, and make them command more respect for professionals from other fields and to win public confidence.

Pros of the Problem 

After four years of study, the BSN degrees usually enjoy the benefit of obtaining higher salaries than the diploma graduates. The BSN nurses are preferred by the employers because of the comprehensive competences (Aacn.nche.edu). Similarly, more exposed patients and community members prefer the BSN nurses when seeking medical attention and occasionally ask for being attended by certain nurses. This experience can be very demoralizing to the rejected nurses, thus standardization is required. BSN degree also allows the individuals to advance to management positions or pursue additional education. This degree is favorable if the graduate intends to be a nurse practitioner or a Certified Registered Nurse Anesthesia (CRNA) in future. This status is restricted to the degree holding nurses (Blais & Hayes, 2011). ADN degrees and Diploma certification may not be preferred for career advancement into managerial roles, unlike the BSN who are preferred because of their rich knowledge in social, political, cultural, economic, and computation skills. Equally, it is very difficult for ADN graduates to enroll for master’s accreditation or nurse practitioner status (Aacn.nche.edu). This restriction is an advantage to the BSN graduates who are considered more qualified.

Cons of the Problem

Attaining the BSN degree is more expensive than earning the diploma and associate degree. This means that fewer students may comfortably afford to pay the required fees, resulting in the lower number of students. With the presently existing deficit of nurses in the global market, because of the increased demand for different nursing services, the plan of having all nurses go through the 4 year BSN course may prove to be detrimental in case the enrollment declines. It also takes longer years to adequately train a nurse than the 2 year diploma and associate degree programs are used (www.nursetogether.com).      

Philosophical Assumption Strategies and Remedies

It is assumed that the nursing services rendered by the licensed nurses are of equal standard irrespective of the certification level. This is because all the three groups must pass the licensing exam before they are allowed to practice (Bosher & Pharris, 2009). To respond to the community demands, to transform the healthcare system and the training of healthcare professionals, AACN has upheld the debate with an extensive representation of stakeholders with focus on the knowledge, skills, and attitudes needed by nurses to practice effectively, which is tested by the Baccalaureate Education essentials administered through the NCLEX-RN. Nursing education should also train future professionals to provide patient centered health care as members of inter-professional team, with emphasis on evidence-based practice, informatics, and quality upgrading methods, thus the call for standardization.

Conclusion

Nursing influences greatly the overall transformation of healthcare provision to a higher quality, safer and more cost-effective system (IOM. 2004). This transformation is aided by the Baccalaureate Education essentials that provide a curriculum for nursing education that can efficiently address the currently emerging issues (AACN, 2008). BSN degree offers the core knowledge and skills necessary to all healthcare nursing professionals by focusing on patient-centeredness, interpersonal team relations, evidence centered practices, quality upgrading, and safety of patient, informatics, and clinical reasoning (Aacn.nche.edu). However, there had been growing concerns over the perceived non-standardized nursing education where nursing students undergo different levels of study for diploma certification, ADN, and BSN degrees and pass independent exams in their respective colleges but provide the same level of services (www.nursetogether.com). This has led to confusion within the community. To adequately respond to the push for transformation, nursing programs should be standardized to the 4 year BSN program that train students on a wider scope of competencies. AACN on the other hand engages all the stakeholders to put more emphasis on the delivery of knowledge, relevant nursing skills, and attitudes needed by nurses to practice.

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