Current statistics show that at present, there are 1,048 Associate Degree Nursing (ADN) colleges and 696 Baccalaureate Degree Nursing (BSN) institutions in the United States (Cherry & Jacob, 2017). Recent studies show that a correlation exists between patient safety outcomes and whether a nurse has an ADN or BSN. Linda Aiken, PhD, RN, who is associated with the Robert Wood Johnson Foundation (RWFJ), believes that hospitals who employ more BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014). In 2003, Aikens reported on studies done in Pennsylvania hospitals showing a 5% decrease in patient deaths at hospitals that staffed a 10% increase in BSN-prepared nurses (RWJF, 2014). Challengers of Aikens note that these studies raise further questions (Sentinel Watch, 2014). For example, what were the actual causes of death of these patients, and were they related to the action of an ADN nurse? Could there be other factors or causal relationships that affected patient care in these circumstances? In defense of Aikens, the Sentinel (2014) states that no one is calling ADN nurses “bad nurses”. In fact, errors, infections, and adverse events are often due to process and system problems. Aikens maintains that by promoting evidence-based practice and leadership, the BSN curriculum will better prepare nurses to correct problems and implement solutions. I agree that it is advantageous for nurses to expand their knowledge by obtaining a BSN degree, but I do not feel that deaths and adverse outcomes are the result if ADNs care, or lack of. Many other factors need to be considered. For example, poor staffing, long shifts, poor communication, fatigue, documentation errors, etc. affect everyone no matter what type of degree they hold. I have been at the hospital where I am currently employed for almost 20 years and have seen no evidence that the care given by ADNs is substandard to the care given by BSN-prepared nurses. References Cherry, B. & Jacob, S. (2017).Contemporary nursing, issues, trends, & management. St. Louis: Elsevier Robert Wood Johnson Foundation. (2014).  Building the case for more highly educated nurses. Retrieved from The Sentinel Watch. (2014). How does your nursing degree affect patient mortality rates? Retrieved from http://www.american

The debate on whether nurses with an Associate Degree in Nursing (ADN) or a Baccalaureate Degree in Nursing (BSN) provide different levels of care and impact patient outcomes has been ongoing for many years. Current statistics show that there are significantly more institutions offering ADN programs (1,048) compared to BSN programs (696) in the United States (Cherry & Jacob, 2017). Linda Aiken, PhD, RN, a prominent figure associated with the Robert Wood Johnson Foundation (RWJF), argues that hospitals with higher proportions of BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014). Aiken’s research in 2003 found a 5% decrease in patient deaths at hospitals that increased their proportion of BSN-prepared nurses by 10% (RWJF, 2014). However, critics of Aiken’s work question the causal relationship between nurse education and patient outcomes, suggesting that there may be other contributing factors that need to be considered (Sentinel Watch, 2014).

Aiken’s research raises important questions about the potential impact of nurse education on patient safety. However, it is crucial to recognize that patient outcomes are influenced by a multitude of factors, and attributing improvements solely to the educational level of nurses may be oversimplifying the complex nature of healthcare delivery. Deaths and adverse outcomes cannot be solely attributed to ADNs’ care, or lack thereof. Poor staffing, long shifts, poor communication, fatigue, and documentation errors are just a few examples of system-level factors that impact patient care, regardless of nurses’ educational background.

In defense of Aiken’s perspective, it is important to note that no one is labeling ADN nurses as “bad nurses” (Sentinel Watch, 2014). Rather, Aiken emphasizes the need for evidence-based practice and leadership skills that are often more emphasized in BSN programs. By promoting these aspects, Aiken suggests that BSN-prepared nurses are better equipped to identify and address system problems, leading to improved patient outcomes. However, it is important to critically examine the evidence supporting Aiken’s claims and consider alternative explanations for the observed associations between nurse education and patient outcomes.

One limitation of Aiken’s research is the potential for confounding variables. For example, hospitals with higher proportions of BSN-prepared nurses may also invest in other resources and implement evidence-based protocols that contribute to improved patient outcomes. In these cases, it is difficult to isolate the effect of nurse education alone. Additionally, Aiken’s research primarily focuses on mortality rates as an outcome measure. While mortality is undoubtedly a critical indicator of patient safety, it does not capture the full range of patient outcomes, such as quality of life, satisfaction, or functional status.

Furthermore, the availability and accessibility of ADN programs make them a viable option for many individuals who may otherwise be unable to pursue a BSN due to financial constraints or personal circumstances. Limiting access to ADN programs could potentially exacerbate the shortage of nursing workforce, particularly in underserved areas. It is crucial to consider the potential unintended consequences of shifting the emphasis solely towards BSN education and ensure that individuals with ADN degrees are not unjustly stigmatized or discriminated against.

While expanding nurses’ knowledge through obtaining a BSN degree can undoubtedly benefit their practice, it is important to recognize that deaths and adverse outcomes are multifactorial and cannot be solely attributed to nurses’ educational background. Instead of focusing solely on the educational level of nurses, it is vital to address broader system-level issues such as staffing, workload, communication, and patient safety protocols. Future research should aim to explore the complex interactions between nurse education, workforce factors, and patient outcomes to inform evidence-based policies and improve the overall quality of nursing care.