The level of expertise for a registered nurse is critical for quality patient care (McHugh & Lake, 2010). As the population of the United States becomes increasingly old, there is need for nurses to be prepared for the numerous challenges in the healthcare setting. There are different levels of education for a registered nurse in the United States, which prepares nurses to work in different hospital settings or to advance their education. The levels of education have different levels of educational preparation and responsibilities.
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Associate Degree in Nursing (ADN)
Educational Preparation
The most common way of becoming a registered nurse (RN) is through the associate degree in nursing. The degree program takes two years to complete before taking certification exams to become a practicing nurse (NurseJournal, 2016). Before enrolling for the RN program, one is required to have prerequisites such as biology, math, chemistry and English. The ADN classes are offered according to the area of specialization such as microbiology, anatomy, nutrition, pharmacology and physiology. The program offers practical skills such as insertion of catheters, operational of technical equipment, starting of intravenous lines, both in class as wells as in hospital shifts.
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Levels of Responsibility
The major responsibilities of the registered nurse or ADN, is to work in the healthcare setting or specialties taking care of patients. Their work includes making diagnostic tests, documenting in charts, performing treatments and giving medications to patients. In addition, they work in advocacy, educating patients and families in order to meet their needs.
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Benefits and Challenges
The ADN is not a specialty program, which offers the benefits of diverse job opportunities. Although it is more affordable and takes reasonably short time to gain licensure, the ADN offers no specialization, which means the RN works in all aspects of patient care. The ADN also offers no opportunity for leadership and management positions due the general kind of education.
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Baccalaureate (Bachelor of Science in Nursing- BSN)
Educational Preparation
The standard or generic baccalaureate program is a four year college or university education, which incorporates a variety of courses, education and professional training (American Association of Colleges of Nursing, 2017). The baccalaureate program is designed for high school graduates without previous nursing experience. The first two years in college includes classes in humanities, social sciences, nutrition, ethics, sociology, basic sciences and basic sciences.
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The general requirement for the bachelor’s of science in nursing varies depending on education and experience (American Association of Colleges of Nursing, 2017). The RNs who wish to gain reentry into the baccalaureate degree program must possess a valid RN license and an associate degree or hospital diploma. In some programs, the baccalaureate education may start in sophomore classes. The admission into the last two years of the baccalaureate degree program requires an average GPA of 2.8. Moreover, the baccalaureate degree program is offered in diverse settings, including clinics, healthcare maintenance organizations and community hospitals.
Levels of Responsibility
The BSN graduates enter the field of nursing as generalists with the foundation for graduate studies in nursing profession. The BSN accredited graduates have responsibilities of working in all the healthcare units, including the ICU, outpatient, mental health and public health. According to (American Association of Colleges of Nursing, 2017) the BSN nurse is also suited to work in neighborhood clinics, outpatient centers and private homes. Other responsibilities include planning of nursing care, supervision of other support staff and nursing personnel, guide and educate patients on available healthcare options.
Benefits and Challenges
The BSN nurses have the benefit of moving higher in the administrative and management positions (American Association of Colleges of Nursing, 2017). BSN nurses can work alongside physicians in research or sometimes hold clinical teaching positions. In addition to more preference by the employing organizations, the BSN offers many job outlets than the ADN. A BSN nurse has an opportunity to pursue many nursing education and certifications, for example the clinical nurse specialist (CNS) and nurse practitioner (NP).
However, the BSN degree is expensive and takes longer (4 years) to complete, compared to the ADN. In addition, the BSN nurse faces more challenges due to increased work overload that arise from their generalist and wide area of responsibilities.
Master of Science in Nursing (MSN)
Educational Preparation
The RNs who wish to advance education can apply for the Master of Science in nursing (MSN) (Raines & Taglaireni, 2008). To be eligible for MSN the applicant must possess a bachelor of science in nursing, associate degree in nursing or diploma in nursing from accredited institutions. Moreover, the applicant must have a GPA of at least 3.0, with strong proficiency in statistics and English. The Master of Science in nursing program includes classroom instruction and nurse training in clinical setting. The MSN can lead to a number of specialties, which include nursing administration, public health, mental health, nursing health informatics and adult gerontology.
Levels of Responsibility
The Master of Science in nursing RNs play an important role in advanced care setting providing more specialist role. In addition, their levels of responsibility extend to design and implementation of advanced healthcare plans, performing healthcare research and implementation of healthcare programs such evidence-based healthcare.
Benefits and Challenges
The MSN nurses enjoy a more specialty roles in the healthcare setting. The MSN provides the nurse with an opportunity for managerial and leadership roles. In addition, the MSN registered nurses enjoy a higher pay package. However, it is expensive to pursue the MSN compared to the BSN. The MSN nurses work in more challenging environment as they are required to make important patient decisions and implement healthcare models within healthcare setting.
Doctor of Nursing Practice Program
Educational Preparation
Doctor if philosophy in nursing prepares registered nurses for advanced clinical practice, health administration and advanced knowledge in healthcare, which enables them to conduct and publish nursing research papers (American Association of Colleges of Nursing, 2017). The degree program generally takes three year, with course work and dissertation. The graduates of the program can go on to become future nursing lead researchers and lecturers. One must be a registered nurse with bachelors and masters degrees in nursing from accredited institution(s).
Benefits and Challenges
Doctor of philosophy in nursing allows one to take part in major nursing research projects that directly impact primary care. Moreover, the graduates of the program enjoy higher wages that the nursing graduates of masters and bachelors programs. However, the PHD degree is expensive and requires a lot of dedication to complete. The PHD in nursing may take longer three years due to complexity of the practical dissertation project.
Similarities and Differences among Nurses at all Levels of Education
Regardless of the level of education, all nurses must pass the National Council Licensure Examination (NCLEX). This is a requirement for all registered nurses in the United States. In addition, the BSN, MSN and PHD in nursing prepares nurses for leadership and management roles in healthcare setting. The major differences are the path and time commitment that are required to complete the entire degree program. The ADN takes 2 years, BSN 4 years, Master of Science in nursing 1-2 years and PHD about 3 years. Another major difference is the areas of specialties, the AND is the most general of all the levels, while the masters and PHD prepares nurses for specialty roles. In addition, the BSN, MSN and PHD prepare RNs for management and leadership roles.
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How Level of Education Changes the Role of a Nurse
As the nurse advances in level of education, the graduate nurse takes more specific roles in the healthcare setting. The change in education from ADN to BSN prepares nurse for management and leadership roles. The change in education from BSN to MSN prepares nurse for advanced clinical practice such as research and implementation of evidence-based nursing practice, while change in education from MSN to PHD in nursing prepares a RN for role in nursing research and advanced healthcare practice.
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