Both associates and bachelors degree prepared professional nurses are expected to manage their patients’ care by making clinical decisions through the nursing process, and share findings with other members of the health care team (Mathews, 2013). It has been proven through evidence-based research however, that baccalaureate degree prepared nurses directly improve patient outcomes, and patients deserve the best-prepared nurses participating in their care (Rosseter, 2012). According to Mathews, (2013) the bachelor’s graduate nurse assures patient safety and better outcomes by using evidence based research in order to critically think and address clinical care issues that arise. By being proficient in systems thinking and data management the baccalaureate nurse is often able to lead practice teams in better clinical care management of health promotion across populations.
In a patient care situation the thinking of an associates degree nurse, and the thinking of a bachelors degree nurse may differ when it comes to care in a critical situation. The bachelors degree prepared nurse is proficient in the many theories of the metaparadigm concepts of nursing including person, environment, health/illness, and nursing (Creasia & Friberg, 2010). She takes concepts from various theorists’ abstracts and applies that knowledge to real world situations in order to make a clinically sound decision on nursing assessment and care (Creasia & Friberg, 2010). For instance a patient is admitted to a cardiac floor for treatment of shortness of breath related to congestive heart failure. She is being treated with beta-blockers and intravenous Lasix, however her blood pressure is running low consistently, and sometimes the medications are being held because of this. The patient also has a cough and foul smelling urine, and the nurse asks to send sputum and urine cultures respectively. The patient does not have a temperature or elevated white blood cell count at this time. After working with the interdisciplinary team the nurse advocates for a repeat chest x-ray for her patient. The next day the nurse comes onto her shift to find that the patient has positive urine and sputum cultures, and chest x-ray reveals questionable pneumonia. The patient has already been started on antibiotics. At this point the bachelors degree prepared nurse would take all this information as a whole and continue to investigate further, where the associates degree nurse may continue to follow orders already placed by the doctor/health care team. Using information put in place by theoretical frameworks of the metaparadigm of nursing, the nurse views the patient as a whole and continues to critically investigate the findings of this patient (Creasia & Friberg, 2010). The bachelor’s nurse recognizes that with positive infectious process and low blood pressure the patient may be septic and requests for blood cultures, which should have been sent before initiation of antibiotic therapy and was overlooked, and a lactate level. Both lab values came back positive and the patient is moved to the intensive care unit for observation because of the more educationally prepared nurses ability to think of the person as a whole and use evidence based practice in her decision making for her patient. Lower patient mortality rates, positive patient outcomes, and fewer medication errors are all directly linked to the educational qualities that the bachelor’s degree nurse possesses (Rosseter, 2012).
Continuous changes in healthcare practice drive the need for better-prepared nursing staff