Difference in Competencies between ADN and BSN nurses

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In the nursing profession, entry-level nurses have either completed an Associate’s Degree in nursing or a Bachelor’s degree in nursing. Both degrees train students to perform at a minimum competency level and both train students to perform nursing tasks in all the main areas which include adult medical- surgical, maternal-child, and mental health nursing. ADN and BSN graduates are both required to take and pass the NCLEX licensing exam before they can practice as a nurse. Even though both degrees train students to perform the same duties as a nurse there are some differences between the two programs.

Nurses prepared at an Associate’s degree level are prepared in a two year program at a community college level. Associate degree programs focus on nursing theory and skills. ADN graduates are taught professional and ethical behavior, effective collaboration with others in providing healthcare, application of nursing knowledge, and to provide care in a safe and caring manner to all patients. ADN programs prepare students to perform at a more technical and task oriented level. ADN programs focus more on clinical skills instead of leadership, nursing theory, or public and community health nursing. ADN nurses are basically prepared for bedside nursing, and practice with the fundamentals of nursing. The ADN programs were created after World War II due to a shortage of nurses and high demand of nurses (Rines, 1977).

Nurses prepared at a Bachelor’s degree level are prepared in a four year program and a University level. BSN graduates are taught critical thinking skills, decision making and problem solving, leadership, technological competence, effective communication, population-based health, professional behavior, and clinical practice. BSN programs place a large emphasis on leadership, nursing theory, and critical thinking. BSN nurses are more prepared to be in a leadership role. BSN programs also educate their students in areas such as nursing research, nursing management, humanities, and public and community health nursing.

Emphasis on professional development prepares for a broader scope of practice. BSN nurses are more prepared and educated when it comes to factors that affect patients and the delivery of healthcare, such as social, political, cultural, and economic factors. They are prepared for patient care outside of the inpatient hospital environment. They are qualified to work in places such as community health centers, as school nurses, and can be clinical instructors for nursing colleges. BSN nurses will fill the roles as case managers, clinical nurse educators, and nurse managers in and out of the hospital setting.

The American Association of Colleges of Nursing (AACN) and others involved in nursing research have a strong belief that nurse’s education level strongly impacts their delivery of patient care and that patients have better outcomes when cared for at facilities with a higher number of BSN employed nurses. “Recent studies clearly demonstrate that a higher prevalence of baccalaureate-and-masters prepared nurses at the bedside positively impact patient outcomes, (www.cinhc.org/programs/educational.html).”

Both ADN and BSN nurses provide direct patient care to patients with more than one nursing diagnosis. They work with a multi-disciplinary team to ensure that all patients have the best outcome. ADN and BSN nurses must have strong communications skills. Both delegate care to non-licensed health care personnel and take full responsibility as to the care they provide. The focus for all nurses is to advocate for their patients and provide a safe and healthy environment to promote healing. ADN and BSN nurses educate patients and families in order to prevent further disease and illnesses.

ADN and BSN both posess the same skill sets as far as hands on care. They are equally proficient in obtaining vital signs, starting IV’s, performing patient assessments, assisting with bathing, toileting, and other ADL’s. Both practice medication safety and monitor patients for potential side effects. All nurses practice to maintain a safe environment for their patients. They provide care to patients with many different illnesses and in many different specialty areas.

ADN and BSN nurses both deal with patients from many different ethnicities, religions, beliefs, and lifestyles. All nurses regardless of their degrees must learn how to establish a nurse-patient relationship. In situations where a leadership role is needed, a BSN nurse would be a better candidate. In a high stress situation which involves a patient’s immediate outcome, a BSN nurse is better educated in disease processes and has stronger leadership skills. Though both ADN and BSN nurses provide direct care at bedside, BSN nurses have a stronger foundation in nursing, and are educated to perform in higher positions in the nursing profession. A BSN as the entry level to nursing is on the rise to becoming the standard, due to better patient outcomes.


  • Oermann, Marilyn H., and Karen M. Standfest. “Differences in stress and challenge in clinical practice among ADN and BSN students in varying clinical courses.” Journal of Nursing Education 36.5 (1997): 228-233.
  • Lawler, Therese G., and Mary Ann Rose. “Professionalization: A comparison among generic baccalaureate, ADN, and RN/BSN nurses.” Nurse Educator 12.3 (1987): 19-22.
  • Primm, Peggy L. “Differentiated practice for ADN-and BSN-prepared nurses.” Journal of Professional Nursing 3.4 (1987): 218-225.

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