NRS 430 Contemporary Nursing Practice

To excel in their professional roles, nurses should acquire diverse skills and comprehensively understand practice problems and solutions. Basic clinical skills can be acquired through certificates, diplomas, or degrees. A nurse’s competence is typically higher when they acquire the highest education possible, making nurses perceive continued education positively (Thielmann et al., 2019). As nurses continue to implement their roles, the nursing practice evolves in multiple dimensions. This evolution impacts patient care outcomes, communication strategies, and care models, among other critical aspects. Nurses should understand this evolution and adapt effectively. The purpose of this paper is to describe nursing practice today while primarily focusing on its evolution and differences between associate (ADN) and baccalaureate (BSN) education in nursing.

Nursing Practice Changes, Scope of Practice, and Approach to Client Care

Nursing has evolved in many aspects, profoundly impacting nursing scope and patient care approaches. One of the many changes characterizing modern practice is the evolution of care delivery models. Undeniably, remote care is increasingly dominant in the current practice as providers strive to improve access to care and reduce costs (Snoswell et al., 2020). Besides, there is an increased focus on value-based care in an attempt to improve care quality and patient satisfaction. Another significant change defining the current practice is the broadened scope of nursing. Nurses’ role is not limited to clinical care; nurses can effectively perform other roles that optimize health outcomes, including policymaking, advocacy, and health education.

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The progressive changes in nursing practice have broadened nursing practice not to be limited to patient care. As the push for higher patient outcomes continues, nurses are currently playing a pivotal role in creating safer environments and promoting patient rights. This role typifies patient advocacy, where nurses serve as the voice of patients (Nsiah et al., 2019). Regarding the approach to treating the individual, there is an increased focus on patient-centeredness and patient engagement. In such approaches, healthcare providers are not the sole decision-makers. Patients should understand the treatment processes and consent to them as nurses tailor care according to patient needs.

Comparison of Practice Competencies and Scope of Practice

Nurses’ competencies impact their ability to implement comprehensive patient care and other roles. An ADN is a two-year degree that prepares students to be registered nurses (RNs). However, since it takes a short time, an ADN focuses primarily on the technical skills that prepare nurses as clinicians. As Deering (2023) stated, BSN-prepared nurses are more skilled in clinical roles and other practice areas such as research, nursing leadership, and public health. The four-year program provides BSN nurses with a larger base of knowledge than AND-prepared nurses. The BSN further provides expanded skills in critical thinking and administration. Regarding the scope of practice, BSN nurses have broader roles than ADN nurses due to more competence and a more comprehensive understanding of patient care. Research further confirms a positive link between BSN nurses’ expanded skills and higher patient outcomes, which underlines the need for more such nursing professionals (Anbari, 2019; American Association of Colleges of Nursing, n.d.). As ADN nurses concentrate on the clinical role, BSN nurses conduct research, engage in leadership, and implement change in routine practice. Importantly, BSN nurses also enjoy more independence in decision-making than ADN nurses.

Nursing Care or Approaches to Decision Making

The differences in skills level between ADN and BSN-prepared nurses affect how they approach client care situations. A suitable scenario is where a patient presents to the healthcare setting with a persistent headache. An ADN will likely have a somatic approach to relieve symptoms while trying to calm and comfort the patient. The genesis of the headache could be established through a routine diagnosis to determine an effective treatment. On the other hand, as Kim and Sim (2020) suggested, BSN-prepared nurses are more skilled in critical thinking, communication, and decision-making. Therefore, they will likely take a more holistic approach in the assessment process to determine the potential cause of the illness. Their higher communication and assessment skills would enable them to communicate with the patient, establish a healthy nurse-patient relationship, and develop a treatment plan that integrates the patient to foster adherence.

Significance of Applying Evidence-Based Practice to Nursing Care

The current nursing practice stresses evidence-based practice (EBP) and encourages nurses to apply it to address simple and complex health matters. EBP is primarily about blending current research evidence with clinical expertise and patient values for higher patient outcomes (Abu-Baker et al., 2021). It ensures that multiple components are considered during decision-making to address patient needs comprehensively. The academic preparation of the RN-BSN nurse supports EBP application by expanding nurses’ research and leadership skills. Research skills enable nurses to explore, analyze, and critique current, peer-reviewed research. Leadership skills prepare nurses to lead change whose positive outcomes are achieved by implementing EBP.

Nursing Communication and Collaboration

Nurses work in different settings and need a shared approach to decision-making to achieve enhanced, consistent outcomes. They communicate and collaborate with interdisciplinary teams by sharing information and approaching common issues as a team. Technologies have also allowed timely data sharing and analysis for better communication and collaboration. According to Walton et al. (2019), collaboration across disciplines supports safer and more effective practices by reducing errors and improving care coordination. Health care practitioners within the interdisciplinary team benefit from shared roles and diverse perspectives that enhance their understanding of patient care and interventions as situations obligate.

Conclusion

Nursing is an evolving practice characterized by many changes in patient care approaches occurring over time. Nurses should be competent multi-dimensionally to address patient needs comprehensively and adapt as the practice evolves. As discussed in this paper, the competency differences between ADN and BSN-prepared nurses affect how they respond to situations. Although both sets of nurses are skilled in clinical roles, BSN nurses have expanded knowledge of research, leadership, and critical thinking skills. Research skills prepare BSN nurses for a higher role in implementing evidence-based practice.

References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1), 1-8. https://doi.org/10.1186/s12912-020-00522-x

Anbari, A. B. (2019). What makes a BSN a BSN? Western Journal of Nursing Research, 41(2), 167–170. https://doi.org/10.1177/0193945918803683

American Association of Colleges of Nursing. (n.d.). Fact sheet: the impact of education on

nursing practice. https://www.aacnnursing.org/Portals/42/News/Factsheets/Education-Impact-Fact-Sheet.pdf

Deering, M. (2023). RN Diploma vs. ADN vs. BSN degree: what’s the difference? NurseJournal. https://nursejournal.org/degrees/bsn/rn-and-bsn-degree-differences/#:~:text=A%20BSN%20degree%20and%20an,school%20and%20your%20career%20goals.

Kim, A. Y., & Sim, I. O. (2020). Communication skills, problem-solving ability, understanding of patients’ conditions, and nurse’s perception of professionalism among clinical nurses: a structural equation model analysis. International Journal of Environmental Research and Public Health, 17(13), 4896. https://doi.org/10.3390/ijerph17134896

Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298

Thielmann, B., Parker, K., Post, J., & Abraham, S. (2019). Factors influencing nurses’ perceptions of the Baccalaureate Degree in Nursing as minimum requirement for Professional Practice. Nursing Education Perspectives, 40 (1), 25-29. doi: 10.1097/01.NEP.0000000000000391.

Walton, V., Hogden, A., Long, J. C., Johnson, J. K., & Greenfield, D. (2019). How do interprofessional healthcare teams perceive the benefits and challenges of interdisciplinary ward rounds. Journal of Multidisciplinary Healthcare, 12, 1023–1032. https://doi.org/10.2147/JMDH.S226330

NRS 430 Contemporary Nursing Practice