Nurses are considered the backbone of the medical care-giver community. Good quality patient care centers on having a competent educated nursing labor force. There is a wealth of empirical evidence that has demonstrated Baccalaureate (BSN) nurses are associated with fewer medication errors, lower mortality rates, and greater overall positive patient outcomes than nurses at lower levels of educational achievement. For example, Brady, Malone, and Fleming (2009) performed an extensive literature review and found that BSN nurses made fewer medication errors than their less educated counterparts. Aiken and associates (2003) found a strong link between RN education level and patient outcomes. Their findings indicated that for every ten percent increase in the proportion of BSN nurses in a surgical unit there was a four percent decrease in the risk of death to patients. In a large study of nearly 47,000 patients conducted at the University Toronto it was found that hospital systems that had higher proportions of BSN-prepared nurses tended to have significantly lower 30-day mortality rates (Tourangeau et al., 2007). And Friese et al. (2008) found that nursing education level was significantly associated with positive patient outcomes of hospitalized cancer patients undergoing surgery. The researchers concluded that a higher proportion on BSN nurses would significantly lower adverse patient outcomes.
It is clear from the research that BSN nurses demonstrate improved job performance and better patient outcomes than nurses without that level of training. The discipline required to obtain a BSN indicates that the individual also possess a special array of traits and skills that are probably partly inherent in the individual and partly developed by the training. These characteristics include:
1. An empathetic and caring nature. A nurse that does not care about their patients will not deliver proper patient care. But caring is not the same thing as understanding. A good nurse is able to identify with a patient's situation, understand it, and feel it in order to give the patient quality of care that they deserve.
2. Flexibility. Because no one day is like the last a good nurse needs to be able to adapt to different circumstances. Sometimes events will change rapidly in the same day so a good BSN nurse will require a healthy portion flexibility and adaptability.
3. Detail-oriented and responsible. BSN nurses are trained to be meticulous in their duties. Of course this is one reason why they are associated with better patient outcomes. This is a crucial facet in delivering good quality care to patients.
4. Good judgment and the ability to think quickly. BSN nurses must be able to look at a patient's condition and assess it accurately. During times of emergencies a patient's life may hang on the decision of the nurse. BSN nurses therefore need to display constant sound judgment and the ability to think and act as the situation demands.
5. There can be a lot of stressors in the professional life of a BSN nurse so being emotionally stable and having good endurance goes a long way. Nursing shifts can be long and the patient to nurse ratio can keep a person quite busy, so being at ease with oneself and having good staying power is important.
6. Good communication skills are a must. Nurses interact with other nurses, doctors, patients, and patients' families on a daily basis. It is important to be able to communicate with others clearly and efficiently. It is also helpful to be able to "read" other people as well.
This is not to say that being caring, detail oriented, and other qualities are not present to some extent in nurses with less education than a BSN; however, the quality of education and training that BSN nurses receive allow them to be able to express these characteristics to a much greater degree, be prepared for many contingencies, and to have the confidence and knowledge to perform their duties efficiently. One area that BSN nurses seem especially adept at as a result of their training is in the area of critical thinking skills. Critical thinking skills allow a person to analyze, deconstruct, and interpret a wide variety of situations from patient care issues, to understanding other people, to understanding one's own issues. Thus, good critical thinking skills can be linked to better job performance, greater job satisfaction, better personal relationships, and overall life satisfaction (Zurmehly, 2008). Critical thinking abilities have been demonstrated to improve in nursing students as they progress through a BSN program. Profetto-McGrath (2003) found that several measures of critical thinking skills improved as students progressed from the first year to the fourth year of a BSN program. Thus, the training received by BSN students is fundamental in not only their nursing skill development, but in their ability to understand and formulate solutions to a wide array of problems.
In order to better understand the job duties, the job setting, and other important issues of a BSN nurse we now turn to a brief interview with a BSN nurse. This allows for a much better feel of how all the variables discussed interact and to savor the subjective experiences, feelings, and accomplishments of a BSN nurse.
Question: Describe your role briefly.
Answer: I work as a staff nurse at Brigham and Women's Hospital in the Shapiro building on a vascular surgery and cardiology focused intermediate care unit. My role includes, but is definitely not limited to: understanding the health history and recent changes in health status of my patients during their admission; accurately assessing my patients' current health status and making the covering MD aware of any changes throughout my shift; understanding my patients' medications and administering them safely and accurately; monitoring telemetry and vital signs; performing patient-specific interventions such as dressing changes and wound care, chest physiotherapy, repositioning, etc.; providing emotional support (which is always needed when patients are hospitalized due to changes they all experience and need to cope with); delegation and knowing what tasks and to whom you can and feel comfortable delegating tasks to; teaching- both with my patients regarding new medications, tests and procedures and what to expect throughout hospitalization, changes in their health status/diet/lifestyle, etc.; and often my role also includes that of charge nurse, which includes overseeing and making sure the unit is adequately staffed, awareness of all patients' health status on the unit (including code status), resource to all staff on unit, maintaining safety and organization of unit, and a bunch of extra paperwork (laughs). In both of these roles, it is also the responsibility of the individual nurse to notify the nurse manager of any potential problems (staff or patient related) that arise at any time on the unit.
Question: What do you believe to be the difference in the preparation of Baccalaureated nurse as compared to other entry options?
Answer: I believe BSN prepared nurses are educated in a more holistic view and approach to patient care. BSN prepared nurses are educated in the background of both the art and science of nursing and the education is standardized throughout BSN programs. The problem with having other degrees such as LPNs, diploma program nurses, associate degree-prepared nurses in addition to BSN prepared nurses is that there is too much variation in the education provided in the different programs, leading to varying levels of knowledge and competence in practice and different views / approaches to patient care. The various nursing environments are becoming more sophisticated and technologically advanced, requiring nursing programs that can provide both a solid knowledge background as well as current issues and trends in nursing with a holistic and diverse view of patients and their families. BSN programs provide this quality of nursing education for today's nurses and should be the expected standard of education (in my eyes).
Question: Describe your most memorable day and how this experience has affected you professionally.
Answer: Just this past weekend I had a very rewarding experience with a patient. I had come on to shift at 7:00 PM on Friday night, and it was quite hectic. I had one patient in flash pulmonary edema who was requiring high-flow oxygen and just started diuresing, another patient was admitted with chest pain and awaiting cardiac catherization and was having active chest pain, and my third patient came rolling by the nurses' station at 7:05 PM (new admission from an outside hospital) as I was waiting to get report from the day nurse. I felt slightly overwhelmed at the beginning of the shift, but quickly my patient having chest pain was brought down to cath lab, so I could focus on my new admission and my patient having respiratory issues. I had a four-patient assignment that night but most of my time and energy was focused on this patient. The patient had three episodes of acute shortness of breath, with oxygen levels desaturating and labored breathing, with patient requiring high-flow humidified oxygen to maintain O2 sats. The patient was very anxious with each episode and noted to be tachycardic, requiring telemetry monitoring and 12-lead EKG, and a lot…