Introduction
When nursing began, it had very little to do with formal medical training and gender
affiliations. In the early days, women learned basic nursing skills from their mothers. Nursing
was not viewed as a respected trade. The women who happened to acquire the necessary nursing
skills and women were generally considered caregivers, an extension of their role at home.
Today, drastic changes have been witnessed in nursing. The introduction of a comprehensive
nursing educational curriculum, extensive training programs, and more diversified staff has
changed the face of nursing. This paper aims to analyze how the nursing practice has evolved
over the years to what it is currently.
Evolution of Nursing
The evolution of nursing has been made possible by several factors, which have brought
changes in how nursing is practiced. This has impacted on treatment approaches that are
practiced in the healthcare setting today. In the past, nursing was only characterized by taking
care of patients. However, the evolution, which envelopes a more robust educational foundation,
has changed nursing's face, as nurses now have diversified responsibilities, like ANP (advanced
nurse practitioners) (Salmond & Echevarria, 2017). Today, nurses are taking part in advocacy,
promoting a safe environment, undertaking research, and shaping healthcare policies in the
patient and general healthcare. Moreover, the advancement of technology in the medical field
has also reshaped nurses' duties and responsibilities, promoting efficiency, competence, and
accuracy. This has developed a high level of prestige that was not there before.
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Associate vs. Baccalaureate Education In Nursing
While both the associate degree nurse and baccalaureate allow one to be awarded a
certificate as a Registered Nurse and practice nursing, the American Association of Nurses
believes that the two groups of nursing have varying knowledge base and competencies that are
brought about by their education (American Association of Colleges of Nursing, n.d.). These two
groups of nurses have the same skills as a prerequisite for patient care, but BSN has built upon
what ADN has. Educational preparation for BSN and ADN entails preparing the nurses through
a core curriculum founded in a clinical setting. Usually, an ADN is enrolled in a two-year
program in a community college, which earns them an associate degree in nursing, a three-year
diploma program offered by the hospital, and a four-year university or a college program. This
earns a student a bachelor's of science degree in nursing.
ADN was introduced in 1958 to help fill in for nurses' shortage after World War II. The
ADN program focused more on providing care for patients with clear and well-defined diseases,
more technical, and focused on tasks and clinical skills while considering their health needs.
ADN nurses understand the importance of systematized data collection and help in obtaining
data comprehensively. Competencies for associate degree nurses revolve around caregiving,
patient-counselor, and educational services (Northrup-Snyder, Menkens & Dean, 2017).
Associate degree nurses do the assessment, implementation, and planning of patient care from
the date they are admitted to the day they are discharged.
The Bachelor of Science Nursing program usually lasts for four years. The curriculum
emphasized research, critical thinking, management, leadership, and community health. Bachelor
of Science Nursing degree holders have impeccable problem-solving skills and can make
independent decision-making abilities (Gravina 2017). Although the BSN and ADN holders can
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share some responsibilities, a BSN nurse incorporates the intellectual, physical, social, spiritual,
and emotional aspects while addressing overall health. Since Bachelor of Nursing knowledge is
theory-based, the holders can venture into teaching or assuming leadership roles in the health
sector. Besides providing sophisticated aspects of patient care and education, nurses are also
charged with designing and coordinating a proper nursing plan for a patient from admission to
discharge, designing teaching plans for patients, and supervision of nurses' assistants. These
competencies distinguish BSN nurses from ADN.
Patient Care Situation
For instance, an 80-year-old patient ailing from breast cancer is admitted to the oncology
department. A cancer technician will arrive and provide daily care to the patient. When a
registered nurse (RN) comes, they will welcome the patient, orient them around the room,
introduce staff that will be working with the patient, check for any visible signs, do an
assessment of the skin, assess the treatment that can be administered for the wound and evaluate
the patient plan care. A BSN nurse will be charged with coordinating the care provided,
assessing the patient and their family needs. BSN nurses will collaborate with physicians,
physical therapists, and social workers to develop a plan depending on their specific needs. As
AACN states, "BSN prepares a nurse for a wider practicing scope across various inpatient and
outpatient setting". The ever-growing complexities in the healthcare sector and technological
advancements call for highly educated nurses to address the situations.
Significance of Applying EBP To Nursing Care
Evidence-based practice is a patient-centered approach based on scientific research,
patient experiences, and clinical expertise. The application of evidence-based practice improves
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patient outcomes. Increasing general patient-care can improve outcomes and health among
patients (McCormack & McCance, 2016). Employing the latest healthcare research can reduce
complications that are usually associated with chronic ailments. Implementing evidence-based
practice reduces the cost of treating individuals with chronic illnesses and reduces expenses for
healthier patients. Most importantly, incorporating EBP helps in sharpening nursing skills. A
nurse develops superior critical thinking and decision-making skills to fit in any situation, work
in interdisciplinary teams, and make great use of informatics. Besides improving a student's
overall knowledge, the coursework will boost a student's professional accountability.
Communication and Collaboration With Interdisciplinary Teams
While spoken words might contain important content, the meaning of the words can be
influenced by the style of delivery. Today, nurses and interdisciplinary teams communicate
through phone calls, handwritten notes, emails, or text messages (Lancaster, Kolakowsky
Hayner, Kovacich & Greer Williams, 2015). Collaboration in healthcare is defined as health care
professionals taking up complementary roles, cooperating and working together, and sharing
responsibility for problem-solving and decision-making as they formulate patient care plans.
Collaboration among healthcare professionals boosts awareness among members as far as
individual skills and knowledge are concerned, increasing efficient decision-making. The result
of proper decision-making is improved patient care.
Conclusion
This paper has illustrated that today, nursing has evolved due to introducing a
comprehensive education system that is dedicated to nursing education, the introduction of
training programs, and diversified staff. Today, nurses' scope of practice has expanded, from
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taking care of patients to taking part in nursing research and reshaping healthcare policy. In
nursing, there are two groups of nurses grouped according to their competencies, BSN and ADN
nurses. ADN nurses' competencies are all about caregiving, patient-counselor, and providing
educational services, while BSN nurses do more research, critical thinking, management,
leadership, and community health. Evidence-based nursing practice can improve patient
outcomes, reduce complications associated with chronic ailments, and help a nurse develop
superior critical thinking and decision-making skills. Lastly, nurses and interdisciplinary teams
can communicate through written phone calls, notes, emails, and messages. Collaboration can
boost awareness levels in a team, resulting in making proper decisions to increase patient care.
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References
American Association of Colleges of Nursing. (n.d.). AACN fact sheet – Impact of education on
nursing practice. Retrieved from https://www.aacnnursing.org/news-information/fact-
sheets/impact-of-education
Gravina, E. W. (2017). Competency-based education and its effect on nursing education: A
literature review. Teaching and Learning in Nursing, 12(2), 117-121.
Lancaster, G., Kolakowsky Hayner, S., Kovacich, J., & Greer Williams, N. (2015).
Interdisciplinary communication and collaboration among physicians, nurses, and
unlicensed assistive personnel. Journal of Nursing Scholarship, 47(3), 275-284.
McCormack, B., & McCance, T. (Eds.). (2016). Person-centred practice in nursing and health
care: theory and practice. John Wiley & Sons.
Northrup-Snyder, K., Menkens, R. M., & Dean, M. (2017). Student competency perceptions
from associate degree to bachelor degree completion. Journal of Nursing
Education, 56(10), 581-590.
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for
nursing. Orthopedic nursing, 36(1), 12.