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Alex Lohan

Professor Sharp

ENGL1113

1 May 2018

Associates Degree Nurses Pose an Unnecessary Risk in the Healthcare Setting

In 1960, the American Nursing Association (ANA) published a position statement, which

stated that the basic standard of education for the “professional” nurse is a baccalaureate level.

Shortly after World War II, There was a national shortage of registered nurses. This is mainly

due to the fact that nurses were required during times of war to tend to the wounded on the

battlefield, and since more were needed overseas, more people had to fill these roles back home.

Once the war in the pacific was ended with the atomic bomb, the influx of people back home

decided they wanted to leave their old jobs and start anew with their recently returned spouses,

parents, children, etc. and many RNs did not return to a professional clinical role. This shortage

lead to the passage of a bill allowing associates programs to create fully licensed practitioners of

nursing. Not more than 15 years after this, The ANA published a paper that essentially

discredited associates degree programs and implied that they are not sufficient to produce

“professional” nurses, but “technical” nurses rather. Since the publication of this document, the

debate has raged on in most every corner of the United States.

Since the inception of these 7 pilot schools with 2-year programs, the scope has grown to

include more than 800 schools around the country that offer a two-year nursing program. Since

the ANA released it’s statement, the question needs to be asked; are the standards of car for 2-

year nurses up to par of a baccalaureate program graduate (BSN)? Simply put by the Australian

Nursing and Midwifery Journal study in 2008, “In hospitals where 60% of nurses had bachelor
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degrees and nurses cared for an average of six patients, the patient mortality rate was 30% lower

than in hospitals where only 30% of nurses had bachelor degrees and nurses cared for an average

of eight patients” (Better Educated Nurses Equals Fewer Deaths). This is a direct statement that

reflects the fear of the ANA from their 1960 statement in that they feel associates degree nurses

are not able to handle critically ill patients as well as someone with a 4-year level of training.

These statistics are unprecedented when you consider that almost 210,000 people died last year

of possibly preventable deaths due to medical error. If there is a direct correlation as suggested in

the above quote, then up to 63,000 fewer people may have died in 2017 if only all of their staff

were 4-year BSN graduates.

Nurses not only have to deal with patients on a daily basis, but also are the framework for

the leadership in a hospital. Nurses are found in all levels of administration and can be

responsible for hundreds of patients and staff when they are in the role of House Supervisor

which can be attained within several years of working for a facility. The Academy of Medical-

Surgical Nurses (AMSN) surveyed a class of graduates from an associate degree program and

were surprised to learn that “Twenty-one (84%) out of 25 respondents indicated that they did not

feel comfortable with their leadership skills as a nurse” (Does Associate Degree Curricula

Adequately Prepare Nurses for Leadership Roles?). An astounding 4 out of 5 graduates felt as if

they were not prepared to lead their peers or other staff in a professional setting. When someone

does not feel confident in their own abilities and strengths, they are at a much higher risk for

mistakes and negligence simply because they do not feel safe making high-stress decisions,

which happen more often than not in a hospital setting. These ingredients do not add up to

making a qualified nursing leadership candidate, and therefore the answer to the question of

whether or not associates degree nurses are prepared for leadership roles would have to be: no.
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A more recent study done by the Online Journal of Issues in Nursing (OJIN), whom is

backed by the ANA, revisited this topic in 2002 and came to a similar conclusion.

“In contrast to nursing, the assistant/technical personnel in many health care

occupations are prepared at the associate degree level. In a climate in which

strong cooperative relationships and interdisciplinary teamwork are becoming

increasingly important in delivering health care, educational differences matter. A

baccalaureate education or higher is needed if nurses are to maintain equal status

with other health care professionals and to participate as full partners on

interdisciplinary teams (“Education for Professional Nursing Practice: Looking

Backward Into the Future”).

This statement most clearly supports the argument for a mandated BSN basic requirement. It is

the general consensus among almost every professional Nursing organization that this standard

should be raised, and the evidence for this statement continues to grow. The United States should

legislate this new requirement since it so clearly and directly affects patient outcome and

experience in a medical setting, and there is no excuse for poorly trained staff when the option

exists to have competent staff educated at levels appropriate to their clinical practice. Patient

mortality due to preventable causes should always be considered an ongoing issue and if

something is identified as a cause of this horrible problem, then it should be addressed

accordingly.
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Works Cited

"Better Educated Nurses Equals Fewer Deaths." Australian Nursing & Midwifery Journal, vol.

21, no. 9, Apr. 2014, p. 17. EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=aph&AN=95455691&site=ehost-live.

Fisher, MaryDee. "A Comparison of Professional Value Development among Pre-Licensure

Nursing Students in Associate Degree, Diploma, and Bachelor of Science in Nursing

Programs." Nursing Education Perspectives, vol. 35, no. 1, Jan. 2014, pp. 37-42.

EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=24716340&site=ehost-

live.

Mbewe, Catherine and Marcia Jones. "Does Associate Degree Curricula Adequately Prepare

Nurses for Leadership Roles?." MEDSURG Nursing, Jan/Feb2015 Newsletter, pp. 1-13.

EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=hch&AN=100884293&site=ehost-live.

Nelson, M. "Education for Professional Nursing Practice: Looking Backward Into the Future".

Online Journal of Issues in Nursing. Vol. 7 No. 3, Manuscript 3.