Nursing is a profession that is heavily rooted in scientific and ethical principles. Nurses of all different educational levels must be well-versed in the guiding ethical principles of their craft. There are differences between the scope of care of a nurse with an associate’s degree and one with a BSN, but like physicians, nurses have a duty to care for their patients and to cause no harm. This discussion will look at the different competencies of nurses with an associate’s degree versus one with a bachelor’s degree in nursing. It will also attempt to identify a patient care situation in which a specific, difficult decision must be made. Alternate approaches to the nursing care decision may be different based on the level of care that the nurse is capable of administering (Blegen et al., 2013).
The associate’s degree in nursing gives the applicant the potential ability to become an RN or a LPN. The associate’s degree allows the applicant to take the NCLEX exam, which is the exam that registers a new nurse as an RN (Blegen et al., 2013). The BSN also has to take the NCLEX exam, and they receive largely the same certification as the associate’s degree nurse; however, a BSN is a four-year degree and this degree is considered more highly than the two-year associate’s degree (Blegen et al., 2013). Although both have the ability to become an RN, the BSN has the ability to progress faster and further. There are also programs that allow the nurse to progress through the associate’s degree in nursing to a BSN in nursing as well, which is a viable option for many who are interested in beginning work in the nursing field while simultaneously progressing to a higher educational level (Blegen et al., 2013).
Nurses who are BSN-trained will often have higher levels of scientific competency, while many nurses who are trained in an associate’s program are trained to be as competent as possible in a wide range of frequently performed procedures. Many who go through associate’s programs do so because they wish to get into the nursing field much more quickly (Blegen et al., 2013). There are benefits to both the paths to the RN, and the only real difference between the associate’s degree nurse and the BSN nurse is when the associate’s degree nurse chooses to pursue a LPN—a license practical nursing degree—rather than a registered nurse degree (Blegen et al., 2013).
Registered nurses, or RNs, have the ability to perform a number of different tasks and procedures during their time in practice. RNs can have a variety of different educational levels, and they often operate under the scope of care of a physician and a head nurse (Blais, 2015). RNs can administer medication to patients and perform a number of different medical treatments. LPNs cannot perform these kinds of procedures because they are not covered under their scope of care (Blais, 2015). Ethically, RNs are liable for their patients to a much greater extent than LPNs because their scope of care is much more significant. Often, RNs are supervisors for LPNs or groups of LPNs, and LPNs perform general medical care like blood pressure checks, catheters, and other general care. LPNs are generally less liable than other nursing professionals.
In most states in the United States, a nurse—that is, an RN—has a number of responsibilities in the realm of patient care. An RN operates under the care and supervision of a physician, and is able to perform a number of duties under the supervision of that physician. In the psychiatric field, for instance, the RN is able to restrain patients and administer intravenous medication at the direction of the supervising physician; in many places in the United States, an LPN or LVN will not have the ability to administer these types of medication (Allgood, 2015). In theory, the differences between these types of nurses are in their scope of care.
Scope of care and the duties associated with an individual nurses’ scope of care is limited by the general ethical code of nursing, but it might also be affected by the location in which the nurse lives, and the clinical setting in which the nurse works. RNs have more freedom than LPNs or LVNs, but nurse practitioners—nurses with a specialized master’s degree in nursing—have still more freedom to do things like prescribe medication and provide diagnosis for patients.
Nurses with advanced degrees are generally considered to have a greater scope of care and a greater ability to participate in diagnostic processes. Of course, an RN cannot provide patients with a diagnosis—diagnostic capability is limited to nurse practitioners and physicians—but physicians can utilize the practical skills of many nurses to carry out diagnostic tests and procedures to determine the best course of care for patients. It is always important that a nurse act within his or her limits in regards to scope of care, because violation of these limits is not only ethically wrong, it is also often criminal.
References
Alligood, M. R. (2013). Nursing theory: Utilization & application. Elsevier Health Sciences.
Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Prentice Hall.
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94.
