Nursing practice has undergone a significant transformation over time, with various factors shaping the profession’s evolution. The approach to treating individuals has shifted from focusing on disease-centered care to embracing a holistic view of care. This evolution has led to changes in the scope of nursing practice, resulting in the differentiation of competencies between associate and baccalaureate nurses. In this paper, we will explore the changes in nursing practice, differentiated practice competencies, evidence-based practice, patient care situations, and interdisciplinary communication and collaboration.
Nursing practice has changed significantly over the years, with significant milestones contributing to this evolution. The nursing profession’s history was disease-focused, with nurses playing a supportive role in the medical model of care. However, nursing practice has since evolved into a holistic model that incorporates a patient-centered approach to care (Bastable, 2016). Nurses are now encouraged to embrace a person-centered approach to care, which involves addressing the physical, social, psychological, and spiritual needs of patients. The nursing practice has thus changed from focusing on the care of the disease to the care of the patient.
The differentiated practice competencies between associate and baccalaureate education in nursing are significant. The associate degree in nursing (ADN) and the baccalaureate degree in nursing (BSN) both offer competencies necessary for nursing practice. However, the BSN curriculum emphasizes additional competencies beyond what the ADN program offers. The BSN-prepared nurse has a broader scope of practice than the ADN nurse, including leadership, critical thinking, and decision-making skills (AACN, 2021). The BSN curriculum includes additional coursework on patient safety, informatics, population health, and evidence-based practice, equipping graduates with competencies necessary to work in a complex healthcare system.
In a patient care situation, the nursing care and approaches to decision-making differ between the BSN and ADN nurses. For example, a patient with chronic obstructive pulmonary disease (COPD) may have an exacerbation, requiring a nurse to initiate oxygen therapy. An ADN nurse may prioritize administering oxygen to stabilize the patient, while a BSN nurse may use evidence-based practice to identify the underlying causes of the exacerbation and implement appropriate interventions to prevent further exacerbations. A BSN nurse may also collaborate with an interdisciplinary team, including respiratory therapists and physicians, to implement comprehensive care for the patient (Duchscher, 2014).
Applying evidence-based practice to nursing care is essential in improving patient outcomes. Evidence-based practice involves incorporating research evidence, patient preferences, and clinical expertise into patient care decisions (Melnyk & Fineout-Overholt, 2018). The academic preparation of RN-BSN nurses supports the application of evidence-based practice by equipping them with competencies necessary to identify, evaluate, and implement evidence-based interventions in patient care. BSN programs teach evidence-based practice and research methods, enabling graduates to use the best available evidence in clinical decision-making.
Effective communication and collaboration among interdisciplinary teams are essential for ensuring safe and effective patient outcomes. Nurses communicate and collaborate with interdisciplinary teams to provide coordinated care, enhance patient safety, and improve quality outcomes. Effective communication among healthcare professionals is essential in ensuring that patients receive the right care at the right time. Collaboration promotes shared decision-making and enhances the integration of healthcare services, resulting in improved outcomes for patients (Mitchell et al., 2018).
In conclusion, nursing practice has undergone significant transformation over time, with the approach to treating individuals shifting from disease-centered care to a holistic model. Differentiated practice competencies exist between the ADN and BSN programs, with the BSN nurse having a broader scope of practice than the ADN nurse.