To Be Bsn or Not

The research by Aiken and colleagues tried to decipher whether or not having a higher education level such as a BSN was a determining factor in increased patient safety. Through their research they concluded that "both lower patient-to-nurse ratios and having a majority of RNs educated at the baccalaureate level appear to be jointly associated with substantially lower mortality and failure to rescue rates for patients undergoing common surgical procedures."(Aiken et al., 2003, p. 1622)

For the most part, I agree with their findings, but I also have my disagreements. First of all I'd like to say that this research does not have adequate statistical backing to support their conclusion, simply for the fact that they only surveyed hospitals in Pennsylvania at a set point in time. The lack of random and mass sampling alone, does not give adequate representation to the truth on a national scale. Maybe my ADN ego is a bit defensive, but I, like many others I'm sure, have had to deal with lots of criticism about my ADN training. The way I see it, we all go through different amounts of necessary training, may it be 2 years or 4 years, yet still we all are expected to pass the same level of competency exam: NCLEX. Now correct me if I'm wrong, but doesn't that make us all equally proficient in our book knowledge?

In the medical field having book knowledge is vastly different from having practical knowledge; it can even be insufficient at times. I feel that this study did not give adequate and well deserved credit to the many, many experienced RNs out there, may they be diploma or ADN. One situation that comes to mind was the first time I partook in a 'code blue', during the code it wasn't my BSN charge nurse who took over and "ran the show" instead it was a more experienced, ADN who stabilized the patient even before the ER doc came to the scene. This is an example where for me personally, book knowledge just didn't cut it. If you asked me, or any other RN, what the steps are in resuscitating a patient in SVT I could tell you step by step, and so pass a written exam, but during that adrenaline rush most of us can't react that naturally. It takes experience for such critical thinking to flow naturally and promptly, which is vital in the critical moments of saving a life. Even if the situation isn't that drastic, experience overpowers book knowledge. I remember my clinical instructor telling me it's vital to always listen to heart sounds and lung sounds even if you don't hear anything abnormal, because that's the only way you will learn what's abnormal when you finally hear one. This same logic is true in many scenarios of patient care, we can always read and study but until we actually see various scenarios unfolding in front of us we won't be able to understand, learn and perfect our care and critical thinking.

I don't feel that higher