Contemporary Nursing Practice


Running head: NURSING 1


Contemporary Nursing Practice

Change in Nursing Practice over Time

Nursing practice has changed significantly over time. Most of the changes has been towards better health care delivery. For instance, the nursing workforce today is much more educated than it was years ago. Nurses are pursuing lifelong education to advance their skills and improve their capabilities in care delivery. There are approximately 2.8 million RNs who are currently employed in the United States. A large percentage of these employed nurses have at least a bachelor’s degree. As of 2013, 61% of nurses in the United States had a baccalaureate degree of a higher education achievement (AACN, 2018). Nurses achieving higher education enables them to adapt to the changing healthcare environment. With the knowledge and skills that they continue to learn, they are able to tackle the issues developing constantly in the evolving health care system.

Another significant change that has taken place in nursing is the change in nurses’ scope of practice. Initially, nurses were responsible for the provision of secondary care. Physicians would be responsible for the primary care responsibilities (AACN, 2017). However, today nurses’ roles have evolved to include the provision of primary care services. Registered Nurses today have become substitution options for physicians especially due to the limitation of primary care health workers (ANA, n.d.).

These changes have enhanced the approaches to care for individuals. People today have more access to quality and safe care due to the advanced skills and knowledge of the nurses, which is developed through lifelong learning. In addition, there is more access to care now that nurses are qualified enough to extend their services to primary care provision.

Comparing and Contrasting Practice Competencies between an Associate and Baccalaureate Education in Nursing

Both an Associate Degree in Nursing (ADN) and Bachelor’s degree in nursing (BSN) give a nurse the skills and competencies to offer quality and safe care. For students who want to become nurses, either education paths will lead them to becoming a care provider. However, there are some significant differences that may influence the scope of work that an ADN or BSN-qualified nurse may be able to do. A traditional role of a Registered Nurse can include both simple and complex procedures. A Registered Nurse may perform some simple roles such as recording patients’ information, educating patients, supporting families, and administering medication among others. There are also some complex roles that nurses may perform such as diagnosing illnesses and prescribing medication under a physician’s supervision. An ADN nurse only performs the simpler roles while the BSN nurse is able to perform the more complex nursing roles. This does not mean that ADN-qualified nurses are less professional, it is only that they are less trained on the more complex roles. In terms of scope of care, the nurse with a baccalaureate degree is at a better position to provide primary care.

The education process for these two nursing qualifications is also different. While the Associate degree takes 2 years to complete, the baccalaureate takes at least four years. The ADN degree is less time consuming and less expensive compared to the BSN. In the extra time students spend in the BSN, they get more advanced and complex training, enabling them to critically think and provide a scientific based practice to their patients.

Differences in care and Approaches to Decision Making between ADN and BSN-prepared Nurses

In a health care environment, the approaches to care that are used by a BSN and ADN-prepared nurse may be different. Take for instance in the following situation. A patient comes into a hospital and is in critical condition. The patient is assessed and found to be dehydrated. In this situation, an ADN-qualified nurse will assess the patient’s vitals and present the information to a physician to make the decisions. On the other hand, a BSN-qualified nurse may assess the patient and make a decision on the best line of care depending on the patient data. This situation demonstrates the decision-making and critical thinking differences between these two qualifications in nursing. The BSN nurses are trained to be better critical thinkers and decision-makers. Thus, they learn how to assess the patient information and develop a care plan with the supervision of a physician. The ADN-nurse, on the other hand, can only assess the patient for the purpose of collaborating with the physician to provide the care.

Significance of Applying Evidence-Based Practice to Nursing Care and RN-BSN preparation of EBP

Evidence-based practice is healthcare practice that is based on the best evidence available. This form of practice is important for the delivery of quality and safe care because it promotes the use of the best possible approaches to care, which have been examined and tested for their effectiveness to be proven. This form of practice promotes an attitude of inquiry (Schmidt & Brown, 2014). Nurses and other healthcare professionals get to ask themselves why they are using specific techniques of care and the impact they expect after applying those techniques. Therefore, they are encouraged to choose the best possible techniques after examining various options. Evidence based practice also ensures consistent improvement of healthcare practice. New research is always being done to develop new strategies of improving the quality of care delivered.

Nursing research gives the foundation to Evidence-based practice. It is through research that nurses develop new information and solutions to various health care issues that they have been able to identify. RN-BSN trains nurses to learn how to research information and develop new evidence that can be used to develop nursing care (Dean, 2018). In this program, students get to learn how to identify clinical issues, assess research available on that issue, and develop new evidence through research. Most importantly, this program enables nurses to learn how to assess the validity and credibility of evidence. Not all evidence developed is usually applicable. Therefore, nurses learn knowledge on the techniques of evaluating the statistical and clinical relevance of evidence before using it in the practice setting.

How Nurses Today Communicate and Collaborate with Interdisciplinary Teams and Impact on Safety and Efficiency of care

Communication and collaboration have become essential in the healthcare environment. Nurses have to communicate and collaborate with each other and other professionals in the care environment to be able to provide the best care to the patients. Nurses collaborate with physicians, lab technicians, radiologists, ICU technicians, pharmacists and various other professionals in the care environment. This communication and collaboration are done through information sharing and collaborating the care plan for the patients. This is facilitated through electronic information sharing that creates a coordinated system of care.

Interprofessional collaboration is essential to the provision of safe and good quality care. The constant communication between nurses and other care professionals reduces the chances of medical errors (Foronda, MacWilliams & McArthur, 2016). All professionals are able to follow the same care plan because they share information about the patient constantly. This system also makes the care system more efficient because each professional is able to perform their role effectively given all the information, they need to be efficient and effective in performing their job. Therefore, it is essential that such a system of care delivery is promoted in all healthcare institutions. Nurses should collaborate with doctors and other healthcare professionals for the purpose of providing safe and quality care to the patients.


American Association of Colleges of Nursing [AACN]. (2018). Creating a more highly qualified nursing workforce. Retrieved from

American Association of Colleges of Nursing [AACN]. (2017). The impact of education on practice. Retrieved from

American Nurses Association [ANA]. (n.d.) Scope of practice. Retrieved from

Dean, J. (2018). Practice and competency development. In Dynamics in Nursing Art & Science of Professional Practice. Eds Grand Canyon University Retrieved from

Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: an integrative review. Nurse education in practice, 19, 36-40.

Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Jones & Bartlett Publishers.