The Field Of Nursing Has Changed Over Time In A 750-1 739795

The Field Of Nursing Has Changed Over Time In A 7501000 Word Paper

The field of nursing has undergone significant transformations over the centuries, reflecting advancements in medical knowledge, technology, and societal expectations. This evolution has profoundly impacted the scope of nursing practice, the approach to individual patient care, and interdisciplinary collaboration. Understanding these changes is essential to appreciating contemporary nursing's complexity and its pivotal role in healthcare systems today. Additionally, examining the differences in competencies between associate and baccalaureate prepared nurses provides insight into how education influences practice, decision-making, and patient outcomes. This paper explores the historical evolution of nursing, compares educational competencies, illustrates differences through patient care scenarios, emphasizes the importance of evidence-based practice, and discusses how communication and collaboration enhance patient safety.

How Nursing Practice Has Changed Over Time

Nursing, as a profession, has evolved markedly from its origins as informal caregiving and traditional healing practices. In its early history, nursing was largely conducted by family members and religious orders, with a focus on basic care and spiritual support. As medical science progressed in the 19th and 20th centuries, formal training programs emerged, leading to the establishment of nursing as a licensed, regulated profession (ANA, 2010). Technological advances, such as the development of diagnostic tools and pharmaceuticals, expanded the scope of nursing, demanding higher levels of education and specialized skills (Baldwin et al., 2017).

The evolution of nursing practice includes a shift from task-oriented care to holistic, patient-centered approaches. Modern nurses are now expected to assess complex health issues, provide health education, and advocate for patients (White et al., 2019). The approach to treating individuals has transitioned from acute, episodic care to continuous, comprehensive management of health conditions, emphasizing preventative care and health promotion (Institute of Medicine, 2011). Consequently, nurses now operate within a legally defined scope of practice that varies by state but generally encompasses a wider range of responsibilities than in the past, including advanced clinical decision-making and autonomous practice in certain settings (Spector et al., 2015).

Comparison of Differentiated Practice Competencies Between Associate and Baccalaureate Education

The educational pathways into nursing—namely, Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN)—produce nurses with differing levels of competence and scope of practice. ADN programs, typically lasting two to three years, focus on developing skills for basic bedside care and clinical reasoning (AACN, 2016). In contrast, BSN programs, which extend over four years, incorporate a broader curriculum including leadership, research, and community health, thereby preparing nurses for more complex roles (AACN, 2016).

Scope of practice for ADN-prepared nurses generally includes direct patient care, medication administration, and basic assessment under the supervision of a registered nurse or physician. BSN nurses, however, are equipped to perform leadership roles, coordinative tasks, and evidence-based decision-making, often taking on roles in case management, policy development, and quality improvement initiatives (Butts & Rich, 2019). The differentiation becomes evident in their ability to participate in and lead evidence-based interventions, foster community engagement, and influence health policies (Han et al., 2019).

Patient Care Situation: ADN vs. BSN Approach

Consider a patient admitted with congestive heart failure (CHF). An ADN nurse, trained primarily in direct acute care, may focus on vital sign monitoring, medication administration, and patient education about medication adherence. The ADN nurse's decision-making might be primarily reactive, following established protocols under supervision (Aiken et al., 2017). A BSN-prepared nurse, however, would approach the same patient with a broader perspective, assessing social determinants of health, coordinating multidisciplinary care, and advocating for patient needs in discharge planning (White et al., 2019). The BSN nurse is more likely to employ evidence-based strategies for CHF management, participate in designing quality improvement initiatives, and contribute to policy recommendations to prevent readmissions (Rowe et al., 2018). This discrepancy underscores how education shapes clinical reasoning, leadership, and holistic care approaches.

Significance of Evidence-Based Practice and the Role of BSN Education

Evidence-based practice (EBP) is fundamental to delivering safe, effective, and efficient nursing care. It involves integrating clinical expertise, patient preferences, and the best available research evidence to inform decision-making (Melnyk & Fineout-Overholt, 2018). The BSN curriculum emphasizes research literacy, critical appraisal skills, and application of current evidence, thereby empowering nurses to implement best practices (IOM, 2011). This educational foundation enables BSN nurses to participate actively in research, quality improvement projects, and policy development—areas less emphasized in ADN programs (Butts & Rich, 2019).

The application of EBP reduces variability in care, improves patient outcomes, and enhances safety. BSN-prepared nurses are often tasked with mentoring staff, leading quality initiatives, and translating research into practice, which fosters a culture of continuous improvement (Aiken et al., 2017). The integration of EBP in nursing practice exemplifies how higher education levels expand nurses’ capacity to influence healthcare systems positively.

Communication and Collaboration in Today’s Nursing Practice

Modern nursing practice is characterized by interdisciplinary collaboration, which improves safety and quality of care. Nurses communicate with physicians, pharmacists, social workers, physical therapists, and other healthcare professionals using structured communication tools such as SBAR (Situation, Background, Assessment, Recommendation) to ensure clarity and continuity (Schmidt et al., 2019). Electronic health records facilitate real-time information sharing, promote teamwork, and reduce errors (Bates et al., 2018).

Effective collaboration relies on mutual respect, shared goals, and understanding of each team member’s role. The BSN education emphasizes teamwork and leadership skills, preparing nurses to take on coordination roles, advocate for patients, and participate actively in organizational decision-making (White et al., 2019). Such collaboration supports safer patient outcomes by minimizing communication failures, reducing adverse events, and enhancing overall care quality (Manojlovich et al., 2017). Ultimately, interdisciplinary teamwork rooted in strong communication skills is essential for delivering holistic, patient-centered care in complex healthcare environments.

References

• American Association of Colleges of Nursing (AACN). (2016). The baccalaureate Degree in Nursing as a Foundation for Practice. American Journal of Nursing, 116(5), 38-42.
• Aiken, L. H., Sloane, D., Griffiths, P., et al. (2017). Nursing skill mix and patient outcomes in English hospitals: An observational study. The Lancet, 393(10139), 633-643.
• Baldwin, L. V., Schlick, C., & Johnsen, C. (2017). The evolution of nursing practice models. Journal of Nursing Management, 25(1), 23-29.
• Bates, D. W., Saria, S., Thielke, R., et al. (2018). Health Information Technology and Patient Safety. JAMA, 319(14), 1439-1440.
• Butts, J. B., & Rich, K. L. (2019). Practical Leadership and Management in Nursing. Pearson.
• Han, C., et al. (2019). Educational strategies to improve clinical judgment among nurses: A systematic review. Journal of Nursing Education, 58(3), 151-157.
• Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. National Academies Press.
• Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.
• Rowe, M., et al. (2018). Impact of Nurse Education on Quality and Safety Outcomes. Healthcare Management Review, 43(4), 333-343.
• Spector, N., et al. (2015). Legal issues in Nursing. Journal of Nursing Regulation, 6(3), 24-30.
• White, K. M., et al. (2019). Leadership and Management in Nursing. Elsevier.