Issues and Trends in Nursing

Nursing practice, as well as the practice of medicine in general, has been evolving throughout the course of the history of humankind. The individuals dedicated solely to the practice of care for the sick, injured, and the afflicted were the first nurses, even if a dedicated word for the profession appeared much later. Modern nurses form the backbone of contemporary medical care. The purpose of this paper is to evaluate the evolution of nursing practice and analyze the differences between an ADN (associate degree in nursing), a BSN (bachelor of science in nursing), and an RN (registered nurse).

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Evolution of Nursing

Nursing is one of the oldest professions in existence and had evolved along with the evolution of humankind. Ancient nursing was science as much as a religious practice, as many sicknesses were attributed to evil spirits, sins, and other supernatural factors (Roux & Halstead, 2017). At the same time, the fundamental tenets of nursing were established during that time period. The fact that an injured or a sick individual needs peace, quiet, warmth, and food to recover from even the most specific diseases has been realized very early in the history of humankind.

Due to distances, language barriers, and a lack of communication, nursing practices did not have a standard, as each nation developed its own methods and remedies for particular injuries and ailments. The profession of medicine and nursing of antiquity and medieval times was associated with Hippocrates, Avicenna, Actuaries, and Paracelsus (Roux & Halstead, 2017). However, the specific role of a nurse was introduced en-masse by the religious organizations in Europe, such as the Order of Hospitallers, who ran large shelters and hospitals for numerous pilgrims en route to the Holy Land.

Nevertheless, the principles of nursing practice remained very disjointed, with significant similarities found across the map. Nursing practice started changing when Florence Nightingale created her paradigm of nursing, which was the first nursing framework to be published. She is considered the mother of modern medicine, as her framework placed a list of demands not only on nursing practices but also on individuals who practiced nursing (Alligood, 2017).

Modern nursing is very different from what it used to be 100-200 years ago. The scope of practice placed the individual patient at the center of all efforts and decision-making. Dogma and religion were removed from medicine, replaced by evidence-based practice. Lastly, a modern nurse is a highly skilled medical professional whose qualities conform to the national and universal standards of nursing.

Similarities and Differences Between an ADN and a BSN

There are many differences between an ADN and a BSN. The core practice competencies do not differ as much, as they cover pediatrics, adult health, maternal nursing, newborn nursing, psychological health, and gerontological care (Anbari, 2018). However, a BSN also gets additional hours in nursing informatics and nursing theory, making them more suited to conducting research.

An ADN nurse takes two years to prepare, whereas a BSN nurse takes 4-5 years (Anbari, 2018). The scope of practice for a BSN graduate is more comprehensive, as BSN nurses are allowed and prepared to conduct research, gain access to more critical and skill-intensive roles, and a possibility for becoming an RN after passing the national and state exams.

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Different Approaches to Patient Care

The differences in education between an ADN and a BSN signify a difference in approaches to patient care. Both roles are highly skilled and trained in applying traditional practices of nursing care for different situations. For example, in a post-operational patient situation, both an ADN and a BSN nurse would perform activities to reduce the chances of developing a pressure ulcer. However, an ADN would not have the competency to go beyond what is stated in the manual. A BSN is taught to adjust the patient’s treatment based on different nursing theories, credible research, and public health concerns (Anbari, 2018).

The Significance of Evidence-Based Practice

The field of medicine is in the process of constant evolution. New practices, theories, and methods are being invented and tested. At the same time, the adoption of novel approaches as a new standard of nursing care is going slowly. It is the responsibility of an RN-BSN nurse to seek out these new practices, analyze them, and see if they could be implemented in a contemporary nursing setting. The academic preparation of the RN-BSN nurse allows for implementing evidence-based practices and producing research in the scope of a much larger set.

Communication and Collaboration with Interdisciplinary Teams

While ADN nurses are trained in the basics of nursing practice, BSN nurses and RN nurses are expected to be part of interdisciplinary teams (Anbari, 2018). The collaboration between different specialists ensures the highest possible quality of care available to the patient, as other specialists would be able to work in their respective fields of expertise. Communication and leadership in such efforts are vital, as poor cohesion results in lowered patient outcomes. All nurses are trained in communication and leadership techniques to be able to take part in interdisciplinary action.


Although ADN is a faster and cheaper way of becoming a nurse than a BSN, the BSN program has a much broader scope of practice, which includes research, critical thinking, and better opportunities for promotion. Thus, it provides a better long-term solution as well as the ability to improve patient care by utilizing advanced evidence-based practices and a more excellent range of nursing theories to fit the situation. Both roles are equally dedicated to providing a high standard of care, and it is not uncommon for ADN specialists to enroll in a BSN program.


Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). St. Louis, MO: Elsevier.

Anbari, A. B. (2018). What makes a BSN? Western Journal of Nursing Research, 41(2), 167-170.

Roux, G., & Halstead, J. A. (2017). Issues and trends in nursing: Practice, policy, and leadership (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

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