Changes in Nursing Scope

The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing
practice today by addressing the following:

  1. Explain how nursing practice has changed over time and how this evolution has changed
    the scope of practice and the approach to treating the individual.
  2. Compare and contrast the differentiated practice competencies between an associate and
    baccalaureate education in nursing. Explain how scope of practice changes between an
    associate and baccalaureate nurse.
  3. Identify a patient care situation and describe how nursing care, or approaches to
    decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.
  4. Discuss the significance of applying evidence‐based practice to nursing care and explain
    how the academic preparation of the RN‐BSN nurse supports its application.
  5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and
    how this supports safer and more effective patient outcomes.

Nursing Practice Today

Changes in Nursing Scope
Nursing history began with the health care that mothers provided to their family members
during minor illnesses and injuries. The profession became significant particularly during the
first and second world wars where females were involved in treating minor injuries from the
wounded soldiers. This led to calls to have the women trained to conduct their roles with
competence. Nursing has, however, evolved over the years to become an autonomous profession
that provides care to people of all genders and age-groups within the hospitals, home, and
community. Nursing is a scientific profession established within the purview of evidence-based
practice and involving broad expertise (Fisher, 2014). Nurses currently have to change roles
from conventional practices such as patient advocacy, administering medications, monitoring the
health of patients and recording signs, as well as collaborating with other members of the health
care team. The profession is no longer under direct supervision from the physicians because
nurses have their distinct code of practice. Nurses are currently involved in inpatient care in
hospitals, families, nursing homes, schools, and community settings.

Comparisons and Contrasts between Associate Degree and Bachelor’s Degree Nurses
Associate degree nurses and bachelor-prepared nurses are licensed as registered nurses
with similar licensing levels and overlapping roles. The training of associate degree nurses takes
two to three years unlike the training of Bachelor of Science nurses that takes a minimum of 4
years. Both courses prepare nurses to practice accepted nursing standards and procedures within
the health care and community settings. The Bachelor’s degree in nursing, however, place more
emphasis on topics like informatics and research as well as more clinical rotations in public and
community health settings.
Patient Care Scenario
A nurse with a bachelor’s degree may not necessarily get more clinical experience in
conducting procedures and assessments in acute care, but are likely to have better ward
management skills. A patient case scenario, for instance, is in the delegation of the nursing role
in acute care settings. Both the associate degree and the bachelor’s degree nurses have almost
similar clinical experience in acute care settings but BSN nurses have more expertise in
management and delegation of duties within the health care settings.
Significance of the Applying Evidence‐Based Practice to Nursing Care
The Application of EBP is significant to nursing care because it allows the nurses to
provide relevant and current care that is anchored on recent scientific evidence and literature.
Nursing autonomy ensures that nurses can govern their profession, have autonomous practice
features, and have a distinct scientific discipline. The incorporation of EBP by the nurses
produces optimal clinical outcomes for patients and reduces hospital stay according to recent
studies. Te practice also reduces health care costs and improves work efficiency (Wojnar and
Whelan, 2017). Academic preparation of the BSN nurses supports the application of EBP as it

encourages rationalism and application of scientific research findings to address the needs of the
Nurses Communication and Collaboration with Interdisciplinary Teams
Nurses could communicate and collaborate with the interdisciplinary team to support safe
and better clinical outcomes particularly in the management of chronic illnesses. Nurses can
achieve this through the implementation of a preliminary care coordination plan. This
preliminary care coordination plan seeks to ensure that there is service integration that meets the
clients’ needs. The focus of the care coordination plan is to provide collaborative services and
recover-focused care that connects individuals to the appropriate services within health care
institutions and the community (McGhie-Anderson, 2018). Of great importance in the care,
coordination plan is the management of chronic illnesses within the community setting and using
community resources. The plan highlights the challenges posed by the chronic illness to the
personal identity of an individual and the changes in social interactions as well as the creation of
An effect on one aspect of life could have a rippling effect on other life spheres. A
chronic illness, for instance, could pose social problems if it affects the social interactions of
individuals. The latter may also result in economic problems by causing unemployment or
retrenchment. These challenges do not affect the individual alone but also the facile, friends, and
the wider health care system (Ganz, Toren, and Fadlon, 2016). A multidisciplinary approach
should, therefore, be used in managing chronic illnesses to ensure the best possible clinical
outcomes for the patients and their significant others. The interconnected problem patients are
thus managed by various health cadres through a collaborative and multidisciplinary approach.



Fisher, M. (2014). A Comparison of Professional Value Development Among Pre-Licensure
Nursing Students in Associate Degree, Diploma, and Bachelor of Science in Nursing
Programs. Nursing Education Perspectives, 35(1), 37-42.
Ganz, F., Toren, O., & Fadlon, Y. (2016). Factors Associated With Full Implementation of
Scope of Practice. Journal Of Nursing Scholarship, 48(3), 285-293.