Among the key messages of the Institute of Medicine’s Future of Nursing report released last fall is that, “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.” Related recommendations set goals to “increase the proportion of U.S. nurses with a bachelor’s degree from 50 to 80 percent; and to double the number of nurses with a doctorate by 2020.”
These goals speak to a number of barriers that currently impede our ability to meet a growing demand for a better educated nursing workforce. Among them is an insufficient capacity to prepare adequate numbers of nurses at entry and advanced levels of education. Despite compelling evidence that links BSN education with lower rates of patient death, medical errors, and better patient outcomes, approximately 60 percent of new nurse graduates are currently educated in associate degree programs. Research also indicates that nurses who initially graduated from associate degree programs are much less likely than nurse graduates from bachelor’s degree programs to ever pursue and obtain a master’s or higher degree.
This is really important for a number of reasons. First, demands on nurses are growing, thanks to an increasingly complex health care delivery system and the need for nursing to be full partners and manage care along a continuum as members of interdisciplinary teams. This will require nurses to obtain an advanced education that fosters a deeper understanding of the many factors that influence patient health and illness. A bachelor’s degree better prepares nurses to meet those challenges. Second, with fewer nurses pursuing advanced education, our efforts to produce adequate numbers of nursing faculty or advanced practice RNs to meet future demands within educational and provider arenas – particularly primary care – are seriously impeded. Third, over the next decade, more than half of current nursing faculty is expected to retire, along with as many as 500,000 experienced nurses from the clinical workforce.
Taken together, these facts speak to a number of changes that need to occur in the immediate future to prepare sufficient numbers of qualified nurses at entry and advanced levels within the workforce. First, nursing education systems must evolve so that the goal of achieving a much greater proportion of BSN nurse graduates can be realized. Beyond articulation agreements that, to date, have been limited in their effectiveness, one strategy posed for achieving this goal is for all pre-licensure nursing programs to be permitted to confer bachelor’s degrees. Narrowing the gap between clinical and academic salaries is also necessary to create incentives for nurses to pursue advanced education in order to qualify for faculty positions. Second, employers must place greater emphasis on the attainment of higher education levels by nurses through hiring practices, as well as by facilitating educational advancement opportunities. Finally, it is critically important that nurses without a BSN take advantage of opportunities to pursue advanced education to become better prepared to care for patients in an increasingly complex health care delivery system.
These are just some of the reasons ANA continues to support “BSN in ten” initiatives. Assuring a well-prepared nursing workforce is key to providing access to affordable, effective care. Advancement of our system of nursing education will be integral to achieving that goal.