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Today, someone wanting to become a nurse can do so by earning an associate's degree in nursing (ADN) or a bachelor of science in nursing (BSN). However, a recent New York state initiative may eliminate the option of an ADN.
The bill under consideration would require all newly registered nurses to obtain a bachelor's degree within 10 years to continue working in New York. While no state currently has such an initiative, a nationwide call to raise educational requirements for nurses has begun to take shape.
Rhode Island and New Jersey have been considering implementing a similar policy over the past several years. Despite failures to progress in the past, this year New York's bill has support in both chambers and could be debated as soon as January 2012.
The bill is intended to address an increasingly unhealthy population, as well as the 32 million Americans who are promised healthcare by 2014 under the Affordable Care Act.
The "BSN in 10" initiative - backed by nursing associations and major health policy organizations - aims to attack the complex problem of too few nurses trained to care for an aging population that includes hundreds of thousands of nurses expected to retire in the coming years. But some in the healthcare industry worry increased education requirements could worsen the problem by discouraging entrants into the field, the Associated Press reports.
In attempt to stop nurses from leaving the field, current RNs would be exempt from the new education requirements.
Calling for Change
The issue of a BSN requirement has long been the center of debate among healthcare officials, but with the release of the 2010 report, "The Future of Nursing," by the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), has pushed the issue to the forefront.
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression, according to the report.
"Nurses have very specific skills ¾ critical in caring for much sicker and older patients," said Susan B. Hassmiller, PhD, RN, FAAN, senior advisor for nursing at RWJF and director, The Future of Nursing: Campaign for Action. "And we know from research, people who got an associate degree, like myself, then went on to higher degrees know a greater feeling of competence and confidence and will be best suited to care for those in the community and public health settings, where the need will be greatest."
To date, about 50 percent of U.S. nurses have a baccalaureate degree or higher. The joint IOM and RWJF report says, 80 percent of nurses should have their BSNs by 2020.
On top of this particular report other studies have found that higher levels of nursing education lead to higher quality of care for patients. The 2003 University of Pennsylvania study, led Linda Aiken, PhD, RN, FAAN, FRCN, found a 10 percent increase in staffing by nurses with bachelor's degrees results in a 5 percent decrease in the number of surgical patients dying within 30 days of admission and the rate of failure to rescue.
Nursing Education's Future
Many issues remain, including the question of a limited number of nurse educators. Without them, higher education standards in the field will be impossible to reach. Also, institutions that offer 2-year programs have shown concern the new bill will negatively impact enrollment.
While the details of the initiative remain uncertain and concerns must still be addressed, many nursing professionals and government officials alike agree there is a need for a change in the way nurses are educated.
"It's critical nurses be able to translate current knowledge and research into evidence-based nursing practice," said Karen A. Ballard, MA, RN, FAAN, former president of the New York State Nurses Association in the January/February 2011 issue of New York Nurse. "Even for nurses who graduated only 10 years ago, you already know you're practicing differently today. Try to imagine what the level of practice will be like in 2025.
"For the profession to continue to provide the level of care patients are increasingly requiring, a bachelor's degree is essential," Ballard added. "More importantly, all nurses must assume responsibility for their own academic progression."
Catlin Nalley is editorial assistant at ADVANCE. Gail O. Guterl contributed to this article.
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