EDITORIAL
A Better-Educated Nurse Workforce MAUREEN ANTHONY, PhD, RN
W
hen I was a student at a diploma school of nursing more than 40 years ago, our instructors warned us that a bachelor’s of science in nursing (BSN) degree would soon be required for all nurses. Taking their advice to heart, I entered a BSN completion program the September following graduation from nursing school. Working full time slowed me down, but I did earn that BSN, even though—as you know—it never did become a requirement. Although it may not be required, more and more nurses with associate’s degrees in nursing (ADNs) are returning to school to earn a BSN. The U.S. Department of Health and Human Services National Center for Workforce Analysis (2013) reported that 55% of registered nurses (RNs) have a BSN degree or higher, up from 50% in 2003. That number is sure to rise dramatically in the coming years because the number of RN-BSN graduates increased an astounding 86.3% in the 3 years before the report. Two factors have led to this increase: hospitals, in the quest for Magnet status, have begun to favor applicants with a BSN and some have started to require newly hired nurses with an ADN to complete a BSN within 10 years of hire. Secondly, recent research suggests there are better patient outcomes when a higher proportion of nurses are educated at the BSN level or higher (Aiken et al., 2014). As a nurse educator, I have witnessed the tremendous increase in nurses with ADNs returning to school to earn a BSN, many coming directly after graduation from community colleges. It is a trend that I am thrilled to see. Despite the growing body of evidence that higher levels of nurse education are correlated with better patient outcomes, some nurses are still resistant to furthering their education. For some, I suspect it feels like criticism, that they are not “good enough,” and they are quick to defend their clinical skills. No one would argue that these nurses are not fully equipped for the bedside nursing of yesterday, but nursing today requires that we see the bigger picture. Certainly, bedside clinical skills are important; no one would argue the opposite. But skills beyond the bedside, whether in a hospital or community setting, are needed for successful nursing practice today. Do nurses have the skills to locate and evaluate current evidence-based practice? Can they anticipate the patient’s needs once they leave the hospital? Do they have the knowledge necessary to prevent unnecessary readmissions? Are they familiar with community resources for patients? Do they have a firm grasp of educational principles and change theories to help patients make healthy behavioral changes? Nursing and healthcare in general have become very complex and we need the same or more educational preparation as those in other health disciplines. Physicians, physical and occupational therapists, social workers, and pharmacists, to name a few, need considerably more education than nurses to enter practice. Shouldn’t nurses, with such a tremendous amount of responsibility, be comparably educated? I don’t think nurse education at the ADN level should go away. As an educator, I have seen many fantastic nurses have come up through the ranks, beginning their careers as an ADN or even as a licensed practical nurse. What is important is that
vol. 32 • no. 8 • September 2014
Home Healthcare Nurse 453
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
it is not an endpoint. No matter what the level of entry, every nurse should come into the profession with an inquisitive mind and a strong desire to be a life-long learner.
The author declares no conflicts of interest. DOI: 10.1097/NHH.0000000000000118
REFERENCES Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R, ..., Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. Lancet, 383(9931), 1824-1830. doi:10.1016/S0140-6736(13)62631-8 U.S. Department of Health and Human Services National Center for Workforce Analysis. (2013). The U. S. nursing workforce: Trends in supply and education. Retrieved from http://bhpr.hrsa.gov/healthworkforce/supplydemand/ nursing/nursingworkforce/nursingworkforcefullreport.pdf
454 Home Healthcare Nurse
www.homehealthcarenurseonline.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
A Better-Educated Nurse Workforce MAUREEN ANTHONY, PhD, RN
W
hen I was a student at a diploma school of nursing more than 40 years ago, our instructors warned us that a bachelor’s of science in nursing (BSN) degree would soon be required for all nurses. Taking their advice to heart, I entered a BSN completion program the September following graduation from nursing school. Working full time slowed me down, but I did earn that BSN, even though—as you know—it never did become a requirement. Although it may not be required, more and more nurses with associate’s degrees in nursing (ADNs) are returning to school to earn a BSN. The U.S. Department of Health and Human Services National Center for Workforce Analysis (2013) reported that 55% of registered nurses (RNs) have a BSN degree or higher, up from 50% in 2003. That number is sure to rise dramatically in the coming years because the number of RN-BSN graduates increased an astounding 86.3% in the 3 years before the report. Two factors have led to this increase: hospitals, in the quest for Magnet status, have begun to favor applicants with a BSN and some have started to require newly hired nurses with an ADN to complete a BSN within 10 years of hire. Secondly, recent research suggests there are better patient outcomes when a higher proportion of nurses are educated at the BSN level or higher (Aiken et al., 2014). As a nurse educator, I have witnessed the tremendous increase in nurses with ADNs returning to school to earn a BSN, many coming directly after graduation from community colleges. It is a trend that I am thrilled to see. Despite the growing body of evidence that higher levels of nurse education are correlated with better patient outcomes, some nurses are still resistant to furthering their education. For some, I suspect it feels like criticism, that they are not “good enough,” and they are quick to defend their clinical skills. No one would argue that these nurses are not fully equipped for the bedside nursing of yesterday, but nursing today requires that we see the bigger picture. Certainly, bedside clinical skills are important; no one would argue the opposite. But skills beyond the bedside, whether in a hospital or community setting, are needed for successful nursing practice today. Do nurses have the skills to locate and evaluate current evidence-based practice? Can they anticipate the patient’s needs once they leave the hospital? Do they have the knowledge necessary to prevent unnecessary readmissions? Are they familiar with community resources for patients? Do they have a firm grasp of educational principles and change theories to help patients make healthy behavioral changes? Nursing and healthcare in general have become very complex and we need the same or more educational preparation as those in other health disciplines. Physicians, physical and occupational therapists, social workers, and pharmacists, to name a few, need considerably more education than nurses to enter practice. Shouldn’t nurses, with such a tremendous amount of responsibility, be comparably educated? I don’t think nurse education at the ADN level should go away. As an educator, I have seen many fantastic nurses have come up through the ranks, beginning their careers as an ADN or even as a licensed practical nurse. What is important is that
vol. 32 • no. 8 • September 2014
Home Healthcare Nurse 453
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
it is not an endpoint. No matter what the level of entry, every nurse should come into the profession with an inquisitive mind and a strong desire to be a life-long learner.
The author declares no conflicts of interest. DOI: 10.1097/NHH.0000000000000118
REFERENCES Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R, ..., Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. Lancet, 383(9931), 1824-1830. doi:10.1016/S0140-6736(13)62631-8 U.S. Department of Health and Human Services National Center for Workforce Analysis. (2013). The U. S. nursing workforce: Trends in supply and education. Retrieved from http://bhpr.hrsa.gov/healthworkforce/supplydemand/ nursing/nursingworkforce/nursingworkforcefullreport.pdf
454 Home Healthcare Nurse
www.homehealthcarenurseonline.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
