This is a copy of a paper from one of my courses; Professional Nursing Practice. I picked this topic because I wanted to research the reason behind the shortage of job opportunities in hospitals for an associate degree nurse.

Should a BSN be a requirement for nurses to gain entry into practice?

 

Introduction

                The baccalaureate of science (BSN) degree was first introduced at the University of Minnesota in 1909 (Scheckel, 2009). In 2008, the US Department of Health and Human Services reported that about 47% of the nursing workforce had a Baccalaureate of Science (BSN) in nursing. A BSN prepared nurse is trained and educated with physiological, psychological, and social knowledge, they have better professional communication skills and improved patient supervision ability; all of which creates better patient outcomes (Liao, Sun, Yu, Li (2016).

The call for nurses to gain a higher education came from the American Nurses Association (ANA)in 1965 (Taylor, 2008).  The American Nurses Association wanted to abolish the apprenticeship program for nurses in hospital-based programs and educate them in colleges and universities where they would be exposed to a science-based practice (Taylor, 2008).

Entry-level requirements

Presently, nurses that attain a certificate, an associate or a baccalaureate degree in nursing are eligible to take the National Council of Licensure Examination (NCLEX). Increased education of nurses equipped them to strive for better and improved patient outcomes. To stay abreast of complex patient needs, ever changing technology and research; the nursing profession must require a baccalaureate degree as an entry level requirement to practice. “Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcer, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay” (Blegen, Goode, Park Vaughn and Spetz, 2013).

In contrast, an argument exists that all registered nurses are ‘equal’ whether they obtain their education in a certificate program, associates or bachelor’s degree program; since; they all are eligible to take the National Council of Licensure Examination (NCLEX), (Masek, 2008). Masek continued to argue that an associate degree program is dominated with students who have changed their careers; as well as older students. She also lamented that requiring a baccalaureate degree as an entry to practice would only deter individuals who would want to become nurses; therefore, creating a nurse shortage. Since, the associate degree is a two-year program while the baccalaureate degree program is a four-year program.

In 2010, the Institution of Medicine (IOM) set a new demand on the nursing profession. The IOM set a target goal that require 80% of all nurses to acquire a baccalaureate degree by 2020. This was a result that stemmed from academic research that showed that patients in hospitals where the majority of nurses have higher-level academic degree, have better patient outcomes and patients receive better care (Villanova University, 2017).

“Nurses are being called upon to fill primary care roles and to help patients manage chronic illnesses, thereby preventing acute care episodes and disease progression. They are expected to use a variety of technological tools and complex information management systems that require skills in analysis and synthesis to improve the quality and effectiveness of care” (Institute of Medicine). Thus, the complexity of the patient’s illness is one of the reasons a BSN is required for an entry level position as a nurse; more advanced training and education is needed beyond a two-year degree.

With advancing technology; patients are able to research on their own to gain knowledge of hospitals who were given awards for their excellent nursing care (Magnet Status). Most patients would feel comfortable knowing that the nurses caring for them are highly educated, licensed, experienced and certified. The American Nurses Credentialing Center (ANCC) devised the Magnet Recognition Program, to draw attention to healthcare facilities that promote nurse empowerment, which leads to excellent nursing care that is evidence-based. For a hospital to gain the Magnet Recognition status, one of the requirement is that “100% of the organization’s nurse managers have a BSN or graduate degree” (Villanova University, 2017).

The American Nurses Credentialing Center (ANCC); requires a high number of bedside nurses to attain a baccalaureate degree if, the institution is going to seek magnet status. The IOM report, in addition to hospitals seeking Magnet Recognition is one of the reasons why RNs who graduate from an associate degree program have great difficulty finding employment in a hospital; “many nursing administrators want nurses prepared at the baccalaureate (BS) level” (Blegen et al, 2013).

The associate degree program is equated to that of a technical degree while the baccalaureate degree allows a RN to deal with the professional aspects of nursing (Taylor, 2008). The call for nurses to gain a higher level of education came from the fact that they are seen as the least educated, when compared to other professional counterparts. “Across settings, nurses are being called upon to coordinate care and collaborate with a variety of health care professionals, including physicians, social workers, physical and occupational therapists, and pharmacists, most of whom hold master’s or doctoral degrees” (Institution of Medicine report, 2010).

In conclusion, the nursing education requirement for entry into practice has been debated for more than 50 years. With the Institute of Medicine (IOM) report asking institutions to increase their nursing workforce to 80% of nurses who are baccalaureate prepared by the year 2020; newly graduated associate degree nurses would be forced to gain a higher education in order to gain employment in these organizations. Throughout the years, nursing education have progressed from hospital-based programs to colleges and universities science-based programs; yielding baccalaureate degree and as a result; nursing is now seen as a well-respected profession.

 

References:

Taylor, D. (2008). Should the entry into nursing practice be the baccalaureate degree? Association of PeriOperative Registered nurses (AORN) Journal, 87 (3) 611-620.

Masek, S. (2008). Differing views on the nurse as the entry level unto nursing practice. Association of PeriOperative Registered nurses (AORN) Journal, 88 (2) 181-183

Scheckel, M. (2009). Nursing Education: Past, Present, Future. Jones and Bartlett, Sudbury, MA (2009), pp. 27-61

Liao, L. Sun, X. Yu, H. Li, J (2016). The association of nurse educational preparation and patient outcomes: Systematic review and meta-analysis. Nurse Education Today: (42) 9-16.

Blegen, M., Goode, C., Park, S., Vaughn, T. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94. Doi:10.1097

 

Institute of Medicine (2011).  The Future of Nursing:  Leading change, advancing health.  Retrieved from http://www.nap.edu/catalog.php?record_id=12956

 

Villanova University (2017), retrived on November 13^th, 2017. https://www.villanovau.com/resources/nursing/hospitals-require-bsn-for-nurses/

 

US Department for Health and Human Services. Retrieved on November 14^th, 2017 https://www.hhs.gov/.

 

 

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