 |
 |
 |
 |
 |
 |
|
New Jersey and New York are pursuing legislation that would require registered nurses to attain a bachelor’s degree within ten years of initial licensure. This approach, first introduced in legislation by New York in 2005, is unlike any nursing education policy change attempted in the past. Both New York and New Jersey have introduced bills advancing the policy for the current, 2007-2008 legislative session, and interest in the initiative is growing in other states. So why are the state nurses associations behind this movement? And what will this mean for the registered nurses in those states if the law is passed? Efforts to advance nursing education are not new. In 1964 the American Nurses Association (ANA) House of Delegates adopted a motion that "ANA continue to work toward baccalaureate education as the educational foundation for professional nursing practice" resulting in the 1965 position paper on Educational Preparation for Nurse Practitioners and Assistants to Nurses. In subsequent years, the House of Delegates continued to revisit advancing nursing education by agreeing to recommend and seek ways to ensure the baccalaureate in nursing degree as the minimal educational qualification for entry into professional nursing practice. Only one state enacted such a law, North Dakota, and the nation watched as that one state overturned the law several years later. Essentially, failure of the nursing community to unite in support has resulted in the inability to achieve a baccalaureate degree in nursing for entry into practice. So why consider another approach now? There is extensive evidence linking educational levels and safe patient care. The U.S. Department of Health and Human Services, the National Advisory Council on Nursing Education and Practice urged that two thirds of the basic nurse workforce hold a bachelor's or higher degree in nursing by 2010. The increasing complexity of medications, treatments, technology, and chronic health conditions along with a change in consumer expectations underscores the need for nurses to continue their education. A strong foundation in liberal arts and sciences (attained through baccalaureate education) strengthens the analytical and critical thinking skills needed for safe, culturally competent care. These skills, further developed through baccalaureate education, better prepare nurses to engage in process improvements and meet the demands in the evolving health care environment. An increase in baccalaureate prepared nurses would also provide a ready pool of candidates to pursue master's degree education for assuming faculty positions; thwarting the crisis we now face. And while nursing has debated educational preparation, other health professions have advanced their minimum education requirements: doctoral education for physical therapists and pharmacists, master's degree for social workers and more recent attempts to elevate respiratory therapist education to a bachelor's degree. All of these requirements have occurred during a time of shortage for each of these health care professions. This approach for advancing nursing education is different. It is not baccalaureate education upon entry into the profession. This model recognizes the value of multiple entry points, but with baccalaureate education as the ultimate goal for all registered nurses within ten years of initial licensure. The nurse gains experience and satisfies education requirements simultaneously. The NY and NJ bills exempt those licensed RNs and students enrolled in nursing programs at the time the law is enacted from the baccalaureate degree requirements. For this model to be successful, there is much to do. Critical is education of nursing colleagues and post-secondary education administrators that this model is different from "entry". This approach continues to recognize diploma and associate degree in nursing education as an option for entry into the profession. Nurses currently licensed would be exempt from the new requirement. Paving the way for nurses to attain the baccalaureate degree requirement will also require articulation agreements between nursing schools, colleges and universities as well as employers assuring work schedules, release time and other types of support to enable nurses to pursue the degree requirements. Much is already happening. Employers are providing tuition assistance, even creating on site classrooms. There has also been a growth in distance learning programs over the past two decades. As our nursing colleagues, certified nurse practitioners, are also seeking educational advancement with doctoral preparation, perhaps now is the time to unite as a profession: time to seek educational advancement for registered nurses. |