In 2010, the 80% BSN by 2020 initiative rolled out in an effort to boost nursing’s competency level. Have we reach the 80% goal? Read on to find out if we’ve made progress over the past 10 years.
A decade ago, our healthcare system was growing more complex and patients were sicker than ever. In response, The Robert Wood Johnson Foundation and the Institute of Medicine (IOM) rolled out a 2-year initiative to determine if the nursing workforce was prepared to face these challenges. Data was gathered, analyzed and in 2010, the IOM released a report of evidence based recommendations to improve the skill and competency of working nurses.
80% BSN by 2020
The report was clear… nurses needed a higher level of education. Therefore, the IOM pushed for more BSN nurses by setting the goal of 80% of RNs earning a BSN by 2020. When the report was released in 2010, only 49% of nurses were educated on a baccalaureate level.
Distinct Differences
BSN and ADN nurses fill many of the same positions, with both performing similar tasks. But, there is a growing number of research studies that show BSN graduates bring greater skill to their work than ADN or diploma graduates. The American Association of Colleges of Nursing (AACN) provides an overview of numerous studies in the fact sheet, The Impact of Education on Nursing Practice.
According to research, BSN graduates are better prepared to:
Use evidence-based practice
Analyze data
Implement and manage projects
Communicate with other disciplines
Promote patient safety
Work in leadership positions
Nurses with a bachelor degree have also been linked to:
Lower odds of patient deaths
Better patient outcomes
Leading to lower costs
Fewer adverse events
Fewer medication errors
Stronger use of research
Stronger leadership skills
Progress Towards Goal
The nursing profession won’t meet the goal of an 80% BSN workforce by 2020, but progress is being made. The Future of Nursing’s Campaign for Action works to implement the IOM’s 2010 recommendations. Here is a quick look at their progress:
Starting in 2012, the number of nurses graduating with a BSN, including RN-to-BSN, is higher than those graduating with an associate degree.
From 2010 to 2012, the number of RN-to-BSN graduates increased by 180%.
In 2018, the percentage of working nurses with a bachelor's degree (or higher) was up from 49% in 2010 to 57% in 2018.
Since 2010, the number of nurses with a doctorate degree has doubled.
To reduce the hurdles faced by nurses in obtaining advanced degrees, 30 states are now enrolling nursing students into 1 of 5 promising program models:
RN-to-BSN degree from a community college to allow RNs to complete bachelor education at a community college
State or regionally shared outcomes-based curriculum
Accelerated RN-to-MSN programs
Shared statewide or regional curriculum between universities and community colleges.
Shared baccalaureate curriculum to shorten the time between obtaining an associate and a bachelor's degree.
Making it Easier to Return to School
ADN graduates share common concerns about returning to school. Online RN-to-BSN programs are designed to address these concerns by:
Building on previous education to shorten the time it takes to earn a BSN
Providing multiple start dates for RNs to enroll at a time convenient for them
Formatting coursework to be completed at a time and place that works best for the student
Making online programs more affordable than traditional campus-based programs
Nurses may also qualify for loan forgiveness and loan-for-service programs
BSN Minimal Degree for Entry Level Nurse
The American Association of Colleges of Nursing (AACN) stated in a draft position paper the organization “strongly believes that registered nurses should be minimally prepared with the bachelor of science in nursing or equivalent nursing degree”.
So where does this leave the associate level nurse? The National League for Nursing (NLN) argues entry points into the nursing profession shouldn’t be limited, as more nurses are needed to ease the nursing shortage. In addition, the NLN argues 2-year community college programs are “front and center in attracting students of color and those who may be marginalized by economic disadvantage”.
Does The ADN Still Matter?
We are all feeling the strain of the nursing shortage, especially as the pandemic marches on. What does this mean for ADN graduates? It’s impossible for baccalaureate programs to graduate enough nurses in a time-frame needed to fill the current (and future) shortage gap. Both inpatient and outpatient settings need all the nursing “hands on deck” they can get. So, the answer is a loud “YES”, associate trained nurses are still needed and new grads will have no problem finding a job.
What Do You Think?
Do you agree with requiring a percentage of working nurses to hold BSNs? Also, is it fair for employers to mandate the nurses they hire to obtain a bachelor degree within a specific time-frame?
Obviously an exaggeration, I was aware of that. It included video assignments, such as videotaped assessment, making PowerPoint presentations and presenting, discussions and multistage quality improvement projects. Research papers and looking for scholarly sources took only about 1/4 of the entire program.
I would still call those "papers" although in digital format, I should have clarified better.
I can make the same argument you made for barbers and hairstylists.
Barbers and hairstylists don't have codified ethics or take an oath. They don't have a section in a college library or meet the strict definition of a profession. I'm sorry that you feel like you are merely doing tasks. The quality of our work corresponds to the effort we put into it. Those of us who are old enough to remember pre-cookbook practice can sympathize.
Barbers and hairstylists don't have codified ethics or take an oath. They don't have a section in a college library or meet the strict definition of a profession. I'm sorry that you feel like you are merely doing tasks. The quality of our work corresponds to the effort we put into it. Those of us who are old enough to remember pre-cookbook practice can sympathize.
You know what? It doesn't matter what you call it, as it's not being treated as a profession by the industries that utilize it.
What is it about nursing that you feel makes it a non-profession?
The thing that makes me disappointed is the number of ill-considered ideas we will sign up for hoping to catapult ourselves. Meanwhile business people rub their hands together and practically salivate because whether or not our latest effort at engineering is good for us or not, it will surely be good for them. The clearest examples in my mind being these bridge programs and the BSN push and then of course the state of our advanced-provider education, which is on a completely-off-the-rails downhill trajectory that is making us look more foolish practically by the day.
That said, I realize that other professions make similar choices and have leaders who assent to dumb plans that go completely against the integrity of the profession, so these complaints in and of themselves don't make nursing not a profession.
1 hour ago, Jedrnurse said:
You know what? It doesn't matter what you call it, as it's not being treated as a profession by the industries that utilize it.
That's the bottom line. We can have our own libraries and our own researchers and our own theories and our own code of ethics but until we stop the level of stupidity that an 8-year-old could figure out and stop trying to magically catapult ourselves by doing deals with the devil and assenting to every grand plan that might benefit someone else who is supposed to help us back but never does, we've got nothing.
Barbers and hairstylists don't have codified ethics or take an oath. They don't have a section in a college library or meet the strict definition of a profession. I'm sorry that you feel like you are merely doing tasks. The quality of our work corresponds to the effort we put into it. Those of us who are old enough to remember pre-cookbook practice can sympathize.
If you have to clock-in and out to track your hours at the plantation so that you can perform skills and interventions that are guided by an authoritative figure, you're in a vocation, not profession. Bedside nursing is a trade irrespective of codes, ethics, and oaths. Bedside nurses have zero authority, maybe autonomy to choose interventions in a given rectangle, but if they think and act outside that box, there are punitive consequences, even if they did the right thing.
It has been nurses who have stood in front of staff meetings and proudly said that they are working very hard to decrease our need to use critical thinking.
It is nurses who claim xyz is right one day and wrong the next, all as part of their ill-considered mad dash to protocolize our every action.
It is nurses who have helped business people successfully make the charge that our autonomy and our judgment are big problems that need to be eliminated.
It has been nurses who have chosen to discipline their underlings for the most inane reasons.
It has been nurses who have helped ***-staff our units and then tried to pick up some pom-poms and gaslight us all into thinking that everything is our fault for our bad attitudes and if we only had a better attitude it wouldn't be that bad.
It has been nurses who have tried to "make the best of things" by abusing other nurses: Guilt-tripping, accusing, making the work more impossible by the day, blame-shifting...
It is nurses who have signed up for this BS idea of people being "burned out," instead of ever saying, 'gee, a lot of people sure are suddenly burned out. Maybe it isn't that thousands and millions of nurses are burned out, but some other problem....'
It has been nurses who tout this BS line about professionals at the bedside while we are all still there being treated the same crappy way regardless of degree, knowledge or experience.
It nurses who make rotating shift schedules, lie about job details during interviews, lie about pay scales, lie about reasons for changes and "quality improvements," scheme and lie in order to make staffing grids look like they're being upheld, give out candy and dollar store prizes as they are actively spiting the people who are working hard.
It is nurses who have stood by and given open invitations as we have been increasingly abused by patients.
It is nurses who demand that we flat out lie to patients about their safety and the situations in which we are working.
It is nurses in our educational institutions that are pushing the most embarrassing craptastic education ever, so that humongous institutions with huge endowments can make more money. Or even for-profit entities. Just anyone, feel free to make a buck at our expense. We will help you.
It is nurses who sign up other nurses for contracts where they have to pay for orientation one way or another, knowing that the company prefers cheap labor and has chosen that as their business plan.
It is nurses who have helped employers become less and less cooperative with the clinical rotations that student nurses need.
It is nurses who offer *** orientations and then try to make the orientees feel like crap for not "getting up to speed" fast enough.
It is nurses who have signed up for the "efficiency" and "lean" BS and driven it full bore, even though we are caring for human beings and actually we ourselves are human beings, too.
It is nurses who agree to work hard on these meaningless "special status" programs, ram everyone through various magic chutes so that a multi-billion dollar corporation can get shiny awards and designations, and then spend every free minute not honoring the spirit of what these things were held out to mean.
It is nurses who full-on act like our Code of Ethics that we are so proud of doesn't apply to people once they aren't strictly in a staff level role.
It is nurses who have a huge pathological chip on their shoulder about their own role compared to others' roles and therefore start spouting some of the most ridiculous claims of greatness anyone has ever heard. Like true delusions of grandeur.
These things are all true, I am not making them up or even exaggerating them. Lots of people reading this will identify the same-old-same-old that has also happened in their workplaces.
Anyone can call it a profession if it makes them feel better. I personally don't see the point. We are workers. Some of us feel better about themselves by being a middle-boss worker instead of a regular worker. And here we are.
It has been nurses who have stood in front of staff meetings and proudly said that they are working very hard to decrease our need to use critical thinking.
It is nurses who claim xyz is right one day and wrong the next, all as part of their ill-considered mad dash to protocolize our every action.
It is nurses who have helped business people successfully make the charge that our autonomy and our judgment are big problems that need to be eliminated.
It has been nurses who have chosen to discipline their underlings for the most inane reasons.
It has been nurses who have helped ***-staff our units and then tried to pick up some pom-poms and gaslight us all into thinking that everything is our fault for our bad attitudes and if we only had a better attitude it wouldn't be that bad.
It has been nurses who have tried to "make the best of things" by abusing other nurses: Guilt-tripping, accusing, making the work more impossible by the day, blame-shifting...
It is nurses who have signed up for this BS idea of people being "burned out," instead of ever saying, 'gee, a lot of people sure are suddenly "burned out. Maybe it isn't that thousands and millions of nurses are burned out, but some other problem....'
It has been nurses who tout this BS line about professionals at the bedside while we are all still there being treated the same crappy way regardless of degree, knowledge or experience.
It nurses who make rotating shift schedules, lie about job details during interviews, lie about pay scales, lie about reasons for changes and "quality improvements," scheme and lie in order to make staffing grids look like they're being upheld, give out candy and dollar store prizes as they are actively spiting the people who are working hard.
It is nurses who have stood by and given open invitations as we have been increasingly abused by patients.
It is nurses who demand that we flat out lie to patients about their safety and the situations in which we are working.
It is nurses in our educational institutions that are pushing the most embarrassing craptastic education ever, so that humongous institutions with huge endowments can make more money. Or even for-profit entities. Just anyone, feel free to make a buck at our expense. We will help you.
It is nurses who sign up other nurses for contracts where they have to pay for orientation one way or another, knowing that the company prefers cheap labor and has chosen that as their business plan.
It is nurses who have helped employers become less and less cooperative with the clinical rotations that student nurses need.
It is nurses who offer *** orientations and then try to make the orientees feel like crap for not "getting up to speed" fast enough.
It is nurses who have signed up for the "efficiency" and "lean" BS and driven it full bore, even though we are caring for human beings and actually we ourselves are human beings, too.
It is nurses who agree to work hard on these meaningless "special status" programs, ram everyone through various magic chutes so that a multi-billion dollar corporation can get shiny awards and designations, and then spend every free minute not honoring the spirit of what these things were held out to mean.
It is nurses who full-on act like our Code of Ethics that we are so proud of doesn't apply to people once they aren't strictly in a staff level role.
It is nurses who have a huge pathological chip on their shoulder about their own role compared to others' roles and therefore start spouting some of the most ridiculous claims of greatness anyone has ever heard. Like true delusions of grandeur.
These things are all true, I am not making them up or even exaggerating them. Lots of people reading this will identify the same-old-same-old that has also happened in their workplaces.
Anyone can call it a profession if it makes them feel better. I personally don't see the point. We are workers. Some of us feel better about themselves by being a middle-boss worker instead of a regular worker. And here we are.
While it's certainly not a panacea, I've always thought that administrative/managerial nurses should be required to pick up a proscribed number of staff shifts working in the facility that they're managing. If people had to experience the working conditions that their policies and management create, maybe that would help initiate some positive changes.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
5 hours ago, Jedrnurse said:
While it's certainly not a panacea, I've always thought that administrative/managerial nurses should be required to pick up a proscribed number of staff shifts working in the facility that they're managing. If people had to experience the working conditions that their policies and management create, maybe that would help initiate some positive changes.
I know several managers who have tried this approach, specially to start with. In fact most managers have to fill in staffing holes if they can’t get them filled. In general it isn’t managers or even directors who are the issue. It is society and capitalism that do not see value in care giving. Let’s be honest with ourselves for one hot second. Nursing school is terribly hard and obtaining licensure is difficult. Slave like work conditions also make it an undesirable work field, but being a nurse, care giving, is not a job that most people can’t learn to do. They just have to have no money or resources and then they will do it themselves....like cutting your hair. So without the rigorous testing and licensure requirements which keep our pay relatively higher, we would be a dime a dozen....we almost already are. There isn’t a nursing shortage. What is the issue is that nurses, like technology, are an expense for facilities that they will always be trying to minimize as much as possible.
While it's certainly not a panacea, I've always thought that administrative/managerial nurses should be required to pick up a proscribed number of staff shifts working in the facility that they're managing. If people had to experience the working conditions that their policies and management create, maybe that would help initiate some positive changes.
In my experience this has very little impact. Most managers will still need to answer to a higher level manager so still have very little say in changing policies. Also, said manager will always get soft ball treatment for the day so usually won't get the full picture of the difficult patient's, the high acuity patients etc and the day after day experience.
In my experience this has very little impact. Most managers will still need to answer to a higher level manager so still have very little say in changing policies. Also, said manager will always get soft ball treatment for the day so usually won't get the full picture of the difficult patient's, the high acuity patients etc and the day after day experience.
I was actually referring to high level admin, as I know that in (many) places unit managers pick up patients at times. As the CNO has an active license, they'd be right on the rotation with the rest of management.
Let’s be honest with ourselves for one hot second.
Yes, let us (I am going to disagree with you for a second here):
19 hours ago, KalipsoRed21 said:
Nursing school is terribly hard and obtaining licensure is difficult.
No it isn't. The material for a bachelor's degree in nursing simply isn't truly challenging. However, nursing school itself is a complete mind-[blank] rigamarole because of ?....
Nurses with self-esteem problems.
On 11/28/2020 at 3:15 PM, Jedrnurse said:
While it's certainly not a panacea, I've always thought that administrative/managerial nurses should be required to pick up a proscribed number of staff shifts working in the facility that they're managing. If people had to experience the working conditions that their policies and management create, maybe that would help initiate some positive changes.
Unfortunately....sadly....I disagree with this, too, including your clarification that it be high level management. I couldn't be more thrilled if the solution was this easy, but the problem is simply way bigger than that.
The problem isn't that our superiors don't know the impossible situation that direct patient care has become. They do know. They have elbowed their way out of the dumps and "risen" to where they can be rewarded for finding more ways to take advantage of nurses instead of being taken advantage of and disregarded.
Trust me, their hands are rarely but occasionally held to the fire. Every great once in awhile they grace a staff meeting or show up on "leadership" rounds and accidentally find themselves in a position to answer for something. And that is when they turn angry and start spewing angry words and literally blaming everyone in sight. I have seen these people stand in front of a large group of nurses at a staff meeting that didn't go as they planned, and call literally a couple of their very best, top-notch staff nurses liars, in front of everyone, when one of these "liars" dared to timidly admit that it was true that breaks were neither offered, facilitated nor realistic on the particular shift in question.
It was memorable, for sure. But it certainly hasn't been the only time.
I've seen with my own eyes the pattern of how these people become full-on enraged and spiteful and completely out of control when they find themselves in a position where the best answer would be to simply admit that something is wrong and bad and needs to change in nurses' favor.
Having them work in the slums will be of no consequence. They would only consider it temporary stooping, for which they would fully believe themselves to be all the more ethical and altruistic and would expect some leadership awards.
[And I'm guessing this opinion of mine is probably somehow because I am not yet educated enough and don't understand leadership and don't know the details of the terrible ethical dilemmas (which are certainly worse than anything any staff nurse could ever experience) that they are forced at gunpoint to face up there at the top].
If you have to clock-in and out to track your hours at the plantation so that you can perform skills and interventions that are guided by an authoritative figure, you're in a vocation, not profession. Bedside nursing is a trade irrespective of codes, ethics, and oaths. Bedside nurses have zero authority, maybe autonomy to choose interventions in a given rectangle, but if they think and act outside that box, there are punitive consequences, even if they did the right thing.
It's not only allowed, but required as a function of our professional license that we have autonomy to refuse to follow a Physicians instructions when we deem it appropriate.
I don't get even half the number of nasty-grams that the Physicians I work with get telling them they can't do this or that, most of which notable come from nurses, and if they don't abide by that 'authority' then there are punitive consequences. Is Medicine not a profession then?
Hourly vs Salary doesn't define a profession, although if it did, most of the Physicians in my hospital are paid hourly, they don't bill for individual services. So again, they aren't "professionals". The fact that nurses are typically paid hourly is because we're more savvy than those who agree to paid by salary, I went into nursing in large part to get away from salaried work.
MunoRN, RN
8,058 Posts
I would still call those "papers" although in digital format, I should have clarified better.