Making RNs Obtain a Baccalaureate Degree?

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I was curious what everyone thinks about the debate over the law being proposed in New York which seeks to require all registered professional nurses to attain a baccalaureate degree in nursing within ten years of their initial licensure?

http://www.advisory.com/Daily-Briefing/2012/01/04/BSN-in-10

The New York bill A01977 wouldn't apply to registered professional nurses who are already licensed in the state of New York. Also those currently in school to become registered professional nurses in the state of New York would also be grandfathered in and exempt from the new legislation.

I have looked into research regarding this topic and the research I have seen seems to support the fact that nurses educated at the baccalaureate degree have lower mortality rates for patients. One study indicates that increasing nurse's educational level decreases the risk of patient death and failure to rescue by four percent (Aiken et al., 2008). Also hospitals with a higher proportion of baccalaureate-prepared nurses have a lower mortality rate (Friese et al., 2008). In fact the Institute of Medicine has issued a call for 80% of registered nurses to possess a baccalaureate degree or higher by 2020 (Institute of Medicine, 2011). Other research I found supports the fact that BSN nurses are associated with lower mortality rates. I have included this research below:

Estabrooks, C. A., Midodzi, W. K., Cummings, G. G., Ricker, K. L., & Giovannetti, P. (2005). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, 54(2), 74-84.

Tourangeau, A. E., Doran, D. M., Hall, L. M., Pallas, L. O. B., Pringle, D., Tu, K. V., et al. (2006). Impact of hospital nursing care on 30-day mortality for acute medical patients. Journal of Advanced Nursing, 57(1), 32-44.

To be fair I tried locating research that would cast doubt on the research above or that would come to a different conclusion. I was however unsuccessful in locating any such research. If anyone has any additional research that would repudiate the fact that nurses prepared at the bachelor's level seem to have a lower rate of mortality for their patients could you please post it? I would love to see such a study and would be very interested in reading it.

References

Aiken, L.H., Clarke, S.P., Sloane, D.M., Lake, E.T. & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223-229.

Friese, C.R, Lake, E.T., Aiken, L.H., Silber, J.H. & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), 1145-1163.

Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

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Sounds like a way to eliminate LPN's. Could this mean that current ADN RN responsibilities would be matched to what LPN's currently do, and a BSN RN has the responsibilities of what an ADN RN currently has?

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Well ADN's would still have the same rights to practice as they always have but would need to obtain their BSN in 10 years. According to the bill any licensed ADN nurse who doesn’t obtain a baccalaureate degree in the required time would face disciplinary action including but not limited to the loss of their registered nursing license.

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there is research that refutes the bsn only staffing models, hall-mcgillis' study showed "the lower the proportion of professional nursing staff employed on a unit, the higher the number of medication errors and wound infections. the less experienced the nurse, the higher the number of wound infections".

http://www.ncbi.nlm.nih.gov/pubmed/1473703

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Specializes in Med/Surg, Academics.

From a practice standpoint, I think it is a good idea.

However, bill opponents argue that its requirements could exacerbate the nursing shortage by discouraging new entrants in the field. Although the industry recently has seen an uptick in young nurses entering the workforce, researchers say the industry still should expect shortages as the sector continues to add jobs. For example, 2004 federal data show that New York could face a shortfall of 54,000 RNs by 2020.

Part of the argument given against it is based on an inaccurate premise. Aside from that, I can see an opportunity for partnerships formed between CCs and BSN-conferring institutions to fast-track students to BSNs. In addition, you may see quite a few more online RN-BSN options being created among traditional brick and mortar non-profit schools. There is more than one way to skin a cat by school administrators who think creatively.

In addition, William Van Slyke, a spokesperson for the Healthcare Association of New York State—which opposes the four-year degree mandate—notes that there are too few nursing faculty to support the requirement. "If you start the clock and you don't have the educational system, we may find ourselves having to turn away staff and have shortages," he says.

This might be true, in that a BSN program educator must have a master's degree, in my state at least. The number of MSN-prepared nurses who want to teach is seriously lacking. On the other hand, through online RN-BSN programs, you would conceivably not need as many faculty because there is no in-person lecture time, and your faculty aren't limited by geography, as long as they meet licensing requirements for the program. That could balance out the disparity between the # of students and the # of educators.

I wonder if the licensing requirement exempts currently-licensed nurses and those currently in nursing school because the hospitals don't want to shell out tuition reimbursement monies.

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Specializes in Med/Surg, Academics.
There is research that refutes the BSN only staffing models, Hall-McGillis' study showed "the lower the proportion of professional nursing staff employed on a unit, the higher the number of medication errors and wound infections. The less experienced the nurse, the higher the number of wound infections".

I just read the abstract, and nowhere did I see a variable in the study was the level of education of the nurse. Did you link the article you intended to link?

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Dishes I was able to find the whole article that you mentioned in your link:

http://www.jblearning.com/samples/0763744379/Hall.pdf

The study you mentioned does not refute the BSN only staffing models. It only states that a higher proportion of professional nursing staff (which this study defines as RNs and RPNs) in the staff mix have better outcomes than nursing staff mix’s that include unregulated staff (URW) and a lower proportion of professional nursing staff. RPNs in this case refer to registered practical nurses which in Canada have roughly the same practice rights as LPNs here.

“Specifically, staff mix models that included a lower proportion of professional nursing staff (RNs and RPNs) were related to the use of more nursing hours (t = -2.09; P = .05). The fewer RNs and RPNs employed on the unit, the fewer hours of nursing care used. In contrast, the higher the proportion of unregulated staff on the unit, the greater the nursing hours costs.”

No where in this study did I see it state how the (RN/RPN) nursing staff model performed in relation to the all-RN nursing staff model. However if you think I missed something you think is particularly relevant which will show me to be in error feel free to point it out and I will look over the study again.

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Specializes in Hospital Education Coordinator.

we actively seek to hire BSN over ADN. We are working towards eliminating LVN from the hospital. The stats speak for themselves - education trumps "training"

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Education, education. More education for the same job has been coming for a long time. Will they do a study that says nurses who are more computer literate equals lower mortality? Nursing has changed so much over the years you cannot hardly recognize the same job. Fortunately or unfortunately the change is going to be greater and greater. Maybe education is the answer. With higher acuity levels soon even med-surg units will need 1-3or4 nurse patient ratios. Soon everybody admitted to the hospital will have to be on telemetry just to prove they are still alive. Can you hear higher cost?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Well ANd would still have the same rights to practice as they always have but would need to obtain their BSN in 10 years. According to the bill any licensed ADN nurse who doesn't obtain a baccalaureate degree in the required time would face disciplinary action including but not limited to the loss of their registered nursing license.

This argument again.....:banghead:

EXCEPT......and I quote

The New York bill A01977 wouldn't apply to registered professional nurses who are already licensed in the state of New York. Also those currently in school to become registered professional nurses in the state of New York would also be grandfathered in and exempt from the new legislation.

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Specializes in CRNA, Finally retired.

Quick. Someone shoot this thread before we have to be subjected to this argument one more time.

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Specializes in Trauma.

Its foolishness. My Director has been forced out of her position b/c she had to have a masters by 2012. Now some spring chicken 6 years out of nursing school with an MSN is up for the job! I feel my Director should have been grandfathered in 20 plus years speak volumes as opposed to a few letters. Its a sad transition I'd like to see end but as hospitals move toward "Magnet" status, this is becoming the norm. But should it be a law, ABSOLUTELY NOT. and that research sounds great, but other factors should be considered.

Many nurses have ADN's but got BSN's online was that accounted for? I doubt it. This research is focusing on the wrong variables if you ask me.

Signed,

I'll miss my boss

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