NY "BSN in 10" Initiative
Under a bill lawmakers are considering as part of a national push to raise educational standards for nurses, new RNs have to earn bachelor's degrees within 10 years to keep working in New York. The "BSN in 10" initiative - backed by many nursing associations and major health policy organizations - aims to address the complex problem of too few nurses trained to care for an aging population especially in light of the hundreds of thousands of nurses expected to retire in the coming years. However, some in the health care industry worry that increased education requirements could worsen the problem by discouraging entrants into the field.
Nebraska Grappling with Nursing Shortage
No state requires a four-year degree for initial licensing or afterward, though New Jersey and Rhode Island have considered proposals similar to New York's over the past several years. New York's legislation died in committee last session, but it has bipartisan support in both chambers this year.
Advocates of the bill say that in addition to improving patient care, a key reason for requiring more education is to put more nurses in position to move on to jobs in administration and in-demand specialties like oncology, and to teach at nursing schools, where the average faculty age is 53.
The New York bill's main sponsors, Democratic Assemblyman Joseph Morelle of Rochester and Republican Senator James Alesi of Monroe County, said the bill is needed to further professionalize nursing. In addition to helping provide future teachers, the lawmakers say the added education and critical thinking skills are needed as patient care has become more sophisticated and studies show staff with higher levels of education serve patients better.
Current registered nurses would be exempt from the education requirement to prevent driving more nurses from the field.
Researchers say almost 900,000 of the nation's roughly 3 million licensed RNs are older than 50, and while there's been an uptick in new, younger nurses, shortages are still expected as the health care industry continues to add nursing jobs. The federal Bureau of Labor Statistics estimated in 2009 that almost 582,000 new RN jobs would be created by 2018.
Federal projections in 2004, the most recent available, forecast a shortfall of 54,000 RN jobs in New York by 2020; the state currently has about 170,000 working nurses. But the state and national shortage estimates have varied greatly as the overall economy and national health policy have changed. A study published this year in the journal Health Affairs reports a surge among younger RNs entering the workforce, pointing to an easing of a national shortage previously forecast to reach 400,000 by 2020.
That shortage concerns New York's health care providers. William Van Slyke, spokesman for the Healthcare Association of New York State, said the organization representing health care networks and hospitals supports having a better educated nursing workforce, but opposes a four-year degree mandate. One problem, he said, is the lack of nursing faculty - the same issue advocates say the bill would address.
At a November 29, 2011 hearing, two legislative committees heard that nurses are in short supply in Nebraska, and that the shortage is expected to grow in severity in the next decade, just as the aging population requires more medical care. The hearing before the Health and Human Services and Appropriations Committees is part of an interim study on what to do about the nursing shortage in Nebraska.
Program May Ease Growing Mississippi Nurse Shortage
Solutions to alleviate the shortage were discussed including recruiting and retaining nursing professors, addressing infrastructure needs, improving access in rural and underserved areas, and addressing health care reform issues. Another possible solution is development of post-graduate residency programs for RNs and nurse practitioners. There are two key issues in Nebraska related to nursing shortage: a shortage of number and type of nurses needed as well as a shortage of faculty.
Seventy-three of Nebraska's 93 counties have fewer nurses than the national standard. According to the study, more need to be trained, but 402 qualified applicants to Nebraska nursing programs were turned away in 2010-11, mainly because of a lack of qualified educators. Only half of Nebraska registered nurses have four-year baccalaureate degrees; 5.3 percent have master's or doctorates. In the next nine years, the shortage will reach 5,581, according to projections by the Nebraska Center for Nursing.
The Mississippi Office of Nursing Workforce may have accidentally found a way to increase the number of students one nursing educator can reach. A grant-funded program launched in 2009, the Geriatric Dedicated Education Unit Initiative, involves grouping one to three students with a working nurse in the geriatric ward of a hospital or other care facility while nursing faculty oversee the mentors. Students are working with geriatric patients because they represent a majority of whom nurses will care for in the field.
Four nursing schools and six hospitals and care facilities are already participating in the program. Eventually, the nurse facilitator is able to take up to three students for as long as a semester, and faculty members are able to oversee eight to 10 facilitators. About 250 students, faculty, and nurse facilitators have participated so far, and they report high satisfaction rates, as do the patients and hospital administrators.