HealthFebruary 19, 2017

IOM: 80% of registered nurses to have BSN degree by 2020

With an aging population and millions more Americans gaining access to healthcare coverage, the Bureau of Labor Statistics projects a shortage of more than 1 million registered nurses by 2022.

The statistics are startling, highlight the vast need for a more educated nursing workforce better equipped to meet the demands of an evolving health care system. Between 2010 and 2030, one in five Americans will be a senior citizen; with that aging general population also comes an aging nursing workforce. Around 1 million registered nurses are currently older than 50, meaning one-third of the current nursing workforce will reach retirement age in the next 10 to 15 years. Add the rise in chronic disease, and it paints a picture of a health care system pushed to its limits. But that's not all.

Nursing education programs are regularly turning away viable nursing candidates because they lack sufficient numbers of professional nursing instructors. There are huge supplies of students wanting to be nurses to help alleviate these health care stresses, but the fabric of our nation's nursing education system simply can"t handle the numbers.

The solution? Increase the proportion of nurses with a bachelor of science in nursing (BSN) degree.

Increase the BSNs

A BSN allows nurses to have more responsibility, supervisory roles and higher salaries in the workplace than a registered nurse (RN) with an associate"s. An increase in the proportion of nurses with a BSN also would create a workforce poised to achieve higher levels of education at the master's and doctoral levels, required for nurses to serve as primary care providers, nurse researchers, and nurse faculty.

With a number of sources drawing public attention to the critical shortage of nursing staff, the Institute of Medicine (IOM) appointed the Committee on the Future of Nursing, sponsored by the Robert Wood Johnson Foundation (RWJF). This committee was tasked with producing a report that would make recommendations for an action-oriented blueprint for the future of nursing. Through its deliberations, the committee developed four key messages in its report, “The Future of Nursing: Leading Change, Advancing Health. The Campaign for Action":

  • Nurses should practice to the full extent of their education and training.
  • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
  • Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.
  • Effective workforce planning and policy making require better data collection and information infrastructure.

Infographic courtesy of IOM

Each of these key messages can be addressed, in part, by evolving our current nursing educational programs. Indeed, nurses need to be encouraged at all levels of educational achievement to continue as life-long learners.

Nurses are increasingly being required to take on more complex tasks, participating as partners on the healthcare team making critical decisions. They"re having to use more sophisticated technology and information management systems that require skills in analysis and synthesis.

Despite compelling evidence that links BSN education with lower rates of patient death, medical errors, and better patient outcomes, approximately 60 percent of new nurse graduates are currently educated in associate degree programs. In 2010, the committee recommended that the proportion of nurses with baccalaureate degrees be increased to 80 percent by 2020.

A BSN education broadens student competencies in such arenas as health policy and health care financing, community and public health, leadership, quality improvement, and systems thinking.

But can we do it?

But is 80 percent by 2020 an achievable goal?

While the IOM anticipates that it will take a few years to build the educational capacity needed to achieve this goal, the committee maintains that it is bold, achievable, and necessary to move the nursing workforce to an expanded set of competencies. Nurses need to be well-positioned to lead change and advance health.

And since that report was released, BSN programs around the country have started booming. Many colleges and universities with nursing schools recently announced new programs to facilitate academic progression. A number of these nursing education programs have aligned with online instruction and simulations such as those offered by Wolters Kluwer to boost the number of BSN degrees.

Changes that need to occur in the nursing field immediately to prepare sufficient numbers of qualified nurses at entry and advanced levels within the workforce include:

  • Nursing education programs must evolve so that the goal of achieving a much greater proportion of BSN nurse graduates can be realized. Understanding the limited ability of many existing nursing education programs to meet this demand under more traditional classroom methods, nursing education can conceivably accommodate a larger number of students with current professional nursing educators by aligning with online resources available.
  • The current wage gap between clinical and academic careers for nurses must be narrowed. Incentives such as competitive salaries to attract clinical care nurses into the nursing education profession need to be offered. With an increased number of nursing students achieving the academic degrees required to be nursing educators, the number of nursing students achieving BSN degrees will also grow proportionately.
  • Employers must place greater emphasis on nursing staff candidates having achieved higher level degrees in nursing. If more nursing staff candidates were required to have their BSN at time of hire, more nurses would be incentivized to work toward that specific degree. Similarly, employers need to facilitate educational advancement opportunities for their own nursing staff members. Incentives such as scholarships or higher salary levels, as well as ongoing courses offered within the healthcare facility, would be likely ways to create such opportunities.
  • Finally, it is critically important that nurses without a BSN take advantage of opportunities to pursue advanced education to become better prepared to care for patients in an increasingly complex health care delivery system.

Making progress to transform nursing education

The Institute of Medicine in December 2015 released a report on the progress achieved to date on the recommendations set forth in its 2010 report. The Campaign for Action, a nursing initiative developed by the Robert Wood Johnson Foundation and AARP, has worked with nurses nationwide since 2010 to advance the IOM recommendations.

Data from the American Association of Colleges of Nursing shows that there are many nurses returning to school to get advanced degrees, and there are many institutions and communities and some states who have or will reach the 80/20 goal.

Some organizations have set up a solid and sustainable infrastructure for the future, and are seeing community colleges and universities working together and developing seamless transition policies.

As far as doctorate-prepared nurses, the RWJF Future of Nursing Scholars program is making an investment by providing scholarships and leadership development for nurses interested in going back to school for their PhDs.

Yet, we continue to need well-educated nursing leaders in healthcare who will engage in research, develop products and provide the solutions needed to better our health and healthcare system. We need nurses who have earned their BSN and will serve in clinical capacities in the ever-more-complex nursing field.

Check out Lippincott RN to BSN Online, designed to help both existing and new RN-BSN programs meet this growing demand. Lippincott RN to BSN was developed with the practicing nurse in mind, with self-paced modules that capture the learner where they are in their career, and exceptional instructional design strategies - including storytelling, modeling, case-based, social, and collaborative learning - to achieve higher outcomes in an online environment.

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