April 29, 2011
DATE: May 17, 2010
CONTACT: Dr. Roxanne Debski- Seigel
Karen Ann Quinlan Memorial Foundation
PHONE: 973-383-0115 FAX 973-383-6889
EMAIL: [email protected]
By: Roxanne Debski-Seigel, Ph.D.
As we come to the close of national nursing week (May6-12th), those looking to enter the nursing field are once again faced with the debate revolving around what should be their minimum educational requirement. Dating back to 1965 when a position paper was published by the American Nursing Association calling for the BS (Bachelor of Science) being the minimum requirement for entry into professional nursing practice, this controversy continues today to frustrate and divide those in and associated with the field.
The debate seems to boil down to one of technical knowledge verses academic knowledge, and what will be necessary to face and keep up with the advancements and the complications of modern medicine as practiced today and going forward. In one area, the importance of developing more well-rounded educated nurses as a profession seems reasonable going forward, but then the practical side of the current shortage rears its head. And historically, when shortages become severe, necessary credentials have slackened. But according to many in the industry, the so called relaxed versions are fundamentally acceptable with respect to patient care, critical thinking and decision making. Many say the hands-on experience and teachings of a 4 year hospital based nursing certificate program or Associates two year program deliver what patients need. “Considering that an average 4 year Bachelor’s degree is 2 years of your major course study and 2 years of “rounding” course work, then it stands to reason a 2 year AAS in nursing is equal professional training-wise to a 4 year BSN acknowledged Darrin Adams, RN, LPC and Karen Ann Quinlan Hospice administrator. He continued “So as far as a BSN advancing the nursing profession, I just don’t buy it.”
But the other side states the Bachelor of Science Nursing degree from a traditional four liberal education institution is what is needed to advance the profession. And to carry the controversy further, those who have received their RN’s will not be grandfathered into their profession, but will have to pursue and complete their BSN to practice. While in NJ there is a period of ten years proposed to complete this, it still constitutes a hardship for those in the field who now may have other obligations and do not have the finances or time to chase a four year college degree. This may result in many nurses leaving the field or pursue other careers, and so the shortage grows. The opposite of this view is that because BSN’s have not been required, there is now also a shortage of nursing teachers; for there is a big gap between the 2 year degree and an advance degree.
Our health population is growing in two basic ways; the population where the most advanced technology will be used to treat and the aging population where such programs as hospice are used when curative treatments are not being pursued. This is not suggesting that one segment should receive better care than the next, but rather, the trained nurse who does not have the BSN, many in the industry argue, is as competent in providing the necessary patient care.
So where does this controversy put the industry? Should the states care about a shortage? Are hospitals willing to pay what should be appropriate for those nurses who have incurred the expense of a four year college degree? Should then RN’s be grandfathered, but receive a lesser pay than BSNs.
The introduction of on-line schools have eased the entry for those who have decided to continue for their BSN; for many of us who achieved their Bachelors degree and further, have paid that price, so why not a profession who is directly involved with our medical care?
North Dakota has required all new nurse hires to possess a BSN degree since 1987. The New York State Board has similar legislation pending. The Dept. of Veteran’s Affairs began requiring all new hires to possess at least a BSN degree in 2005. In New Jersey there is pending legislation that would require RN’s to obtain their BSN within ten years in order to practice their profession. Who knows what’s coming next?
“Rapidly expanding clinical knowledge and mounting complexities in health care mandate that professional nurses possess educational preparation commensurate with the diversified responsibilities required of them. As health care shifts from hospital-centered, inpatient care to more primary and preventive care throughout the community, the health system requires registered nurses who not only can practice across multiple settings – both within and beyond hospitals – but can function with more independence in clinical decision making, case management, provision of direct bedside care, supervision of unlicensed aides and other support personnel, guiding patients through the maze of health care resources, and educating patients on treatment regimens and adoption of healthy lifestyles. In particular, preparation of the entry-level professional nurse requires a greater orientation to community-based primary health care, and an emphasis on health promotion, maintenance, and cost-effective coordinated care.” (American Association of Colleges of Nursing, Position Statement, Dec. 2000)
“As a nurse for ten years I have seen the changes occurring in the healthcare field. I know we must increase our education levels. As a profession we need to advocate for our expertise, our knowledge and our skill.” stated Beth Sylvester, RN and Karen Ann Quinlan Hospice Nurse Supervisor.
For now there have been no satisfactory solutions presented that appease everyone, and the controversy continues while our nursing and shortage grows and our health care becomes more demanding.
If you or your loved one would like more information on hospice services you may reach the Karen Ann Quinlan Hospice at 800-882-1117. The hospice staff is well educated and trained to assist you and can contact your physician to determine if a referral to hospice is appropriate. Another way to inquire about hospice is to talk with your physician, and he or she can make a referral to hospice. Karen Ann Quinlan Memorial Foundation is passionately dedicated to providing Hospice care for the terminally ill, Bereavement for those who have lost loved ones and Home Care assistance for recovery patients. For Northern NJ and PA, please call 800 882 1117 to reach any of our services. Karen Ann Quinlan Hospice, 99 Sparta Ave., Newton, NJ, Karen Ann Quinlan Home Health Care, 755 Memorial Parkway, Phillipsburg, NJ and Karen Ann Quinlan Hospice, 315 West Harford St., Milford, PA. For all programs and events or for more information please visit their web site www.karenannquinlanhospice.org.
Other sources: Donley, R., & Flaherty, M. (2008, May) Revisiting the American Nurses Association’s first position of Education for nurses.