Educating nurses better

By Linda Gural

Nearly half a century ago, in 1960, the American Nurses Association's Committee on Current and Long-Term Goals proposed that a bachelor's degree be the minimum educational requirement for professional nursing practice. But today in New Jersey, we still have not implemented this important, and possibly life-saving, recommendation.

In 2001, the National Advisory Council on Nurse Education and Practice repeated the 1960 recommendation (formally adopted by the American Nurses Association in 1965), urging that two-thirds of the nursing workforce hold a baccalaureate or higher degree by the end of this decade. The council cited changes in the nursing-practice environment, including major changes in drug therapy, technology, complex changes in health-care-delivery systems, and the increasing prevalence of chronic illness. It called this renewed effort "A Fresh Approach to an Old Issue."

In New Jersey, this "fresh approach" takes the form of a new bill sponsored by Sen. Joseph Vitale (D., Middlesex), chairman of the Senate Health, Human Services and Senior Citizens Committee. The legislation would require registered professional nurses to earn a bachelor's degree in nursing within 10 years of their initial licensing. The legislation, which was introduced last year, exempts already licensed RNs.

Common sense and the facts call for the enactment of this legislation.

A University of Pennsylvania study revealed that at hospitals where just 20 percent of the nurses had bachelor's degrees, there were 90 deaths per 1,000 patients. There were 76 deaths per 1,000 patients at hospitals where 60 percent of the RNs were baccalaureate-prepared. Nurse education and preparation are critical to safe care, and the evidence is clear: Better-educated nurses mean better patient outcomes.

The legislation we have developed with Sen. Vitale and others need not change the way nurses currently enter the workforce. Community colleges and hospitals will remain a vital entry point for nursing professionals. In fact, it is our hope that even more men and women will choose nursing as a profession as a result of the bill.

The good news is that the nursing profession is already beginning to move in the direction of a better-educated and more informed labor force. In 1980, the federal Division of Nursing found that more than half (55 percent) of all registered nurses held a hospital diploma as their highest educational credential and less than one-fourth (22 percent) had earned a bachelor's degree. Twenty years later, the division's 2000 report found the number of registered nurses who held a hospital diploma was down to less than one of every four (22.3 percent), while those who had earned a bachelor's degree was up to a third (32.7 percent).

Last year, the New Jersey State Nurses Association formally joined the growing call for better-educated nurses by adopting a resolution supporting the 10-year bachelor degree requirement at our general membership meeting. It was not an easy vote. Change always carries with it a degree of trepidation and fear of the unknown. But nurses have always seen the need to adapt to an ever-changing environment.

The Vitale bill meets individual nursing needs and recognizes the valued contribution that schools have been making to the nursing profession. The bill maintains all entry levels and provides for a smooth transition for educational advancement. In fact, new nurses will have up to 10 years to earn a bachelor's degree, and current nurses are exempt from the requirement. There is even a hardship provision that will permit new nurses with special circumstances to apply for an additional two years to complete the requirement.

This legislation will bring New Jersey nursing into the 21st century. It is our hope that the legislature will act quickly on this important measure.