By Teresia Odessey of Bloomfield College
As a nursing student, I have had the privilege of observing many nurses in different units; pediatrics, maternity, the burn unit, hospice, medical surgical, ICU, CCU, wound rounds, and psychiatry. I’ve realized from these experiences that school nurses are by far the most unappreciated and de-valued. As I gathered information on the role of school nurses, and shadowed an elementary school nurse for my senior capstone project, I discovered the challenges faced by school nurses.
Contrary to popular belief, the school nurse’s role is critical to the well-being of students’ health and academic achievements. The scope of practice for the school nurse includes supervision of school health policies and procedures; promotion of health education; health services; competence of interventions; facilitation of health care screenings; making referrals to other healthcare providers; patient advocacy and maintenance of the appropriate environment to promote health. This role requires the nurse to be knowledgeable and competent in various skills and interventions. School nurses provide care, support and teaching for diabetes, asthma, allergies, seizures, obesity, mental health, and immunizations to all students (Beshears & Ermer, 2013). The role of the school nurse as defined by the National Association of School Nurses is as follows: “a specialized practice of professional nursing that advances the well-being, academic success and lifelong achievement and health of students” (Board, Bushmiaer, Davis-Alldritt, Fekaris, Morgitan, Murphy &Yow, 2011).
Clearly, it is not just about Band-Aids and ice packs but still 25% of US schools have no nurse present and 16% of students have a medical condition that warrants a skilled professional (Taliaferro, 2008). One in every 400 children under 20 years is diagnosed with diabetes; 10% of students nationwide have asthma; prevalence of school allergies have increased drastically; 45,000 students are diagnosed with seizures each year; obesity rate has tripled among children 6 to 11 years, and more than tripled for children 12 to 19; and one in five students have mental health issues (Beshears & Ermer, 2013).
Despite having laws allowing disabled children to attend school, increasing the workload on the nurses, there are no laws that mandate a nurse to student ratio. The national recommendation for nurse to student ratio is 1:750 but on average some nurses are responsible for up to 4,000 students (Resha, 2010). Nwabuzor (2007) mentioned that parents and stakeholders cannot truly advocate for more school nurses because most of them do not comprehend the role, responsibilities, and advantages of having a school nurse. The major reason for the school nurse shortage is the lack of legislation on school nursing; not enough funding, and no laws forcing schools to hire nurses. Therefore, many educational facilities have opted to hire unlicensed assistive personnel (UAP) instead.
Yes, it is likely more cost effective to hire UAP’s instead of Registered Nurses but that does not make it acceptable. It is my belief that we have different titles and scopes of practice for a reason. I find it mind boggling that some schools do not have school nurses. How is it that some parents are comfortable with sending their children to a school without a nurse? Is it that they don’t inquire about the presence of a school nurse? Or could it be that maybe they assume that every school has a full-time nurse? I wonder if some parents are aware of the nurse to student ratio at their child’s school. Yes, there are budget cuts due to many reasons but why do these schools say they don’t have enough funding to hire a school nurse but they have six assistant coaches for any one of the sports? So yet my question remains unanswered: what is the priority?
Beshears, V., & Ermer, P. (2013). SCHOOL NURSING: It's Not What You Think!. Arkansas
Nursing News, 9(2), 14-18.
Board, C., Bushmiaer, M., Davis-Alldritt, L., Fekaris, N., Morgitan, J., Murphy, K., &Yow, B. (2011, April). Role of the school nurse. Retrieved from http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/87/Role-of-the-School-Nurse-Revised-2011
Nwabuzor, O. (2007, February). Legislative: "Shortage of Nurses: The School Nursing Experience." Online Journal of Issues in Nursing Vol12 No 2. doi:10.3912/OJIN.Vol12No02LegCol01
Resha, C., (2010, May 31) "Delegation in the School Setting: Is it a Safe Practice?" OJIN: The
Online Journal of Issues in Nursing Vol. 15, No. 2, Manuscript 5. doi:
There are 5.5 million nurses and nurse’s aides in America. That’s 2.6% of the population and yet nursing is still one of the fastest growing occupations. In fact, the country is currently facing a nursing shortage unlike any other before.
Nursing is essential for a smooth running health care system. Nurses are far from one-trick employees – they perform countless vital tasks in hospitals, nursing homes, schools, and more. The number of nurses on hand (or a lower nurse-to-patient ratio) has been directly related to patient survival and recovery without additional complications.
Some of the most in-demand specializations for nurses include:
- Forensic Nursing: Nurses who care for patients that were victims of crime. These nurses assist with collecting evidence from their patient’s injuries in order to build a case against the attacker.
- Infection Control: Nurses who care for patients infected with diseases such as HIV, STDs, or tuberculosis must be specially trained to ensure the contagious disease is not passed along unintentionally to either the nurse themselves or other patients.
- Management: These days, nurses who can educate or manage other nurses are in high demand. These career-oriented positions typically pay better, sometimes even into the six figures, but do require additional education. Management, education, and advocacy are three essential roles in recruiting more high quality professional nurses to the field.
Nursing isn’t an easy job. Over half of nurses report that stress and frustration plague them daily in their job. However, most nurses also agree that their job is very fulfilling. Very few careers are as directly related to public health and serving the community as nursing. Also, the public is genuinely grateful for nurses. For the last eleven years, nurses have been ranked by Americans as the most trusted profession – a pretty impressive feat.
Currently, there is a shortage of nurses in the workplace. This shortage is caused by a range of reasons, but the main ones are:
- Baby boomers are aging and require more intensive care
- The recession forced many people to neglect preventative care or lose their insurance, driving up the demand for health care in the long term
- Fewer nurses are pursuing bachelor’s degree which would enable them to get the best nursing jobs
The shortage is leading to salary wars (hospitals offering hefty bonuses to new nurses and more). At the end of the day, professional, skilled, and intelligent people are desperately needed in the nursing field in the US and around the world.
Despite “measurable progress” in the three years since the release of the Institute of Medicine’s landmark report on the future of nursing, more work remains “to fully realize the potential of qualified nurses to improve health and provide care to people who need it.”
That assessment is part of a commentary by Harvey V. Fineberg, MD, PhD, president of the IOM, and Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, on the aftermath of the report.
“The Future of Nursing: Leading Change, Advancing Health” was released Oct. 5, 2010, by the IOM with the support of RWJF. It provided a blueprint for transforming the nursing profession to “respond effectively to rapidly changing healthcare settings and an evolving healthcare system,” according to a report brief.
The key recommendations: allow nurses to practice to the full scope of their education and training, provide opportunities for nurses to serve as healthcare leaders and increase the proportion of nurses with a BSN to 80% by 2020. Following the report, RWJF and AARP formed the Campaign for Action to implement the report’s recommendations at the state level.
Regarding scope of practice for advanced practice registered nurses, Fineberg and Lavizzo-Mourey wrote that 43 state action coalitions have prioritized initiatives to remove scope-of-practice regulations that prevent APRNs from delivering care to the full extent of their education and training. Iowa, Kentucky, Maryland , Nevada, North Dakota, Oregon and Rhode Island have removed barriers to APRN practice and care, and 15 states introduced bills this year to remove physician supervision requirements that can hinder APRN care.
Regarding education and training, the proportion of employed nurses with a BSN or higher degree was 49% in 2010 and 50% in 2011. “Progress is likely to accelerate in the years to come,” Fineberg and Lavizzo-Mourey wrote, “because between 2011 and 2012 along there was a 22.2% increase in enrollment in RN-to-BSN programs and a 3.5% increase in enrollment in entry-level BSN programs.” The authors also noted a recent increase in the number of students enrolled in nursing doctorate programs. Of the 51 action coalitions, 48 have worked to enable seamless academic progression in nursing.
The authors noted that the influence of the campaign has paid off with a $200 million Medicare initiative to support the training of APRNs at hospital systems in Arizona, Illinois, North Carolina, Pennsylvania and Texas.
Regarding nurse leadership, Fineberg and Lavizzo-Mourey wrote, the “Campaign for Action has tapped established and emerging nurse leaders across the nation and is working to provide them with opportunities for networking, skills development and mentoring. A key strategy is to advocate for more nurses to serve on hospital boards.”
Full commentary: http://bit.ly/176XyZs
Campaign for Action: http://www.rwjf.org/en/topics/rwjf-topic-areas/nursing/action-coalitions.html
“Future of Nursing” report: www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx
Graduate Nurse Education Demonstration: http://innovation.cms.gov/initiatives/gne/.
Faced with a shift in the healthcare landscape toward outcomes-based practices and quality improvements, the American Association of Colleges of Nursing (AACN) sought to update the scope of nursing practice with a new master's prepared role: the clinical nurse leader (CNL).
The first new nursing role in over 35 years, the CNL grew out of the 1999 Institute of Medicine report "To Err is Human" which challenged care providers to reduce medical errors and focus on patient safety.
Rising to the challenge, the AACN initiated an investigation into the barriers to improved care delivery and in 2005 introduced the new role as a way to prepare nurses to thrive in the changing healthcare system, according to the AACN website. For many, it couldn't have come at a better moment.
"We are at a pivotal time for the role," said Bob LaPointe, MS, MSN, RN, CNL, president, Clinical Nurse Leader Association (CNLA), and MICU staff nurse at Penn Presbyterian Medical Center, Philadelphia.
"Healthcare is increasingly complex, and we need leaders who are trained in complexity theory to be able to navigate that and understand it to have better patient outcomes and that's what clinical nurse leaders are uniquely trained to do."
As defined by the CNLA, the CNL is an advanced clinician who serves at the point of care as the lateral integrator, facilitating, coordinating and overseeing care within the unit while also collaborating across the healthcare continuum.1 The CNL is trained to facilitate evidence based care at the bedside and ensure positive outcomes for even the most complex patients. Such training, especially these days, is a great option for nurses of all kinds looking for a way to make a difference at the bedside.
"The role really is about improving clinical outcomes-improving the care of the patient as well as improving financial outcomes," said Tracy Lofty, MSA, CAE, director, Commission on Nurse Certification (CNC), an autonomous agency of AACN, Washington, DC. "Regardless of practice setting, the ultimate goal is to improve outcomes, so really everyone benefits from the role."
When Veronica Rankin, MSN, CNL, Carolinas Medical Center, Charlotte, N.C., decided to go back to school, she chose to do so through a CNL program after her facility's assistant vice president introduced the role at a town hall meeting. Since graduating in 2011, she and her fellow CNLs have been making a huge difference for patients, colleagues and the hospital as a whole.
"We bring that continuity of care back to the bedside, so that even though the nurses may change every shift every day, you are still going to have the same clinical nurse leader Monday through Friday taking care of that patient," Rankin said.
"It has given me the opportunity to stand back and see the big picture of my patients' journey. I can get in there and see, 'OK, out of everyone that is involved in this patient's care, we have all these hands in this pot, what are we missing and where are the bridges I need to help connect?'"
Rankin's ability to streamline care and improve both patient and hospital outcomes comes directly from her training, and nurses and facilities across the nation are starting to see the difference CNLs can make on a unit-by-unit basis.
"When you take a policy and implement it in your unit, in your hospital, in this city, with the resources you have available, it can be the best evidence based practice out there," LaPointe emphasized. "But we have to apply it to our patients and our staff as well, and that's really where the clinical nurse leader's role really comes into play. How does this make sense for us as a unit, and for our patients."
Since the pilot program that tested in the fall of 2006, more than 2,500 nurses have earned CNL certification from CNC. Part of the success, according to LaPointe, is the fact that anyone inspired to become a CNL can do so.
"Nursing has always had multiple points of entry, which leads to lots of people being able to do it, but it also leads to lots of variability about the training and preparation," LaPointe said. "There is so much more to know and healthcare is so much more complex, that to have training in complexity theory, change management and in the science of outcomes, that's going to be good for anybody."
To make the CNL educational track available to nurses already practicing as well as those looking to get into the field, the AACN created five different models so that regardless of educational background, there is an entry into a CNL education program. The five models are:
- Model A - Master's degree program designed for BSN graduates
- Model B - Master's degree program for BSN graduates that includes a post-BSN residency that awards master's credit
- Model C - Master's degree program designed for individuals with a baccalaureate degree in another discipline
- Model D - Master's degree program designed for ADN graduates (RN-MSN)
- Model E - Post-master's certificate program designed for individuals with a master's degree in nursing in another area of study2
Following graduation of a CNL education program, licensure as a registered nurse, and successful completion of the CNL Certification Exam, candidates may be awarded the CNL credential.
With the role gaining momentum, the CNC decided to revamp the certification exam in 2012 to make sure it reflected the basic competencies of a CNL.
"The new exam is based on a CNL job analysis study that was completed in 2011, so the exam reflects the knowledge, skills and abilities of a competent CNL," Lofty said. "It's all about application, so you may be in an educational program, but then you need to be able to apply the knowledge, and that is demonstrated on the exam."
As new CNL graduates start the search for the right clinical setting, they need to keep in mind that some healthcare organizations have yet to fully integrated the clinical nurse leader into their staffing model.
"There are many healthcare institutions specifically recruiting to full clinical nurse leader positions," said Lofty. "For other institutions, it may not be that title, there may be a different title like care coordinator, or they are still looking for someone with the same skill set and they are still hiring individuals with those competencies and perhaps applying them to other positions."
But CNLs need not worry about their job prospects, because their CNL skills are valuable in just about every care setting. According to a 2012 survey conducted by the CNC, 96% of the respondents indicated that they apply their CNL knowledge in their current role, 92% feel they are an important member of their team and 87% said they are valued as an employee because they are a CNL.3 LaPointe knows from personal experience just how useful being a CNL can be regardless of job title.
"I am not functioning in a job that is called 'CNL' right now, and that is true for many people who currently have the certification," LaPointe said, who was confident he would still use his training despite not being hired specifically as a CNL. "I helped write our successful Beacon Gold application, I was very involved in our hospital's first Magnet designation, I am on the evidence based practice committee for the hospital, and the chair of our unit-based council as part of the shared governance structure of the MICU, so I am using this stuff all the time."
No matter where CNLs end up, they are sure to improve care coordination, communication and hospital-wide outcomes.
"You are basically in there improving care for nurses, patients, and physicians," Rankin said. "You are improving care delivery and the receiving of care for the patient population, so you are in there with your hands so much."
"Bring evidence based practice to your unit to show what the worth of the role is," Rankin advised nurses considering the CNL role. "In the end we are also taught that the clinical nurse leader is the guardian of the nursing profession, so we have to get in there and be the guardian. I would say, go for it, go hard, and be a guardian for the nursing profession."
Source: Advance for Nurses
When it comes to nursing education, African Americans tend to aim for more advanced degrees, yet their percentage among all U.S. nurses is far lower than it is in the general U.S. population. Phyllis Sharps, PhD, RN, FAAN, intends to find out what is behind that disconnect as a key step toward correcting it.
Sharps, associate dean for Community and Global Programs, director of the Center for Global Nursing, and the principal investigator for a $20,000 grant from the National Black Nurses Association (NBNA), will use the funding to conduct a national survey to identify the drivers and barriers to success among African-American nursing students and nurses. Through research funded by the new grant, “Enhancing the Diversity of the Nursing Profession: Assessing the Mentoring Needs of African American Nursing Students,” Sharps hopes to determine what mentoring needs are essential to keeping African-American nursing students on track in their education and their career paths.
While African-Americans are underrepresented in the profession (5.5 percent of U.S. nurses vs. 13.1 percent of the U.S. population), the 2008 National Sample Survey of Registered Nurses (NSSRN) shows that African Americans as well as other minority groups in nursing are more likely to pursue baccalaureate and higher degrees—52.5 percent pursue degrees beyond the associate level, while only 48.4 percent of their white counterparts seek equal degrees.
“As nurses, we all know what we needed while attending nursing school,” says Reverend Dr. Deidre Walton, NBNA President. “We need to have a better understanding of what this generation of nursing students needs in this new technological and innovative world of nursing.”
Source: John Hopkins University
By Jane Gutierrez
When you think of a nurse, what’s the first image that comes to mind? Chances are, you think of a woman — and for good reason. The vast majority of professional nurses in the U.S. are white women. In fact, only about six percent of nurses are male and, Considering males make up approximately half of the population and minorities are 30 percent, there’s a major disparity in the profession.
That disparity is reflected in equal measure in nursing schools, both in the student population and faculty. Experts argue improving the diversity in nursing education will improve health care by creating a more culturally sensitive healthcare workforce with improved communication abilities, reduced biases and stereotypes and fewer inequities, as well as increasing the diversity of the nurse education faculty.
At a time when the healthcare system is faced with a nursing shortage caused at least partially by a shortage of nurse educators, some argue males and minorities represent an untapped resource for recruiting new educators. They believe that by creating new opportunities to attract traditionally underrepresented populations to the field, we can both solve the shortage and make a measurable improvement to our healthcare delivery system.
Why Diversity Is an Issue
While minorities have made great strides in other traditionally white-dominated fields and women have done the same in traditionally male fields, nursing is one area where diversity initiatives seem to have been ineffective.
In the case of men, much of the resistance to nursing as a profession comes from a cultural perception of nursing being a “female” profession. Men report while they enjoy the care giving aspects of the job, it’s difficult when others ask questions or make comments deriding their career choice. For example, male nurses report being asked why they didn’t choose to become doctors, with the implication that they did not earn adequate grades or were too lazy to become doctors. In addition, men report feeling left out of the profession, with most training and professional development materials referring to nurses as “she” and a female-centric approach to teaching and training.
In the case of minorities, including African-Americans and Latinos, studies attribute the disparity in the nursing profession largely to lower overall academic achievement in those groups. Given that admission to nursing school generally requires at least a moderate level of academic achievement — and earning a
degree in nursing education requires at least a bachelor’s degree and some experience — it’s no surprise that groups that aren’t as academically advanced are lacking in the nursing profession.
Fixing the Problem
Because improving diversity in the nursing profession is a key to solving the nurse shortage — and by extension, the nurse educator shortage — the healthcare field is looking for new ways to recruit, mentor and retain minority nurses, male nurses and educators.
One step is to recruit potential professionals earlier — in some cases, as early as high school. Throughout the country, in the field in exchange for high school credit, with the goal of encouraging them to maintain their academic performance and attend nursing school.
However, academic performance is only part of the equation. The cost of education is another barrier to many potential students, regardless of sex or ethnicity. The cost for a four-year BSN program can be over $100,000 in some cases, while a two-year program generally runs between $5,000 and $20,000. Factoring in the master’s and doctoral degrees required to become nurse educators, and the cost only goes up.
In response, many schools, as well as states and the federal government, have instituted financial assistance programs designed specifically for minorities and males. The Federal Nursing Workforce Diversity program allows minority students to borrow money for school, and have some or all of their loans repaid if they agree to work in specific, undeserved areas. For those who want to become nurse educators, the government’s Nurse Faculty Loan Program offers partial or full repayment of student loans for agreeing to teach for at least two years after graduation.
With the nursing shortage only expected to grow, thanks to increased access to healthcare, reaching out to minorities and males only makes sense. Not only will it solve a serious problem, it will ensure quality, effective health care for future generations.
About the Author: Jane Gutierrez is a nurse educator and a member of her employer’s diversity initiative committee. She visits with local high schools to encourage students to consider careers in health care
By Jennifer Larson
If you’re looking for a nursing job in 2013, you could be in luck--especially if you have pursued your education and have some experience in the field. While the recovering job market is looking strong for the most part, it holds even more potential in future years. The important thing for nurses is to understand how to position themselves for success, both now and in the coming months.
The U.S. Bureau of Labor Statistics’ most recent report on registered nurses predicted a 26 percent growth rate in employment for registered nurses during the 2010-2020 period. That’s considered “faster than average” when compared to all other populations.
A number of factors are expected to contribute to growth in particular areas. For instance, the aging of the baby boomer population and increasing pressure on hospitals to discharge patients as soon as possible is expected to spur job growth in outpatient care centers, as well as in home health and long-term care facilities.
For the coming year, however, it’s unlikely that the overall employment situation will be significantly different from last year.
“I haven’t seen a lot of change,” said Geraldine “Polly” Bednash, PhD, RN, FAAN, chief executive officer and executive director of the American Association of Colleges of Nursing (AACN), which surveys nursing schools to gauge the experiences of new graduates in finding employment.
Do your homework
If you plan to look for a new nursing job in 2013, it’s important to prepare yourself. Check out the job market in the area where you wish to live, or, if you’re open to different locations, find out where nurses with your specialty have the most opportunities. Know which employers are hiring, and what types of positions are in most demand.
For example, in the field of school nursing, some areas of the country are eagerly looking for qualified candidates to fill vacant positions in schools, while other regions can barely afford the nursing staff they already have, due to funding issues.
“It’s all over the map, depending on the state,” said Linda Davis-Alldritt, RN, president of the National Association of School Nurses. “Some states are seeing not so much a shortage of school nurses but a shortage of funded positions. The further west you go, that’s the situation, especially in California.”
Although the overall job market for nurses is predicted to be good, nurses in certain pockets of the country--particularly the ones with the least amount of experience--may have trouble landing their dream job right away. But that’s been true for the last few years in high-demand areas like the Bay Area in California and a few other places, and experts typically recommend that job seekers show flexibility in those situations.
If you’re willing to move or work the night shift or try other types of nursing jobs, you’ll be in a better position to get hired; this flexibility can also help new graduates acquire the basic experience that so many employers are seeking.
Take advantage of advanced education
What is most likely to help you land a new job in the current health care environment? More education and training. That might mean attaining a certification in your specialty area, or it could mean returning to school for another degree.
A baccalaureate degree could be especially useful. The Institute of Medicine’s landmark Future of Nursing report, released in 2010, called for increasing the percentage of the nursing workforce with a BSN to 80 percent by 2020, and a growing number of hospitals are prioritizing candidates with the degree.
According to information gathered from nursing schools in August 2012 by the AACN, 88 percent of new graduates with a BSN degree received job offers within four to six months of graduation.
“We’re always very pleased to see the baccalaureate graduates are getting hired,” said Bednash, adding that employers “understand they can make a choice, and they are going straight to the best-educated clinicians and hiring them.”
Graduates with master’s degrees fared even better; within four to six months after graduation, 92 percent of them were fielding job offers, according to the AACN’s survey.
“The hottest commodity on the market today is a graduate-prepared nurse practitioner,” said Bednash.
Expect more jobs on the horizon, thanks to ACA
When the Supreme Court upheld the Affordable Care Act (ACA) in June 2012, many noted that the law will likely expand the possibilities for nurses in the future.
As the law continues to undergo implementation, more than 30 million additional people could be added to the insurance rolls. Those people will need primary care--and primary care providers. Advanced practice nurses will be called upon to fill those spots in many places, especially in light of the ongoing shortage of primary physicians. In fact, the January 2013 issue of Health Affairs even noted that the use of “non-physicians” could help improve access to care for many people and avert a physician shortage in the future.
“They ought to be thinking carefully about going on to get a graduate degree,” Bednash said of nurses who are interested in the new possibilities opening up.
The Affordable Care Act also encourages the patient-centered medical home model, which utilizes care coordinators.
“And that’s a nursing role,” said Bednash.
Copyright © 2013. AMN Healthcare, Inc. All Rights Reserved
The American Association of Colleges of Nursing has released preliminary survey data showing that enrollment in all types of professional nursing programs increased from 2011 to 2012, including a 3.5% increase in entry-level BSN programs.
The AACN’s annual survey findings are based on data reported from 664 of the 856 nursing schools in the U.S. with baccalaureate and/or graduate programs (a 77.6% response rate). In a separate survey, the AACN found a strong hiring preference for new nurses prepared at the baccalaureate level, and a comparatively high job-placement rate for new BSN graduates.
"AACN is pleased to see across-the-board increases in nursing school enrollments this year given our commitment to encouraging all nurses to advance their education as a catalyst for improving patient care," AACN President Jane Kirschling, RN, PhD, FAAN, said in a news release.
Baccalaureate nursing education
The AACN said its annual survey is the most reliable source for actual — as opposed to projected — data on enrollment and graduations reported by the nation’s baccalaureate- and graduate-degree programs in nursing. This year’s 3.5% enrollment increase for entry-level baccalaureate programs is based on data supplied by the same 539 schools reporting in both 2011 and 2012 (see www.aacn.nche.edu/Media-Relations/EnrollChanges.pdf for year-by-year enrollment changes in baccalaureate nursing education from 1994 to 2012).
Among the most noteworthy findings, the number of students enrolled in RN-to-BSN programs increased by 22.2% from 2011 to 2012 (471 schools reporting). This year marks the 10th year of enrollment increases in these programs, signaling a growing interest among nurses and employers for baccalaureate-prepared nurses, the AACN noted.
Stakeholders inside and outside the nursing profession — including the Institute of Medicine, Tri-Council for Nursing, National Advisory Council for Nursing Education and Practice, Carnegie Foundation for the Advancement of Teaching and many others — are calling for higher levels of academic progression in nursing.
Graduate nursing programs
Preliminary data from the AACN’s 2012 survey show that enrollment in master’s and doctoral degree nursing programs increased significantly this year. Nursing schools with master’s programs reported an 8.2% jump in enrollment, with 432 institutions reporting data. In doctoral nursing programs, the greatest growth was seen in DNP programs, where enrollment increased by 19.6% (166 schools reporting) from 2011 to 2012.
During this same time period, enrollment in research-focused doctoral programs (PhD, DNS) edged up by 1.3% (96 schools reporting), even though 195 qualified applicants were turned away from these programs, based on preliminary findings.
"Momentum is clearly building for advancing nursing education at all levels," Kirschling said. "Given the calls for more baccalaureate- and graduate-prepared nurses, federal and private funding for nursing education should be targeted directly to the schools and programs that prepare students at these levels.
"Further, achieving the Institute of Medicine’s recommendations related to education [calling for 80% of nurses to have BSNs by 2020] will require strong academic-practice partnerships and a solid commitment among our practice colleagues to encouraging and rewarding registered nurses committed to moving ahead with their education."
Although interest in nursing careers remains strong, many individuals seeking to enter the profession cannot be accommodated in nursing programs, despite meeting all program entrance requirements. Preliminary AACN data show that 52,212 qualified applications were turned away from 566 entry-level baccalaureate nursing programs in 2012. The AACN expects this number to increase when final data on qualified applications turned away in the fall of 2012 are available next March.
The primary barriers to accepting all qualified students at nursing colleges and universities continue to be a shortage of clinical placement sites, faculty and funding, according to the AACN (see www.aacn.nche.edu/Media-Relations/TurnedAway.pdf for information about the number of qualified applicants turned away from entry-level baccalaureate nursing programs over the past 10 years).
In addition to its annual survey, the AACN has collected data on the employment of new graduates from entry-level baccalaureate and master’s programs to assess how these RNs fare in securing their first jobs in nursing.
Conducted for the third consecutive year, survey findings show baccalaureate nursing graduates remain more than twice as likely to have jobs at the time of graduation as those entering the workforce in other fields. While the employment rate at graduation increased slightly, from 56% in 2011 to 57% in 2012 for BSN students, the employment rate at four to six months after graduation was identical over the two-year period (88%). By comparison, the National Association of Colleges and Employers conducted a national survey of 50,000 new college graduates across disciplines and found that only 25.5% of new graduates in 2011 had a job offer at the time of graduation.
The AACN also collected data on entry-level MSN programs, which remain a popular pathway into nursing for those transitioning into nursing with degrees in other fields. Graduates from these programs were most likely to have secured jobs at graduation (73% for MSNs vs. 57% for BSNs) and at four to six months after graduation (92% for MSNs vs. 88% for BSNs). These data further illustrate a renewed employer preference for hiring the best educated entry-level nurse possible.
Once again this year, the AACN queried nursing schools about whether hospitals and other employers express a preference for hiring new nurses with a bachelor’s degree. A significant body of research shows that nurses with baccalaureate level preparation are linked to better patient outcomes, including lower mortality and failure-to-rescue rates, according to the news release. With the Institute of Medicine calling for 80% of the nursing workforce to hold at least a bachelor’s degree by 2020, moving to prepare nurses at this level has become a national priority.
In terms of this year’s survey, schools of nursing were asked whether employers in their area were requiring or strongly preferring new hires with baccalaureate degrees, with the findings showing that 39.1% of employers require the BSN for new hires while 77.4% strongly prefer BSN-prepared nurses.
To download the complete research brief on the "Employment of New Nurse Graduates and Employer Preferences for Baccalaureate-Prepared Nurses," visit www.aacn.nche.edu/leading_initiatives_news/news/2012/employment12.
The AACN works on several fronts to enhance the number of baccalaureate-prepared nurses in the workforce, including:
• Working collaboratively with leaders from associate degree programs and the community college arena to encourage academic progression in nursing (see www.aacn.nche.edu/news/articles/2012/academic-progression).
• Partnering with the National Organization for Associate Degree Nurses to disseminate a new brochure titled "Taking the Next Step in Your Nursing Education" (see www.aacn.nche.edu/students/your-nursing-career/Academic-Progression-Brochure.pdf).
• Advancing the Robert Wood Johnson Foundation’s "Academic Progression in Nursing" initiative as part of the Tri-Council for Nursing, which is focused on implementing state and regional strategies to create a more highly educated nursing workforce (see www.aacn.nche.edu/news/articles/2012/rwjf).
• Joining with the Robert Wood Johnson Foundation to enhance diversity in the nursing workforce through the "New Careers in Nursing" program, which provides financial support and guidance to students from under-represented groups enrolled in accelerated nursing programs (http://www.newcareersinnursing.org).