Want to spark a lively debate among your peers? Ask them one question and step back while the sparks fly.
The question: Do you need a bachelor's degree to be a good nurse?
The responses will vary widely depending on who you talk to. Some will even quote quantifiable research by nurses like Linda H. Aiken, PhD, RN, FRCN, FAAN, who demonstrated hospitals that employ a higher proportion of nurses with at least a bachelor's degree have lower rates of death for surgical patients.
Since Aiken's findings were printed in JAMA in 2003, a number of proposals have emerged to elevate the nursing profession.
The American Organization of Nurse Executives supported a proposal calling for a bachelor's degree to be the entry level for all new nurses.
Others - such as the New Jersey State Nurses Association and the American Association of Colleges of Nursing - support a compromise plan. Initially conceived by Barbara Zittel, PhD, RN, executive secretary of the New York State Board of Nursing, the plan would keep open the multiple paths to become an RN (diploma, associate and bachelor's), but require new nurses to earn their BSNs within 10 years of passing their boards. Current nurses would be exempt from the BSN requirement.
There are pros and cons to both proposals but the goals of both are similar: elevate the nursing profession, increase critical thinking among nurses and improve patient outcomes.
Here's another option to throw into the mix: Evidence-based practice (EBP) in 10 years. Every new nurse could pick one of two tracks, either earn a BSN in 10 years or complete a significant EBP project in the same time period.
For nurses choosing EBP, they'd need to do research on a topic or area they work in, compare literature and options available, develop a thesis/hypothesis and conduct experiments. This would require the nurse to work with her facility leaders and fellow nurses on her unit to test it, report it and suggest changes to facility operations as necessary. EBP projects could be clinical in nature or environmental.
Of course, we'd need some sort of oversight for the plan to work. I suggest the licensing board of each state be tasked with reviewing the reports, serving as project advisors, asking for changes, etc. Perhaps a group of nurses with varying academic degrees could serve as a sounding board during the process and as an approval board when the project was complete.
Then, each year, the state would compile a synopsis of its best EBP findings and post them on the Web for nurses across the country to view and learn from.
This plan isn't perfect and it's certainly not for everyone. Some nurses may opt for the more straight-forward approach of getting their BSN in 10 years. And that's fine.
What this plan does is give people options. It encourages and rewards nurses for critical thinking, teamwork and searching out new options for better patient care. It may be a more attractive - from a family or financial standpoint - than an additional 2 years of school.
This plan also preserves the multiple entry points to nursing that is even more important now as America continues to gray and the nursing shortage worsens. This plan would help create a national database of EBP and encourage nurses everywhere to look beyond the status quo.
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