What does this brand-new year have in store for nurses across the United States? The healthcare landscape is undergoing substantial changes. Some might say it’s being strip-mined, while others see signs of careful reforestation occurring amid the chaos. It’s very difficult to make firm predictions across such a diverse industry in a country where economic conditions vary substantially from one state and one county to the next. But we’ll take a crack at outlining a couple of trends that could impact you and the nurses you know.
The BSN Is the “In” Degree
Nurses living in New York and New Jersey are intimately familiar with the “BSN in 10” bills that are being considered by state legislators. If these laws go into effect, they will “require registered professional nurses to attain a baccalaureate degree in nursing within ten years of their initial licensure; with exemptions provided for those currently licensed or enrolled in nursing programs.”
Proponents of these bills point to studies demonstrating better patient outcomes (fewer deaths and a lower failure to rescue rate) in hospitals with a higher percentage of BSN nurses. They acknowledge that nurses do not learn more hands-on skills at the bachelor level, but claim the increase in theoretical knowledge, critical thinking and leadership skills translate to better care. Obviously, this is a highly charged and controversial topic, with many current RNs feeling that their decades of on-the-job experience are being discounted.
There’s no telling whether 2013 will be the year that these bills and similar initiatives being considered in other states (such as Pennsylvania) will finally pass. However, the effect of this kind of thinking is already being felt on the employment landscape. Even though these laws would supposedly grandfather in existing RNs and student nurses, hospitals can and do set their own standards for hiring. Some organizations aren’t waiting for laws to pass—they are instituting narrower hiring guidelines now. If an employer requires a BSN for a position, nurses had better be prepared to show they meet these educational requirements. While some hospitals are footing the bill for higher education, many will simply choose to “externalize” this cost and place the burden squarely on the shoulders of nurses.
2013 is likely to see an increase in BSN requirements for nurses across a wide swath of the industry—especially in regions where supply outstrips demand (if you take “demand” to mean the number of nurses that hospitals are willing to hire, rather than the number they should hire to meet patient needs and relieve chronic understaffing). Since there are sticky legal and financial implications involved in requiring existing employees to go back to school for a bachelor’s degree or face firing, hospitals tend to target their new requirements at new hires. This is likely to have a depressing effect on career mobility for RNs regardless of experience level. Freshly minted BSNs are likely to see more promising career opportunities than just-graduated RNs. In fact, many student RNs are deciding to stay in school longer to get their bachelor’s out of fear that the RN alone won’t be sufficient to land a job in 2013.