August is back to school time. New pencils, crayons, fresh paper, and unopened books. Back to school time holds the promise of making new friends, learning new facts, and forming new ways to look at the world. The possibilities stretch before all returning students whether they are beginning kindergarten, entering high school, or setting off for college. For many nurses it means returning to school for that advanced degree, whether for a bachelor's of science in nursing (BSN), a master's degree, or doctoral work. Unfortunately, there are many nurses not making that choice who should be.
It has been 3 years since the Institute of Medicine published its report on the future of nursing.1 The report called for a number of changes in nursing, including an increase in the number of doctorally prepared nurses and for the number of nurses with a BSN to increase to 80% by 2020.1 The recommendation for more BSN-prepared nurses is not new. Nearly 50 years ago, in 1965 the American Nurses Association recommended the BSN as entry into practice.2 There is no need to debate that recommendation further here. Clearly, there is a need for nurses to be educated and to be lifelong learners. The difficulty is in how to encourage nurses to go back to school, attend educational events, and become involved in their profession.
As the Future of Nursing report points out, nursing is increasingly complex. Patients are sicker and their hospital stays are shorter. Nurses are expected to coordinate care and must understand community resources, healthcare finance, and overall healthcare systems. Nurses must be prepared to read and understand research and evidence and be able to apply that evidence to patient care. Nurses must be prepared to conduct research, discover best practices, and build nursing knowledge. These increasing responsibilities mean that nurses cannot afford to put off gaining education.
Many of the healthcare team members have already moved beyond us. Physical therapists, pharmacists, and physicians have doctoral degrees. Social workers, occupational therapists, speech pathologists, dieticians, and psychologists have master's degrees or beyond. The nurse, who spends more time with the patient than anyone, cannot afford to be the least educated member of the team.
Nurses are the largest body of healthcare workers and must be part of leading healthcare in the future. Too often nurses are left off of the decision-making teams. The Future of Nursing report also noted that nurses need to be part of the leadership in healthcare. Nurses should have a place in the boardroom and bring their perspective to healthcare design, information systems, and decisions that impact nurse staffing, workflow, and patient care. We cannot do that without a firm understanding of how healthcare works, including finance and policy.
If it is not enough to think about leadership, evidence-based practice, and a broadened perspective, consider the personal implications of putting off the education that you need. Too many nurses, particularly advanced practice nurses, have been caught up in changing rules and regulations regarding prescriptive authority, certification, and state requirements. Many nurses assume that they will continue to work where they are now and will be allowed to practice as they are until requirement. Unfortunately for some, healthcare is a fluid, constantly changing environment. Hospital units close and unexpected influences alter circumstances. Hoping to get by without getting a degree may limit options in the future in unexpected ways.
Obviously getting an advanced degree does not mean the end of learning. Part of what makes nursing interesting is the fact that we are constantly learning how to do it better. There have been many changes in neonatal nursing since I started my career in 1980. This means we cannot be satisfied with merely showing up and going home every day, no matter how efficient we are in completing our daily tasks. We have to keep up with what is happening. If you have the degree you need, or you are waiting to start, consider the last time you attended a conference or other continuing education event. There is no time like the present. The next NANN national meeting is coming up in October. The conference is full of innovated ideas, the latest research, and opportunities to see the latest technology to help you in your practice. It is a chance to meet those who are leaders in the profession you have chosen and to learn how to become involved in leadership yourself. Now is the time to sign up. See you in October.
1. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2010.