In her address to nursing leaders during the third anniversary of the Institute of Medicine’s landmark report, “The Future of Nursing: Leading Change, Advancing Health,” Donna Shalala, chair of the IOM report committee, praised the progress that nurses were making on its recommendations.
“Nursing organizations are starting to work together in unprecedented ways. This is clearly nursing’s time,” said Shalala, Ph.D., FAAN.
But there is more to be accomplished and individual nurses need to take an active role in strengthening the profession, she added.
If your New Year’s resolution is to advance your career, it might be a good idea to make 2014 a year of learning.
“There’s no doubt that nurses need more education. Patients are sicker and as health care becomes more complex, more is required of us,” said Lisa Eichelberger, dean of Clayton State University’s College of Health and co-chair of the Georgia Nursing Action Coalition to advance the IOM report’s recommendations.
Earning a BSN degree, which is considered the gateway to nursing leadership, would be a great place to start. There has been an explosion of RN-to-BSN programs in Georgia, “but we still have a long way to go to reach the IOM recommendation of 80 percent of nurses holding BSN degrees by 2020,” said Eichelberger, Ph.D.
In 2013, a Clayton State nursing department health care policy advocacy project surveyed Georgia’s RN-to-BSN programs and found that 32 out of 49 nursing schools in the state have them. Only four community colleges lack an RN-to-BSN program, and of the 13 technical colleges with ADN programs, more have made articulation agreements with four-year colleges to allow their students to earn BSN degrees.
“The data has shown us that patients do better with BSN-prepared nurses. They have lower morbidity rates, recover quicker, have fewer readmissions to the hospital and get better quality of care overall,” Eichelberger said. “In this whole era of cost-containment, hospitals are recognizing that having adequate staffing with nurses who have the right education is important.”
In urban areas especially, more hospitals have moved to BSN-degree nurses preferred or required when hiring. Many are encouraging current staff nurses to earn BSN degrees or advanced degrees through tuition reimbursement programs, bonuses and pay increases.
Growing and learning
“Part of our strategic plan at WellStar Health System is to provide an atmosphere where our employees can keep growing and learning,” said Melissa Box, MSN, RN, chief nursing officer at WellStar Douglas Hospital. “We’d like to see 80 percent of our nursing staff hold a BSN degree by 2020. It’s easier for working nurses to pursue their education today, with so many online programs.”
Georgia State University has a new online RN-to-BSN program.
“The enrollment numbers had dropped for our traditional RN-to-BSN program because working students couldn’t get to class, so we totally revamped the program and put it online,” said Paula Gordon, clinical assistant professor at Georgia State University’s Byrdine F. Lewis School of Nursing and Health Professions. “We know it can be scary to go back to school, but we offer good technical support and the kind of courses that today’s nurses need.”
A portion of the 39-credit hour, three-semester program includes classes in end-of-life issues for veterans and others, informatics and evidence-based research.
“Today’s nurses need to be able to utilize research at the bedside and they need stronger critical-thinking skills,” said Gordon, RN, MS. “Nurses are asked to take on bigger roles today and a BSN degree can give them the confidence to do so.”
Georgia State is accepting applications for its fall 2014 class of 30 students.
“Continuing their education is hugely important for nurses because of all the changes going on in health care. All nurses need to be lifelong learners,” Box said. “One of the hardest things for nurses who have been out of school awhile is knowing where and how to start.”
Employer support
At WellStar since 1989, Box said she was fortunate to have an employer who encouraged her to earn BSN and master’s degrees, as well as a certification in critical care, while working and moving up the ladder.
“If you’d like to advance in your career, talk to your supervisor and other nurses. There are so many more options for nurses now, including the clinical nurse leader role, which is a master’s degree for nurses who want to stay at the bedside,” Box said.
Ask your employer about tuition reimbursement programs, foundation or community scholarships, and pay raises after you earn degrees or certifications.
“Become a member of a professional organization and take advantage of their continuing education classes and conferences, as well as the programs offered by your hospital,” Box said.
WellStar offers lunch-and-learn sessions, continuing education classes and education fairs in which local colleges and universities are invited to promote their programs to staff. The School at Work program helps all employees who want to prepare to take the GED test or go to college via online courses. Many of them continue their education in health care fields. The health system also offers fellowship programs for nurses who work in critical care or emergency care, and nurse residency programs for new nursing school graduates.
Nurses may also apply for the Clinical Advancement Program, which is WellStar’s nursing professional development initiative. By completing a degree, certification, continuing education, research and other requirements each step of the way, nurses progress through the program’s four levels, with salary bonuses of $3,000 (Level II), $5,000 (Level III) and $7,500 (Level IV).
“CAP supports the growth, development, recognition and retention of our nurses,” Box said. “And we reimburse nurses who earn certifications in their fields. To me, a certification validates that a nurse is an expert and that she has gone above and beyond to learn more.”
Importance of certification
Certification has been around since the 1970s when nurse practitioners were required to earn one to practice, but the concept really began to grow as nursing specialties increased about 20 years ago. In 2012 there were 24,220 nurses who achieved or renewed nurse practitioner, clinical nurse specialist or specialty nursing certifications through the American Nurses Credentialing Center. Affiliated with the American Nurses Association, the ANCC is the largest accrediting nursing organization in the world.
“There are only about 250,000 certified nurses,” said Karen Drenkard, executive director of the ANCC. “To earn a certification in a nursing specialty, a nurse goes through the highest rigor of learning and takes a national exam. Nurses tell us that it gives them an incredible sense of pride and confidence in their practice. A certification is a tangible piece of evidence that says they have the education and skills to do the job.”
The profession as a whole and many health care employers value certification. Some hospitals reimburse nurses for certification exams (which can cost $325 to $500), promote them up the clinical ladder or increase their pay. Some even offer a one-time bonus.
For some nurses, a certification is a first step to a higher degree, and some nursing schools offer academic credit for certification.
“It’s always nice to have a friend or a colleague who wants to make the journey with you, but the ANCC has made it easier for everyone by offering test outlines, review books and study groups online,” said Drenkard, Ph.D., RN, NEA-BC. “Since continuing education is required for renewal, certifications are also a good way to stay current in your specialty and keep up to speed with the changes in health care.”
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