SNYDER: An unnecessary barrier to entry

November 17, 2012

Thomas J. SnyderA few months ago, I was visiting a friend in the hospital. As I observed the staff attending to him, I was impressed by the quality of care he received. It was clear he was in good hands.

As I considered this, another thought struck me: While a wide variety of professionals were involved in my friend’s care, the one constant was the nursing staff. They were most responsible for his satisfaction at their facility—and more important, most responsible for his likelihood of making a complete recovery after he was sent home.

My experience reflects a national reality: Nurses are the backbone of our nation’s health care system. And as our population ages, the growth of our nursing work force will be more critical than ever before.

Despite this fact, a movement is under way that would limit access to careers in the field. A small contingent of special interest groups is advocating that hospitals seeking “nursing magnet” status restrict employment to those with bachelor’s degrees in nursing. Their efforts would have catastrophic results not just for those with associate degrees in nursing, but for our health care system as a whole. And may result in increased health care costs.

Their position is supported by claims that just aren’t true. For example, those promoting bachelor’s degrees as a prerequisite to a nursing career imply that associate-credentialed nurses provided a diminished quality of care. However, there is no evidence supporting these claims. Even studies that call for an increase in bachelor-credentialed nurses have found no relationship between the education level and patient outcomes.

One primary reason may explain why a different credential is not correlated with a different patient outcome: All candidates, regardless of their education, take the same national licensure exam to become RNs—the National Certification Licensing Examination. Today, in fact, the majority of new RNs are educated in associate degree programs. If this exam is the true determinant of career-readiness, how can it be argued that one path that prepares students for the exam is superior to another?

This argument obscures the very real need for nursing candidates to have options. For many, a bachelor’s is the best choice because it offers an advantage in competing for management positions. For others, even a bachelor’s is not enough: If they want a career in nursing education, they will likely need a master’s of science in nursing.

For others, however, an associate’s is not only the best choice—it may be the only choice, given the unparalleled affordability of community colleges.

The associate credential plays another critical role in preparing professionals in that credits earned can be transferred to four-year institutions. So for some that means if they wish to pursue a bachelor’s they can get started at a community college, then continue toward a bachelor’s and save thousands of dollars.

The bottom line is that our best chance of ensuring we are prepared to respond to this need is by making the profession accessible to all qualified candidates, including those credentialed with an associate’s or a bachelor’s.

So, when you hear the arguments in favor of limiting the nursing profession to those with a bachelor’s degree, ask yourself whether such restrictions would be in the best interest of everyone who depends upon our health care system, or just those who would benefit from shutting out otherwise qualified candidates.•


Snyder is president of Ivy Tech Community College. Send comments on this column to ibjedit@ibj.com.

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