More Nurses Pursuing Advanced Degrees, Improving Chances of Being Hired

By Jennifer Larson, contributor

January 8, 2013 - More nurses are advancing their knowledge by seeking bachelor’s and graduate degrees, according to preliminary 2012 survey data released in early December by the American Association of Colleges of Nursing (AACN).
“These are wonderful numbers,” said Geraldine “Polly” Bednash, PhD, RN, FAAN, CEO and executive director of AACN. “We are thrilled to see the continuing growth, and we know the deans and schools are having to be very flexible given the fact we have restraints on resources and faculty.”
Maryjoan D. Ladden, PhD, RN, FAAN, a senior program officer at the Robert Wood Johnson Foundation (RWJF), which has contributed millions of dollars to advance the nursing profession, agreed, calling it “great news and a great start. The Institute of Medicine’s Future of Nursing report, sponsored by the Robert Wood Johnson Foundation, calls for 80 percent of the nursing workforce to be baccalaureate-prepared by 2020.”
At the time the report was released in 2010, about half of nurses held bachelor’s of science in nursing (BSN) or higher degrees.
Preliminary data from the AACN survey of 664 schools with baccalaureate and graduate programs shows a 3.5 percent enrollment increase in entry-level BSN programs, which follows a 5.1 percent increase in 2011. The data also shows nursing programs turned away 52,212 qualified candidates in 2012.
National publicity about the nursing shortage, coupled with information about job openings in the health care field have drawn more prospective applicants to nursing, said Patricia L. Starck, DSN, RN, FAAN, at the University of Texas Health Sciences Center at Houston, who reported an increased interest in nursing for the past five to seven years.
In a separate study, AACN has found that baccalaureate-nursing graduates were more than twice as likely to have jobs when they completed their studies than those entering the workforce in other fields.
AACN also found a 22.2 percent increase in baccalaureate degree-completion, RN-to-BSN programs, representing the 10th annual increase for these programs.
“It’s tremendously exciting to see the huge growth in the RN-to-BSN programs,” Bednash said. “That tells us something about the market wanting better-educated nurses, and about nurses understanding the importance of getting more education to be the best providers.”
Additionally, AACN found that nursing programs participating in its survey reported 39.1 percent of employers in their areas were requiring a BSN for new hires, and 77.4 percent strongly preferred BSN-prepared nurses.
Texas Health Resources (THR) has implemented preferential hiring for BSN-prepared nurses.
“[THR] maintains a deep commitment to assisting nurses in achieving their baccalaureate degree through dedicated programs, funds and flexible scheduling,” said Meera Ananthaswamy, PhD, MBA, RN, FACHE, director of the Center for Advancing Professional Practice at Texas Health Presbyterian Hospital Dallas. “Texas Health Dallas is a great example of being intentional about the promotion of BSN at the bedside, achieving a 10 percent increase in one year, moving from 52 percent to 62 percent.”
Elizabeth Asturi, MS, RN, NE-BC, associate chief nursing officer at Texas Health Dallas, added, “The IOM Future of Nursing report's vision for 2020 and the push by organizations to become Magnet-recognized are two key drivers in the need for more BSNs. Additionally, the increase in BSNs is being driven by the recognition of and realization that patient outcomes are improved with BSN-prepared nurses.”

“BSN-prepared nurses are generally more satisfied with nursing as a profession,” Asturi continued, “and having nurses who are best prepared to read and translate evidence into practice has the greatest potential to improve quality.”
Increased BSN enrollments relate to the growing demand for skilled nurses and nurse leaders who can manage patients with complex, chronic health issues as well as the needs of patients and their families, at a time when America is aging and granting access to health care for more people through the Affordable Care Act, added Mary E. Kerr, PhD, RN, FAAN, dean and the May L. Wykle professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, Ohio.
The RWJF, the Tri-Council for Nursing—an alliance between the American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives, and the National League for Nursing—along with AACN and other organizations have been working to enhance better-prepared nurses. One of the latest efforts is the RWJF’s Academic Progression in Nursing, which encourages states to collaborate with various stakeholders to develop plans to meet the BSN recommendation, such as seamless progression from associate degree programs to higher education.
The RWJF’s New Careers in Nursing Program promotes diversity in the nursing workforce. The foundation also funds the RWJF Faculty Scholars Program, which supports leadership development and expands the recipients’ research projects.
“It’s our attempt to grow the next generation of faculty leaders,” Ladden said.
A lack of faculty, as well as clinical sites, remains a concern in better educating America’s nursing workforce. Despite that, nursing programs have increased their enrollments. Ladden attributes that to colleges and universities becoming more creative in using distance learning, simulation and clinical partnerships and to nursing faculty not retiring at the rate expected.
“Because they are so committed to nursing and the profession and there is no one to backfill the positions, they have decided to stay on,” Ladden said. “Nursing is clinically intensive. You need good clinical placements and good faculty.”
UTHealth has shown innovation in the current environment. It has invited retired physicians to teach clinical assessments, and then the doctors coach the students on their communication skills, such as how to prepare to call a provider for orders. It also hires part-time faculty. In addition, it offers tuition and stipends, made possible through donations, in an accelerated nurse practitioner program and an accelerated doctor of nursing practice (DNP) program that will allow it to add 10 faculty members this summer.
Master’s degree nursing programs reported to AACN an 8.2 percent increase in enrollment. Bednash expects advanced practice master’s programs will end, but other master’s programs will remain to prepare nurses for public health, management, leadership and generalist positions.
The IOM report also called for doubling the number of doctorally-prepared nurses by 2020; less than 1 percent of nurses held a doctoral degree when the report came out.
The AACN survey showed a 19.6 percent enrollment jump in DNP programs, a clinically focused degree, and a 1.3 percent increase in enrollment in PhD or research-focused doctoral programs.
“We think it is wonderful to have both options for nurses,” Ladden said. But “we are concerned about the lack of a significant increase in the number of nurses seeking PhDs.”
Bednash added that the growth in the DNP program, which AACN endorsed in 2004 as an additional option for obtaining a terminal degree, has become a “fixed part of the academic preparation for professional practice, and students are going in droves.”
“The degree elevates the nursing to a level of leadership on par with other health care professional that hold clinical doctorates such as MDs and PharmDs,” said Kerr. Case Western began a DNP program in 1979. “As our graduates and nurses in general assume more leadership positions—such as chief nursing officers and health policy makers—the degree has become more accepted and more in demand by leading health care organizations.”
Starck also reported an increase in nurses pursuing DNP degrees. UTHealth has added nurse anesthetist and administration tracts.
“Nurses go back to school because they want to improve their professional ability,” Starck said. “Once we developed the DNP, there was a huge untapped market [among nurses] who did not want a PhD and research role. They wanted to stay on the patient side.”