Editor's Note

A Matter of Degrees
Nursing education could use a healthy shot of support
Carol Bradley, MSN, RN, Editor

The reality of the nursing shortage concerns anyone who is involved in providing health care today. In California, where the shortage is most acute, there is the promise of a public health crisis unless there is immediate intervention. The Scott Commission (a result of AB 655) prepared a plan for Gov. Davis and the state Legislature to correct the gap in our RN workforce.

The report, sent to the Legislature in June, outlines six recommendations that are important to expanding the production of registered nurses in this state. While the report includes many well-documented facts contributing to the shortage and general recommendations to address them, I would like to offer additional observations.

Our community college system has been a workhorse in delivering associate degree nurses to the field, but the lottery system for student selection should be eliminated immediately. The nursing profession is strengthened by diversity, but let’s ensure that the standards of academic ability and demonstrated performance are maintained as candidates are considered for the limited slots within our educational system. Quality cannot be sacrificed in our enthusiasm to expand enrollment or to meet faulty policy mandates.

The lack of nurses with bachelor’s degrees in this state is probably the most critical problem affecting the shortage and the care delivery system. Wherever we find medical schools and teaching hospitals in California, we should also find strong, viable nursing schools preparing BSN, MSN, and Ph.D. nurses. Despite the efforts of key nursing leaders, the University of California system has failed to adequately support nursing education.

The California State University system and a group of private nursing schools deserve credit for giving us the BSN-educated nurses we do have.

While the Scott Report recognizes that inadequate faculty salaries pose a serious threat to increasing the education of nurses, this issue was not addressed in the recommendations. All nursing programs need to be appropriately funded to optimize faculty recruitment and retention, ensuring that salaries are competitive within the nursing marketplace. Expanding programs is futile without qualified nursing faculty.

AD and BSN programs should ensure that their curricula are fully articulated. Nurses still experience unreasonable obstacles to advancing their education. AD and BSN faculty, as well as nursing leaders in practice settings, should encourage students and practicing nurses to continue their education.

Let’s all work to increase the transition of associate degree nurses to BSN preparation.

Finally, the Scott Report fails to articulate the important role employers should play in facilitating the education of nurses. Employers should assist schools in meeting the student-faculty ratios for clinical rotations.

Most hospitals have master’s-prepared nurses who would enjoy some clinical teaching and oversight of students. We also need to expand clinical opportunities for students wherever possible.

Employers also need to distinguish RN roles and educational levels with significant salary differentials. This alone would change many nurses’ attitudes about advancing their education.

Employers also can influence the education of nurses through tuition assistance programs and flexible scheduling. Some hospitals have stepped forward with enhanced tuition programs and on-site education for their nurses. Employers would do well to focus their resources on long-term workforce strategies versus hiring bonuses and foreign recruitment programs.

Beyond the importance of getting the attention of our state government, it is vital that members of the nursing community, both those in practice and education, and our health care delivery system work as a team to address the issues confronting the California nursing workforce.