March 26, 1998

So, how much education do you really need to do your job? For years, registered nursing has been deeply divided on this subject. Some have insisted that a baccalaureate degree should be the minimum. Others have argued that the sheer success of so many community college and diploma grads shows that a four-year requirement is unnecessary and could be a big and costly barrier.

Medicine and most of the allied health professions, of course, settled this argument long ago. And I think nursing must, too, if it is to thrive in the new century.

Here’s why. If people knew that most RNs in this country don’t have a college degree, they’d be shocked. RNs talk about how we’re the one profession that coordinates the entire spectrum of care, but in many cases, we have less education than the person whose expertise is drawing blood or managing the ventilator. If patients knew nursing’s little secret—that we are, in fact, on the average one of the least educated of the health professions—would they really lobby to have a nurse involved in their care?

There was a time when getting a college education was a big deal. It’s not any more. In fact, as high schools accomplish less and less, college is almost a necessity for even entry-level jobs outside of health care. Like it or not, college is now the baseline for professional careers.

College doesn’t make a great nurse—or a great physical therapist or a great teacher or a great engineer. It’s no guarantee. But you know what a college education does give you? Confidence. It’s that sense of security when you sit down at a hospital committee meeting or when you’re arguing a point with a physician or when you’re talking to the City Council about the need for bus service for seniors—you know you’re educationally on a par with the others.

College also gives you a bigger window on the world. Why does a nurse need a course on world history, or Spanish literature, or even sociology? Because it’s the only way to get a truly broad perspective, and it sharpens the mind.

Here’s my proposal. State by state, we grandfather in those nurses who are practicing now. We set a date after which a baccalaureate degree is required to get a license to practice nursing. Make it 2010. Or 2020. And then we have to find a way to ensure that the community college curriculum allows students to move right on through to the baccalaureate.

What holds the nursing profession back more than anything else isn’t managed care, short staffing, inadequate funding, or hospital policies. It’s us. It’s our fear of insulting the wonderful, experienced, capable RNs who don’t have a college degree. It’s our fear of feeding a shortage by mandating an extra year or two of education. Maybe, too, it’s nursing’s almost innate practicality and frugality, the feeling that it’s somehow a bit wasteful to mandate more education than is absolutely needed to do the job as we know it today.

But if we don’t someday make a college degree mandatory, we can forget the questions of prestige, power, and salary. Our roles will shrink, not expand. That won’t be good for patients, and it won’t be good for us. What do you think?

What do you think?

Barbara Bronson Gray, MN, RN
Editor in Chief

Looking for CE? Visit our online store.

PREVIOUS Editor's Notes

Character Counts: Your actions are a window on your soul

Assisted suicide in Oregon. What is next? Ads for 1-800-JUST-DIE?

Patient care decisions belong at the bedside

Questions about quality have no easy answers

PREVIOUS Articles

How you can reenter the job market

How many beds make a hospital?

Web Ed: Looking for patient education Web sites.

Cyber Flo

Mental health coverage in a time of managed care