April 16, 1998

The big question when it comes to the controversial issue of whether nursing should—someday—require a bachelor’s degree for entry-level practice comes down to this: Will registered nurses soon need to know more than they can possibly learn in two or even three years?

Almost everyone agrees that you can master the clinical basics of nursing after a couple of years of study. The rest, some nurses say, can be picked up the old-fashioned way, by working and watching and testing just what works in the real world.

But will there soon be a point when what nurses need to know just cannot fit into a two-year time span? Health care is getting more and more complicated and challenging every day. Nursing is changing. The body of knowledge is increasing dramatically every year. The need for nurses to teach and to explain health care to patients and to the community is greater than it has ever been. And in 20 years, health care will not be any simpler. Care will rely on even more complex technology, and cures will increasingly be based on genetic manipulation and computer analysis of signs and symptoms.

It’s not that AA and diploma grads aren’t qualified now; they are. And many of them have the advantage of years of experience. But as health care continues to get more complex, the profession will have to expand its core education.

Much of what nurses will soon need to know isn’t covered in most associate and diploma nursing programs. For nurses to truly understand and work effectively with the incredibly diverse communities of the future, they will need a solid background in psychology, sociology, and a second language. To be able to explain patient risk and the newly emerging pharmaceutical therapies, nurses will need to understand the basics of human genetics and quite a bit of pharmacology. To continue to improve the way things are done in health care, nurses will need to know how to analyze—or even do—a research study and decide whether or not some of the procedures on the unit need to change. To start new programs or disseminate information about diseases and conditions, nurses will need strong and effective communication skills, particularly writing skills.

The other healthcare professions are already confronting this issue. Occupational therapists are considering requiring a master’s degree to practice. By 2003, physical therapists entering practice will need to have a master’s degree. Speech therapists need a master’s degree. Medical record librarians need at least a bachelor’s degree. And the number of jobs requiring a bachelor’s degree will increase 25 percent between 1996 and 2006, according to the Bureau of Labor Statistics.

It’s true that some of the skills nurses must have will never change. But other demands on nursing are increasing all the time. Do you think nursing students of the future will be able to learn all they will need in just two years?

What do you think?

Barbara Bronson Gray, MN, RN
Editor in Chief

Looking for CE? Visit our online store.

PREVIOUS Editor's Notes

How much education do RNs need?

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

Is it time to spice up your career?

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