By Rose O. Sherman, EdD, RN, FAAN
The phone call began like so many others over the past two years. It was a nurse manager who was seeking guidance about the fastest way to get the BSN. “I am in trouble”, she confessed, ”my Chief Nursing Officer gave me a five year deadline to get my BSN and the clock is running out.” I then asked her what she hoped to learn from a BSN program. She observed after a little reflection, “thats just the point, I am not sure that I will learn anything. I have been a nurse for 20 years and a manager for the past eight years.” I am used to these conversations, and have learned not to argue the benefits before the nurse begins the program. Instead, I usually suggest that he/she start the program with one or two courses. If you still feel that you are not learning anything, I advise, then I want to meet with you again. I have never had a nurse manager come back to argue the value of a BSN after they start the program. Instead, they often become the strongest advocates of the BSN as the entry level degree and usually continue their education and earn a master’s degree. As I often tell my students, you don’t know what you don’t know - until you do.
Educational Trends and the Nurse Manager Role
We have very limited nursing workforce research about the educational preparation of our nation’s nurse managers. Data from the 2008 national nursing sample and research that I have conducted in my community indicates that between 30 and 50% of nurse managers are prepared at the associate degree level in nursing. In 2008, the Commission on Magnet made the decision to set educational expectations for nurse managers. Craig Luzinskii, a Magnet Program Director, in a recent article in the Journal of Nursing Administration noted that beginning this month (January 2013), 100% of nurse managers must have either a bachelors or masters degree in nursing at the time of magnet application. The decision was in support of a 2010 Institute of Medicine Report on the Future of Nursing which recommended the goal of an 80% BSN prepared workforce by 2020. Magnet organizations, he observed, must set the tone for achieving the IOM goal and that needs to begin with nurse managers.
Why do nurse managers need a BSN?
Nurse managers set the tone on their units for professionalism and the value of being a continuous learner. If the goal is to have a 80% BSN prepared workforce by 2020, this will not happen without strong role modeling by those in leadership roles. There are also three other key points to consider.
1. Highly Complex Environments Require Stronger Leadership Knowledge Skill Sets.
The IOM report makes a strong case to support that advances in science and increasing patient complexity have accelerated our need for nurses with the skill and knowledge to manage a challenging and increasingly diverse health care environment. Unlike Associate Degree programs, BSN curriculum provides content on evidence-based practice, health policy and finance, interprofessional communication and collaboration, systems leadership, disease prevention and population management. This is program content that nurse leaders need to navigate not only today’s health care environment but also the changes anticipated with health reform.
2. Nurse Managers must be well informed about the value and importance of evidence-based practice.
One of the strongest arguments to support the need for a higher percentage of BSN prepared nurses is the research evidence that a richer mix of BSN nurses results in better patient outcomes. Work done by Aiken (2003), Estabrooks et al. (2005), Tourangeau et al. (2006), Blegen &Goode (2009) indicates that a higher percentage of BSN prepared nurses lowers patient mortality. The key to these differences is thought to be the focus on evidence-based practice in BSN programs. Nurse managers must understand the value of evidence-based practice and the tools that nurses use to make their practice evidence-based.
3. Current Education Models Support the Movement of Nurse Managers from Associate to Bachelors Degrees without leaving their leadership roles.
Historically, it was difficult for nurses and nurse managers from associate or diploma programs to find flexible programs to complete their BSN. Today, there are many options especially with the rising number of online programs. In a number of states, community colleges have moved to become colleges and now offer RN-BSN programs in addition to associate degrees.
Undoubtedly, some nurse managers will continue to argue the need to further their education and avoid returning for their degree for as long as possible. Sometimes, all they may need is a push from their Chief Nursing Officer. It is a career move that is not only in their own best interest but also in the interest of their staff and patients.
Read to Lead
Aiken LH, Clarke SP, Cheung RB, Sloane DM, Silber JH. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290(12), 1617-1623.
Estabrooks CA, Midodzi WK, Cummings GG, Ricker KL, Giovannetti P. (2005). The impact of hospital nursing characteristics on 30-day mortality. Nursing Research, (2), 74-84.
Goode CJ, Blegen MA. The link between nurse staffing and patient outcomes. ANCC National Magnet Conference; October 2, 2009; Louisville, KY.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington DC: National Academies Press. Future of Nursing 2010 Recommendations
Luzinski, C. (2012). Transformational leadership and navigating change. Journal of Nursing Administration, 42(12), 543-544.
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