Nursing degrees increasing, but not on track to meet goal for acute care

(Reuters Health) - The proportion of registered nurses with nursing bachelor’s degrees has climbed in recent years to 57 percent in U.S. acute care settings, but it’s not rising fast enough to reach a goal of 80 percent by the year 2020, researchers say.

“When more nurses have degrees, there’s a higher quality of care, lower mortality rate and better patient outcomes,” said lead author Chenjuan Ma of New York University’s Rory Meyers College of Nursing in New York City.

Nurses make up the largest healthcare workforce in the U.S., with 2.75 million registered nurses in 2014 and 1.6 million of these working in hospitals, the study team notes in the Journal of Nursing Scholarship.

“On one side, we’re happy to see that the number of nurses is increasing,” Ma told Reuters Health in a telephone interview. “On the other side, we need to put more effort and commitment into increasing these numbers even more.”

Ma and colleagues analyzed data from the National Database of Nursing Quality Indicators covering more than 2,000 units in 377 hospitals across the country. The research team looked specifically at nurses working in acute care units, which can include intensive care units, cardiology floors, emergency departments and other parts of a hospital where patients with serious conditions need continual and sometimes complex care.

In these settings, the proportion of nurses with a bachelor’s degree in nursing rose from 44 percent in 2004 to 57 percent in 2013, the study found.

In particular, the researchers paid attention to trends after the U.S. Institute of Medicine’s 2010 Future of Nursing report, which raised an alarm about an overall nursing shortage and a growing need for educated nurses to take care of aging patients in a complicated healthcare system. The report set a goal of 80 percent of nurses obtaining bachelor’s degrees by 2020.

The study found that this proportion bumped up an average of 1.3 percent each year before 2010 and 1.9 percent each year after 2010.

At the same time, the proportion of units where 80 percent of nurses had a bachelor’s or higher degree rose from 3 percent in 2009 to 7 percent in 2013.

Based on current trends, Ma and her colleagues estimate that 64 percent of nurses in acute care hospital units will have a degree by 2020. The 80 percent goal won’t likely be reached until 2029.

“Senior nurses with a lot of experience are retiring, and we’re concerned about how to replace that wealth of experience,” said Joanne Spetz, a health policy researcher at the University of California, San Francisco, who wasn’t involved in the study.

“Having a higher education level doesn’t necessarily replace experience, but it’s one of the strongest strategies we have, and patient outcomes show it works,” she told Reuters Health by phone.

“Millions of American have inadequate access to primary care, and health insurance expansions continue to build demand, but supply won’t be able to match that,” said Peter Buerhaus, a registered nurse and healthcare economist at Montana State University in Bozeman who wasn’t involved in the study.

“When compared to other fields, nurses are really satisfied with their decision to go into nursing,” he told Reuters Health by phone. “It has economic security, is a recession-proof profession and has a range of opportunities, particularly if you have a nursing degree.”

National nursing groups are also debating the positives and negatives of requiring a bachelor’s degree in nursing for entry-level nursing positions, said Olga Yakusheva, an economist at the University of Michigan School of Nursing in Ann Arbor who wasn’t involved in the study.

“Nurses and aspiring nurses ought not to misinterpret the upcoming nursing shortage to mean any kind of nurse will soon be in high demand,” Yakusheva told Reuters Health by email.

“If you want to be a nurse, you should be prepared to dedicate yourself to getting at least a baccalaureate nursing degree,” she said. “In this era of high technologies and informatics, nurses are expected to be highly-trained in all aspects of patient care and prepared to participate and lead in system-level decision making.”

SOURCE: Journal of Nursing Scholarship, online October 9, 2017.