The healthcare industry represents a complex organism that requires the highest degree of expertise and competence from all the employees. Nursing professionals occupy an essential place within the field, and their work is of extreme significance to the success of treatment and a decrease in mortality and morbidity rates among patients. In other words, nurses are on “the frontline of defense against negative outcomes,” which stresses their role and the weight of the education and experience that they acquire (Sarver, Cichra, & Kline, 2015, p. 153). This factor leads to the introduction of different legislature directed at specific personal and education requirements for nursing professionals. The bill A1762 of New Jersey sponsored by assemblywoman Nancy Munoz sets the requisitions for nurses to earn a bachelor’s degree in the field within ten years of initial licensure (New Jersey Legislature, 2020). The purpose of this paper is to investigate this legislation and, with research support, defend its implementation and significance.
Bill’s Background and its Significance to Nursing and Health Care
The significance of the bill to nursing and health care is substantial due to the factors that influence the performance effectiveness of professionals. The proposed law states that patient outcomes are directly connected to educational backgrounds (New Jersey Legislature, 2020). Consequently, it is possible to claim that the connection is positive, where higher education and more extensive experience increase the effectiveness of treatment and lower mortality rates. One of the researches revealed that higher levels of education have a relation to “lower rates of patient falls” (Stalpers, de Brouwer, Kaljouw, & Schuurmans, 2015, p. 831). Hence, attaining a degree in nursing becomes a critical attribute of becoming a professional nurse who delivers high-quality care and services and operates efficiently under different conditions.
It is also crucial to investigate the bill’s background and influence. The creation of this statute is a response to the recommendation of the Institute of Medicine to have the majority of registered nurses holding bachelor’s degrees (Sarver et al., 2015). In other words, the Institute suggested that most of the nurses should achieve higher education or a bachelor of science in nursing (BSN). Moreover, the report of the US Department of Health & Human Services stated that more than 30% of nurses held BSN, and more than 60% got an associate degree (Sarver et al., 2015). It implies that fixing the nursing shortage several decades ago resulted in the fact that most nursing professionals are getting shorter education, and only a small proportion is going through Bachelor’s education cycle.
However, with the increase of education possibilities, the number of nurses with Bachelor’s degrees started to grow. Thus, after 2012, the part of those possessing BSN overcame 50% (Altman, Butler, & Shern, 2016). When the states started to push the legislation in response to the suggestions of the Institute of Medicine, the number of educational programs for nurses began to grow. As a result, there are numerous possibilities for professionals to attain their degrees, and the legislation takes into consideration different cases. For instance, there are particular exceptions, where nurses are given two additional years (NJ Legislature, 2020). In such a way, those who are pushing the law strive to achieve a high proportion of registered nurses obtaining higher education to improve the healthcare industry outcomes and the results for the patients.
Another significant factor is the employers’ preferences in terms of the hiring process and the requirements. The American Association of Colleges of Nursing (AACN) (2019) encourages organizations to promote environments “that embrace lifelong learning and offer incentives for RNs” (para. 2). Thus, employers should assist nursing professionals who are already staff members and who aspire to advance their education and obtain BSN. Moreover, the data released by AACN discloses that although the employers do not require baccalaureate levels from the nurses, the preference for this factor is significantly growing (Altman et al., 2016). Therefore, the legislation also serves as a measure to provide the necessary background and facilitate education aspirations among the professionals who seek employment to fit all the hiring requirements.
Organizations’ Position Concerning ‘BSN in 10’
In the determination of the policy’s potential effectiveness and influence on the related industry, it is vital to consider the positions of the official organizations that have a substantial impact within the field. In such a way, the American Nurses Association (ANA) (2015) and the Organization for Associate Degree Nursing (OADN) started their collaboration aiming to improve the reach academic progression in nursing. Hence, those organizations support the legislation requiring the nurses to obtain a higher degree within a specific period. It will contribute to meeting the demand of high-quality professionals with proper educational backgrounds, which will lead to progress in the industry and better outcomes indicators for the professionals.
Another influential organization mentioned in the previous section is AACN, which also plays a central role in the significance of the bill because it has a direct connection to education for nursing professionals. The AACN (2019) states that the evidence of BSN graduates providing unique skills and knowledge and delivering effective patient care is essential. This establishment is in favor of the bill, and its active support pursues to improve the level and quality of delivered services. It is also crucial to note that the view on highly-educated nurses gets encouragement from the Tri-Council for Nursing. The ANA, AACN, American Organization of Nurse Executives (AONE), and the National League for Nursing (NLN) promote education as an essential means towards safety and quality of care (Haskins & Pierson, 2016). Accordingly, the bill gets furtherance from numerous influential associations, the position of which has a substantial weight on the outcomes.
As far as the paper discusses the implementation of the legislation in the state of New Jersey, it is crucial to look at the positions of the local institutions. One of them is the Organizations of Nurse Leaders in NJ that has published a presentation listing various advantages of the ‘BSN in 10’ utilization. The Organization of Nurse Leaders in NJ (the ONL in NJ) (n.d.) suggests that one of the strengths of setting education requirements is that nurses with BSN will be able to perform evidence-based care. Consequently, besides producing more positive outcomes and providing support for the professionals, the legislation also opens up more opportunities for integrating gained knowledge and skills. The ONL in NJ (n.d.) mentions that such institutions, as the mentioned AONE, and the Organization of Nurse Executives New Jersey, and the Association of perioperative Registered Nurses, highly support the bill. Thus, one can see solid sustenance behind the proposed requirements, which highlights the significance of the changes and potential improvements.
Arguments for Support of the Bill
The information above summarizes the essence of the legislation, outlines its weight within nursing and health care, and offers the list of organizations that encourage its implementation. Besides the establishments in support of the bill, it is endorsed by the New Jersey State Nurses Association (NJSNA), which also implicates the importance of those requirements (The ONL in NJ, n.d.). It is possible to state that the proposed guidelines disclose unique opportunities for the healthcare industry and can reach excellent results with extensive backing from influential collaborations and through raising awareness.
At this point, it is beneficial to look at the results of the studies conducted to establish the relationship between various patient care factors and BSN. The research showed that patients receiving treatment from the nurses with BSN had a 5% lower risk of mortality within 30 days, and “a 6% lower risk of failure to rescue” (Haskins & Pierson, 2016, p. 46). One can see that the results point out the valuable influence of obtaining education on the essential criteria of the care services. In other words, the increase in the number of RNs getting a degree within a specific period after receiving a license can significantly reduce the probability of negative patient outcomes.
Based on the findings, my position is in favor of the legislature’s active integration. I believe that through inspiring the aspirations for higher education among the nursing professionals, the industry will not only benefit from better patient outcomes but will experience prosperity and will manage to meet the demand. It can also positively influence the nursing shortage within the state. One of the studies revealed that there would be “an inequitable distribution and shortage of RNs in New Jersey by 2030” (New Jersey Collaboration Center for Nursing [NJCCN], 2017, p. 5) Consequently, the need for educated medical staff is growing and requires a timely solution. Moreover, by 2030 the state will experience an excessive supply of licensed practical nurses (LPNs) (NJCCN, 2017). Those estimations emphasize the significance of providing graduate and undergraduate education opportunities to decrease the number of LPNs and increase the presence of RNs with the baccalaureate.
Another critical point that accentuates the bill’s connotation is the projections of the timeline when the desired proportion of nurses can reach the determined goals. The initial recommendation suggests 80% of the nursing professionals obtain BSN, while it is stated that it will be met only around the year 2045 (Anbari, 2015). Therefore, the current situation is far from the established numbers, which points out the necessity to implement the legislation within the nearest future and respond to the initial suggestion as soon as possible. I stick to the point that through the bill’s endorsement that gets support from numerous official organizations, the healthcare industry can possess a large percentage of highly-educated nursing professionals.
One more essential aspect of the question of supporting the bill is understanding the evidence that led to those recommendations. The sections above mention the surveys that have proven the connection between nursing professionals’ education and positive patient outcomes. Besides, the provisions indicated by the ANA and National Nursing Staff Development Organization in the Scope and Standards of Practice state that educators have to analyze the trends within the field (Romp et al., 2014). Consequently, those indicators point out the compulsion to determine the needs of health care facilities and individuals. Thus, based on the findings, it is possible to say that some of the needs are to improve the patients’ outcomes and overcome the nursing shortage issue. Moreover, those involved in the education processes within the industry and change agents support “lifelong learning by advising and mentoring nurses as they execute a professional development plan” (Romp et al., 2014, p. 83). I think that the focus on lifelong learning also stresses the significance of ‘BSN in 10.’
Arguments Against the Bill
Although the position of numerous organizations supports the implementation of the bill, there is a proportion of nurses who oppose the proposed requirements. Hence, some nursing professionals do not feel that obtaining a degree will bring the benefits and justify it by the need to invest substantial time and financial resources in gaining BSN (“10 reasons why RNs,” 2020). In such a way, despite the active maintenance of the bill by healthcare institutions and affiliations, it still faces some resistance.
As far as my position is in favor of the ‘BSN in 10’ legislation, it is advantageous to apply additional effort and contact the assembly people, activists, and influencers working towards gaining more support. The background for the bill includes numerous evidence-based studies and has a substantial promotion from numerous large organizations, such as ANA, NLN, AACN, and others. Acquiring more votes and raising awareness about the issue can generate more attention and encourage more enhancements to the education possibilities within the industry. It is critical to meet the recommendations of the Institute of Medicine and to combat the nursing shortage among the states and in NJ. Establishing the requirements for Bachelor’s can be an efficient incentive to respond to the emerging problems and improve the outcomes.
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Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine report: The future of nursing. Washington, DC: National Academies Press.
American Association of Colleges of Nursing. (2019). Fact sheet: The impact of education on nursing practice. Web.
Anbari, A. B. (2015). The RN to BSN transition: A qualitative systematic review. Global Qualitative Nursing Research, 2, 1-11.
Haskins, S., & Pierson, K. (2016). The impact of the bachelor of science in nursing (BSN) degree on patient outcomes: A systematic review. Journal of Nursing Practice Applications and Reviews of Research, 6(1), 40-50.
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