Several hospital systems in the Northeast United States are now requiring newly hired nurses to either possess a Bachelor of Science in Nursing degree or enroll in an RN-to-BSN program as a condition of employment. At the same time, state lawmakers in both New York and New Jersey proposed and debated legislation last year requiring newly licensed nurses to earn a bachelor's in nursing degree within ten years of their initial licensure. While none of the hospital systems claim their policy changes are directly related to the potential for government action, it's clear the trend toward BSNs in the clinical environment is gaining considerable momentum.
The North Shore LIJ Health System in Long Island, N.Y., was the first major hospital group to publicly require BSN degrees among its new nurses. The "BSN in 5" program, launched in July of 2010, mandates all new RNs either have a Bachelor of Science degree in nursing before they are hired or enroll in an RN-to-BSN program within two years of their hire date and graduate with the nursing degree within five years. Likewise, the Hudson Valley Hospital Center in Manor, N.Y., requires a nursing bachelor's degree for all nurses hired into its leadership program. Neither hospital, however, requires the BSN degree for existing nurses.
Even hospitals that don't explicitly require degrees admit their hiring priorities are based on a candidate's level of nursing education. Executives at the multi-hospital system Meridian Health in New Jersey make it clear that nurses with a bachelor's degree are considered and hired first to fill open positions. According to the hospital, the preference is especially strong when evaluating nurses who have only recently finished school and obtained their license.
Leaders of these hospital systems point to a growing body of research demonstrating a strong relationship between improved patient care and higher levels of education as their motivation for the push toward BSN degrees. Multiple studies have demonstrated that patients attended by nurses with a bachelor's degree or higher statistically show lower mortality, higher-quality outcomes and fewer adverse events. As technology becomes more sophisticated and more deeply integrated into the patient care process, critical thinking skills and the ability to quickly digest and interpret information are emerging as essential traits among good nurses. Earning a BSN degree, some hospital administrators believe, is a sign that nursing candidates have these skills in abundance.
Another driving force in hospitals' move toward BSN degrees may be the rising importance of Magnet recognition. The American Nurses Credentialing Center bestows Magnet status on hospitals who meet a variety of benchmarks related to patient care and the working environment for nurses. Since the mid 1990s, more than 300 hospitals have achieved Magnet recognition, and the credential is used to recruit top nursing candidates and as a marketing tool for patient outreach. One of the primary requirements for Magnet status is the overall level of education among direct-care and leadership nurses. The level of support provided by the hospital to help nurses continue their education is also heavily weighted. By requiring or giving preference to BSN graduates when hiring new nurses, a hospital can quickly raise its ratio of degree-holding nurses and improve its standing in the Magnet program.
At North Shore Health System, Meridian Health and other hospitals where a Bachelor of Science in Nursing is required or encouraged, many resources exist to help nurses earn the degree. Meridian reports more than $250,000 is given to nurses every year in tuition reimbursement. At the Hudson Valley Hospital Center, managers give special scheduling considerations to nurses who are pursuing the degree. The growing popularity of affordable online RN-to-BSN programs is also making it possible for nurses to earn their online nursing degree without sacrificing significant time from work, and employer tuition reimbursement may be available to help offset much of the cost.