Trends in nursing education

A push for more registered nurses (RNs) to attain a baccalaureate is yielding results, according to a new report on nursing jobs.

RNs with bachelor’s degrees or higher outnumber those with an associate degree or lower by two to one, according to a new study by the Center on Education and the Workforce (CEW) at Georgetown University. In 1980, the numbers were flipped: 68 percent of RNs had an associate degree or less, compared to 32 percent who had a baccalaureate or higher.

Demand among hospitals and other healthcare facilities for nurses with higher and more specialized skills is driving the trend, the report says.

The trend is also reflected among entry-level nursing jobs that require only a certificate. The number of licensed practical nurse (LPNs) and licensed vocational nurse (LVNs) credentials awarded more than doubled between 2000 and 2011 to 59,600 before steadily declining to 49,800 in 2016, according to the report.

The drive toward encouraging more nurses to have bachelor of science in nursing degrees (BSNs), in part, comes from the 2010 Future of Nursing report by the Institute of Medicine, which set a goal of having 80 percent of nurses nationwide with BSNs by 2020.

As hospitals increasingly prefer nurses with bachelor’s degrees, community colleges have developed innovative ways to ensure nursing students have an opportunity to continue their education. Some have agreements with universities for dual enrollment, for example, while others have formed partnerships allowing for a seamless transition to university-level programs with shared faculty and curriculums. Some two-year colleges are even encouraging state lawmakers to allow them to offer BSNs, especially in areas where there is great demand for nurses and in rural areas, where students may have difficulty traveling long distances to a university.

Missing mark in diversity

Despite the higher postsecondary degrees attained by nurses, diversity in the field has not kept pace, the report shows. White women still dominate the field. Latinos — who comprise 16 percent of the U.S. population — in particular are not represented well, accounting for 7 percent of all RNs in 2016.

However, the LPN/LVN workforce is more diverse. In 2000, blacks comprised 14 percent of LPNs/LVNs, increasing to 27 percent in 2016. Among Latinos, the rate grew from 6 percent in 1990 to 12 percent in 2000, before ebbing to 9 percent in 2016.

The CEW report says the figures show that minorities are overrepresented among LPNs/LVNs and underrepresented among RNs. More needs to be done to help blacks and Latinos attain higher degrees to advance to the higher-skilled, higher-paid RN level, it adds.

“Though there are well-established career pathways in the nursing field, the increased presence of minority nurses at the LPN/LVN level, but not the RN level, suggests that many minority nurses do not move up those career pathways,” the report says.

Associate-degree nursing advocates who have opposed making BSNs the minimum degree for RNs frequently cite that LPNs/LVNs often serve as entry-level jobs for many nurses, especially for low-income minorities who don’t have the money or time to invest into a BSN because of finances or family obligations. They argue that such “degree inflation” will only prompt them to lose their jobs and lead to fewer qualified nurses, especially in rural areas.

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