Credential debate continues in health care

Diane Osterhaus Neefe, president of the National Network of Health Care Programs in Two-Year Colleges, outlines trends in the health-care workforce. (Photo: Matthew Dembicki)

SAN DIEGO — Over the years, nursing has been in the spotlight during debates about the right credential needed for entry-level jobs in the health-care field. But other allied health occupations face similar encroachment among proponents who want to replace associate degrees with bachelor’s degrees as the entry-level credential.

The most recent one is for respiratory care. Last week, the American Association of Respiratory Care sent a position paper to its members supporting bachelor’s degrees as the entry-level credential for respiratory therapists by 2025.

Diane Osterhaus Neefe, president of the National Network of Health Care Programs in Two-Year Colleges (NN2), noted the position paper at a session on emerging trends in the health-care workforce at the American Association of Community Colleges’ Workforce Development Institute. She stressed it’s important for allied health-care faculty at community colleges and others to continue to advocate for keeping the associate degree as the entry-level credential for these fields (adding that she supports efforts that create a pathway to higher degrees).

While proponents of the entry-level baccalaureate for many health-care occupations argue that raising the credential will increase professional recognition and pay, supporters of the associate degree counter with an array of reasons to keep it as is. Topping the list are workforce issues. Like many other fields, health care is facing workforce shortages across the country, and requiring new workers in those jobs to earn a bachelor’s degree will exacerbate the shortfall, especially in rural areas, said Osterhaus Neefe, who also is director of regional learning centers at Western Technical College in La Crosse, Wisconsin.

Among nurses, 45 percent have and associate degree in nursing (ADN) and 55 percent have a bachelor’s degree in nursing (BSN). But the latter figure doesn’t include nurses who first earned their ADN, according to ADN advocates. About 48 percent become registered nurses through associate-degree programs.

Cost and capacity

There’s also a cost issue. A higher degree can more than double the cost of attaining an entry-level credential, which again would make it hard to recruit new workers, Osterhaus Neefe said.

There’s also a challenge in providing the training. Many four-year institutions don’t have the capacity to add more allied health students. In terms of respiratory therapists (RT), for example, Florida has 23 two-year and three four-year RT programs, Tennessee has seven associate- and two bachelor’s-degree programs, and Wisconsin has seven two-year and no four-year degree programs, Osterhaus Neefe said.

It’s also increasingly difficult to find properly credentialed faculty to teach those programs as professional nurses and other allied health workers opt for better-paying jobs in the field.

“You’re starting to look for a one-eyed purple unicorn,” Osterhaus Neefe said.

A seat at the table

The higher degree doesn’t translate into better bedside skills, two-year degree advocates note. The ASN and BSN, for example, provide the same hands-on training, but the baccalaureate adds components such as management, research, community health and other areas, said Bryan Hoffman, deputy director of the Organization for Associate Degree Nursing (OADN).

Hoffman emphasized the importance of advocates plugging into various local, regional and national organizations that affect nursing and allied health care. Too often, four-year degree nursing advocates have a seat at the table during discussions with policymakers and employers, and it’s important that two-year supporters are also there, he said.

About the Author

Matthew Dembicki
is editor of Community College Daily and serves as publications director for the American Association of Community Colleges.