The healthcare landscape is shifting. The changes we are seeing today are mole hills compared to the looming mountains that healthcare will climb. Nurses must be engaged in the debate and must prepare for changes in care delivery.
To handle increasing complexities of care and greater responsibilities, nurses will need more education and training. Today, only about half of RNs have a baccalaureate degree. In 2008, the proportion with advanced (master's or doctorate) degrees was about 13.2%.
The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, has identified increasing the educational levels of nurses as a critically important component of professional development and devoted two of its eight recommendations to the issue.
The first recommended that 80% of nurses should have baccalaureate degrees by 2020. It called on schools of nursing to partner with employers, public and private sectors, and communities to find ways to increase the number of nurses entering baccalaureate programs. The second recommended doubling the number of nurses with doctorate degrees by 2020, which would increase the cadre of nurse faculty and researchers.
At an individual level, nurse leaders around the country are taking the report to heart and looking for ways to encourage and support nurses to pursue further study. Some organizations are requiring that all nurses obtain their BSNs within a certain timeframe after hire. Others are emphasizing the value of education and serving as role models for pursuing advanced degrees.
"I ask my nurses: 'When you're sitting around the table with care managers, physicians, physical therapy, etc, do you really want to be the least-educated person at the table?'" says Kim Sharkey, BSN, RN, MBA, NE-A, BC, who is CNO/vice president of medicine at Saint Joseph's Hospital in Atlanta. "The answer is no. [At Saint Joseph's] we've got a constant agenda to raise the level of our nursing staff because it puts them at a more equal place at the decision-making table."
Sharkey is leading by example and is enrolled in a doctor of nursing practice (DNP) program at American Sentinel University, which allows her to work full time while studying.
Sharkey has been with Saint Joseph's since 1979 and says she realized early on that to be an effective leader, she needed to pursue advanced degrees. Her educational journey has taken her from a diploma program in the 70s, to a baccalaureate degree in nursing in the 80s, to an MBA in the 90s. She pursued a master's in business, instead of a master's in nursing, because she wanted to be exposed to different ways of thinking outside the healthcare world.
When Sharkey became CNO a few years ago, her organization was moving to a service line structure and she was put in charge of the medicine service line. This makes her VP of medicine as well as CNO.
"It's becoming more common for execs at all levels to become broader in their scope," says Sharkey. "I have a dual position. I'm over medicine service line as a business leader, but also over nursing wherever it is."
The role of nursing leadership is expanding, says Sharkey. "Nurses really touch every aspect of patient care. They need to be more globally involved in the business of healthcare as well as the business of nursing."
Sharkey's enrollment in the DNP program echoes a growing trend in the country, which has seen the DNP skyrocket in popularity.
"I wanted to find a doctorate degree that would allow me to grow as a nurse executive and a healthcare leader," says Sharkey. "I started looking at the DNP role, which is a practice doctorate. [Such things are] very common in professions like pharmacy and physical therapy. It's not a new concept for healthcare professionals, but it is new concept for nursing."
The DNP is a good option for professionals who are not interested in academia or spending the amount of time in research that is required for a PhD. In her role where she interacts with doctoral-prepared medical practitioners, she did not want to be the least educated person at the table.
"If nurses really want to make an impact on healthcare reform and transforming healthcare, we need to get ourselves educated at a higher level," says Sharkey. "I needed to find a program that would allow me to gain that skill and knowledge. I've finished a year of the program and it has really expanded my vision, scope of thinking, my ability to access and use evidence-based practice. It puts me at a more advantageous position at the table negotiating with other people."
Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits www.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.