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NY Health System’s Bold Stance on Nurse Preparation

Rebecca Hendren, for HealthLeaders Media, July 20, 2010

Why do you need so little education to be a nurse? Physical therapists are required to have a doctoral degree for entry into practice. Speech therapists need a master's. But the most important figures in patient care can enter practice with only an associate's degree.

It's an issue that has puzzled me for the last five years as I have devoted my professional career to writing for and about nurses. I am not a nurse, no surprise there, and as I've studied, befriended, and generally immersed myself in the world of nursing, I am amazed that an associate degree-level education is all that's required for entry into practice.

Before you start sending me hate mail, let me be clear that I am not denigrating associate degree nurses. I applaud you. In an increasingly complicated healthcare environment, where nurses care for multiple patients with more complex needs than ever before, it takes a lot of intelligence, skill, mental agility, resourcefulness, empathy, and courage to be a good nurse, and I commend those of you who do this—and who learn to do it well—without years of education and training.

The debate about entry to practice is almost as old as the profession itself. Studies have shown that if you test associate and baccalaureate nurses at graduation they are relatively equal in their skill sets. But modern nursing requires more from nurses than simple task completion. It requires critical thinkers who can operate in a high-tech environment as skilled professionals who practice based on best evidence and research.

I asked Maureen White, RN, senior vice president and chief nurse executive of 15 hospital North Shore-LIJ health system, what she thought the main difference is between associate and baccalaureate-prepared nurses.

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