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NY Health System’s Bold Stance on Nurse Preparation

Rebecca Hendren, for HealthLeaders Media, July 20, 2010

"I think it's their level of critical thinking," says White. "The inquisitive nature that you tend to get in a baccalaureate program as opposed to other kinds of programs. I just think it's a different mindset, a different focus that you learn at the baccalaureate level because of the number of years you have to go through for a baccalaureate as opposed to an associate program. You get a longer period to really hone your critical thinking abilities in a baccalaureate program."

North Shore-LIJ has just made the decision that all newly hired nurses will have a baccalaureate degree or they will earn one within five years.

Although professional associations and researchers have called for baccalaureate to be the entry level, the profession has always resisted it. Most recently, the biggest stumbling block has been the chronic nursing shortage. How can we limit entry when the nation is about to be desperately short of caregivers? I don't have an answer for that, and so it surprised me to see a large New York State healthcare system make such an announcement. Where will they get enough nurses?

White said they're not focusing on that. They simply made the decision that baccalaureate nurses provide better patient care.

White cites the work by Linda Aiken, which examined patient outcomes and how they are linked with educational preparation of nurses. White says the study has been duplicated several times and always produced the same results.

"This is something we have been discussing for quite some time now," says White. "There have been many studies done, all coming up with the same results that the more highly educated the bedside nurse is, the better the quality outcomes for the patients. Mortality is reduced, adverse events decrease, there are decreases in failure to rescue. For myself that was true evidence that there is something to be said for higher levels of education."

White says the organization felt a responsibility to provide patients with the best care possible. "If there are studies that have shown that having staff nurses at a baccalaureate level reduced adverse events and improved quality of care, then we have a responsibility to follow that study," she says.

The area North Shore-LIJ serves is not suffering a shortage right now. "Within our health system we have less than a 3% vacancy rate for our positions," she says. "Our turnover rate is less than 6% for RN positions."

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