In the second Perspective article, nursing policy researcher Linda Aiken of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, pointed to a major obstacle holding back nursing advancement: The lack of nursing school programs that offer bachelor or doctorate degrees.
The IOM report recommended that the proportion of nurses who hold at least a bachelor's degree be expanded from 50% to 80% by 2020.
"Approximately 60% of new nurses graduate from associate's degree programs, 36% from bachelor's degree programs, and 3% from hospital-sponsored diploma programs," Aiken wrote. "But a serious unintended consequence of permitting the majority of new graduates to enter nursing practice with an associate's degree or less is that too few nurses advance through multiple additional degrees to qualify as faculty or advanced-practice registered nurses."
She said that of the approximately 72,000 nurses graduating from associate's degree nursing programs in 2010, only 4,000 are likely to ever obtain a master's or higher degree, "a yield that cannot produce enough faculty to replenish a workforce of more than three million nurses."
She concluded that it will be "extremely difficult, if not impossible, to generate enough nursing faculty, advanced-practice registered nurses, and nurses to fill leadership and executive roles requiring graduate-level education if entry-level nursing education does not shift entirely to the baccalaureate level."