A significant body of research indicates that a more highly educated nursing workforce can help ensure our nation’s population has access to high-quality, patient-centered care. Having at least 80 percent of nurses holding a bachelor’s degree or higher by 2020 is a key recommendation of the Institute of Medicine’s landmark report, The Future of Nursing: Leading Change, Advancing Health. It is also one of the primary recommendations addressed by the Future of Nursing: Campaign for Action and the driving force behind the Academic Progression in Nursing program, launched by the Robert Wood Johnson Foundation (RWJF) and leading nursing organizations this spring.
Now, a new study published from the RWJF RN Work Project provides critical information that can help advance that goal. It identifies the characteristics and factors that best predict whether nurses will return to school to earn higher degrees.
Christine T. Kovner, PhD, RN, FAAN, professor at the College of Nursing, New York University and Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo direct the RN Work Project. They were the lead investigators for the study, which was published in the November/December issue of the Journal of Professional Nursing.
“Charting the Course for Nurses’ Achievement of Higher Education Levels” identifies a variety of internal and external motivators that influence registered nurses (RNs) to pursue bachelor of science in nursing (BSN) or higher degrees. They include: career and professional advancement; gaining new knowledge; improving social welfare skills; and being a positive model for one’s children. RNs also identify a desire to achieve personal and job satisfaction and professional achievement as important motivators. Nurses with graduate degrees are more likely to report being extremely satisfied with their jobs, compared with nurses who hold associate’s degrees, who more frequently report moderate to extreme dissatisfaction with their jobs.
According to a study by Joan Warren, PhD, RN-BC, NEA-BC, and Mary Etta Mills, ScD, RN, NEA-BC, FAAN, "Motivating Registered Nurses to Return for an Advanced Degree," RNs report that support from employers and educational institutions increase the likelihood that they will return to school. RNs who say they are undecided about continuing their nursing education identify organizational incentives and rewards as important motivators. Those include tuition reimbursement, compatible work and class hours, paid sabbaticals, forgivable loans for service, pay for attending class, and Web-based and worksite classes.
“As our health care system changes, the need for more nurses with bachelor’s degrees or higher is increasing,” said Kovner. “The patient population is aging and more patients are presenting with more and more complicated conditions. Health care is relying ever more heavily on information technology. More people are able to access care. Not only do we need more BSN-prepared nurses to provide care in this increasingly complex system, we need more nursing faculty at our institutions of higher education to educate the next generation of nurses. Knowing what motivates nurses to seek BSN and higher degrees is crucial.”
Barriers and Motivators
Nurses also identified several barriers to pursuing an additional nursing degree. The two most prevalent responses were “cost” and “family/children.” A “lack of time” came in third. Of those reporting cost and time as significant barriers, many cite difficulty scheduling classes around their work schedules as a significant challenge.
“Given that the cost of education is a major barrier for many nurses, increasing scholarships and other financial incentives for returning to school should be the highest priority for funders,” Kovner added. “Scheduling bachelor’s-level and graduate classes at times and in places that make them more convenient for RNs is also very important.”
The study looked at motivators for pursuing more education among nurses with associate’s degrees and among nurses with bachelor’s degrees. It found that for nurses with associate’s degrees, being Black, living in a rural area, having non-nursing work experience, an optimistic outlook, higher work motivation, working in the intensive care unit or step-down unit, and working the day shift are among the most important predictors that they will pursue a bachelor’s degree.
For nurses holding bachelor’s degrees, being Black, having non-nursing work experience, holding more than one job, living in a non-rural area, working the day shift, working voluntary overtime, lower intent to stay at current employer, and higher work motivation are among the top indicators that they will pursue a higher degree, such as an MSN.
“Understanding the characteristics of nurses who obtain higher degrees is key to knowing how to increase the number of nurses with BSNs and advanced degrees,” Brewer said. “We still have quite a ways to go to meet the Institute of Medicine report’s goal of having 80 percent of RNs hold a BSN or higher degree by 2020, but these findings give us insight into the factors that influence nurses to return to school, and the best targets for recruitment and encouragement.”
The RN Work Project is a 10-year study of newly licensed registered nurses that began in 2006. It is the only multi-state, longitudinal study of new nurses’ turnover rates, intentions and attitudes—including intent, satisfaction, organizational commitment and preferences about work. The study draws on data from nurses in 34 states, covering 51 metropolitan areas and nine rural areas.