The Case for Nursing Education Progression

Mar 23, 2012, 12:00 PM

By Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation


Change is a constant in health care. In the face of skyrocketing costs, system fragmentation, health disparities and an aging and sicker population, more care will be delivered in primary care and community/public health sites than in acute- and hospital-based settings. Yet we also face a primary care shortage and the coming infusion of 32 million newly insured people into the system.

To ensure an adequate supply of nurses with the advanced skills and expertise necessary to help bridge the gap while ensuring quality, higher levels of education are imperative. Thus, health care organizations, educational institutions and others are looking intently at the case for advancing nursing education as outlined in the Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health. Specifically, the IOM report recommended creating a system that produces more nurses educated at the Bachelor of Science (BSN) level and beyond.

Since its inception, the Robert Wood Johnson Foundation has understood the value of a strong, well-trained health care workforce. And we agree with the IOM report that the nursing profession has the potential to effect wide-reaching changes in the health care system. Further, we concur that an improved education system is necessary to ensure that nurses can continue to deliver safe, quality, patient-centered care required for the 21st century and beyond.

As I recently told, there are a number of things that hospitals and other organizations that employ nurses can do to facilitate education progression. And it is to their benefit to do so.

In a American Organization of Nurse Executives (AONE) survey of Chief Nurse Officers, half of respondents said their hospitals preferentially hire BSN nurses, although just over a third pay BSN nurses more at the time of hire. And some of the nation’s leading nurse employers, including Johns Hopkins in Baltimore, the Veteran’s Health Administration and Tenet Health Care, have also taken steps in support of nursing education.

We are seeing innovative examples in the states, too. The Oregon Consortium for Nursing Education has created a shared curriculum across eight community colleges and the Oregon Health & Science University School of Nursing. In New Mexico, leaders have developed a uniform nursing curriculum and shared faculty pool. In Florida, an RN-to-BSN educational model will help community college students transition to state college programs, and efforts in Colorado will also enable seamless BSN transitions for nursing students.

Solutions like these, along with action by employers, businesses and others, are exactly what’s needed—diverse sectors coming together to transform nursing, which in turn will help to ensure access to high-quality, patient-centered care for all. What we need is for many people and organizations to get involved with the Future of Nursing: Campaign for Action’s efforts to implement the IOM report recommendations and with their state Action Coalitions.


This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.