A key recommendation of the Institute of Medicine’s landmark report The Future of Nursing: Leading Change, Advancing Health is to have nurses achieve higher levels of education, with a goal of 80 percent of nurses holding a bachelor’s degree or higher by 2020. Now, a new study identifies the factors that best predict whether nurses will return to school to earn those degrees.
According to the study—part of the RN Work Project, funded by the Robert Wood Johnson Foundation— there are a variety of motivators, from desire for advancement to job dissatisfaction, that influence registered nurses (RNs) to pursue a bachelor of science in nursing (BSN) degree or higher. The study was published in the November/December issue of the Journal of Professional Nursing.
Motivators cited in the study include an interest in career and professional advancement, gaining new knowledge, improving social welfare skills, and being a positive model for one’s children. RNs identified a desire to achieve personal and job satisfaction and professional achievement as important intrinsic 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.
Lead investigators for the study were Christine T. Kovner, PhD, RN, FAAN, professor at the College of Nursing, New York University; Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo. Kovner and Brewer direct the RN Work Project.
The research team also asked nurses about barriers to returning to school and getting 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.
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.”
“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,” added Kovner. “Scheduling bachelor’s-level and graduate classes at times and in places that make them more convenient for RNs is also very important.”
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 those holding a bachelor’s degree, 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,” said Brewer. “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 (NLRNs) 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.
About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter (www.rwjf.org/twitter) or Facebook (www.rwjf.org/facebook).