California, the nation’s most populous state, has a "well-educated" nursing workforce, according to a survey published in June by the state’s Board of Registered Nursing. About 60 percent of the state’s registered nurses (RNs) have earned a bachelor’s or graduate degree in nursing or another field, the survey found.
Still, the Golden State has a long way to go before it reaches a nurse education goal set in 2010 by the Institute of Medicine (IOM) in its landmark report on the future of nursing. The IOM recommended that 80 percent of nurses hold bachelor’s degrees or higher by 2020. Ever since, a national Campaign supported by the Robert Wood Johnson Foundation (RWJF) and AARP has been working to implement that and other IOM report recommendations.
Nursing is the largest health profession in the United States, and nurses spend more time with patients than other providers. A more highly-educated nursing workforce is needed to play a greater role in the delivery of primary care and community-based services and to meet increasing demands for highly skilled care for an older and increasingly complex and diverse patient population, according to the IOM report. Studies have also linked higher nurse education levels with improved quality and safety of care and better patient outcomes.
For the survey, researchers at the University of California, San Francisco (UCSF) sent questionnaires last year to 2,500 RNs with active California licenses and addresses. Nearly 1,300 respondents—or 53 percent—completed the survey. Joanne Spetz, PhD, associate director for research strategy at the Center for the Health Professions at UCSF, was the lead author and is also a consultant to the RWJF-supported Future of Nursing: Campaign for Action.
About half of the respondents (51 percent) said they entered the nursing profession with an associate degree in nursing (ADN), while about one-third (32 percent) said they entered with a bachelor’s degree. Twelve percent first earned a hospital-based diploma, which is no longer available in California. Many advanced their education after completing pre-licensure education.
More than one-third (36 percent) of employed nurses completed at least one post-licensure degree, with 29 percent obtaining a post-licensure nursing degree, 4 percent finishing a non-nursing degree, and 3 percent completing both nursing and non-nursing degrees.
Nearly 40 percent of respondents—and nearly 80 percent of those under 35—said they are considering or seriously considering additional education, citing reasons including the desire to acquire more skills and knowledge, personal fulfillment, and higher salaries. Barriers to continuing education include home and family responsibilities and the high cost of education.