Letter to the Editor on The Nursing Shortage: Is This Cycle Different?

The Nursing Shortage: Is This Cycle Different?

April 15, 2009
Response by Mariann Mickey Craddock to: The Nursing Shortage: Is This Cycle Different? (January 31, 2001).

Dear Editor:

I would like to respond to the Nursing Shortage topic by reflecting on the BSN-in-10 initiative. The BSN-in-10 initiative proposes the development of legislation requiring that nurses prepared in Associate Degree and Diploma programs obtain their Bachelor of Science in Nursing (BSN) degree within 10 years of receiving their initial licensure so as to allow them to continue practicing as registered nurses. One goal of this initiative is to provide a pool of nurses prepared to pursue master's and doctoral degrees that would enable them to address the urgent need to fill faculty and other leadership positions in nursing, thus helping to alleviate the nursing shortage. I believe that the BSN-in-10 initiative has the potential to address the current and projected nursing shortages, but only if it is introduced at the national, rather than the state level, and only if it is implemented as part of a comprehensive program that addresses our present nursing shortage.

Currently, the BSN-in-10 initiative is in danger of going the way of the 1987 North Dakota model that required the baccalaureate degree as the educational credential for those wishing to take the RN licensure exam. While this effort did increase the state's number of BSN-prepared nurses to 54%, it was repealed by the state legislature in 2003 due to the lack of support from those in the nursing community who did not advocate requiring a baccalaureate degree to enter professional nursing and to differing professional nursing entry-level requirements in other states (Mason, Leavitt, & Chaffee, 2007). The problem in North Dakota was that the state totally phased out Associate Degree in Nursing (ADN) programs. However, they did grant licensure to ADN graduates from other states with the promise from these ADN graduates that they would obtain a BSN degree within 8 years. Subsequently, nursing students started leaving the state to study for the ADN degree in neighboring Minnesota rather than entering BSN programs in North Dakota. During the 2002-2003 academic year, more than 200 students left North Dakota to study in neighboring states (American Association of Community Colleges, 2003). To prevent nurses from '˜working around new laws' requiring additional nursing education in only one or several states, all states need to implement essentially the same legislation at about the same time.  However, it is important to continue to make ADN programs available so that nurses who are not in a position to complete a BSN program initially can enter professional nursing through an ADN program and complete a BSN program at a later date.

It is important to remember that not all nurses who advance their education through a BSN degree will seek a career in nursing education or leadership. To encourage nurses to want to stay in nursing and to seek additional education, the healthcare industry will have to make the package more attractive. This can be done through improving working conditions, for example by providing an adequate number of staff nurses for each shift. The Magnet program, which emphasizes the value of an all-BSN-prepared staff, already encourages nurses to seek more education. However, additional incentives for faculty, such as salary increases, loan repayment programs, and more creative approaches to tenure and promotions, are also needed. The bottom line for developing a more educated nursing work force, which is necessary for the survival of nursing as a profession, is collaboration among all concerned parties; nursing educators, administrators in healthcare and higher education, and nurses themselves will need to work together to come up with answers to meet the ever increasing demands of our future society.

Mariann Mickey Craddock, RN, BSN
Student in the MSN-FNP Program
University of Texas Health Science Center
San Antonio, Texas


American Association of Community Colleges. (2003, December 9). New York board claims and community college responses. Retrieved on November 14, 2008 from the AACN Web site: www.aacc.nche.edu/Resources/aaccprograms/health/Pages/nyboard.aspx

Mason, D.J., Leavitt, J.K., & Chaffee, M.S. (2007). Policy and politics in nursing and health care (5th ed.). St. Louis: Saunders/Elsevier.