Nursing within healthcare organizations is changing and developing and integrating new theories and models to improve practice. One way this is done is through organizational assessments. I work for a system that is Magnet rated, so organizational assessments are constantly being done. One of the big organizational changes my facility is pushing for is more educated nurses. This involves encouraging higher education, certifications, nurse residencies, and making advanced training more widely available. This change was implemented by first creating a sense of urgency. According to Kotter’s 8 steps, urgency is, “Helping others see the need for change through a bold, aspirational opportunity statement that communicates the importance of acting immediately” (Kotter, 2018). The way this was done in my organization is by signing contracts. Older employees were grandfathered in, but are still being offered bonuses or raises to further their education. New employees are required to sign a contract to pursue a BSN or higher within three years of hire. My organization is focusing on evidence-based research showing BSN educated nurses and higher have more developed critical reasoning skills, which results in better patient outcomes. Step 2 in Kotter’s model involves building a coalition, and would include nursing committees dedicated to the advancement of nurses within the organization. They meet quarterly to discuss how to reach the goal and the progress so far. Step 5 discusses removing barriers. For providing educational opportunities and more advanced training, this would mean offering tuition reimbursement, coverage for nurses on the floor while other nurses are at training, and reimbursement for certifications, just to name a few examples. Steps 6, 7, 8, to me, are all related and Kotter discusses short-term wins, acceleration, and instituting widespread change. In my organization, when individuals finish their degrees, it’s celebrated by their departments and are congratulated for their hard work, and are given a raise if they are participating in the clinical ladder program. Altogether, it leads to a more formally educated pool of nurses who develop into advanced practice nurses, leaders, and administrators. This allows nursing to progress as a profession.
Kotter, J. (2018). 8 step process. Kotter Inc. Retrieved from: https://www.kotterinc.com/8-steps-process-for-leading-change/
Great post! The organization that I work for also has new hires sign a contract that they will obtain a BSN in 3 years. It used to be 5 years but the organization is trying to obtain magnet status so it is necessary to have 80% of RNs with a BSN or higher. I think ADN nurses are phenomenal and have excellent clinical skills and critical thinking skills. BSN nurses in my opinion are a bit more well rounded because they have learned the leadership/management part of nursing which I think completes the circle of the nursing profession.
I have seen quite a few hospitals requiring ADNs to obtain a BSN or higher within a certain time frame after hire. It’s good in a sense because this will help progress the nursing field as a whole. I like that your hospital is following some of the ideas expressed by Kotter by recognizing the achievements with celebration and a raise in wage.
Unfortunately, the organization that I work at does not make this a requirement, but I wish that they did. The IOM report that we are currently learning about says that advancing nursing careers are what is going to advance this profession. Your organizations are making a great first step towards this goal and it will benefit them tremendously.
Nursing in the United States is an anomaly among major professional workforces outside health care in that graduates of hospital‐based diploma programs, 2‐year associate degree programs, and 4‐year baccalaureate degree programs are equally accepted for a single licensing exam. Licensure as a registered nurse, in turn, serves as the basis for entry into the profession. Once licensed, RNs are frequently employed in positions with little differentiation, either in pay or job assignment. Although the associate degree in nursing is unique in the US, analysis of the professional outcomes of two differing collegiate routes, AD and BSN, might provide useful lessons to nurses in other countries working to increase the supply of RNs during a nursing shortage. Preference for baccalaureate education has been the official stance of the American Nurses Association (ANA) since 1965 (American Nurses Association, 1965). The issue has remained contentious and unresolved in the nearly 40 ensuing years.
In 2011 a study was published that showed a 10 percent increase in BSN nurses lead to a 5 percent decrease in patient mortality. I’m willing to bet more and more information will come out confirming the need for increased education in our nursing staff. More schooling required of nurses leads to greater respect for the role. A nurse’s willingness to perform all the tasks needed in a class shows their devotion to and the importance of their role as nurse. More knowledge leads to better patient education and less errors. School can help nurses stay up to date on the latest research and best practice in their field.
Source
uilding the Case for More Highly Educated Nurses. (2018, January 29). Retrieved April 07, 2018, from https://www.rwjf.org/en/library/articles-and-news/2014/04/building-the-case-for-more-highly-educated-nurses.html
Teaching was a lot like nursing in that the schools wanted magnet status as well. The administrators wanted their teachers to have master degrees in teaching. However according to the teachers I know in Ohio, that boat has left its dock, because Administration now does not want to pay for master degree teachers. interestingly enough, Magnet status for schools is based on student grades. Hence you can have a child that did not attend school, but still passed it because of that magnet status of needing a certain per centage of students passing.