In 2012, about 45 percent of White Plains Hospital’s nursing staff had bachelor’s degrees or higher. By 2017, the number was 92 percent. The giant shift is emblematic of an overall change in the health care field that has seen more hospitals and other care providers expect nurses to have at least a bachelor’s degree, and is forcing community colleges to adapt.
For White Plains Hospital, the increase in nurses with a Bachelor’s of Science in Nursing comes from a concerted effort. The hospital increased its tuition reimbursement to $10,000 per year for registered nurses already on its staff. It provided an on-site, accelerated BSN program with Concordia College that graduated 47 nurses between 2014 and 2015.
The push for the hospital to add to its ranks of BSN-prepared nurses came, in part, from a report from the Institute of Medicine in 2010, according to Leigh Anne McMahon, senior vice president of patient care services and chief nursing officer at White Plains Hospital.
The national report said that hospitals should aim to boost their proportion of nurses with baccalaureate degrees to 80 percent by 2020. Hospitals pursuing magnet status, a nationally-recognized nursing designation from the American Nurses Credentialing Center, must have a plan to achieve the goal of 80 percent BSN trained nurses by 2020.
The report represented the first time that anyone “really put a stake in the ground that entry level for nurses should be at the bachelor-prepared level,” according to McMahon. By 2012, White Plains Hospital implemented a plan to reach that recommended goal.
“We had some senior nurses that really felt, I’m not going to do this, I’m not going back to school,” McMahon said. “But we really dangled this in front of them to say, ‘OK, here’s all the reasons you should go back to school — it’s a complex environment and having this education helps you to adapt and advance health care outcomes.’”
She said the hospital’s goal is to be fully staffed with baccalaureate-prepared nurses by 2022.
White Plains Hospital is not alone in its effort to add nurses with four-year degrees. In a 2016 survey of more than 500 nursing schools nationwide by The American Association of Colleges of Nursing, 54 percent of schools reported that hospitals and other health care providers are requiring new hires to have bachelor’s degrees, up about 7 percent from the previous year. Colleges reported that 98 percent of employers expressed a strong preference for bachelor’s program graduates.
At Westchester Medical Center, there are no set requirements for nursing education at its three-hospital Valhalla campus or in its WMCHealth network, which includes six additional hospitals in the Hudson Valley region. But the number of nurses with baccalaureate, or more advanced training, in the WMCHealth network is above the national average, said Patricia Wrobbel, senior vice president for patient care services and chief nursing executive for Westchester Medical Center.
Wrobbel said the hospital has a tuition reimbursement program and relationship with institutions that offer bachelor’s programs for registered nurses. “As an academic center, there’s a personal belief, as well as an institutional belief, that supporting individuals to advance their education is a key part of our obligations,” she said.
The change in employer preference has been evident in the degrees awarded in New York. Between 2004 and 2015, the number of associate degrees in nursing awarded in the state declined slightly, while the number of bachelor’s degrees in nursing increased 9 percent, according to a study by the University at Albany’s Center for Health Workforce Studies. In 2015, 38 percent of BSN graduates were what the study referred to as “completers,” registered nurses who returned to school for a bachelor’s.
The hiring trend has forced community colleges, the typical path for students training to be registered nurses, to adjust.
“Community colleges have been really critical in providing the workforce for the traditional medical model,” said Dutchess Community College President Pamela Edington. In fact, she said during a March panel discussion at the annual EDs & Meds Summit of the Hudson Valley Economic Development Corp., she “can probably guarantee that if you’ve been in a hospital in Dutchess County in the last 60 years, one of our (trained) nurses was at your bedside.”
As hospitals have pushed to increase their number of nurses with bachelor’s degrees, community colleges have sought out partnerships with institutions granting BSN degrees.
At Dutchess Community College, “If someone comes into our programs now for nursing, we are telling them that that is really the first step in your medical practice journey,” Edington said. “And if you complete an associate degree, you need to plan for a bachelor’s program.”
In some states, community colleges have begun offering BSN programs, although not in New York. Florida has the largest number of community colleges approved to offer a BSN degree.
At Westchester Community College in Valhalla, administrators said they have noticed a steady increase in the educational requirements for nurses for a couple decades. But the associate degree in nursing remains a popular option, according to Ronald L. Bloom, dean of WCC’s School of Health Careers, Technology and Applied Learning.
“We’re not seeing any decline in the number of students wishing to enroll in the (associate degree in nursing),” Bloom told the Business Journal. “So it may be a preference of some hospitals, but it’s not practically enforced.”
Westchester Community College each year admits about 60 students to its nursing program, Bloom said. The two-year college has several articulation agreements that streamline the process for graduates of its nursing associates program to pursue a BSN with another college or university.
One such option has WCC graduates first sit for the NCLEX-RN licensing exam to become registered nurses before starting classes for the Bachelor of Science in nursing, which could include online programs. For those programs, students “find they can work and earn their bachelor’s at the same time,” Bloom said.
For nurses, McMahon said at White Plains Hospital, seeking advanced degrees is a way to advance the profession as a whole.
McMahon has been with White Plains Hospital for almost 33 years. She started as a graduate of an associate degree program and used the hospital’s tuition reimbursement to receive two graduate degrees; she currently is working on a doctorate.
“We need to advocate for our profession,” McMahon said. “Pharmacy, physical therapy, social work, they are all moving past graduate programs into doctorate programs. (Nurses) have the most difficult and complex roles in health care. We have to know it all and do it all, the world is changing. And you need to have that education to be able to do that.”