New registered nurses would have to earn bachelor's degrees within 10 years to continue working in New York under a bill lawmakers are considering as part of a national push to raise educational standards for nurses, even as the health care industry faces staffing shortages.
The "BSN in 10" initiative backed by nursing associations and major health policy organizations aims to attack the complex problem of too few nurses trained to care for an aging population that includes hundreds of thousands of nurses expected to retire in the coming years.
But some in the health care industry worry that increased education requirements could worsen the problem by discouraging people from entering the field.
Currently, most registered nurses have two-year associate's degrees. No state requires a four-year degree for initial licensing or afterward.
New York's legislation died in committee last session, but it has bipartisan support in both chambers this year and could be debated as early as January.
Demand for more skilled nurses is increasing as the population gets older and has more chronic diseases and as the new federal health care law promises to help 32 million more Americans get health insuranc coverage in a few years.
Federal health officials have recommended upgrading nurse education to BSNs for more than a decade, and the idea got a boost in a 2010 report, "The Future of Nursing," by the National Academy of Sciences nonprofit Institute of Medicine and the Robert Wood Johnson Foundation.
As of 2008, about 33 percent of RNs had bachelor's degrees or higher, according to federal statistics. The Institute of Medicine recommended increasing that to 80 percent by 2020.
Advocates say that in addition to improving patient care, a key reason for requiring more education is to put more nurses in position to move on to jobs in administration and in-demand specialties like oncology, and to teach at nursing schools.
"More and more hospitals are looking to hire BSNs, but the catch is that not that many schools offer the RN-to-BSN program or have the faculty to teach it," said Sharon Shockness, an adjunct teacher at Mercy College in Westchester County.
The bill's main sponsors, Democratic Assemblyman Joseph Morelle of Rochester and Republican Sen. James Alesi of Monroe County, said the bill is needed to further professionalize nursing.
In addition to helping provide future teachers, the lawmakers say the added education and critical thinking skills are needed as patient care has become more sophisticated and studies show staff with higher levels of education serve patients better.
In a memo supporting the bill, the New York State Nurses Association cites a 2003 University of Pennsylvania study that found every 10 percent increase in staffing by nurses with bachelor's degrees results in a 5 percent decrease in surgical deaths.
Current registered nurses would be exempt from the education requirement to prevent driving more nurses from the field.
"This bill shouldn't discourage anyone at this point because it doesn't involve anyone even applying for licensure right now and 10 years is a long time to get a degree that will give you better pay," Alesi said.