April 30, 2004
in response to topic Entry Into Practice: Is It Relevant Today? (May 31, 2002)
I am responding to the Entry into Practice Topic. I find it amazing that this issue needs to be discussed yet again, considering that the discussion has been ongoing for more than thirty years. The nursing profession must step up and require the baccalaureate degree as the minimum standard for licensure as a registered nurse.
Fear, the most base of human emotions, is controlling the profession. Fear of unemployment, fear of education, and fear of change have us immobilized as a profession. We would rather see the profession of nursing die on the vine than make the change we all know is needed. The associate degree nurse educators are more interested in their own job security than with the profession as a whole. Our own disdain for education has spread to our employers who refuse to recognize the value of a baccalaureate degree in nursing, financially or otherwise. The present shortage, and the even larger nursing shortage to come, have again caused the national nursing organizations to shelve this Entry into Practice issue. The problem is that, as a profession, we refuse to make a stand against our own. We are continually trying to find a way to make everyone happy – how typical of nurses.
Many have recommended that we develop a different licensure status between nurses prepared at the associate degree level and those prepared at the baccalaureate degree level. I believe this different licensure status would be lethal to our profession. I envision a scenario having two pay scales, with the nurse prepared at the associate level earning substantially less than their baccalaureate-prepared counterparts, and employers hiring large numbers of these new quasi-professionals nurses who might be supervised by substantially fewer baccalaureate-prepared nurses.
We need to make the leap to minimal entry into the nursing profession being at the baccalaureate level. We can grandfather in all present registered nurses and keep their support in this initiative. Yes, this may slow down the entry of new nurses into the field. But it may also increase the number of baccalaureate-prepared nurses, some of whom have bypassed nursing for other fields because nursing didn’t appear professional enough to consider as a career.
Our failure to act thirty years ago means we have not only let down ourselves as a profession, but also the aging Baby Boomers who are going to desperately need us in the near future, when we are not going to be there for them. I only hope that when this crisis is over, the Registered Nurse will still be around to provide the care that patients need.
Paul Esmond, RN
East Sandwich, MA