by Melanie Bell, MSN, RN, CNEP, Senior Workforce Director

Socrates once said, “I know that I know nothing,” which may ring true when trying to predict the long-term future of an industry. But in the case of the nursing industry, here’s what we do know…and here’s why you need to know it.

1. The BSN requirement isn’t going away.
Seven years have passed since the Institute of Medicine (IOM) released “The Future of Nursing” recommendations that included the goal of 80 percent of RNs holding a BSN by 2020. According to a 2013 survey by the Health Resources and Services Administration, 55 percent of the RN workforce held a baccalaureate or higher degree. A survey in August 2016 indicated that employers are getting on board with this recommendation. Fifty-four percent of health care employers are requiring new hires to have a BSN and almost 98 percent indicated a strong preference to hold one. If you have been waiting to enroll in an ADN to BSN bridge program with the thought that this movement was going away, it’s time to submit that application.

2. The U.S. Department of Health and Human Services projects that there will be a surplus of nurses by 2025.
Due to the rapid expansion of nursing programs across the country, the pool of new RNs continues to grow at an unprecedented rate. The rate of nursing graduates nearly tripled between 2001 and 2013. However, historical swings in graduation rates by as much as 25 percent and economic trends like variations in retirement age tell us that projections of workforce more than a decade out can fluctuate dramatically. That being said, this information should be an even larger motivator for RNs to obtain their BSN, as a larger workforce allows employers to place more strict skill, experience and educational requirements on their open positions.

3. Hospitals are facing more financial challenges than ever.
I know, I know. I remember being at the bedside and thinking, “I don’t care about all of this budget stuff, I am just here to take care of patients!” Unfortunately, RNs can’t afford to think that way anymore. The Congressional Budget Office released a report last September indicating that if hospitals do not make operational changes to improve their productivity, they will face losses by 2025 due to changes in reimbursement. While there are changes afoot in Washington, one thing that hasn’t changed is that increases in the cost of health care continue to outpace inflation with some of the biggest jumps in history. As employees and consumers we feel this in the costs of our insurance premiums, medications and our ever-rising deductibles. Remember when there was a $10 copay on doctor’s visits and a $100 copay on admissions?

What does that mean for you as a bedside nurse? It means hospitals will not be able to sustain themselves financially if they don’t get their spending under control. Considering that the cost of labor at most facilities is more than 50 percent of the budget (and roughly half of that amount is allotted to nurses), they are not going to be able to significantly impact costs without taking a hard look at nursing operations. This is a problem that affects all of us—and a solution is going to require all of us as well.

As a bedside RN, make sure to:
• Clock in and out on time (not early or late)
• Use your time wisely; don’t drag your feet finishing up your charting when you are flexed off early due to low census
• Get involved in your shared governance or other committees so that your ideas and opinions are heard, and help and encourage your peers to do the same.

I always thought these exercises were just a product of my manager being a penny pincher, but things like this add up to hundreds of thousands of dollars a year in costs. Support your nursing leadership in the huge challenge that faces them to provide high quality care in an effective and efficient way. This isn’t easy for any of us, but we make it harder when we aren’t confronting it as a united profession.

4. Your patients trust you.
Most of us became nurses because we wanted to make a difference. Nursing was recently recognized as the most trusted profession for the 15th year in a row! That tells me that even in the midst of rising health care costs, highly charged politics and massive changes in policies and regulations, nurses continue to put the patient first. The impact that we have as a profession is a profound testimony to the difference that each and every one of us makes with our patients.

About the author. Melanie Bell is an experienced nursing administrator with a background in labor and process optimization in the acute care setting. Prior to her career as a registered nurse, she was a business and financial analyst, working as a liaison between finance and IT. Utilizing her unique experience in the clinical and business settings, Bell has managed nursing operations through rapid expansion and new facility openings. In her current role, she leads technology and operations for Vizient’s Workforce Optimization team and is responsible for Contract Labor Optimizer.

Published: May 9, 2017