Matthew Roberts has been a certified nursing assistant for five years.
"I really enjoy like a lot of the patient contact you get," he said.
But the 23-year-old is taking his career to the next level. Roberts recently wrapped up his associate degree at Front Range Community College in Westminster. After he passes the licensing exam, Roberts will be a registered nurse (RN).
"I would say going through nursing school is one of the hardest things I've done in my life," Roberts said. "(But) it's like totally worth it and I know that it will be worth it."
Roberts is also one of about 20 students enrolled in the first class of the Front Range's new RN-BSN (Bachelor of Science in Nursing) Completion Program. The online program, which started in October, is for working nurses or associate degree students.
"Getting my bachelor's degree really helps to give me more opportunities in my career. It helps to have the opportunity to become like a charge nurse," Roberts said. "Or it gives me like opportunities to move up higher in management."
Colorado has a nursing shortage and at least 500 BSN positions remain unfilled every year. Projections show a cumulative shortage of 4,500 BSN nurses by 2024.
The demand for nurses with more education is part of a trend happening in other health care professions, including pharmacy and physical therapy which require doctorate level degrees, said Edith Matesic, program director and faculty member at Front Range.
"All of that is because health care is very complex," Matesic said. "People are living longer. They have multiple diseases. It's complicated in the health care setting. We have electronic health records. Everything is computerized, very, very different than what it looked like before."
The future of nursing
In 2010 the Institute of Medicine (IOM), now the National Academy of Medicine, released "The Future of Nursing: Leading Change, Advancing Health." The report included recommendations that focused on the intersection between patient health needs and nursing workforce readiness. It also provided a blueprint for improving nurse education, data collection and opportunities for nurses to move into leadership roles.
One of the recommendations was to increase the number of nurses with baccalaureate degrees from 50% in 2010 to 80% by 2020.
The Robert Wood Johnson Foundation (RWJF) collaborated with the IOM on the report. After it was released, RWJF's Academic Progression and Nursing, a national advisory committee, created different models of academic progression.
"One of the models was that community colleges would confer the RN to BSN degree," said Donna Meyer, chief executive officer for the Organization for Associate Degree Nursing (OADN), which represents community college nursing programs.
Meyer was part of the advisory committee and said implementing the RN to BSN completion program can be challenging.
"Because of the fact that usually for a community college to confer a baccalaureate degree in many states it does require a legislative change," she said.
In 2018 the Colorado legislature passed a law allowing Front Range and six other schools in the state's community college system to offer BSN programs. Colorado is one of just 12 states to offer this degree.
Joanne Spetz, an economics professor at the University of California, San Francisco, worked on the future of nursing report. Community colleges have been an important pathway for rural care, she said, and for students who are not be able to attend a university but still want to pursue a bachelor's degree.
"They want to stay in their communities," Spetz said. "Basically, there are nursing jobs in every sector of health care and in almost every community. It's a great career opportunity for people."
Employers' increasing requirements
There are almost 4 million registered nurses in the nation, making the profession the largest in health care. A 2018 study by the American Association of Colleges of Nursing found 46% of employers require new hires to have a bachelor's degree while 88% strongly prefer baccalaureate-prepared nurses.
UCHealth is one of Colorado's largest health care systems. In 2018 it employed more than 6,000 nurses and 73% of them had a BSN degree. Depending on the hospital, nurses are either required to have a bachelor's degree or must agree to complete one within three years of employment. For nurses in the latter group, UCHealth provides tuition reimbursement, scheduling flexibility and other supports to help them pursue a baccalaureate degree.
A BSN gives nurses more foundational knowledge in areas including anatomy and physiology, which allows them to provide better patient care, said Kay Miller, chief nursing officer and vice president for patient care services at UCHealth Greeley Hospital. They also work more effectively with other health care professionals who have doctorate degrees.
As hospital stays shorten, nurses require a greater understanding of larger health care issues like public health and co-morbidities which are studied more in-depth in a BSN program, Miller said.
"I think the research that was done and published really shows that with more of the science approach in addition to the human caring and all of the clinical exposure," Miller said. "The safety and quality metrics for the patients they're providing the care for go up with the academic preparation of the nursing staff."
'A big jump'
The future of nursing report recommended that 80% of nurses have a bachelor's degree by 2020. But this goal will not be achieved. According to the most recent data, only 56% of nurses nationwide held a baccalaureate degree in 2017. But Meyer isn't worried — she said it takes a while for RN to BSN programs to be developed.
"I think we're going to see kind of a big jump the next few years because of the fact that so many associate degree students, so many nurses that are working that have an associate degree are continuing their education," she said.
The National Academy of Medicine seems to agree. It extended the vision outlined in the future of nursing report to 2030.