When the BSN-in-10 legislation was signed into law by New York Gov. Andrew Cuomo on Dec. 17, 2017, professional registered nursing practice took a giant step forward in my opinion.
As is the case with any change, however, it was followed by many questions and concerns -- even worries, fears and protests -- from nurses in New York and beyond. It is not easy to get legislation passed and takes time, commitment, collaboration, cooperation and months -- often years -- of work. In the case of this legislation, nurses, lobbyists and bill sponsors worked long and hard to bring the legislation to Gov. Cuomo's desk.
BSN in 10 encourages continued learning
The American Association of Colleges of Nursing recommends employers encourage continued learning and reward nurses for earning their BSNs. Nurse leaders recognize the importance of the BSN, according to the AACN. In fact, many professional nursing organizations tout the need for baccalaureate education for nurses. Nurses are at the heart of the care team, leading and directing, running units and working with other professionals such as social workers, physical therapists, occupational therapists and pharmacists -- most of whom are required to have educational credentials that go beyond the bachelor's degree. And there is support out there for nurses who want to advance their education and practice. But nurses need to have their questions answered first. Leaders can help explain the law, and highlight the resources available to nurses, whether they live in New York or another state. Pointing out the educational resources at their facilities and beyond can help a lot of nurses get to their goals. I have followed the law's progress closely, and in the wake of its passage, heard the kinds of questions nurses have on the controversial topic. In response, I have answered 11 key questions that leaders should review with their staff.
1 -- How long did it take for this legislation to be signed into law?
The process -- which has taken more than half a century -- began back in 1964 when the American Nurses Association House of Delegates adopted a motion supporting baccalaureate education. The ANA presented a position paper in 1965 calling for the BSN as the educational foundation for the RN, and confirmed their position on it in 2000. After garnering support NY Assembly bill #A1842-B was passed, followed by New York's Senate bill #S6768 in 2017. This led to signing of the legislation in December.
2 -- What are the specifics of the law, and where can I find the entire text?
If you would like to review the full bill with your staff and fellow nurses, bill #AO1842-B/SO 6768 can be found online.
3 -- Does any other state have a law like the New York law?
No, not at the present time. Prior to the New York law, only North Dakota had a law regarding BSNs from 1987 to 2003, which required nurses to have a BSN to get licensed. The law was overturned in 2003 because of a shortage of RNs. Rhode Island (bill #HB7416) and New Jersey (bill# S803) are the only other states to put forth BSN in 10 bills, but after working on it almost as long as New York, they are still under study and have not been passed.
4 -- Will other states be moving to enact a similar law?
Many states have been considering a similar bill and were waiting to see what happened in New York. Many now are likely to move toward proposing similar legislation.
5 -- How can I find out what legislation may be pending in my state?
Nurses can look to their state boards of nursing for information on the status of any bills under way.
6 -- Would a bachelor's degree other than the BSN meet the requirement, or must it be a BSN?
As enacted, the New York BSN-in-10 law states the RN must obtain a BSN. Other bachelor's degrees would not fulfill the requirement.
7 -- Which groups of RNs are "grandfathered in" and not subject to the 10-year deadline?
Three groups are included in the "grandfather" clause exempting them from the time limit on practice without a BSN: currently licensed RNs in New York State, students enrolled in a nursing program in New York State; and those who have nursing school acceptances pending in New York State.
8 -- What does the New York law have to do with the 2010 Institute of Medicine Report recommendation?
The recommendation made by the IOM in 2010 that 80% of RNs nationwide obtain a BSN by 2020, was a recommendation; it was not a law and should not be confused with the law in New York or with any other state law that may follow.
9 -- Will there be any assistance or support provided by nursing programs or nursing and hospital leaders to help nurses meet the BSN-in-10 requirements?
Nurse leaders can advise their nurses about the various articulation programs, on-site classes and bridge courses that are available, perhaps in their own facilities, and talk with them about tuition reimbursement plans. Perhaps on-site child care is available for mothers who are students or special flexible work schedules can be worked out for nurses to attend classes? Also, keep them informed about partnerships that are springing up between BSN programs and associate degree and diploma programs.
10 -- Will any accommodation be made for a nurse who at the end of the 10 years has not yet obtained his or her BSN?
The text of the law does address the possibility of granting extensions in extenuating circumstances to nurses who at the end of the 10 years were unable to get access to a BSN program; who were not accepted; or who were unable to attend classes or afford tuition.
11 -- If I have a New York license and I also am licensed and practicing in another state, am I grandfathered in along with nurses currently practicing in New York?
Yes, if you are licensed in New York, even if you are not currently practicing in the state, you will be grandfathered.
Have open, honest conversations
This new law for nurses, whether they live in New York or elsewhere or how long they've been licensed, will affect them in the future in one way or another. They need to understand what it means and why it was signed into law, so let them know your take on it, as well as what is being said about the law by nurses and associations. Discuss with them why, even if they are not mandated to get a BSN, they still may want to consider working toward a BSN. Over time, the degree will increase opportunities and affect salary, professional growth and advancement. The positives of having a BSN far outweigh any negatives that may concern nurses. Point out that there are both online and brick-and-mortar options that make getting a BSN easier than ever, and as our healthcare system grows more complex, so may our hiring practices. Nurses with BSNs may not only be preferred but also required by healthcare systems, and some facilities may view the BSN as minimum preparation and look for degrees beyond the BSN for certain roles. To assist nurses, a commission has been established as part of the New York law to look at barriers for entry into BSN programs, including availability, finances and other issues. The findings of this commission are due to the New York governor in December 2018. The best tool to address the law's naysayers or those who feel the law is a step in the wrong direction is honest, open communication. You may not have all the answers, but -- as a leader -- it's your duty to try to find them. Nurses, are there other questions about this law that you would like your nurse leaders to address? Add them in the comments section below.
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