CNO influence key to advanced nurse education

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Alexandra Wilson Pecci, for HealthLeaders Media, December 4, 2012

Advancing nurses' education is a major goal for stakeholders ranging from the Institute of Health to individual hospitals. But are there certain nurses who are more likely than others to continue their education? And what are the reasons behind nurses' decisions to pursue or not pursue more advanced degrees?

A new study provides answers to some of those questions, and according to its lead author, the findings should spur chief nursing officers to take action.

"I think that most hospitals are very interested in what they can do that can either increase revenue or decrease cost. And there's some evidence that better educated nurses can do a lot for both of those," says lead author Christine T. Kovner, PhD, RN, FAAN, a professor at the College of Nursing, New York University.

She says hospitals are in a position to help nurses overcome their major barriers to education, and it's in their best interest to do so, since studies link nurse education to better outcomes.

"It's up to the chief nursing officer to make that case," she says.

The findings of the RN Work Project study, published in the November/December issue of the Journal of Professional Nursing, will help chief nursing officers do just that. According to the study, nurses said that the two most prevalent barriers to continuing their education were "cost" and "family/children." A "lack of time" came in third.

Many nurses said they have trouble fitting school around their work schedules and that their hospitals are inflexible when it comes to allowing them to change their work hours in order to accommodate classes.

When barriers are identified, solutions aren't far behind, and the solution here is obvious: Hospitals should do what they can to help nurses fit education into their lives.

"That seems to me that's something fairly easy for hospitals to do," Kovner says. "I do see it with some of my own students, that there's no flexibility on the part of the hospital…to help them in terms of going back to school."

In addition to flexible scheduling, hospitals might offer some types of classes on their own campus.

Kovner also suggests a more creative—and likely harder to achieve—solution for hospitals: Help to remove busy work from nurses' lives.

"One of the big hospitals in New York has a concierge service for their employees," she says. "At a central place in the organization you can do everything from get your dry cleaning to get repairs on your car."

Plus, she adds, service providers would likely jump at the chance to have a constant and reliable client base among the hospital employees.

In addition to time, cost was cited as a major barrier for nurses. Kovner says she's surprised at how many nurses don't have tuition benefits to encourage them to go onto school. Again, it's an area in which hospitals could lend a hand.

"They could provide some kind of financial incentives," for going back to school Kovner says, such as paying for schooling in exchange for nurses promising that they work a certain number of years at the organization.

Indeed, the study showed that RNs who are undecided about continuing their nursing education identify organizational incentives and rewards as important motivators.

Incentives include tuition reimbursement, compatible work and class hours, paid sabbaticals, forgivable loans for service, pay for attending class, and online and worksite classes.

The study also looked at the other side of the coin—which nurses are more likely to continue their education—and uncovered some interesting findings.

For nurses with associate's degrees, being black, living in a rural area, having non-nursing work experience, an optimistic outlook, higher work motivation, working in the intensive care unit or step-down unit, and working the day shift are among the important predictors that they will pursue a bachelor's degree.

For those holding a bachelor's degree, being black, having non-nursing work experience, holding more than one job, living in a non-rural area, working the day shift, working voluntary overtime, lower intent to stay at current employer, and higher work motivation are among the top indicators that they will pursue a higher degree.

"The one finding that we were surprised about was that black nurses were more likely to go onto school because we hear a lot and we know that there are not enough black nurses in the workforce," Kovner says. She adds that those findings are encouraging. "There's movement in the right direction."

Factors such as race and having a positive attitude are out of a hospitals control, but barriers such as cost and time are not. It's in a hospital's power to help nurses achieve greater levels of education, and now, armed with studies like this one, chief nurses officers should feel obliged to go to bat for their staff's education.

"It's important for organizations to look at what they can change," Kovner says.

Source: HealthLeaders Media