Magnet® Facility Nurses: Pursuing a Baccalaureate Degree in Nursing

Saturday, 7 November 2015

Elizabeth J. Winokur, PhD, MSN, BSN, RN, CEN
St. Joseph Hospital, Orange, CA, USA
Dana N. Rutledge, PhD, RN
Department of Nursing, California State University, Fullerton, Fullerton, CA, USA
Amy D. Hayes, MSN, BSN, ADN, RN, PCCN
Clinical Education, St. Joseph Hospital, Orange, CA, USA

Background: In Future of Nursing (2011), the Institute of Medicine (IOM) concluded that nurses should be prepared at the baccalaureate level.  Magnet organizations are encouraged to meet the IOM goal of 80% nurses with a BSN by 2020. Aiken’s recent comments (2014) on the value of employing a predominately BSN workforce in hospitals underline the benefits in decreasing lengths of stay and readmission rates (cost savings), as well as improved patient mortality. With ~60% BSN-prepared nurses, our twice Magnet-accredited hospital is working toward this goal. Little is known about the effect of Magnet status on employed nurses considering or returning to school.

Method: In February 2014, a 15-item online survey (14 multiple choice, 1 open-ended) was sent to hospital nurses to assess factors that motivate RNs to pursue a BSN. Descriptive statistics for multiple choice items and thematic analysis for open-ended responses were completed.

Results: A 20% response rate (N = 191) was achieved. Most respondents already had a BSN/MSN or were currently enrolled but had entered nursing as associate degree/diploma graduates. “Encouragement from other nurses” was the most frequently selected factor facilitating return to school/ graduating.  Impeding factors included personal factors (e.g., finances) and the belief that the BSN would not enhance competence.  Of nurses who returned to school, 20% reported that the 80% Magnet goal was a catalyst in deciding. Of nurses not intending to obtain further education (15%), most perceived lack of value in obtaining a BSN.

Discussion: Our findings supported our literature-driven conceptual framework, which posits that employed nurse motivation to return and stay in school is influenced by individual nurse characteristics along with organizational and academic program influences.  The three types of influencing factors (individual nurse, employing organization, and academic program characteristics) appear to drive nurses to return to and stay in school.  Factors can serve as both positive and negative facilitators; for example, older age may serve as a positive influence (perception of fewer family or financial responsibilities) while serving as a barrier (why bother to get further education when I will not be working much longer). At the individual nurse level, in aggregate, these factors influence nurse motivation to pursue further education.  Additionally, perceived personal effort, self-efficacy, and how well the influencing factors or facilitators address specific individual nurse barriers can further modify motivation. The perception of feasible amounts of personal effort, as nurses described in our qualitative data, seem to strongly influence whether a nurse either returns to school, or once enrolled, continues enrollment.  Of interest is the contrasting idea that nurses reported being paralyzed when they perceived the effort required to attain a baccalaureate degree was too much; thus, they did not return to school. Peer support was noted as highly important to nurses in our sample.  As seen in Warren and Mills work (2009), the degree to which varying facilitators actually work is that they contradict or act against individual nurse, organizational, or academic factors.

Implications: Findings suggest that peer/leadership support play a larger role in facilitating BSN completion more than previously reported, and that Magnet culture influences decision making.  Additional investigation is required to understand factors hindering nurses from returning to school and facilitators to staying in school.

See more of: Magnet Posters
See more of: Magnet Posters