Identifying Bedside Staff Nurse Barriers and Facilitators in Moving from an RN to a BSN Degree

Purpose: Recognizing the IOM recommendation of 80% BSN by 2020, one large academic medical center conducted a study in order to answer the question “What are the perceived barriers and facilitators of associate degree staff nurses returning to school to obtain a BSN?” With a nursing force of approximately 3,000 registered nurses, this hospital’s current rate of BSN prepared nurses was at 48.7% with 48.6% holding an Associate degree, clearly indicating a need to formulate a plan of action. As a teaching hospital, higher education is not only promoted and encouraged, but also supported through a tuition reimbursement program. However, the relatively low number of nursing staff with an associate’s degree currently in school to obtain a BSN indicated that more than a tuition reimbursement program was needed for staff to enroll in school. The purpose of the study was to identify the barriers and facilitators for returning to school to obtain a BSN degree.

Methods: Email invitations were sent to bedside nurses with an associate’s degree asking them to participate in one of six focus groups. Facilitated by the study investigators, each focus group was asked questions designed to identify their perceived barriers and facilitators to returning to school for a BSN. Information gathered from the focus groups was used to create a 15 item survey which was sent via email to bedside nursing staff to further evaluate the barriers. The survey was designed as a likert scale using an online survey tool.

Results: Twenty bedside staff nurses participated in the six focus groups. The themes identified by participants as barriers included family obligations; money, including books, fee’s, and work schedule; difficulty and need to obtain pre-requisites, and lack of support from nursing management. The themes were incorporated into a survey. Results from the survey echoed the focus group themes with the greatest barriers identified as cost of education, family obligations, work schedule, and time. Participants identified the following as facilitators for returning to school: support from family and co-workers, online classes, personal growth, and personal satisfaction.

Conclusion: Bedside staff nurses want to pursue higher education but feel they lack the resources, direction, support, and encouragement. Through collaboration with school of nursing faculty, hospital nursing leadership can create structures to support bedside staff nurses in returning to school for a BSN.