Hospitals across the state are taking different paths to meet a recommendation that 80 percent of direct care nurses hold a bachelor's degree by 2020.
Judith Thompson, CEO of the South Carolina Nurses Association, said there is not a “one-size-fits-all solution” for addressing the issue.
“A difficult question to answer is what should an employer do?” Thompson said.
Spartanburg Regional Health Care System announced last October that its nurses with associate degrees — nearly 397 out of 1,590 — would have to attain their bachelor's of science degrees in nursing by 2018.
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According to a document hospital management distributed to nurses, if the associate does not obtain the BSN degree by Dec. 31, 2018, it might result in “automatic relinquishment of employment.”
Spartanburg Regional's policy reflects the hospital's efforts to meet recommendations by the Institute of Medicine and the Commission on Magnet that states 80 percent of direct care nurses must hold a BSN by 2020.
The American Nursing Association, which is over the Commission on Magnet, and the Institute of Medicine were asked how many other hospitals across the country are enacting similar policies. Both organizations said they do not keep that information, even though the organizations made the recommendations.
There are three Magnet hospitals in South Carolina, including Spartanburg Regional Medical Center. AnMed Medical Center in Anderson and Bon Secours Roper St. Francis Hospital in Charleston are the other two.
“The need for highly educated nurses continues to grow,” said Pennie Peralta, vice president of nursing and senior nurse executive at Roper St. Francis Health Care System. “Health care is rapidly evolving, and the way nurses provide care to patients will continue to change as people live longer and develop more chronic conditions, such as cardiovascular disease, hypertension, diabetes and arthritis.”
Roper St. Francis Hospital, however, is not requiring all nurses on staff to attain BSN degrees.
Going forward, 75 percent of the nurses hired at Roper St. Francis Hospital will be BSN nurses, according to media relations manager Shane Ellis.
The new nurses who do not have their BSN are signing a contract saying they would have their degree within five years.
AnMed Health System has a similar policy. New hires are being told they have three years to attain their BSN degrees.
Hospitals that are not affiliated with Magnet have policies as well.
Tony Ciuffo, spokesman for the Medical University of South Carolina in Charleston, said RN staff hired on or after July 1, 2013, with an associate or diploma degree in nursing are required to initiate education for a BSN within two years and complete the program within four years of hire date. Employees are required to sign an agreement regarding the education requirement.
Sandy Dees, spokeswoman with Greenville Health System, said the hospital will only hire BSN nurses beginning later this year.
In Columbia, Palmetto Health's current plan requires nursing leadership – including nurse managers, assistant nurse managers and administrators on duty – to obtain a bachelors' degree by Dec. 31, 2016.
'Fear of change'
Thompson said “good for them” when told about Spartanburg Regional's new policy in October, and she lauded the effort again during a recent interview.
“I think they are making a commitment to their employees and to their area of service,” she said. “If this is what the institution is choosing to do, then nurses are having opportunities given to them. They are given three years to look at how they can improve themselves and their practice. It would be totally different if an institution said, 'As of tomorrow, if you don't have a BSN, you're out.' That's not what they are doing.”
Hospital spokeswoman Jenny Connell said in a statement the system is offering financial assistance for tuition for all part- and full-time employees who have been with the system for at least one year. Full-time nurses are eligible for $4,000 per year, while part-time nurses are eligible for tuition reimbursements of $2,000 per year.
Several four-year colleges in the area offer RN to BSN programs. Full-time tuition per semester at each college exceeds $4,000.
For example, USC Upstate offers the program for $4,509. The cost of the program at Lander University in Greenwood is $5,050 per semester.
Katharine Gibb, dean of the Mary Black School of Nursing at USC Upstate, said most nurses enroll as full-time students.
“We have seen a large influx of associate degree nursing applicants from SRHS and other hospitals for our RN-BS program,” Gibb said. “Many of them are completing general education pre-requisites this spring and summer, and hope to start the nursing classes in the fall. Others have more courses to take, so they may not start for a while.”
Hospital officials say most of the nurses who are working toward their BSN are attending classes part time, often taking advantage of online programs. Few of the full-time nurses are attending full-time classes in a traditional classroom setting, according to the hospital.
When the policy was announced in October, Chief Nursing Officer Susan Duggar said it was the right thing to do for patients.
“As CNO, it's my job and responsibility to make sure that our patient care is absolutely the best it possibly can be,” she said at the time. Wouldn't you want to be cared for by somebody who has all the educational preparation possible?”
Duggar did not return phone calls or emails to answer follow-up questions regarding the policy.
Thompson said she understands why Spartanburg Regional's new policy might cause concern to some nurses. It's the fear of change, she said.
“I understand that this is an emotional issue. It's a psychological issue, it's a financial issue. But we are dealing with professionals,” she said, adding that other professions don't pay employees when they decide to advance their education. “These nurses are being faced with a change that will have a positive effect on them if they do what is required.”