A registered nurse RN license can be obtained by completing a baccalaureate degree BSNan associate degree ADor a diploma program. The aim of this article is to examine the return to baccalaureate education from the Mandating bsn nurses jobs of the nurse. National Sample Survey of Registered Nurses, and The effect of education on RN Mandating bsn nurses jobs is estimated using multivariate regression, both for initial education and for completing a second degree.
The coefficients are used to calculate lifetime expected earnings. Multinomial logistic regression is used to examine the relationship between education and job title. Lifetime earnings for nurses whose initial education is the BSN are higher than those of AD Mandating bsn nurses jobs only if the AD program requires 3 years and the discount rate is 2 percent. The BSN is associated with higher likelihood of being an advanced practice registered nurse, having an academic title, and having a management title.
Because baccalaureate education confers benefits both for RNs and their patients, policies to encourage the pursuit of BSN degrees need to be supported. Nursing is one of a few professions that have multiple educational paths for entry.
In most states, a person is eligible for a Registered Nurse RN license after completing a baccalaureate degree program in nursing BSNan associate degree ADor a 3-year hospital-based diploma program.
Associate degree education is the most common among newly graduated nurses, accounting for about 60 percent of graduates National League for Nursing and about half of the total RN workforce Health Resources and Services Administration However, since the American Nurses' Association ANA has advocated that all RNs be required to have a BSN, based on the belief that nursing has become more complex due to technological and organizational change and thus requires a higher level of education Friss ; Dillon ; Institute of Medicine The ANA also argued that a higher "Mandating bsn nurses jobs" standard would increase the status of the nursing profession and thus alleviate nurse shortages; this claim assumed that the primary cause of shortages was a lack of interested applicants.
Most recently, the Institute of Medicine recommended that 80 percent of RNs attain a bachelor's degree by Institute of Medicine The IOM's report echoed the ANA's belief that the increasing complexity of nursing care warrants a higher educational standard, and also referred to a growing body of research linking higher levels of RN education with better patient outcomes in acute-care settings.
Sincea number of studies have found a significant association between the educational Mandating bsn nurses jobs of RNs and hospital outcomes such as mortality rates Aiken et al. However, several other studies have not found significant associations between BSN education and patient outcomes Blegen, Vaughn, and Goode ; Sales et al.
AD and BSN nurses spent most of their time performing routine nursing care activities and utilized more complex or advanced skills, such as teaching and managing care, at similarly low rates. If baccalaureate education improves the clinical expertise and skills of RNs, then employers should pay for this increased productivity with a higher wage. This implication is derived from human capital theory, which predicts that nurses with more education will receive higher wages because the marginal product of nurses should increase with education Freeman ; Willis However, until recently payers have not provided financial incentives to hospitals to provide higher quality care, and thus the benefit of baccalaureate nurses to patient safety was a public good and not realized by hospitals.
In this case, there would be a public policy argument in of higher educational standards, but employers would not pay a higher wage to BSN-educated nurses. Accordingly, numerous studies have found that the economic return to the BSN relative to the AD and diploma was not large enough to compensate for the foregone earnings and higher tuition costs associated with the bachelor's degree Mennemeyer and Gaumer ; Booton and Lane ; Lehrer and White ; Link; Lehrer, White, and Young ; Schumacher and Hirsch ; Ault and Rutman ; Seago and Spetz ; Spetz There is reason to hypothesize that the return to baccalaureate education changed in the past decade.
First, as noted above, a growing body of research has demonstrated an association between RN education and patient outcomes. Second, emerging payment reforms penalize hospitals for poor quality and reward them for high quality. This financial incentive may have led hospitals to recognize that increasing the education level of their RN employees could provide them with financial rewards—in other words, the marginal product of education changed Kovner and Schore If so, then employers should reward baccalaureate-educated nurses with higher wages and pursue strategies to increase the education level of their employees.
Recent reports have indicated that a growing number of hospitals explicitly favor BSN nurses in their hiring practices, particularly teaching and specialty hospitals Goode et al. This article examines whether the return to baccalaureate education changed for RNs in the first decade of the s. Using nationally representative surveys of RNs from, anda wage equation is estimated to measure the independent and interactive effects of education and experience. The results are used to estimate the lifetime value of initial RN education at the baccalaureate and associate degree levels for a prospective nurse considering his or her entry-level education.
A second wage equation is estimated to explore the marginal value of obtaining a bachelor's degree after initially completing an AD to obtain RN licensure, and the lifetime value of this supplementary education is computed. Finally, we explore other labor market outcomes, specifically whether there are systematic differences in job titles based on the education attained by RNs. To examine the relationships between education, experience, and wages, we analyze data from the U.
Department of Health and Human Services Spetz The survey sample is based on state license records and includes all U. The survey includes detailed questions about nursing non-nursing education, employment setting and job title, hours worked per week and per year, earnings, and demographic characteristics.
Prior research on the return to nursing education has used the surveys through Spetz ; this article examines data from the, and surveys. In each of these years, the dataset includes approximately 30, observations.
The primary outcome variable is the hourly wage in the RN's principal nursing position, which is constructed from other variables in the dataset. The survey requests the nurse's total annual earnings for all nursing positions held, as well as separately for the RN's principal nursing position. The usual number of hours worked per week in the principal nursing position is reported in andand the number of hours worked "Mandating bsn nurses jobs" the prior week is reported in and Registered nurses also reported the number of weeks per year they normally work in their principal position in andand the number of months per year in To construct the hourly wage, the annual earnings from Mandating bsn nurses jobs principal nursing position were divided by the estimated number of hours worked per year.
Forestimated hours per year are computed by multiplying usual hours per week by weeks per year. Inhours per year are estimated as the number of hours actually worked last week multiplied Mandating bsn nurses jobs weeks per year.
Forestimated hours per year are derived by multiplying usual hours per week by months per year multiplied by 4. All wages are adjusted using the chained Consumer Price Index to be expressed in dollars. The explanatory variables in the wage equation follow standard human capital models with the key variables being years of experience in nursing and initial nursing education level. Education is measured as the first nursing degree completed that qualified survey respondents for their first U.
Because only about 3 percent of newly licensed RNs complete a nursing diploma program for their initial education National Council
Mandating bsn nurses jobs State Boards of Nursingwe excluded diploma-educated RNs. We also excluded a small number of RNs whose initial education was at the graduate-degree level.
Experience in nursing is measured as the number of years that have passed since the nurse's graduation from his or
Mandating bsn nurses jobs initial RN education program. Finally, regional differences in wages are controlled with a set of dummy variables to indicate the state of the RN's residence California is the excluded stateas well as an indicator for rural residence.
In our analysis, we also predict the decision of nurses to work. Non-nursing income is estimated based on data describing total household income.
We estimated non-nursing income by subtracting total nursing income from the midpoint of each categorical income bracket. If this calculation produced a value that was negative but within the range of error that could come from using the midpoint of income brackets, non-nursing income was recoded to zero.
Other implausible values were set as missing. Nurses educated outside the United States, those whose entry-level education was not the AD or BSN degree, nurses with improbable reported wages, and those with missing data for outside family income, years of experience, or state of residence were excluded from the analysis. Table S1 details the numbers of cases excluded for each criteria.
We included observations with imputed data; data imputation was performed only for the NSSRN using regression modeling to generate likely responses for missing values Health Resources and Services Administration Descriptive statistics are provided in the supplemental tables Tables S2 and S3. The mean age of the sample rose from There was little change in the ethnic or gender diversity of the sample over this time period.
The share of the sample employed in nursing positions increased from This growth in labor force participation mostly came from a higher share of RNs working full time in The employment settings and job titles of employed RNs changed only slightly over this time period.
Notably, the share of RNs with baccalaureate or higher education or
Mandating bsn nurses jobs care—related employment prior to completing RN education rose between and The wage premium received for nursing education can be evaluated by examining the relation between wage a nurse's experience and educational background. Education can both increase the productivity of new entrants to the workforce and also affect the rate at which experience increases productivity.
Thus, differences in the effect of education on human capital might be observed both in entry-level wage differentials and in wage increases associated with experience Lehrer, White, and Young ; Spetz Our analysis of the impact of initial RN education focuses on the estimation of a standard wage equation that has the form: To control for geographic variation in wages, we include indicators for rural residence and for each Mandating bsn nurses jobs California is the excluded state.
AD education is the baseline category of initial education.