New York (NY) continues to be a national leader in advancing legislation to promote the education of nurses. New York introduced its legislation in 2005 requiring future nursing graduates of diploma and associate degree programs to attain a baccalaureate degree in nursing within ten years after receiving their RN licensure to maintain the registration of their license. Those licensed prior to the effective date of the legislation are not affected and are “grandfathered.”

The BS in Ten proposal has made slow but steady progress and was finally passed by the NY State Assembly in 2014. The bill remains stalled in the State Senate Higher Education Committee. The Coalition for the Advancement of Nursing Education has actively lobbied for passage of this legislation since its introduction and been strongly supported by the New York Organization of Nurse Executives and Leaders (NYONEL), American Nurses Association-NY (ANA-NY), and most recently by the deans and directors of the Associate Degree (AD) and Baccalaureate Degree (BS) nursing programs. The latter four groups have partnered to form the New York Nursing Alliance.

The fourth of the eight recommendations of the Institute of Medicine’s 2010 report, The Future of Nursing: Leading Change, Advancing Health, is to “increase the proportion of nurses with BS degrees to 80% by 2020.” The Academic Progression in Nursing (APIN) grant funded for two years by the Robert Wood Johnson Foundation to the Foundation of New York State Nurses provides financial assistance to facilitate creation of educational models to facilitate the transition. A 2015 Future of Nursing – NY state program, sponsored by APIN, reported that numbers of BS graduates surpassed those of AD in 2013 and 2014. The innovative Dual Degree Model 1+2+1 (1 year BS, 2 years AD and eligibility to take the licensure examination, 1 year BS) initiated between Lemoyne College and St. Joseph’s College was replicated across New York State. Advantages of the model include: seamless transition in programs, increased numbers of BS-prepared nurses, attractive to recent high school graduates, greater retention in BS programs, and shared resources vs. competition between programs.

See also
The State of Nursing in the U.S.

In spite of the myriad pipelines to obtain entry into the nursing profession in NY, some major obstacles remain for potential nursing students: tuition increases, sufficient availability of qualified nurses into faculty positions, and availability of clinical sites. The rising costs of higher education, reduction in student loans for nurses, and the need to increase faculty compensation to make these positions attractive to nurses contribute to the looming faculty shortage.

Another issue facing nurse leaders in NY is a “Military Spouse” bill introduced by a new legislator from western NY state. The bill seeks to expedite permission for nurse spouses of military personnel to practice in NY. Much of the wording after the first few pages sounds like language included in National Council of State Boards of Nursing (NCSBN) Multistate Compact information. New York is not a compact state but is listed on the NCSBN website as a site of legislative activity.

New York has seen some regional progress in increasing the numbers of RNs with BS degrees. Hospitals reported that the percentage of nurses with a BS in nursing grew 6% with hospitals reporting that 57% of their RNs were baccalaureate-prepared according to the  Healthcare Association of New York State’s 2014 Nursing and Allied Professionals Workforce Survey Report. Furthermore, nursing school deans and directors are reporting fewer positions for nurses with ADs, suggesting that employers are selecting nurses with a BS over those prepared solely at the AD level.

The landscape in NY, with ongoing delivery system reforms, has offered new roles and new settings for nurses. Increasingly, New Yorkers are receiving health insurance coverage through the Affordable Care Act with over 2.1 million participants, 88% of whom were uninsured at the time of enrollment according to the New York State of Health, the state’s official health plan marketplace. This move to population health, reduced hospitalizations, and improved patient outcomes benefits employment of nurses in varied practice settings. The steady increase in patient-centered medical homes offers new reimbursement models to keep patients healthy in their communities, with less reliance on expensive hospital-based care. In NY, the Delivery System Reform Incentive Payment, part of the NY Medicaid waiver, is driving both consolidation and health system redesign to improve care and lower cost for the state’s Medicaid recipients. In addition, the NY State Health Innovation Plan is shifting toward a primary care model that integrates providers across a system, rather than stand-alone providers, with little communication.

See also
Columbia Nursing Professor Patricia Stone Receives Distinguished Scientist Award

These reforms, both state and regionally, rely heavily on electronic records and the ability to share information. Therefore, nursing informatics is a key competency that all nurses practicing in NY state will need for the future. Caring for populations relies on information about the population, particularly the outcomes of care delivered. These data are collected through the documentation nurses and other care providers enter into the electronic record.

Nurse Managers remain difficult to recruit, with 47% of survey respondents indicating shortages. Salary is reported as one challenge (31%), but the variety of opportunities for nurses to move into new roles such as care coordination, ambulatory care, care management, and advanced practice, reduces the numbers of nurses who may choose administration as a career choice. To that end, the NYONEL offers mentoring support, membership for aspiring leaders, and reduced membership dues for students in order to increase visibility for nursing administration positions. For more information, visit www.nyone.org .

These are exciting and challenging times for nurses and nursing in New York!

 

 

Elizabeth Anne Mahoney & Kimberly Glassman
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