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BSN-in-10 law ushers in new era of nurse education
New York legislation has broad implications
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EDITOR'S NOTE:
Read more BSN in 10 stories at
Nurse.com/blog
.
As the push for baccalaureate-prepared nurses becomes the norm, nurse leaders and healthcare experts agree the BSN is not only the way of the future, but also a path to better patient care and improved outcomes. 
New York Gov. Andrew Cuomo in
December 2017 signed into law a requirement that nurses earn a BSN within 10 years of initial licensure
.
This new law has many implications for RNs in New York
as well as across the country. Research has shown hospitals with nursing staff with a higher number of baccalaureate-prepared nurses have fewer deaths or poor outcomes, whether pneumonia, UTIs or patients being re-hospitalized within 30 days of discharge.  “A huge population of 232,000 patients demonstrated that for every 10% increase in the number of bachelor’s degree-prepared nurses, there was a 5% decrease in preventable deaths,” said nurse consultant Barbara Zittel, who began working on the creation of the bill in 2003 while serving as executive secretary of the New York State Board of Nursing.  She cites research published in 2003 by Linda Aiken and others in the Journal of the American Medical Association describing educational levels of hospital nurses and surgical mortality. That data prompted the New York State Board of Nursing to decide something needed to be done to increase the number of nurses with baccalaureate degrees, Zittel said. With nearly 300,000 licensed RNs in New York, this one state may set a precedent for others attempting to pass similar legislation. Questions remain for nurses who may be concerned they are no longer valued or able to work. 
Still, even with the existence of a grandfather clause and any similar provisions that may be added should other states enact
BSN-in-10 legislation
in the future, the consensus is having more baccalaureate-prepared RNs, benefits everyone, including nurses.  “In the end, it is a win for all RNs and our patients,” Karen Ballard, MA, RN, FAAN, past executive director of ANA New York, said upon passage of the BSN-in-10 legislation. With the passage of the New York law and the support and work of the American Nurses Association, all the state action coalitions, AARP and the Robert Wood Johnson Foundation, this is not going away. 
Grandfather clause protects working RNs
What may help calm those fears is the
new law comes with a grandfather clause
— a statutory provision exempting persons or other entities already engaged in an activity from rules or legislation affecting that activity. When this clause is added to a piece of legislation that becomes a law, it allows the current status of something pre-existing to remain unchanged regardless of whether changes are made in the future. In the New York BSN-in-10 law, it specifically states in Section 4 a-c to whom the provisions of this act do not apply (those who are “grandfathered in”). Those individuals include:
A.
any student entering a generic baccalaureate program preparing registered professional nurses after the effective date of this act;
B.
any student currently enrolled in, or having an application pending in, a program preparing registered nurses as of the effective date of this act;
C.
any person already licensed as a registered professional nurse or any unlicensed graduate professional nurse who is eligible to take the National Council Licensure Examination as of the effective date of this act.  Regardless of your educational background, if any of these apply to you, then you aren’t legally required to get your BSN in 10.
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