Linda Aiken, PhD, RN, FAAN, FRCN, The Claire M. Fagin Leadership Professor of Nursing, professor of sociology and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia, said the need for more nurses with bachelor’s degrees or higher is increasing. “There’s a huge push for nurses to have a minimum of a bachelor’s degree in nursing,” Aiken said. “While there is a strong preference in all healthcare settings for nurses to have a bachelor’s degree, many hospitals in particular prefer to hire nurses who have a BSN.” Aiken has conducted several studies showing hospitals who employ a larger number of BSN-prepared nurses have lower patient mortality rates. Her first study, published in 2003 in the Journal of the American Medical Association, found a 10% increase in the number of BSN-prepared nurses reduced the likelihood of patient death by 5%.

A 2013 study she co-authored also indicated a link between nurse education and patient outcomes. The study found hospitals that hired more BSN-prepared nurses between 1999 and 2006 experienced lower patient mortality rates than other hospitals. As a result of this and similar academic research, the Institute of Medicine introduced guidelines in 2010 for the nursing profession in the report “The Future of Nursing: Leading Change, Advancing Health.” The IOM’s target goal is for 80% of nurses to have a bachelor’s degree by the year 2020.

Given the research and trend toward hiring more BSN nurses, Aiken suggests nurses who do not have a bachelor’s degree enroll in RN-to-BSN programs. For nurses who plan to pursue a leadership role, Aiken recommends striving for a master’s degree program, some of which target specific career tracks.

For instance, the clinical nurse leader role is designed for a master’s-prepared advanced nurse generalist who oversees patient care in specific hospital units. The CNL role is an attractive option for nurses who want to remain at the bedside and involved in direct patient care. A master’s degree also is fitting for RNs who ultimately want to pursue a managerial position in areas such as clinical care, nursing education, executive leadership or case management. The U.S. is facing a physician shortage estimated to be between 40,800 and 104,900 physicians by the year 2030, according to the American Association of American Medical Colleges, and some say having more nurse practitioners — practicing at their full potential — can help in this regard. And increasing the diversity of the advanced practice nurse workforce also would serve patient care, as well as diverse communities. Anabell Castro-Thompson, MSN, SPRN, ANP-C, FAAN, president of the National Association of Hispanic Nurses, said in order to effectively reduce healthcare disparities that exist among many minority populations and to provide better health outcomes, more students of color need to pursue advanced nursing degrees.

More than 30% of the members of NAHN have advanced degrees, according to Castro-Thompson. “In order to be it, you have to see it,” Castro-Thompson said. “We need more diverse academic role models and nurse leaders that resemble the communities they are serving.” Aiken points out there is a growing trend toward nurses pursuing a doctoral degree — either a PhD, which is necessary for teaching and research, or a DNP to help advance clinical careers, and some nursing association see the doctoral degree as a necessity to work in some specialties.

For instance, the American Association of Colleges of Nursing recommended in 2004 that the DNP should be the new standard for advance practice nurses, and the American Association of Nurse Anesthetists have since added their support of doctoral education for entry into the nurse anesthesia practice by 2025. In their 2010 report, the IOM recommended doubling the number of nurses with a doctorate by the year 2020.

As nursing education requirements continue to evolve, many nursing schools have started offering BSN- or MSN-to-DNP programs in which RNs with a bachelor’s degree can earn a DNP in three years, and nurses with a master’s degree can earn it in two years.

“A DNP degree can definitely be a more cost effective route for nurses who think they ultimately may want to pursue leadership and clinical roles,” Aiken said. “Getting an advanced degree ensures that you don’t exclude any future career possibilities.” As APNs continue to take on more responsibilities such as prescribing certain medications without an attestation agreement from a physician, Castro-Thompson said the push also continues for more nurses to obtain a doctorate, the level of education required to teach, perform research and serve as clinical leaders. In 2013, the AACN and the Robert Wood Johnson Foundation initiated the Doctoral Advancement in Nursing project to enhance the number of minority students completing PhD and DNP degrees. But there’s work to be done in making a doctoral degree an attainable goal for more nurses.

“Right now the majority of scholarships seem to be for full-time nursing students,” Castro-Thompson said. “Since some people pursue nursing as a second career, I’d like to see more scholarships available for those who may be returning to school while also juggling work and raising a family.”