Rural associate degree nurse perceptions of the importance of incentives necessary for academic progression
Smith, Hillary Annette
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Multiple routes of educational entry into nursing exist. Associate and baccalaureate prepared nurses take the same licensing exam and practice based on the same scope of practice. With minimal difference in salary, the current and future problem involves encouraging associate degree registered nurses to continue their education. Once the associate registered nurse is licensed and working, advancing to a baccalaureate degree may not be a priority. Evidence suggests improved patient outcomes, a decrease in morbidity and mortality rates, and higher job and personal satisfaction with bachelor prepared registered nurses. Because of this evidence, the Institute of Medicine (2010) recommends 80% of registered nurses in our nation hold a baccalaureate degree by the year 2020. Statistics suggest that the majority of rural registered nurses are educated at the associate degree level, which is true of rural Montana. This study examined the perceptions of associate degree registered nurses in rural Montana with regard to importance and incentives that would motivate nurses to return for a bachelor's degree in nursing or higher. For this phenomenological qualitative study eight associate degree registered nurses that currently live and work in Montana underwent face-to-face interviews, which were then analyzed and themed for trends in perception. Questions were open-ended which allowed each subject to speak freely about their experiences, thoughts, and opinions. Eight associate degree registered nurses were interviewed. Common perception themes included: education is important; education is expensive; associate nurses should not be required to return for a bachelor's degree or higher unless they choose; bachelor and master degrees are important for management or advanced practice; and higher degrees can increase career options. Incentives that would motivate nurses to pursue a higher degree included: tuition reimbursement; flexible scheduling; higher wage/differential; on-site/on-line courses; and time off for class hours. Barriers to returning for a higher degree included: cost; less personal/family time; getting back into "school mode"; difficulty getting time off work; and no increase in wage for BSN. Results indicate that rural Montana associate degree registered nurses do value education. Cost and time are the perceived barriers and monetary support and time flexibility are the perceived incentives.