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Halifax Regional Hospital ramps up nursing requirements / December 02, 2013
Halifax Regional Hospital is making the transition to an acute care nursing staff made up mostly of RNs with bachelor’s degrees, a goal that the hospital expects to achieve by the end of the decade.

The hospital is encouraging all current Licensed Practical Nurses (LPNs) to enroll in a two- or four-year degree program by 2015, with the aim of completing their training as Registered Nurses (RNs) by 2020, said Patricia Thomas, the hospital’s chief nursing officer.

Halifax Regional also is encouraging its current RNs who do not have bachelor’s degrees to raise their level of education, with an eye towards creating a nursing staff that consists of 80 percent baccalaureate degree holders.

There are several different degree levels associated with becoming an RN, including diploma, associates, bachelor’s and master’s.

Thomas said the hospital began consulting with nurses some two years ago about the new job requirements, which come on the heels of a 2011 Robert Wood Johnson Foundation study that highlights the role of the nursing profession in broad-based reform of the nation’s health system.

Urging acute care nurses to earn the BSN (Bachelor’s of Science in Nursing) degree comes in response to evidence pointing to “better patient outcomes with BSN nurses,” said Thomas.

Out of more than 200 nurses at the hospital, 18 are LPNs, and a “significant number” of RNs hold either a nursing diploma or associates degree, levels below a BSN. Of that group, “we have met with them to encourage them to go back to school” to attain a higher level of professional training and education, said Thomas.

The hospital is no longer hiring LPNs for acute care positions, although it continues to employ them in other roles such as long-term care. By the same token, Halifax Regional will seek to accommodate its current LPNs who choose not to further their education by shifting them into positions outside the hospital setting as they become open.

In addition to the hospital, Halifax Regional Health System operates two nursing homes, a skilled care facility for patients with Alzheimer’s and other forms of dementia, and physician clinics in Halifax, Mecklenburg and Charlotte counties.

HRHS President Chris Lumsden noted that the nursing initiative was under way long before the hospital decided to partner with Norfolk-based Sentara earlier this year.

Thomas seconded that view: “This is not something that is being handed down to us from Sentara,” she said.

Rather, the hospital is heeding the recommendations of the Robert Wood Johnson study, which spells out an expanded role for nurses in the health care system in wake of passage of the Affordable Care Act (ACA).

“Although passage of the ACA is historic, realizing the [law’s] vision … will require a transformation of many aspects of the health care system,” state the authors of the foundation report, which was done for the Institute of Medicine, a branch of the National Academies of Science. “This is especially true for the nursing profession, which, with more than 3 million members, represents the largest segment of the health care workforce.”

Nurses in the hospital setting, the report notes, “must make critical decisions associated with care for sicker, frailer patients and work with sophisticated, life-saving technology” and “fill primary care roles and to help patients manage chronic illnesses, thereby preventing acute care episodes and disease progression.” Nurses are required to coordinate with doctors, pharmacists and other health professionals, many with master’s or doctoral degrees, and “[s]hortages of nurses in the positions of primary care providers, faculty, and researchers continue to be a barrier to advancing the profession and improving the delivery of care to patients.”

Nurses “are at the front lines in ensuring that care is delivered safely, effectively, and compassionately,” the study adds.

The foundation urges a “seamless academic progression” for nurses who choose to continue their training. To accomplish that goal, Halifax Regional Hospital is working with colleges and nursing education programs to provide an array of continuing education options for its employees, both in the classroom and via the Internet.

“A lot of programs are on-line,” said Thomas. “There are a lot of options out there.”

The hospital provides nursing scholarships through its Project PRIME Scholarship Endowment Fund, and it is also offering nurses a service payback option whereby they can reimburse HRHS for tuition assistance over time through their ongoing employment at the hospital.

“We’re working with these people so they have the opportunity to go back to school,” said Thomas.

By earning higher level degrees, nurses are “absolutely” setting themselves up for increased pay, she added.

While industry trends point towards higher nursing degree requirements, Thomas noted that “some of the best nurses I have ever worked with are licensed practical nurses.” She added, “When I came out of nursing school in 1975, there were licensed practical nurses who taught me things I never learned in nursing school.”

From the hospital’s perspective, the change is needed to make the workforce more efficient and productive, and eliminate the need for supervision of nurses with a lower level of training, said Thomas.

“It’s not that LPNs don’t deliver great care,” she added, “because they do.”

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Most online courses are BS, I took one submitted a paper of blah blah blah (copy and paste) just to see if On line prof. was paying attention, got an A on paper. A degree does not make a person a good nurse. I know several nurses that have a BS and they are complete jerks, when it comes to bedside manners. Hello Obummer care!

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