More nurses are needed at the bedside than ever before, yet the profession continues to suffer from shortages and turnover rates as high as 37 percent in some regions. And although pursuing advanced nursing degrees may sometimes lead practice away from bedside roles and into others, Master of Science in nursing degrees are still worthy of pursuit, experts say.
Nationally, only 15 percent of registered nurses in the U.S. hold a master's degree and 2.2 percent hold a doctoral degree, according to the American Association of Colleges of Nursing. The low percentages are surprising to some, including Lisa Rowen, DNSc, RN, the senior vice president and chief nurse executive for Baltimore-based University of Maryland Medical System.
"I just assumed it would be way higher now. That caught me a little bit by surprise," she told Becker's.
She said the numbers could be lower because many nurses enter the profession with associate degrees and are then strongly encouraged to obtain their bachelor's degree in the field. "It could be that they do that and they feel like they're finished. It could be that … they just want to stay at the bedside and work in a hospital setting."
Of course, the profession would not work if everyone wanted to advance into roles away from the bedside, so it makes sense that there are some who desire to stay at it rather than pursue an MSN or higher degree, Dr. Rowen said.
Nursing is also a profession in which those who do choose to go back to school often do so later on in life, which can become complicated with possibly having children, working full time and managing other facets of personal life, so fewer may tend to pursue it.
"Whenever you have a profession that is predominantly women, pursuing higher education is always a difficult balancing act with family responsibilities and going back to school," Beth Brooks, PhD, RN, clinical advisor to Vivian Health, a healthcare hiring company, told Becker's.
But just as more nurses are needed at the bedside, Anne Dabrow Woods, DNP, RN, chief nurse for Wolters Kluwer, a clinical information company, said the profession also needs more nurse educators who go on to teach those who are graduating with any level of education in field, and more nurse practitioners, informatics professionals, leaders and those in strategic roles to guide the profession as others retire.
With rising burnout rates, financial burdens that often come with higher education and barriers to entry due to family constraints and obligations, the questions become: How can the profession incentivize more individuals to pursue advanced degrees? And why should they?
The why
Drs. Rowen, Brooks and Dabrow Woods all worked while they were pursuing advanced degrees in nursing, which wasn't easy, but resoundingly all three echoed that it was worth it.
"When I got my doctorate, I had two young daughters," Dr. Rowen said. "It was a piece of work to be in a leadership role and do that at the same time. … Is it worth it? Yes. I think it just makes you a better professional in whatever specialty in nursing you're going into. And I don't think you need to do it quickly. And it doesn't need to necessarily incur debt, and it does position you ultimately for more options and for pay options that are at increased rates."
Dr. Rowen said she always wanted to be a nurse. Similarly, Dr. Brooks did as well and even dressed up as a nurse for Halloween growing up, she shared. Her "why" was simply that she loves caring for people, she loves being a nurse and wanted to further specialize that passion to provide better care to patients.
"As the profession has evolved and grown, we're beginning to understand much more that we need nurses with higher levels of education because of the way that healthcare and the population have changed," Dr. Brooks said. "Having these different specialties [will] teach nurses how to care for different people. … So graduate school is that time to become specialized and then that allows us to care for the different kinds of patients we have in our country."
Dr. Dabrow Woods said her decision to pursue an advanced career in nursing was to initially become a nurse practitioner and increase the impact of care she was having on patient lives and to gain an understanding about where healthcare truly needs improvement — then fill the gaps.
"The best decisions I ever made in nursing were one, to go for my master's degree and become a nurse practitioner. The second was to go for my doctorate in nursing practice," she said. "It's allowed me to do my job more effectively, but it also has allowed me to have a much better understanding what healthcare currently is, where deficits are and what we need to do to improve healthcare, not only locally where I live, but in our country as well as globally, giving me that additional knowledge that I did not have before."
The how
While pursuing advanced degrees in nursing helped them tremendously, the three still acknowledge that some of the challenges can make the pursuit daunting.
Financially, nurses on average go into around $47,321 of debt after pursuing a master's degree, according to NerdWallet. Between that and juggling a job and personal responsibilities, some may feel like it is more difficult to go back to school than it is worth.
While no perfect solution exists, Nicole Beeson, RN, MSN, chief nursing officer of the University of Maryland St. Joseph Medical Center — and soon to be Dr. Beeson in just a few weeks — told Becker's what hospitals and health systems can do better to support and incentivize those who want to get advanced degrees is offer tuition assistance and be as flexible as possible with scheduling as they work through the program. As for nurses: Look for places that will support you in these ways and go at your own pace.
"There is no doubt education is an investment. It is an investment of your time, your focus and your financial resources," Ms. Beeson said. "That being said, it pays dividends in the long haul over the duration of your career. So what I would say is, I don't see a reason to go into a massive amount of debt for your education when there are resources that provide this, and if you can do it at a pace with which you're able to pay through your own means and also through either minimal loans or through your employer reimbursement, that helps. It's really all about pace and prioritization as well."
As the nursing profession evolves, programs should also evolve their curriculums, Drs. Rowen, Brooks and Dabrow Woods and Ms. Beeson underscored. To continue graduating successful advanced-degree nurses into the profession in 2023, they each echoed that more programmatic focus needs to be placed on a few key things:
- Virtual nursing and technology
- The financials behind healthcare
- New care delivery models
- Leading versus managing courses
- Evolving programs to meet and graduate students efficiently
"Morale and the teamwork, communication, collaboration and really partnering together around an important mission is something that deserves a lot of thought and conversation and consideration, and it is also important to consider new types of roles that support nursing, so nurses can work at the top scope of their profession," Dr. Rowen said.