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The American Nursing Workforce is Rapidly Changing

By James X. Stobinski

The makeup of the American nursing workforce is rapidly changing as our health care system transitions to value-based reimbursement. As the CEO of the Competency and Credentialing Institute (CCI) I am witness to the evolving nature of the work of nurses with a focus on perioperative nursing. I am proud to say that CCI plays a small but significant role in this transition as we develop programs to assist perioperative nurses in their Continuous Professional Development (CPD) journey throughout a career.

When I began my nursing career in the mid-1980s it was very typical for nurses to enter the profession with an associate degree or diploma of nursing, have a long, productive career and not complete any further academic education such as a BSN. The practice of nursing has become far more complex in recent years and new skill sets are needed. Nurses must now continue to acquire additional skills throughout their career or be faced with markedly decreased career opportunities. The skill sets now required for proficient nursing practice was not part of our pre-licensure education and, as nurses, we must devise methods to acquire these requisite skills.

BSN completion courses and graduate level coursework are seemingly everywhere. When we also consider the ubiquity of online courses most nurses have ample opportunity to further their education. The market, in the form of available education programs, has built up to meet the needs of nurses. This availability of programs combined with the widespread availability of tuition assistance as a fringe benefit removes many of the barriers to pursuing additional education.

Many nurses whose highest level of education was an associate degree or diploma of nursing are now retiring from the profession. These nurses did not pursue additional education after licensure, but their replacements are increasingly educated at the baccalaureate level. Nurses now entering the workforce are compelled, by a variety of forces, to enter the profession with baccalaureate level education or to quickly complete a RN to BSN program shortly after entry. For those aspiring to fill a management role, graduate level coursework is increasingly required with an MBA often seen among perioperative nurse leaders and managers.

Much of this push to reach higher levels of academic preparation may be attributed to the requirements set by employers and to accreditation requirements such as those of the ANCC Magnet program. CCI believes that certification organizations have a role to play. In the policies and programs that support credentialing programs, certification organizations can facilitate and encourage baccalaureate level education for those entering the profession. Later in the course of career progression certification organizations can also promote graduate level coursework.

For perioperative nurses the recent change in emphasis by CCI from a CE focused system for recertification requirements to a system centered on lifelong professional development is very favorable for many nurses. At CCI, we are seeing an increasing use of the professional development points system (points method) for those nurses pursuing additional academic education. A common path for nurses holding the CNOR credential is to fulfill recertification requirements using the points method for their BSN completion program and then progress on to graduate coursework. The subsequent completion of an MSN or MBA degree then fulfills the recertification requirements for the next recertification cycle.

At CCI, we strive to assist perioperative nurses with their professional development needs. We have recently published a whitepaper on BSN level education, and this will soon be available on our newly refreshed website and as part of a professional development activity in our learning management system. We embrace our small part in the professional development journey of perioperative nurses.

James X. Stobinski, PhD, RN, CNOR, CSSM (E), has in excess of 30 years experience in the operating room. He has 18 years of management experience in perioperative nursing and has published and presented extensively at the national level on perioperative management related topics. He also serves as adjunct faculty at Nova Southeastern University in Ft. Lauderdale, Florida and Wilkes University in Pennsylvania. In February 2017, he began serving as the CEO of the Competency and Credentialing Institute. He maintains an active research agenda centered on nursing workforce issues and certification.



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