Continuing Education For Nurses (CNE)
As divergent as MNA members are - representing all practice settings and areas - MNA share a common purpose for nurses: advancing excellence in nursing.One initiative for that common purpose is to ensure nurses have access to information that will enhance their knowledge, skills and attitude.MNA HUSM Branch supports that initiative by facilitating professional CNE and making the case for change.
Contact the CNE Taskforce at:
Ms.Ng Kam Mey
MNA HUSM Branch
Universiti Sains Malaysia
16150 Kubang Kerian
Tel: +906 767 3258
The Importance of the Baccalaureate Degree in Nursing Education in Malaysia
by Dr. Soon Lean Keng, PhD, MMID, RN, RM School of Health Sciences Universiti Sains Malaysia Malaysia
Malaysian nurses face a myriad of challenges in the 21st century, amongst them the need to provide healthcare to international standards. Despite extensive discussion and debate of nursing education, there are various opinions on upgrading nurse education and training programs from diploma entry level of nursing students to a baccalaureate nursing degree programs in Malaysia.
The path to a nursing degree involves different options and may exhaust many before they reach their goal. The first step is a three year diploma nursing program and the second is a four year bachelor’s degree from a college or university. This is followed by master degree and Ph.D program respectively.
For the past few years, researchers and policymakers have pointed out how much education makes a difference in the quality of care delivered by nurses. A nursing baccalaureate program also known as a bachelor’s of science in nursing (BSN) program provides greater in depth study of nursing science, physical science, research, management, social sciences, humanities and public health. This broader understanding of healthcare and health policy allows nursing students to grow professionally and truly understand the many factors that impact the health of an individual and which are related to social, economic and cultural influences.
Nursing education is linked to patient safety and better quality care with improved health outcomes. Research has shown that there is a relationship between the number of BSN educated nurses and the quality of patient care. A 2003 study published by the Journal of the American Medical Association found that hospitals that employed a higher numbers of registered nurses (RNs) with a bachelor's or graduate degree had surgical patients who experienced lower mortality rates. In other words, education levels are connected to lower levels of patient deaths.
The demand for acute healthcare services has been increasing due to medical breakthroughs, new technology, treatments and faster patient discharges. Hospitals and healthcare facilities are expanding their intensive care units to include advanced cardiac monitoring and treatment, respiratory assistance and the ability to treat a wide range of illnesses and injuries. This means that skilled, educated and specialized RNs to work in these facilities are needed.
The importance of adequate nurse education in the U.S. was expressed in 1965 through the American Nurses Association (ANA), which wrote a position paper stressing the educational requirements of nurses. The ANA paper promoted the idea of changing the educational requirements of the nursing professional into one that was more comprehensive. It stressed that nurse education needed to be provided through universities in order to ensure that nurses were properly trained and educated.
Health care has changed dramatically with technological advances, advances in science and patients’ knowledge of health and disease. In today’s global job market, employers are demanding that RNs hold a BSN degree. With healthcare services and medical treatment becoming more advanced, hospitals are requiring a highly trained RN workforce to meet the needs of their patients and the health system. This means having a sufficient number of nurses with adequate educational backgrounds which prepare them to meet patients’ expectations and needs and to be partners in the healthcare team.
The American Association of Colleges and Nursing (AACN) as well as many other nursing professional organizations and advocacy groups internationally acknowledge the BSN degree as a minimum education requirement for practicing nurses. Also, having a BSN degree is essential for individuals seeking to advance to managerial or specialized roles. The AACN which is the leading voice of higher education nursing degree programs in the United States takes the position that a baccalaureate degree in nursing should be the minimum requirement for professional practice.
The importance of nursing baccalaureate programs is connected to the fact that healthcare is changing from just hospital focused care to other forms that stress the need for thorough and comprehensive training. This includes community health and outpatient centres, private homes, public schools and health maintenance organizations. Also, many healthcare facilities are integrating and coordinating patient care with outside community organizations. Since healthcare is becoming more complex and interconnected, nurses need to be adequately trained and educated to deal with the changing nature of patient services.
BSN degree educated nurses are being given more responsibility and flexibility in their jobs as hospitals throughout the country are recognizing how their education and training can contribute to patient treatment. Many BSN educated nurses are better able to handle more intricate levels of treatment and education. They are also responsible for creating, coordinating and implementing comprehensive treatment plans for the length of a patient's stay at the hospital. This includes pre-admission, discharge, supervising other nurses and medical staff, educating patients and their families and collaborating with physicians and other hospital personnel. Nurses who hold the lesser associate degree mainly work in less complicated care situations compared to those who hold a BSN degree.
A BSN degree prepares nurses for broader roles within the healthcare setting and better job opportunities. The BSN degree is preferred in just about all health care environments including mental health, critical care, public and community health and ambulatory care. It provides nurses with flexibility in employment. Because a BSN degree equips nurses with important communication , critical thinking and problem solving skills, in depth medical training, knowledge of psychological and social factors that affect health and leadership preparation. Such personal and professional development is not typical of the more superficial diploma programs.
Since nurses often make rapid, and sometimes life and death decisions, the need to understand a patient’s health condition is crucial. This includes properly assessing a patient’s symptoms, signs and treatment options. They also need to communicate effectively with other medical staff and even supervise nurses.
Teamwork and collaboration are essential in delivering high quality care. Nurses with a BSN degree are better able to respond to patient needs, educate patients and their families on treatment and sometimes coordinate care with outside agencies. This requires thorough training that only a BSN or graduate nursing degree can provide. The AACN also reports that increasingly, RNs are starting to seek a BSN degree. It found that in 1980, 55% of RNs held only a hospital diploma as their highest form of education and that only 22% held a BSN degree. The number of RNs with a BSN degree increased to 32.7% by 2000. A report released by the Health Resources and Services Administration found that in 2002, the number of nurses with just an associate degree declined at a faster rate than those with a BSN. These figures demonstrate that nurses are increasingly placing a higher value on quality education and training to compete in today’s job market.
In 2010, the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) released the report, The Future of Nursing: Leading Change, Advancing Health. The report recommends that nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression and take their place in the frontline of healthcare. The report also recommends that the proportion of nurses with a baccalaureate degree be increased to 80% by 2020 and the number of nurses with a doctorate doubles by 2020.
With advances in medicine, medical technology, increasing life spans and an aging population hospitals and health care facilities are faced with new challenges. They need highly trained RNs with in depth medical knowledge. Employers seek nurses who are trained at the bachelor’s and master’s nursing degree level who are able to deliver complex patient care for a variety of situations such as primary care, acute care and community health. These nurses need to also provide other services such as diseases prevention, education and case management. For specialized healthcare areas such as critical care, neonatal, emergency room, ambulatory care, demand is very high for RNs with at least a BSN education. There is also a growing demand for nurse practitioners and clinical nurse specialists, which requires obtaining a Master’s of Nursing degree (MSN).
Although the majority of RNs work within the hospital setting, many RNs also work in a variety of other health care settings which include private practice, clinics, outpatient centres, nursing homes, mental health clinics, hospices, home health care, schools and government agencies. There is also a growing demand for nurse-academics in nursing programs at colleges and universities to prepare future generations of nurses. Teaching positions as well as advanced practice and leadership positions usually require clinical experience and an MSN degree. In addition, nursing has been identified as having the potential for making the biggest impact on a transformation of healthcare delivery to a safer, higher quality, and more cost effective system. With the increasing awareness of the need for change in the healthcare system, the clinical microsystems (small, functional units where care is provided within the larger system) have become an important focus for improving healthcare outcomes (Nelson, Batalden, & Godfrey, 2007). Therefore, nursing in Malaysia must develop in parallel with international trends. A BSN is a requirement for admission to master’s in nursing programs. In response to calls for transforming the healthcare system and how healthcare professionals are educated, nurses with BSN degrees are well-prepared to meet the demands placed on today’s nurse. The Essentials for Baccalaureate Education for Professional Nursing Practice serves to transform baccalaureate nursing education while contributing to a positive impact in shaping Malaysian nurses’ growth in relation to nursing scope of practice, development of the nurse professional role, nursing leadership, and nursing research; including possible mutual recognition internationally.