Minnesota's population is getting older, and that's changing the way nurses think about their education.
Nursing schools have historically trained nurses to work at the bedside, in hospitals. But the rapidly aging population means more nurses are delivering care to patients outside of traditional hospital settings. Students are looking beyond two-year-nursing programs to learn more about physical therapy, treatment management and psychological care while pursing a bachelor's degree.
"Nurses also need to acquire skills around, frankly, public heath nursing, community-based nursing," said Dawn Bazarko, a senior vice president at UnitedHealth Group's Center for Nursing Advancement. "Care is going to be delivered in the home, preparing family members to be extended members of the care team."
That's particularly important in rural communities, where seniors are more likely to age in place and where nurses make up a larger percentage of health care providers, Bazarko said.
"Issues around care coordination, chronic disease management, all of that become much more important, and it's more complex," she said. "There are more difficult patients to care for."
Population estimates indicate that the number of Minnesotans age 65 and older will rise 40 percent in the next 10 years. Nurse educators say two-year degree programs are not enough to keep up with the increasing demands on the profession, and more nursing students are pursuing four-year programs.
Enrollment in undergraduate and graduate nursing programs increased 8.5 percent last year, from 238,799 in 2010 to 259,100 in 2011, according a recent report by the American Association of Colleges of Nursing,
Eric Reiland, of Rochester, Minn., made the leap from a two-year nursing program to a four-year program for a bachelor's degree in nursing a few years ago.
"The opportunities are limited with a two-year nursing degree," said Reiland, 37. "You want to move up or work in the ICUs and stuff; it's just a good idea to get the BSN degree where you can do more management-type stuff."
When he was in his mid-20s, Reiland received an associate nursing degree from Rochester Community and Technical College. He worked five years as a surgical nurse at the Mayo Clinic before returning to school to complete a four-year RN program at the College of St. Scholastica.
Reiland said the added degree gave him a better understanding of how to handle the broader range of responsibilities that nurses take on within a health care team. He now works as a clinical documentation improvement specialist at Mayo.
"Nurses have a lot more input now, I think, than they ever did before -- you know, more teamwork and the holistic approach to nursing, and everybody has input," he said. "So it's kind of nice to see nursing changing. Even since I've been in it eight years, I've seen how the nurse's role has become more important."
Nursing schools are also pushing for advanced degrees because more hospitals are making a bachelor's degree a requirement.
In Minnesota, seven hospitals require nurse managers to have at least a bachelor's degree as part of the American Nurses Credentialing Center's Magnet status program. They include Abbott Northwestern Hospital and the University of Minnesota Medical Center in Minneapolis; Fairview Ridges Hospital in Burnsville; Gillette Children's Hospital and United Hospital in St. Paul; the Mayo Clinic in Rochester; and St. Cloud Hospital.
A two-year associate's degree or diploma in nursing is still a good entry point into the profession, said Tom Stenvig, a professor of public health and health policy at South Dakota State University. But hospitals are increasingly making the distinction between the two types of nurses, he said.
Stenvig, who has been a nurse for 41 years, said many undergraduate programs include coursework on leadership skills that employers want to see on a resume.
"Nurses are mangers," he said. "Whether they think they're going to be managers or not, they're managing all kinds of things, and there's more specific content in four-year curriculum about that.