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The nursing profession faces a number of significant workforce challenges. Both the nursing workforce and US population are aging, leading to a wave of nurse retirements and a simultaneous increase in need for health care, especially in long-term care settings. Furthermore, the current nursing workforce does not mirror the racial and ethnic diversity of the population. Released following the Center on Education and Skills New America (CESNA) report 'Apprenticeship and the future of nursing' [available in VOCEDplus at TD/TNC 137.1230], this guide aims to explore why and how apprenticeship could diversify the nursing workforce and increase academic and career progression for nurses. While apprenticeship may not be a silver bullet for workforce challenges, the model can lower financial and logistical barriers to entry and progression for those that may have felt such a career was out of reach.

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This report represents a starting point for the Articulation and Recognition in Higher Education Initiative, an identified priority focus of the Industry Leaders Group for the [Health Skills Formation Strategy] HSFS. The initiative aims to ensure maximum articulation pathways are available between [vocational education and training] VET qualifications and higher education courses relating to health in Queensland. The report provides details about established articulation and reverse articulation arrangements between [registered training organisations] RTOs and higher education for nursing qualifications in Queensland. Whilst nursing has been an obvious starting point with its more established education pathways (in line with the National Review of Nursing Education 2006) it is recognised that other health careers also need to be targeted to ensure that well developed career and education pathways are available and promoted.

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Bachelor of Nursing (BN) programmes for Registered Nurses (RNs) were developed in New Zealand in the 1990s. With the introduction of pre-registration degree programmes, transition arrangements that recognised the prior learning of RNs were established allowing existing RNs to obtain an undergraduate nursing degree through a shortened course. Many RNs entered these programmes, despite there being no requirement to obtain a degree qualification and with other education options available to them. Professional debate exists regarding the need or value of RNs undertaking such study and whether these programmes should continue. A case study approach utilising mixed methods was used to examine the personal meaning and the national professional significance of RN to BN programmes.

While ultimately the outcome of earlier professional efforts, these programmes occurred as a result of change, change within the socio-political and economic context of New Zealand and nursing education. Change at this macro level affected the individual choices of RNs. These choices were further complicated by a lack of professional consensus and a landscape of difference, with programme requirements and availability differing between institutions, while employers varied in the amount of support and recognition they gave those who chose this option. There were personal and financial costs to completing a RN to BN programme, yet the RNs in this study all believed it was worth it, reporting positive personal and professional outcomes. The professional and educational environment has changed since the introduction of RN to BN programmes and the numbers of individuals and institutions involved with them have greatly reduced. Currently decisions regarding the continuation or demise of these programmes are made by individual educational institutions based mainly on economic rationale. Consensus and direction is required nationally and professionally regarding the place of these programmes within post-registration education. While these programmes have provided benefits for individual RNs, their time in nursing education may be coming to an end.

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Studies have shown that hospitals with more bachelor degreed nurses generate better patient outcomes. Therefore increasing the share of registered nurses with a Bachelor of Science in Nursing (BSN) is a top priority for many health care systems around the country. However, restricting new hires to nurses with a BSN could leave heath care centres with a much less diverse nursing workforce than it currently has or wants due to the cost and time constraints of attaining this qualification. This report addresses the creation of a Registered Apprenticeship program for nurses in need of bachelor's degrees, exploring one such program created at Fairview Health Services in Minnesota. The relative ease with which Fairview incorporated apprenticeship into its existing professional development strategies demonstrates that it is already a close fit. It also shows that apprenticeship can be a valuable tool for helping the field reach its goal of increasing the share of bachelor-degreed nurses to 80 percent. But expanding the use of apprenticeship in nursing and realizing its full potential as an education and training model will require support from a broad range of stakeholders across the public and private sectors. The report recommends these groups: (1) convene key stakeholders to discuss Registered Apprenticeship; (2) create targeted grant programs; (3) support research and evaluation of the impact of the bachelor-degreed nursing program on patient outcomes; (4) raise awareness of the apprenticeship pathway; (5) fund and evaluate pilot programs; (6) partner with health care workforce intermediaries to develop apprenticeship programs and; (7) partner more selectively with institutions of higher education to ensure quality and drive down tuition.

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