Health Policy Debate Paper

Should Continuing Education be Mandatory for All Nurses, Why or Why Not?

The Assembly Regulated Professions Committee of the New Jersey legislature is currently deliberating Bill number A2182, sponsored by Assemblywoman Nancy Munoz of the 21st District, which seeks to expand nurses continuing education requirements. The Bill seeks to make it mandatory for nurses to obtain at least one continuing education credit on topics related to domestic violence as a pre-condition for biennial license renewal (New Jersey Legislature, 2024).

While there is consensus that continuing education for nurses is crucial for effective and safe professional practice, there are differing opinions on whether the same should be mandated as a regulatory requirement or left to the individuals discretion (Mlambo et al., 2021). Continuing education is considered mandatory if it is imposed as a requirement for re-licensure (Mlambo et al., 2021). In most cases, these requirements are passed through state legislation and enforced by professional licensing boards (Mlambo at al., 2021). Conversely, continuing education is voluntary if individuals choose whether or not to participate, and what programs or topics to undertake. Thus, professionals are not mandated to participate, and often do so because they understand the importance of increasing their professional expertise and proficiency (Mlambo et al., 2021).

Arguments by Supporters of Mandatory Continuing Education

One of the primary arguments by proponents of mandatory continuing education is that such education guarantees accountability in professional practice by ensuring that nurses keep up professionally and offer competent healthcare services to patients (Lera et al., 2020). In their study assessing the effect of continuing education workshops and meetings, Forsen et al. (2021), established that mandatory continuing education significantly improved professional practice among health personnel.

Additionally, the proponents argue that mandatory continuing education helps to maintain the professions credibility by ensuring that individuals who are not willing to keep up professionally are prevented from practicing and endangering patients lives (Lera et al., 2020). Lera et al. (2020) posits that it is important for professionals to undergo some form of assessment before they can be re-licensed in a bid to ensure that their practice remains relevant to the evolving needs of patients (Lera et al., 2020).

Thirdly, participation in continuing education increases competence levels, minimizing the risk of professional scandals that could result in dwindling public confidence in the profession. In their systematic review, Main and Anderson (2023) found that mandatory continuing education requirements are a strong motivator for professionals to improve their competence. The study also found that generally, jurisdictions in Australia with mandatory continuing education requirements reported positive practitioner behavior and higher levels of knowledge than those with voluntary continuing education requirements.

Mlambo et al. (2021) posits that mandatory continuing education also provides opportunities for professional interchange among nurses. Nurses attending continuing education programs or workshops get to learn from their peers and to reflect on their practice, which could help professionals reluctant to practice move back to the mainstream. However, the authors contend that this largely depend on individuals personal characteristics because nurses who are uninterested in socializing with their peers will still chose to remain isolated despite participating in continuing education.

Finally, supporters of mandatory continuing education argue that it provides a means for the state and professional groups to control the content of continuing education programs and to establish requirements that participants should meet (Mlambo et al., 2021). This creates a systematic approach to continuing education, in which nurses are exposed to standard content through programs approved by relevant professional associations (Mlambo et al., 2021). Ultimately, this gives the profession greater control over the quality of professional services offered to its members.

Arguments by Opponents of Mandatory Continuing...

…surgery-related mortality by 7 percent in the general care setting (Aiken et al., 2018). Unfortunately, high nurse to patient ratios equally affect nurse outcomes. Studies have associated high ratios with high levels of job dissatisfaction, burnout, and intent to leave. Shin et al. (2018) found that an increase of one patient in the nurse-patient ratio increased the odds of job dissatisfaction by 8 percent and the intent to leave by 1.05 times.

Fortunately, nurse-to-patient ratio legislation may be an effective solution for regulating staffing levels in hospitals and consequently, improving patient outcomes. However, their effectiveness depends on the type of legislation. Such legislation takes various forms, including requiring hospitals to put in place staffing committees, imposing minimum nurse-patient ratio requirements, and requiring hospitals to publicly report nurse staffing levels (Han et al., 2021). A prospective study by Hugh et al. (2021) comparing patient outcomes between Queensland hospitals bound by minimum nurse-to-patient ratio legislation and those not bound by such legislation found that the former had shorter lengths of stay, lower readmission rates, and lower patient mortality. Unfortunately, staffing committees and public reporting requirements alone have minimal effects on health outcomes as shown by Han et al. (2021).

Thus, a more effective solution to the nurse staffing problem facing the state would be one that combines nurse staffing committees with requirements for minimum nurse-patient ratios (Han et al., 2021). Thus, there is a need to push for amendments to the current bill to include minimum nurse-patient requirements in addition to staffing committees in hospitals. Currently, California is the only state with legislation that imposes minimum nurse-to-patient ratios (Han et al., 2021). In my view, it is time that New Jersey begins to consider adopting a similar approach to reduce the constant strikes affecting the health sector.

Thanks for your time and consideration. I look forward…