In 1974 the New York State Nurses Association passed a resolution requiring the bachelors in nursing degree as a condition for Registered Nurse licensure by the year 1985. This paper critically examines the rationale of this proposal as set out by the Association and other supporters, and offers an alternate mode of evaluating proposals for stricter requirements for professional licensure.
The three relevant issues to be explored in each case are: whether there is a proven connection between the proposed requirement and quality of care; what the cost of the change would be both in terms of cost of compliance with the new requirement and its impact on the supply of practitioners; and what impact the new requirement will have on accessibility to the profession, particularly for historically disadvantaged groups.
Only tentative answers to these questions are offered; the burden of proof is on the proposal's proponents to demonstrate that the requirement will improve the status quo in a cost-effective fashion. However, it is shown that on the basis of available information, the proposal “fails” all three of the suggested criteria.
Less costly mechanisms for improving the quality of license holders are recommended such as tougher and more relevant examination procedures, more rigorous accreditation of schools and more active post-licensing review. Output variables are preferable to input variables for insuring quality of care. In short, it is questionable whether professionals should be able to set entrance requirements to their professions without vigorous public evaluation of those requirements.