After reading Kristine M. Gebbie's Viewpoint ("Here We Go Again," June), I wondered, "What difference does it make?" Why should nurses commit the time and money needed to obtain a higher level of education if those with a baccalaureate have no increased responsibility or salary compared to those with an associate's degree?

Nursing's leaders must remove barriers, divisions, and conflict within the profession, and they must agree to implement a necessary fundamental: requiring a baccalaureate for RN licensure. Other health care professions require at least this level of education, if not a master's degree.

Tillett1 and the American Organization of Nurse Executives2 have described the steps that must be taken to expand the health care work force and meet the demands of the Patient Protection and Affordable Care Act. These include requiring higher levels of education and training for RNs, expanding their scope of practice and autonomy, and promoting curriculum realignment and interdisciplinary collaboration.

So, "here we go again." But this time health care policy and delivery is in crisis, and nurses will be in a powerful position if we choose-as a collective and unified group-to protect and advance nursing and the well-being of the patients we hold so dear.

Usar Suragarn, BS, RN

Boca Raton, FL

For more letters from AJN readers, go to http://links.lww.com/AJN/A30.

REFERENCES