Academic Progression in Nursing

Academic Progression in Nursing

Academic Progression in Nursing (APIN) in Washington State

APIN - Academic Progression in Nursing logo

As our population’s need for nursing care changes, nurses must also be prepared to plan for and deliver care while leading health care into the future.

Academic Progression in Nursing (APIN) started in 2012 when the Robert Wood Johnson Foundation (RWJF) awarded grants to nine state nursing workforce centers, including Washington State’s WCN. Through the grant, the RWJF aimed to advance recommendations in the IOM’s Future of Nursing: Leading Change, Advancing Health report towards the building of a more highly educated, diverse nursing workforce. The grant was coordinated through the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundations, and the RWJF.

The RWJF APIN grant strongly focused on the IOM’s recommendation of increasing the percentage of nurses with a BSN or higher degree to 80 percent by 2020 and to increase diversity in the nursing workforce to strengthen equity in health care delivery.

The RWJF APIN grant to WCN closed in 2016, however, the important work of APIN to improve academic progression in nursing in Washington state continues and is currently supported under the WCN’s grant from the Washington State Department of Health.

APIN goals include:

  1. Implementing the Direct Transfer Agreement in Washington.
  2. Identifying best practices in education to further expand access, capacity and quality of RN to BSN education in the state.
  3. Working with practice partners to improve workplace support for academic progression.
  4. Continuing efforts to make the nursing workforce more diverse and inclusive.

As of 2020, 63% of surveyed nurses have received a BSN or higher degree. Although we have made progress, we are short of the IOM’s goal in this area. However, when we look at the data by age group, we can see the impact of APIN’s work in nurses between the ages of 19-24, this age group has achieved the IOM’s goal with 81.4% of them receiving a BSN or higher degree. This is according to the results of the survey, Washington State’s Registered Nurse Workforce:

Results of a 2018 Survey report released by WCN and the UW Center for Health Workforce Studies, which showed the trend is moving towards a higher educated nursing workforce in our state.

APIN identifies benefits of nurses receiving a BSN or higher degrees as:

  • Increases the leadership pool for progression to advanced levels
  • Fosters skills in leadership, systems thinking, health policy, problem-solving, moving patients along the continuum of care
  • Provides a bigger picture or larger scope of understanding of nursing as a discipline
  • Provides better communication and teamwork skills
  • Provides nurses with more credibility, more respect from interdisciplinary teams, and increased professionalism
  • Allows for increased career mobility, employment opportunities, and possibilities for advancement
  • Can lead to increased self-confidence, self-esteem, and personal satisfaction
  • Offers more opportunity to be part of leadership conversations, and an increased ability to change the culture of the institution and be a part of practice improvement

APIN identifies common barriers to nurses receiving a BSN or higher degree as:

  • Serious financial considerations: tuition costs, lack of financial assistance, reductions in FTE leading to fewer overall earnings and reduced benefit coverage, no clear understanding of financial benefit with BSN degree
  • Challenges with meeting program pre-requisite requirements (especially statistics), an inability to transfer credits
  • Lack of available support systems, such as: meeting childcare needs, flexible scheduling from employers, and tutoring
  • Inaccessibility of programs entry into programs is competitive and overall is not as available in rural locations

National Academic Progression in Nursing (NEPIN)


NEPIN Mission:

Foster collaboration to ensure nurses have access to higher levels of education and achievement. NEPIN’s goal is to have 1 million incumbent and 90% of new ADN graduates to the BSN or higher by 2025.

Do you have an interest in being part of the change to ensure nurses have pathways to continue their education? Do you have a passion for giving back? Do you want to be part of something more?

WCN Diverse Nurse Faculty Mentorship Program


Click on the link below to fill out and submit a mentor or mentee application.
(Application should take an estimated 15-20 minutes to complete.)
Mentor application link: 
Mentee application link: 

The deadline for applications EXTENDED to Mon, Dec 18, 2023 (11:59 p.m.), Sun, Dec 3, 2023.

Additional Information

Once submitted, the selection committee will review applications pairing mentors and mentees to participate in the program. Efforts will be made to match mentees with the type of mentor they believe would benefit them most. Selected participants will be notified the week of December 18.

Questions? Email,

The Washington Center for Nursing Releases COVID-19 Impact on the Nursing Workforce Study

June 30, 2021

WCN - Washington Center for Nursing

Contact: Brenda Little 

WCN Communications Associate 

Ph: 206.787.1200 x103 


The Washington Center for Nursing (WCN), the state’s nursing workforce center, recently released their COVID-19 Impact on the Nursing Workforce Study conducted by Survey Information Analytics (SIA). The study aims to understand better the challenges faced by Washington nurses responding to the pandemic.

Since the confirmation of the first U.S. case of the deadly coronavirus virus in Kirkland, WA, in Jan of 2020, nurses have stood front and center in the public health emergency, putting their lives at risk. As we move through the pandemic, it is imperative to capture nurses’ experiences to inform necessary improvements to support and retain a resilient nursing workforce, both now and in the future. 

The WCN completed the study at the request of the Washington State Department of Health. Through surveys and focus groups with nursing students, nursing faculty, CNAs, LPNs, RNs, and ARNPs, the study looks to capture a snapshot of the impact of COVID-19 on Washington’s nursing workforce.

As a priority to WCN, the study process kept an equity lens throughout by reaching out to multicultural nurses’ organizations to help promote participation in the study. As a result, the racial diversity of survey and focus group participants, in most cases, matched or exceeded that of the state’s general population. Voices of diverse nurses are necessary to understanding inequities experienced by nurses through the pandemic.

Conducted between January and March 2021, SIA surveyed 418 nurses who held active nursing licenses about their experiences during 2020. Highlight findings from the survey found that of the nurses surveyed:

  • 51% were laid off or furloughed from one or more nursing/healthcare jobs.
  • 42% thought about or made plans to leave the field of nursing.
  • 69% reported moderate or extreme COVID-19 related staffing concerns.
  • 61% reported moderate or extreme concern for their friends’/family’s safety.
  • 42% believed their employers provided adequate quarantining for employees who may have been/were exposed to COVID-19.
  • 67% agreed or strongly agreed their employer provided more telehealth nursing services during the pandemic in comparison to pre-pandemic services.
  • 35% felt they were discriminated against in their primary nursing role because of accent/language barriers.

Additionally, SIA conducted nine focus groups (with a total of 67 participants) with nurses from multiple settings and licensure to collect data on nurses’ experience working during the pandemic.

Among the report findings, fluctuating policy changes, inconsistent communication, lack of mental health resources, and unknown variables such as what workers were “essential” and what was adequate personal protective equipment (PPE), were identified.

“’ I think, going forward, they really need to set up actual crisis plans before the crisis happens. Instead of … clear cut policies, there were daily and sometimes hourly policy changes. We need to work on better communication channels. … crisis management failed … instead of learning from history, we just kind of waited for it to happen.’ (ARNP, 2021)”

“’ The pandemic completely exploded the adaptive system … COVID has been such a mystery; it’s been a year of being lost in the system … it’s just been this cluster of issues … it just felt very scattered, rules all the time, no consistency; it’s been taking a huge toll.’ (Public Health Nurse, 2021)”

“’ I think that the word that I would use to describe the last year is chaos, constant change, constant adaptation, a high level of uncertainty. A year of challenge.’ (Nursing Program Dean/Director, 2021)”

It is important to note that the size of this study means results are not generalizable to the entire nursing workforce in the state.

(To view the press release as a PDF click here.)

Nurse practitioners specializing in psychiatric, mental health, and substance abuse care across Washington serve an essential role in the health of our communities. But what do they do?

Graphic by Gerd Altmann from Pixabay
Graphic by Gerd Altmann from Pixabay

As one of the most trusted professions in the world, nurses in these positions help meet the needs of individuals suffering from mental illness or addiction through quality assessment and treatment.

What is an ARNP?

An advanced registered nurse practitioner (ARNP), also known as a nurse practitioner (NP) or advanced practice registered nurse (APRN), is a nurse with a graduate degree in advanced practice nursing.

ARNPs in Washington State have full practice authority, which authorizes them to practice to the extent of their level of education, training, and licensure. This means ARNPs can practice without physician oversite and prescribe medication and treatment. ARNPs can serve as primary care providers and hold private practices. As such, ARNPs create care plans, order and interpret diagnostic tests, write referrals, diagnose patients, and prescribe therapies, the use of medical equipment, and medicines.

What is a PMHNP?

A psychiatric-mental health nurse practitioner (PMHNP) is a nurse practitioner with additional education and certification in psychiatric and mental health assessment, diagnoses, and treatment, including substance use disorders.

What is a CNS?

In the state of Washington, a clinical nurse specialist (CNS) is an ARNP holding a master’s or doctoral degree in nursing and full practice authority. However, CNSs are also expert clinicians with certification in a specific area of care–such as psychiatric or rehabilitation. Although CNSs can run a private practice and serve as primary care providers, more frequently, they fill leadership roles within health care institutions where they provide authority and support to staff nurses providing bedside care to patients.

CNSs are integral to improving health care delivery because of their skills in evaluating, designing, implementing, and assessing process change using evidence-based care and best practices.

Serious Mental Health by the Numbers

Graphic used with permission by the Treatment Advocacy Center.

The Compound Effects of COVID-19 on Mental Health

Graphics used with permission by Tatiana Sadak PhD, PMHNP, ARNP, RN, presentation slides, “Mental Health and Physical Distancing During a Pandemic” 

Washington’s ARNP workforce

The UW Center for Health Workforce Studies and the Washington Center for Nursing released a report in March of 2020, Washington State’s 2019 Advanced Registered Nurse Practitioner Workforce. According to this report, as of May 31, 2019, there were approximately 4,807 NPs and 75 CNSs practicing in Washington State. Unfortunately, the data did not break down the specialties of these licensees, so the exact number working in mental health care is not known. However, a 2018 Washington State Advanced Registered Nurse Practitioner Survey Data Report recorded 12.7% of the survey respondence certified as psychiatric-mental health NPs or CNSs.

Washington needs more ARNPs and CNSs specializing in psychiatric, mental health, and substance abuse treatment to meet the need

According to a 2015 report by the Substance Abuse and Mental Health Services Administration (SAMHSA), 4.4% of adults living in Washington suffer from a serious mental illness (SMI). That is the equivalent of approximately 238,000 adults. Add in youths with SMI and those suffering from substance abuse problems, and this number is much higher.

Considering a career as a mental health nurse professional?

ARNPs, PMHNPs, and CNSs are considered advanced nursing roles and require a master’s or doctoral degree for practice. (click here to learn more about getting started in a career nursing).

In Washington state, there are six schools that offer advanced nursing degrees:

Department of Nursing
502 E. Boone Ave. AD Box 38
Spokane, WA 99258
Phone: 800-986-9585

Pacific Lutheran University
School of Nursing
12180 Park Avenue S.
Tacoma, WA 98447
Phone: 253-535-7411

Seattle University
School of Nursing
900 Broadway
Seattle. WA 98122
Phone: 206-296-6000

Seattle Pacific University
School of Health Sciences
3307 3rd Avenue West
Seattle, WA 98119
Phone: 206-296-6000

University of Washington
UW School of Nursing
Box 357260
Seattle, WA 98195-7260
Phone: 206-543-8736

Washington State University
College of Nursing
P.O. Box 1495
Spokane, WA 99210-1495
Phone: 509-324-7360

Advanced practice nurses have the potential to fill critical care gaps for people living with mental health disorders or substance addiction. Meeting those needs means improving lives, families, and communities across the state. The work they do is vital to a healthier Washington.

To learn more about careers in nursing, Washington’s nursing workforce, or WCN, please explore our website.

Additional resource:

The American Association of Nurse Practitioner

American Psychiatric Nurses Association

Expanding Mental Health Care Services in America: The Pivotal Role of Psychiatric-Mental Health Nurses

National Association of Clinical Nurse Specialists

Read The Seattle Times WCN article, Mental health nursing: A rewarding career

NEPIN Whitepaper: Equity, Achievement & Thriving In Nursing Academic Progression

National Education Progression in Nursing logo

The National Education Progression in Nursing’s latest Whitepaper: Equity, Achievement & Thriving In Nursing Academic Progression, discusses the need to address the lack of diversity in nursing if the nursing workforce is to meet the needs of patients and reduce health disparities for vulnerable populations. It also gives clear and implementable strategies for achieving this goal. 

“Schools of nursing and employers of nurses should implement institutional and organizational efforts to achieve diversity, equity and thriving in nursing education and practice settings. A strategic plan that addresses diversity, equity, inclusion and cultural proficiency, is essential and must be adopted across all aspects of the organization including teaching, research, service and practice. The plan must include tactics needed for goal attainment and financial and human resources. The plan must also contain methods for tracking the progress toward achieving the specified diversity goals for the organization.”

Open Whitepaper here.

Washington State Programs to Earn Higher Degrees in Nursing

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