R.N. to B.S.N.

Link to MinorityNurse.com

Ambition for a better life is only one reason nurses return to school

By Dr. Pamela Palmer, Ed.D.

Before You Enroll

Dr. Von Best Whitaker

When considering R.N. to B.S.N. programs, find the one that best meets your needs. Ask about credit for experience and how the school assesses/processes it. Look at the school’s accreditation status and weigh costs against what your employer will cover.

Also consider these pre-enrollment tips from Dr. Von Best Whitaker, assistant dean of nursing at North Carolina A & T State University in Greensboro, N.C.

Look at both on- and off-campus courses. Some schools offer Web-based courses/degrees and other forms of distance education. Ask yourself whether the online or the traditional approach best fits the way you learn.
Check what services the school offers to help you learn to balance work, family and education. You can do it all, but sometimes you cannot do it all at the same time.
Assess your life to see how much coursework is possible. Taking one or two courses a semester may be the most realistic plan, given your other responsibilities.
Preplan. Look ahead to avoid problems. For example, do you need to save vacation days to do a clinical? Will your employer be supportive?
Count the distance. How far (and how often) will you have to commute? Will distance education help solve potential commuting problems?
Learn how long the degree will take. The time it takes varies based on how many prerequisites you have when you enter and the requirement of each program.
Are there articulation agreements? Does the school have articulation agreements with other colleges that allow comparable courses taken there to count toward a degree?
Be flexible. Successful people are the ones who are flexible. Recognize that there will be parts of the program you feel are repetitive and would prefer not to do.
Look beyond the bachelor’s degree. Consider opportunities opening up for nurses with graduate degrees and see if those fit your career goals.
Be realistic about what you can and can’t do. See how the program’s coursework flows and if that pattern meets your needs.

When Myron Myers, R.N., talks about going back to school for a bachelor’s degree, his reasons are not difficult to understand.

Five-year-old Kristian Ashley and 5-week-old Myron Carrell, Jr. make the effort worthwhile.

“I want more for my son and daughter,” he says. “I want the best for them, so I have plans. For the last ten years I’ve worked for Baptist Hospital in Memphis, Tenn., but now I’m only working there 12 hours a week and plan to quit soon.”

Myers recently took a full-time position as a charge nurse. “I’m working in community behavior health and I love it! My supervisor says she’ll try to work with me on my schedule. I told her I just had to go back to school,” he continues. “I’ve been an R.N. for three years but I’m not satisfied. I plan eventually to go into anesthesiology.”

A student at the University of Memphis, Myers plans to finish his bachelor’s degree and enter Vanderbilt University’s anesthesiology program. “After the bachelor’s degree, it will take two or three years,” he says. “But I believe in what I am doing. I tell friends to think about the rest of their lives and base career decisions on that. To make a decent living, you have to choose the right field and the right career. Keep striving to excel and make more money.”

For Myers, as for many other R.N.s who return to the classroom, missing family time is difficult. “That’s the toughest part,” he says. “My wife Alisa is an R.N., too. Money is not a problem because we have saved since we left school, but I miss being with her and our children. She supports my going back to school. Marriage has truly been a blessing to me.”

Hire Education

Ambition for a better life is only one reason nurses return to school. Other forces shape the trend. “More and more hospitals and health facilities in this area are restricting their hiring to nurses with a bachelor’s degree,” says Lynette Merriman, director of admissions and student affairs at the University of Southern California’s Department of Nursing in Los Angeles. “From what I hear, they are retaining nurses who were hired without the degree, but some are asking nurses to go back and work toward their bachelor’s. New hires, though, are required to have the degree by some facilities.”

Nowhere is the trend clearer than at the U.S. Department of Veterans Affairs, the nation’s largest employer of registered nurses. In late 1998, the VA announced the National Nursing Initiative, setting the bachelor’s degree as the minimum required educational level. New professional nurse hires must have the degree in hand while existing hires face a 2005 deadline.

Dan Mezibov, director of public affairs at the American Association of Colleges of Nursing, reports that graduates of R.N. to B.S.N. programs may have an advantage over traditional B.S.N. graduates. “Employment commitments for R.N. to baccalaureate programs are higher than for graduates coming out of traditional B.S.N. programs,” he confirms. “While schools in all regions estimate that 98.6% of R.N. to baccalaureate graduates had jobs waiting at graduation, they estimate that 76.8% of graduates from traditional B.S.N. programs had a job waiting. This is a dramatic difference.”

Gaining access to new opportunities is another reason nurses are returning to school. As Merriman explains, “Our R.N. to B.S.N. curriculum focuses on community and home health nursing which I think is the future of nursing. It also focuses on leadership and administrative roles, which students did not get to this extent in their associate degree program.”

The U.S. Department of Health and Human Services confirms the trend, projecting a shortfall of over a quarter million baccalaureate-prepared nurses by next year—just at a time when the public expects nurses to be educated at that level. According to a June 1999 Harris Poll, sponsored by Sigma Theta Tau and NurseWeek Publishing Inc., 76% of the public thinks nurses should have four or more years of education past high school.

Money, too, is a factor. The HHS Division of Nursing looked at annual full-time earnings at various levels of educational preparation in its report on the registered nurse population. The department reports that in 1996, a staff nurse with an associate degree averaged $36,763, while one with a baccalaureate degree averaged $39,790. As an administrator or assistant, the difference was even more pronounced—$44,101 for nurses with the associate degree and $50,984 for those with a baccalaureate degree.

Choosing a Program

“Can I do this and still work?” That’s a question Kathy Keasler hears often from R.N.s considering the University of Iowa program. “What about my family?” they ask. “How flexible is this program?”

When seasoned R.N.s head back to school they look for degree plans tailored to their specific needs. Keasler, program associate for the R.N.-B.S.N. Program at the University of Iowa in Iowa City, tells prospective students, “Our program is designed to accommodate nurses that continue to practice and it is our recommendation that they continue to work. Part of the advising process is to develop an individual plan. We work with each student on details.

“We are committed to distance education,” she adds. “Many of our courses incorporate the Web though none are totally Web-based. Our primary strategy to deliver to distant sites is the Iowa Communications Network, a statewide system that links higher education, plus a number of libraries. In the nursing major, our faculty here in Iowa City connects with three or four remote sites where there is a faculty member available for onsite advising and practicum.”

At the University of Central Florida the R.N. to B.S.N. program is totally Web-based. Popular with some students who love its flexibility, the program has a downside for others. “Most like the convenience of working from home as opposed to driving to campus, fighting traffic and juggling work schedules,” says Dr. Linda Hennig, R.N.-B.S.N. program coordinator. “But the regularly expressed dislikes include comments that it is more time-consuming than a traditional class and takes more work than expected. Some students feel they need more structure and discipline than a Web-based course provides.”

Students must also give thought to earning classroom credit for prior experience, a process which varies dramatically among schools. At the University of Southern California, students in the R.N. to B.S.N. program “have been allowed to challenge certain courses to get credit for experiences either before or after they enroll. This policy is currently being reviewed by the University and may be revised to limit the challenges [that may be made] before enrollment,” says Merriman.

“We do not offer credit for life experiences,” says Dr. Martha Greenberg, assistant professor of the Leinhard School of Nursing at Pace University in Pleasantville, N.Y. “But if nurses have obtained credentials or certification through the American Nurses Credentialing Center in, for example, human development or neurological nursing, we give nursing credit as an elective.”

Variations exist, too, on how much time it takes to earn the degree, though two years is common. Howard University in Washington, D.C., requires a minimum of two years study for their R.N. to B.S.N. program. At the University of Southern California, there is a 64-credit hour rule, a period equivalent to two years of full-time study, says Merriman. “The University wants to make sure the students have the full USC experience.”

Openness to student input is another issue to consider in choosing a program. At focus group meetings, Pace University nursing students tell administrators what they like and dislike. “I think the R.N. to B.S.N. program is becoming more tailored to student needs,” says Greenberg. “Nurses who come back to school want more independence and fewer highly structured clinicals.

“They want choices,” she adds. “Some want distance education via computers and an equal number want classes where they are face to face with the instructor. Most of all, they want to be treated as adult learners and don’t want to repeat what they already know.”

Take Your Time

“I decided to take a break,” says Mary Durand, R.N. “I have an 11-year-old daughter and a 9-year-old son. My husband has always supported me and helps around the house with cooking, cleaning and gardening when he can. Still, the main responsibility falls on me.”

The daughter of Puerto Rican immigrants, Durand is taking time off from her R.N. to B.S.N. degree program at the University of Central Florida. “When I graduated with my R.N. in May 1997, I went to work on a medical surgical unit. After a year, I wanted to do other things but realized that several positions that interested me required a B.S.N., so I started searching the Web and asking different people for information on programs.

“I started with one elective, testing the waters,” she explains. “I enjoyed the class and decided to continue. Then I took my first nursing class in the R.N. to B.S.N. program and also enjoyed it. But I realized it was taking too much time right now. I know that I will eventually get back into it. I’m a wanna-be perfectionist and being out of the program drives me crazy, so I know I’ll go back to finish it.”

It has largely been an issue of timing, Durand notes. “This is my kids’ first year in public schools and my mother is expecting some surgery, so I want to be there to help. I work only two days a week from 7 a.m. to 7 p.m. [in order] to keep my kids at the top of my priority list. I can’t wait to get my B.S.N., but I know I must be patient and keep my priorities in order.”

At the University of Central Florida, R.N. to B.S.N. Program Coordinator Hennig understands that nurses move through the program at different paces. “After beginning a program, some nurses realize they might need to slow down and take only one course per semester,” she says. “Others want to hurry up and get finished. Then there are those who have a boost in their self-esteem for academic achievement. Many realize they have the capacity for graduate education and quite a number go on for a master’s degree.

“I advise students not to overload themselves with too many credits,” Hennig says. “Taking a three-credit course requires a lot of outside preparation, reading and library work. I tell them to slow down and enjoy the learning process. Going part-time is OK; look at things through different lenses. Go back to school because you want to do it. First make the commitment, and then start working toward the goal.”

Hennig also advises a realistic look at the requirements when considering which program to select. “Depending on prior education, many nurses need a lot of general education credits before beginning the B.S.N. classes. Some will need to take a foreign language. Choosing a program that is regionally accredited will prepare you for advanced education in nursing if you decide to continue your education. Talk with a faculty member at the school and ask questions.”

Will the Nursing Shortage Stop the Degree Trend?

Dr. Dorothy L. Powell

Though some speculate the nursing shortage will halt the trend toward degrees, Dr. Dorothy L. Powell, associate dean for nursing at Howard University, disagrees. She admits that the R.N. to B.S.N. program there experiences enrollment fluctuations, saying, “The size varies from year to year depending on the nature of the nursing shortage in the area. When people are getting hired often, there is a decrease. When there are fewer jobs and health facilities are more selective, people think they need to get the bachelor’s degree.”

Ultimately, however, Powell feels the need for baccalaureate-level nurses will not cease. “I think the degree emphasis is a continuing trend,” she says. “When you think about the nursing shortage we have now, sure, part of it is numbers. But if you look at it closely, it is having insufficient nurses with the level of education that is required for the complexities we find now, particularly in the hospitals.”

Powell cites the impact of technology and the trend for patients to be sicker and of a more complex health status as driving the long-term need. “Therefore you need a nurse who is educated at a minimum at the level of the bachelor’s degree,” she says.

Powell continues, “The best investment we can make in nursing is to give the nurse a broad education and a good understanding of a holistic approach to health care, not just individual performance but also the political and social environment’s impact on how health care is delivered. And that comes at the baccalaureate level.”

Dr. Pamela Palmer, Ed.D., is a free-lance writer who specializes in career, business and information technology articles.