Just like anyone else’s journey to an advanced degree, nurses who set out to earn a BSN don’t always take the same path. With an industry-wide push to increase the number of nurses with BSN or higher credentials, many working nurses are now looking for options to get that degree—and community colleges are looking to help fill that need.

Unlike younger nursing students who might opt for a four-year program, working nurses often have families, full-time jobs, and other commitments that decrease not just their available time and funds, but their flexibility to fit in classes, clinicals, and study groups.

As a potential nursing shortage looms on the horizon and more nurses feel the pressure and the desire for a BSN degree, community colleges nationwide are beginning to offer RN to BSN programs that help nurses fit the degree program into their schedules.

According to Deborah Trautman, PhD, RN, FAA, president and CEO of the American Association of Colleges of Nursing (AACN), when the Institute of Medicine called for 80% of nurses in the workforce to have a bachelor’s degree by 2020, hospitals and health systems reevaluated their hiring practices to develop a more highly educated staff. As that deadline nears, many working RNs face a return to school for a new degree, even after many years in the workforce.

But these programs often offer other benefits to nurses who might not typically have the chance to enter a four-year program for various reasons. By reaching larger groups of nurses for these programs, community college RN to BSN programs might even increase the diversity of the nursing workforce.

When it comes to diversity in nursing, almost all sides agree on one thing—more is needed. A nursing workforce that mirrors the incredibly diverse population helps with obvious barriers like language, but also helps with smaller barriers like understanding subtle customs or traditions that have an enormous impact on health care and health practices.

Getting more educated and more diverse nurses into hospitals and health care settings will have positive impacts on patient and nurse satisfaction, safety, and the overall outlook.

In AACN’s 2014 study, Employment of New Nurse Graduates and Employer Preferences for Baccalaureate-Prepared Nurses, respondents from 461 nursing schools indicated that 79.6% of employers are expressing a strong preference for nurses with a BSN. In addition, almost half (45.1%) of hospitals and other health care settings insist new hires have a BSN.

And while the RN-to-BSN process looks different, it still brings the same educated outcome to the workforce. The more opportunity nursing students have to complete their BSN, the better the outcome.

“Community college-based baccalaureate programs provide a new pathway for registered nurses (RNs) to advance their education,” says Trautman, noting that community college RN to BSN programs can help fill the gap in BSN nurses.

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And in many states where community colleges are able to offer the RN to BSN program, increases in nurses with advanced degrees are evident. According to a study by the Florida Center for Nursing, the rate of nurses who graduated from a post-licensure degree program doubled from 2006 to 2013.

The numbers reveal a population of nurses who have already completed an associate’s degree in nursing (ADN) program and passed the NCLEX exams and are now looking to gain greater depth in areas like leadership and community relations and increase their job prospects and chances for career advancement.

“There’s a need and we are filling that need,” says Suzanne Beltz, PhD, RN, GCNS-BC, CNE, program chair of Bellevue College’s RN to BSN program. “We are just offering people a different route.”

And the programs appeal to nurses for whom the four-year programs aren’t possible so the programs open a door that was previously closed to many.

“This gives us another opportunity to reach more students,” says Linda Miles, interim associate vice president of Daytona State College’s College of Health and Public Services. “The whole idea is to increase the number of students. We meet the needs of a student who couldn’t enroll in another program.”

Speaking specifically about Florida, Miles says a concerted effort to raise the percentage of citizens who held a baccalaureate degree resulted in new opportunities for community colleges to offer the RN to BSN programs. But the process for colleges isn’t always easy; so many bristle when they hear some people question the rigor of their course work. Community colleges aren’t willing to create new curriculum, get accredited, and attract new students without producing a top-notch, competitive program, says Beltz.

Although nurses emerge with the same degree from any BSN program, the path to a BSN does not look the same in a community college as at a four-year university or college. In fact, although the end result is the same, student experiences are quite different in the programs.

Gwen Alcorn, dean of health sciences at the College of Central Florida says students entering the programs might not study the material in the same order, but all the material is covered. A traditional entry-level BSN means the student comes to the program with no license and will sit for the NCLEX licensure exams after graduation where they graduate with a bachelor of science in nursing, Alcorn says.

“It’s just a different pathway,” says Miles. In typical community college programs, nursing students enter the RN to BSN program as a completion program. They have already earned an associate’s degree, have passed the NCLEX exams for the RN designation, and often have work experience. After graduating from a BSN program, students aren’t required to retake the NCLEX exams.

The ADN program is very task oriented, says Beltz, and depending on how a particular nursing student works and his or her confidence level, these task-oriented semesters can be a real advantage. Because they have the experience that got them to the RN level, they approach the BSN program’s classroom learning with real-life, hands-on nursing experiences.

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For students who learn by doing, the RN to BSN approach can be transformative. “They can sit for the board and pass to become an RN,” says Beltz. “Then the monkey is off their backs to pass the boards. Now they have an opportunity to focus on learning that isn’t just for the boards. They can pay more attention to the leadership principles and the management principles like how to make an assignment.”

Class assignments, says Beltz, are then based heavily in realistic approaches like conflict resolution or budgeting for your unit, rather than strictly theory or research.

In an entry-level BSN program, hands-on clinicals come after several semesters of theoretical learning. In the RN to BSN programs, that schedule is flipped. Nurses gain their hands-on care of patients in the earliest semesters of the associate’s program. In the RN to BSN program, they then delve into the theoretical approaches, leadership and management practices, and the complex dynamics of community, economics, and politics that impact nursing and patient care.

By earning an associate’s first, students often bring a real-world understanding of the theories they are learning about to their classes. RNs who have the clinical exposure have had the time and opportunity to identify their interests, strengths, and weaknesses and are often able to tailor their BSN program to more closely direct their career goals.

A community college can help students forge a path that maybe they couldn’t have access to at a four-year program and can help them shore up skills that might not have been addressed in the associate’s program. While many BSN programs at four-year institutions complete writing intensive courses in the first couple of years, for instance, RNs don’t all have that background. So an RN to BSN program can help eliminate that barrier.

Writing skills, says Beltz, aren’t emphasized in an associate’s program, where other skills are highlighted more. Bellevue’s diverse student population comes from places as far-flung as India, Japan, China, and Vietnam, so she understands how a lack of proficiency in writing clearly can hurt the nursing career of someone who speaks English as a second language.

You don’t have to be a good writer to become an RN, but to advance to the BSN level, being able to communicate clearly and concisely through writing is essential and often expected. Writing in a language that isn’t your first language can pose a particular challenge, says Beltz, so directing attention to nursing duties and classwork where good written communication is essential helps the nurse and increases accurate communication.

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Miles says an early program evaluation revealed that many stakeholders wanted to see very specific offerings in the school’s new RN to BSN program. In addition to a rigorous curriculum, many replies indicated that the program needed to be flexible and convenient so students could work around family and work obligations.

And although a community college program is competitive academically, it’s generally less threatening, says Beltz, for several reasons. Open enrollment takes some pressure off fitting in application deadlines, and close locations and lower tuition can make a big difference.

“These programs are expected to produce graduates with the same level of competency as graduates from traditional four-year programs,” says Trautman. “The Commission on Collegiate Nursing Education (CCNE), the nation’s premiere accrediting body for baccalaureate and higher degree nursing programs, measures quality in community colleges-baccalaureate programs using the same criteria applied to four-year schools.”

But another factor that came up had to do with something closer to home, says Miles. Familiarity with the program and the college featured prominently in the students’ wishes.

Trautman agrees, noting that many community college programs are especially attractive to students who have graduated from a school’s ADN program. In fact, says Miles, she sees that trend clearly at her own school. “Many who are in the last semester of the ADN are applying to the program,” she says.

And while there are students ready to fill programs, there’s still a need for faculty to teach this new crop of BSN nurses. “Community colleges looking to offer baccalaureate level nursing programs will likely face the same challenges that four-year programs do, including finding sufficient numbers of faculty and clinical placement sites,” says Trautman. “AACN encourages collaboration between community colleges and nursing programs when possible to share resources and facilitate academic progression.”

In the end, the country needs nurses and needs nurses who are well educated and highly experienced. Noting the Institute of Medicine’s 2020 goal, Alcorn says without the RN to BSN programs, states will be hard-pressed to meet that goal.

“The components are different,” says Alcorn, “but we accomplish the same objective. It’s just in a different pattern.”

Julia Quinn-Szcesuil
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