Work, Life, School, Balance

Juggling undergraduate nursing studies with a full-time job and six children at home constantly challenged Shayla Morales Robinson of Philadelphia. But the petite go-getter held firm to her decision to earn a B.S.N. from La Salle University’s School of Nursing and Health Sciences to secure a brighter future for her family.

Even after her mother and babysitter were both diagnosed with cancer and her abusive marriage ended, Morales, 34, kept moving forward in an alternative evening program designed for working parents.

“You just have to do it, literally! You have to want it,” says Robinson, who graduated last year. “I wasn’t going to let the fact I had children, that I was going through a divorce and working full time, and being the sole provider, get me down. A lot of it was trial and error.”

From studying at their children’s soccer games and enrolling in online programs to arranging classes around a flexible work schedule and developing a master family calendar, nurses who resume their studies while raising families use a variety of strategies to cope. They say other nurses who return to school can adapt or modify their methods.

More nurses are returning to school to meet the challenges of the “increasingly more complex health care needs of a multicultural and aging population,” says American Nurses Association (ANA) spokesman Adam Sachs. Other reasons include the shortage of nursing faculty and a limited cadre of nurses from which to draw. The benefits of earning a B.S.N. or more advanced degree include higher job satisfaction and more opportunities for growth. Research shows advanced education can also benefit patients by lowering mortality, he says.

ANA supports nurses advancing their education and endorses the Institute of Medicine’s (IOM) call for 80% of nurses to obtain a B.S.N. by 2020, a goal included in the IOM report The Future of Nursing: Leading Change, Advancing Health.

Be prepared

Realistically assess your situation before returning to school, nurses and nursing professors say. Consider taking some practical measures such as seeking employers offering flexible scheduling and tuition assistance, exploring online or distance learning, and finding programs that combine online learning with on-site clinical and classroom experience.

Nurses who may be on the fence about returning to school “need to think about their physical condition. Will they be able to juggle these three things [family, work, and school] in their lives?” asks Nellie C. Bailey, Ed.D., P.H.C.N.S.-B.C., Associate Dean for Undergraduate Programs at SUNY Downstate Medical Center College of Nursing in Brooklyn, New York. “Your whole life changes, and it is very good to have family support.”

Nurses resuming their studies after a long gap need to review the required time commitment. Financial adjustments may need to be made as well. While family and your employer’s support are crucial, so is the support of your professors. “Take some time to go to the college and talk to the faculty about how supportive [they are] and will they be flexible?” Bailey says. For nurses planning to add to their families, inquire about maternity leave policies as well, she advises.

Your degree options

With hospitals and academic health centers requiring or preferring the B.S.N., such degree programs are thriving. There are 633 R.N.-to-B.S.N. programs nationwide, including more than 400 programs that are offered at least partially online, according to the American Association of Colleges of Nursing (AACN).

The ANA advises people entering a nursing education program to make sure the program is accredited by a recognized nursing education accreditation body and that the program meets their learning and programmatic needs.

Whether nurses are considering an undergraduate, graduate, or doctoral degree, make sure you are clear about your goals and ready for the commitment, says Melissa Gomes, Ph.D., R.N., an assistant professor at Virginia Commonwealth University’s School of Nursing. “The balancing can be tough for students, especially the adult learner. They have to make sure they can set aside time for studying. They have to always carry their work with them, so at a child’s game they can study.”

Online programs allow current and aspiring nurses more flexibility as they try to balance family and work commitment. Excelsior College, an online institution with the largest nursing education program in the country, enabled Monica Muamba, M.S., R.N., an Education Specialist at Albany Medical Center Hospital in New York, to earn her master’s degree in nursing education in April 2012. Online classes allowed her to work full time, take care of her family, and lead a nonprofit organization, she says.

“My question to every nurse out there is ‘Do you have a dream?’ Don’t let it fade! It is never too late to open doors of opportunity in your life,” says Muamba. An online program “opens the floodgate of career opportunities for nurses who could not attend traditional campus education.”

Your work-life balance

For Audrey R. Roberson, M.S., R.N., C.P.A.N., C.N.S.-B.C., family comes first. So when she decided to pursue her Ph.D., she says she discussed with her husband at length, because she knew she would need his full support—in a way, it was going to be a “dual” Ph.D. “It would have my name on it but it would be 50-50,” Roberson says chuckling. To test the waters, the nurse clinician at Virginia Commonwealth University’s Medical Respiratory Intensive Care Unit took one course in 2009. Still, the workload was intense; she organizes a master schedule so she could manage her time, even though that still meant staying up until 1:00 a.m. some nights doing homework.

When considering school, assess your support systems, Roberson says. “You need double the support system if you have children involved. If you are lacking support, reconsider. Entering this without support is not an option.”

Roberson advises nurses to communicate with supervisors and colleagues about any school-related schedules or projects that may interfere with job duties. She is still responsible for her work but she has learned to do more delegating and collaborating, she says. A helpful work environment is crucial. “I have support from my boss who encouraged me to get a Ph.D. She was supportive of me taking the same journey she had taken,” Roberson says.

Once committed to furthering your education, stay focused, says Isaac L. Smith, M.S., R.N., associate professor and Director of Human Patient Simulation at Prairie View A&M University College of Nursing in Houston. Smith, who has two sons, is working on his Ph.D. online at Capella University. “I am finally at the dissertation level. It has required real will. I have worked as a nurse manager for many years. I thought the best way to contribute to the profession of nursing is to give back by teaching other students,” he says.

Another strategy busy nurses use is scheduling time to relax. “Find something that feeds your soul,” says Paulina Marfo-Boateng, M.S.N., R.N., a staff nurse at SUNY Downstate Medical Center, who earned her master’s degree in part to be a role model for her three children. She relaxes by volunteering in her church.

For nurses wary of losing their equilibrium if they return to school, Marfo-Boateng advises studying at one’s own pace. “You can take one class at a time and it goes a long way. I did not do it full time. I did it part time, two classes here and a class there. If you take one class, just don’t give up,” says Marfo-Boateng, who plans to earn her Ph.D. once her daughter enters high school in a couple of years.

A can-do attitude is what led Robinson to add college to her jam-packed to-do list. A team assistant for Penn Wissahickon Hospice and Caring Way at Penn Home Care and Hospice Services in Philadelphia, she returned to school with five of her six children under the age of four, including two sets of twins. “My only motivation has been my children and the fact that so many women give up at their dreams when they are a single parent,” Robinson says.

However, not long after she started classes, Robinson felt overwhelmed and exhausted. Her marriage crumbled, a horrible custody case ensued, and her babysitter was battling breast cancer. Sometimes she missed class to watch her children and had to use class notes and recordings from classmates to keep up with her work. She also borrowed thousands of dollars to pay for babysitters and bills.

“I’d leave work at 4:00 because I had class at 6:00. I’d pick the kids up and go home. I’d put dinner on and do homework with them while I was cooking, then feed them and throw everything into the sink and then kiss them goodbye.” Some nights she stayed up until 3:00 a.m. with homework only to rise again at 6:00 a.m. to start another day.

With such a tight schedule, Robinson had to make adjustments. She called her children’s teachers and asked for an extension on homework on the two nights she had class. She made sure everyone was caught up by the end of the week. She modified her work schedule and asked professors to allow her to take day classes, even though she was in an evening program. She also requested weekend clinicals although she was taking a weekday class.

No matter what the obstacle, Robinson found a way pass it. “I tell people if you really want to do it, you will figure a way.”

Her fierce drive and resilience impressed the faculty so much that after Robinson graduated they took the thank you letter she had written to the university and had it published in the Philadelphia Daily News (May 2011). The response from readers to her accomplishment in the face of tremendous odds touched Robinson, especially the regular updates from three nurses she inspired to return to school.

Robinson passed her National Council Licensure Examination (NCLEX) in June on her second try and is now a registered nurse torn between seeking a job as a psychiatric nurse or a maternity nurse. Her children are doing well. And she’s in a new, healthier relationship.

Out of school a little over a year, Robinson is already prepared to further her education. La Salle University has a dual M.S.N. and M.B.A. program that meets on Saturdays for two years.

“I started looking into this,” she says chuckling, “so I can conquer that.”

Scholarships for Nurses

If you think scholarships are just for baby-faced college freshmen, think again! There are plenty of nursing grants and scholarships offered at every level. Here’s just a sampling.

AETNA/National Coalition of Ethnic Minority Nurse Associations Scholars: $2,000
Sponsor: National Association of Hispanic Nurses Scholarships and Awards
Applicant must have a minimum 3.0 GPA, demonstrate financial need, be a member of the National Association of Hispanic Nurses, have two letters of recommendation from two faculty members, and be enrolled full time in a four-year or master’s degree nursing program.

Eight and Forty Lung and Respiratory Nursing Scholarship: $5,000
Sponsor: American Legion
Applicant must be a registered nurse seeking advanced preparation for a full-time position in supervision, administration, or teaching with a direct relationship to lung and respiratory control.

Estelle Massey Osborne Scholarship: $2,500–$10,000
Sponsor: Nurses Educational Funds, Inc.
Applicant should be a black registered nurse who is a member of a professional nursing association and enrolled in or applying to a full-time master’s degree program in nursing approved by the National League for Nursing and CCNE. Applicant must be a U.S. citizen or have declared official intention of becoming one. Applicant must submit GRE or MAT scores. Selection is based upon academic achievement and evidence of service to the profession.

Ethnic Minority Master’s Scholarship: $3,000
Sponsor: Oncology Nursing Society (ONS) Foundation
Applicant must be an R.N. with an interest in and a commitment to oncology nursing and be of a minority racial/ethnic background.

NAPNAP-McNeil Scholarship: $2,000
Sponsor: National Association of Pediatric Nurse Practitioners
Applicant must be a registered nurse with previous work experience in pediatrics, have documented acceptance at a recognized program, have no formal nurse practitioner education, demonstrate financial need, and state rationale for seeking a pediatric nurse practitioner education.

Neuroscience Nursing Foundation Scholarship: $1,500
Sponsor: Neuroscience Nursing Foundation
Applicant must attend or plan to attend a NLN accredited institution.

Regents Professional Opportunity Scholarship: $5,000
Sponsor: New York State Education Department
Applicant must be beginning or already enrolled in an approved degree-bearing program of study in New York State that leads to licensure in a particular profession. Purpose of award is to increase representation of minority and disadvantaged individuals in New York State–licensed professions.

Scholarship in Cancer Nursing—Master’s: $10,000
Sponsor: American Cancer Society
Applicant must show intent to develop clinical expertise and a commitment to cancer nursing. Relevant personal and professional experience is required.

Source: CollegeXpress. Use CollegeXpress to find nursing scholarships and programs

On the Fast Track

Are you one of the growing number of minority students who are entering nursing school later in life, or returning to school mid-career to continue your education by earning a baccalaureate or post-graduate degree? If so, you may be wishing there was a way to make up for lost time, a way to somehow earn your advanced degree just a little more quickly than usual so that you can put it to work for you as soon as possible.


Happily, fulfilling this desire is not impossible at all. Enrolling in a so-called “fast-track” nursing program—i.e., a program that allows students to earn two degrees concurrently or even bypass one degree level altogether—could be the perfect solution for your needs.


The fast-track approach to advancing your education means that you don’t have to follow the traditional route of first gaining basic registered nurse (RN) preparation in hospital-based (diploma), associate (AA/AD/AS) or baccalaureate (BSN) programs and then sequentially attaining master’s and doctoral degrees. Fast-track programs are a more customized alternative in which, to cite just two examples, a student with an AD degree can go directly to a master’s degree without having to separately earn a baccalaureate, or a nurse with a BSN can go directly to a PhD, bypassing the MSN.


If this approach sounds appealing to you, one of the first and most important decisions you will need to make is choosing the nursing program that will best facilitate your career goals within a fast-track context. With at least 600 nursing programs available throughout the United States, you will find many that offer contemporary options that are far more flexible and non-linear than traditional nursing programs.


When perusing a program’s literature, look for phrases like “individualize your program,” “may be required” and “flexible options.” These phrases signal that the traditional degree sequence may be circumvented or combined, depending upon the student’s needs.

Which Lane is Right for You?

For a closer look at how fast-track degree programs work, and to give you an introduction to the many different possibilities available, here are just a few examples of successful programs from around the country.

Non-Nurse with BS or BA to RN with Master’s Degree. Even if you are not a registered nurse, it is possible to graduate as an RN with a master’s degree in nursing. For example, the University of California, San Francisco, School of Nursing offers the Masters Entry Program in Nursing (MEPN), a three-year program leading to an MS degree for persons without previous nursing preparation but with a baccalaureate degree (BS/BA) in another field. For more information, see the university’s Web site (http://nurseweb.ucsf.edu/www/ucsfson.htm).


About 60 students are admitted to the MEPN program each year. The first year of study, which spans four quarters, provides a general foundation in nursing and qualifies the student to take the California Board of Registered Nursing licensure examination. The final two years of the program are more individually paced.

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RN with Diploma or Associate Degree to RN with Master’s Degree. Several universities offer accelerated coursework for RNs with two-year degrees who wish to earn a master’s degree in nursing, bypassing the BSN. The Department of Nursing at California State University, Los Angeles (www.calstatela.edu/dept/nursing/), currently offers two different fast-track MS degree options. The first program is for RNs with non-nursing baccalaureate degrees; the other is for RNs without a baccalaureate degree. The admission requirements, program length and coursework vary depending on the educational track entered. Both programs offer basic and advanced nursing study.


The University of Michigan School of Nursing (www.umich.edu/~nursing/) is another school that offers an RN-to-MS degree program; however, this option is available at the Ann Arbor campus only. You can complete the RN-to-MS pathway as a part-time student in three to four years, depending on your master’s specialty. The program integrates your prior education and experience into the curriculum by using your transfer credits and by allowing you to earn credit through examinations.

RN with BSN to RN with PhD. If you are an RN with a baccalaureate degree, you can earn a PhD in Nursing Science without having a master’s degree. For instance, at the University of Washington School of Nursing, Seattle (www.son.washington.edu), an RN with an bachelor’s degree can either earn a master’s degree while also pursuing a PhD degree, or graduate with a PhD without going for the master’s.

 

Other schools, such as Johns Hopkins University School of Nursing in Baltimore (www.son.jhmi.edu) have programs where an RN with a BSN can earn a combined MSN/PhD concurrently. Both the Seattle and Johns Hopkins programs are highly selective, have an integrated course of study and allow students to develop their own research programs with faculty guidance.

Can You Handle the Speed?

Fast-track educational options have both benefits and limitations. Because these positives and negatives are interrelated, it’s important to consider them carefully within the context of your career goals. The benefit of completing the required coursework for two degrees in an accelerated format, for instance, is coupled with the fact that the coursework is more intense and time-consuming. The shorter length of fast-track programs requires you to learn more information in less time than a student enrolled in a traditional program in which each degree is earned sequentially.


There are also financial considerations. If you are enrolled in a fast-track option, you may find it impossible to work part-time because of your heavier academic schedule. Therefore, your need for ongoing financial aid is more critical and substantial.


In a fast-track program, you may have fewer opportunities to benefit from educational diversity. For instance, a student earning two separate degrees at two different universities may experience different curricula and teaching styles, while a student earning a fast-track or combination degree will more than likely learn in similar environments with a select group of faculty. On the other hand, students in a fast-track program may be able to form more substantial relationships with their professors over time, building stronger collegial networks which may be beneficial in the future.


One major limitation of earning a PhD without a master’s degree in nursing is that many state boards of nursing, as well as schools of nursing, recognize the master’s degree as qualification for undergraduate- and graduate-level clinical teaching, while the PhD is seen as a research-focused degree. Thus, without the master’s degree, you may not be technically prepared to teach clinical-level coursework—a significant drawback if your desired career plan involves becoming a faculty member.

Getting On the Road

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If you are interested in entering nursing with an advanced degree, or are an RN seeking to increase your career potential by continuing your professional education, now is an excellent time to learn more about fast-track degree programs. Use the Internet as a resource to explore the flexible educational options available to you. Many of these programs are tailored to recognize your abilities and talents while capitalizing on your prior educational and clinical experience.


Earning advanced degrees helps you hone your critical thinking and decision-making skills while introducing you to emerging, innovative areas of nursing. Your career options as an RN will multiply as you discover exciting new areas for professional growth and advanced competency.

E-Learning from Experience

My journey into the world of online education as a student was a completely new experience for me. I had attended traditional universities to obtain my associate’s, bachelor’s and master’s degrees in nursing. While serving in the Army Nurse Corps as an ICU nurse, I completed an adult nurse practitioner certification program offered through the military. But years later, having established a successful career working in every area of nursing, I suddenly found myself contemplating the idea of returning to school to obtain my PhD. This bug was put in my ear by one of my best friends, who is also a nurse—because she was thinking of doing the same thing herself. (It is true that misery loves company!)

At this point in my life, this was a big decision. I made a list of all the reasons why I shouldn’t return to school and all the reasons why I should. Initially, the list of “shouldn’ts” outweighed the “shoulds.” I held an established faculty position in a university and had two children who at that time were under the age of 13. And because I lived in an area where there were no nursing schools nearby, the idea of driving at least one to four hours one way to sit in a class did not appeal to me, because it would mean too much time away from my children.
But the more I thought about returning to school, the more it became appealing.  Obtaining my PhD would be a wise career move, a personal achievement and something that no one else in my family had ever accomplished. Then my good friend told me, “You don’t have to leave home, you can do it all online.”

I did some research for myself. The university that I was interested in, Hampton University School of Nursing, had just obtained a grant for the PhD program. So I applied. The admission process was not as difficult as I imagined. The thought of taking graduate admissions exams like the GRE or MAT (Miller Analogies Test) at my age was not fun, but I was accepted into the online PhD program at Hampton—and so was my good friend.

The Age of E-Learning

Today, online degrees are offered in many areas of interest. Many students opt for online education—also known as distance learning or e-learning—because of its flexibility and low cost. It is a simple way to learn new languages and obtain professional certificates. The World Wide Web has opened the door to a whole new age of e-learning that has provided many of us with a new incentive to learn. And the technology continues to advance, with streaming media, online videos and fast Web servers making it easier than ever to pursue a nursing degree online.  

Compared to the traditional way of earning a degree, students are finding e-learning to be a more enjoyable and lifestyle-friendly option. No longer are you tied to the classroom, rushing to the campus after a long day at work, trying to figure out who can pick up the children and worrying about making dinner. Today you can take courses at your own pace, in your home, even in your pajamas, whenever you are ready. You can work on your courses early in the morning before the family gets up or late at night when all is quiet.

Now that you know the benefits of online degree programs, what else is there to consider?  Let’s look at the economy. It seems that when the economy begins to decline, admissions to colleges and universities increase. This inverse relationship is very understandable. When people’s job security is uncertain, they begin looking toward a new career that will offer more stability and better compensation. Nursing is one such career. For those of us who are already in the nursing profession, staying competitive in a job market where employers are looking for candidates with highly specialized skills means that many of us may need to return to school.

What to Expect

Congratulations! You’ve just been admitted into an online nursing program. Now what? Based on my own experience as a first-time e-learning student, here is some advice on how to make the most of your online learning experience, what you can realistically expect and what pitfalls to avoid.

Let’s begin. First of all, you will need to have a fast-working computer. It doesn’t have to be the fastest model available, but having a high-speed computer that can do faster uploads and downloads definitely helps.

The next thing you need to know is that many online degree programs will not allow you too much freedom. There is a set time frame for each course and you must complete the course within that allotted time limit. Yes, it is true that you are supposed to be able to work at your own pace, but it will not benefit you or the program if it takes you a whole year to complete one course. Many programs will tell you that you must put X amount of hours a day into the courses to avoid falling behind. But because it is an online program, people tend to procrastinate and then try to hurry up and complete the work within the last month. This is not a good approach. 

When I was admitted to my online PhD program, I thought it would be a breeze. Not so! Online learning is convenient but not always easy. Most of the instructors who teach online have a PhD in their area. So don’t make the mistake of thinking that it’s an easy grade. I had a rude awakening in that regard. Luckily, I realized that I had to knuckle down and do the work before I got too far behind.

You will have to write papers that must be completed in a timely fashion and mailed to the instructor’s drop box or emailed. Keep in mind that you have to allow the instructor a one- to two-week turnaround time (depending on his/her policy). These waiting periods may keep you from moving ahead in your course as quickly as you had planned. So this is another reason why waiting until the last minute is not productive. 
There are also online chats and/or teleconference calls that you have to attend. For the teleconferences, the instructor will give you a call-in number and you will be in a pool with five to ten other students (depending on how many are in your class), all wanting to speak at the same time. This is where e-learning etiquette comes into play. Be nice, play nice and don’t interrupt. You will get a chance to speak.

For the online chats, you will be given a day and time to sign into your chat. The instructor will ask questions and the class will respond. On your computer screen you will have a blank section where you can type your response. Some chats are “live” and some are not. In some cases, the instructor will pose a question or discussion and the students must respond by a certain date or time. But in a live chat, you must respond immediately. If you tend to be a slow typist, another student may beat you to it and answer the question first. So what do you do? Sometimes I would just erase what I was going to say, but many times I would hit “enter” and send my response anyway. (Brilliant minds think alike!)

Tech Support

The last thing to remember is that computers are manmade and they will not always work when you want them to. Many times I picked my desktop computer up with the intent of throwing it out the window. Many times I cried, begged, pleaded with the mighty computer to please work. The mighty computer does not care. So if your computer freezes or just stops working, take it to the computer doctor. Having a tech support person(s) who is capable, knowledgeable, reliable, fast and affordable is very important. Word of mouth is one of the best ways to find out who will do a good job of getting your computer back in working condition. Students in your university’s computer sciences department may also offer good, free advice on how to fix your computer problems.

And finally, always back up your work, either on a disk, a floppy (old school) or on the hard drive. Computers do crash, lightning does happen and laptops do get stolen. I remember working on the last chapter of my dissertation during a terrific thunderstorm. I usually turn everything electric off and sit in the dark when there is lightning, but I kept thinking, “just one more sentence.” My computer went blank and never came on again, either that day or the next. Worried that my entire dissertation was gone and my life was doomed, I took my machine to the computer doctors and prayed that they could retrieve my lost document that I had worked on for three years. I had to leave my computer with these strangers for two long days, but when I was called to come pick it up and learned that they were able to recover my document, I could have kissed their hands. Instead I just paid them and took my computer home. Lesson learned.

So would I go through this whole e-learning experience again? Absolutely. I obtained my PhD entirely online. I only had to go down to the university once, to defend my dissertation. I was able to see my children; even though all they usually saw of me was the back of my head, I was there with them.

Is online education for everybody? No. It does take discipline, which I think is one of the hardest traits to have. It would be so easy to blow off doing that paper and go to the beach instead. One thing that I really missed was having face-to-face interaction with my instructors and classmates, not being able to see who I was chatting with, trying to put names with voices. But overall, my journey through the world of e-learning was a truly wonderful experience.

A Faster Path to the PhD

Traditionally, the path to a PhD in nursing has resembled the proverbial long and winding road. RNs interested in continuing their professional education would go back to school and get a BSN degree, then work in the clinical setting for a few years. After a while, they would return to school, earn their master’s in nursing and then go back out into the “real world” to work, or in some cases, teach. For many of the current generation of doctorally prepared nurses, the decision to again go back to school and earn a PhD was made well into the middle stage of their careers.

Today, proponents of a more direct path to the PhD are hoping to increase the number of doctorally prepared minority nurses doing research–and even more importantly, get them into the lab much sooner. A growing number of universities now offer “express track” BSN-to-PhD programs that bypass the traditional MSN degree, giving students an opportunity to become nurse scientists at a significantly earlier point in their lives.

This approach flies in the face of what has long been held as the proper progression of a nursing career. “Before, we said we didn’t want [BSN students] to go straight into graduate programs. Now, we encourage that because time is just too valuable,” explains Gloria McWhirter, MSN, RN, assistant professor and coordinator of academic student resources at the University of Florida College of Nursing in Gainesville, which offers a BSN-to-PhD in Nursing Science program. She believes this slightly accelerated degree program is a good alternative, especially for younger nurses who have seen just enough of nursing to want to do more with their careers.

“When you first get out of college and you’re a nurse, it’s so exciting,” McWhirter says. “A few years later, after you’ve worked those 12-hour shifts, you start wanting to do more. You may want something more challenging and you’ll want to make [changes in the way things are done]. The only way you can do that is to take your education to a higher level.”

According to the American Association of Colleges of Nursing, about 50 colleges across the United States have BSN-to-PhD programs, and that number is expected to grow dramatically in the next decade. McWhirter believes the movement to channel students straight into a terminal degree program is a natural change that would bring nursing into line with other health professions. In fact, she thinks MSN programs may eventually disappear.

“Nursing is simply coming up to the standards that equal those of our health care partners. If you’re in the school of pharmacy, you come out as a Doctor of Pharmacy. You don’t come out with a master’s,” she argues.

Putting Time on Their Side

Proponents believe those who stand to benefit the most from these programs won’t be the nursing schools that hire BSN-to-PhD graduates, nor those students now in BSN programs who will discover exciting research careers sooner. The biggest rewards will instead be reaped by patients. By putting many more nurses into research at an earlier age, these programs have the potential to radically expand the rate of development for new nursing practices, health care reforms and solutions for eliminating racial and ethnic health disparities.

“Historically, nurses [have gone] on to get their PhD degrees mid career,” says Daniel J. Pesut, PhD, RN, CS, FAAN, associate dean for graduate programs at the Indiana University School of Nursing in Indianapolis, which offers a 90-credit post-baccalaureate PhD in Nursing Science program. “Most people recognize that the factor of knowledge development in nursing depends on having [researchers] who have long career trajectories. Many nurses [who earn their doctorates later in life] only have a 15-year period where they have a research career and are creating new knowledge.”

BSN-to-PhD programs could add many valuable years to that window of opportunity and enable more nurses to spend the lion’s share of their careers in research and teaching, instead of spending the first half at the bedside, Pesut explains.

It’s not that those bedside careers aren’t important. Direct patient care will always be one of the most in-demand and rewarding aspects of nursing. But for nurses who already know that they want to move into research, these programs can help get them there sooner.

“We want to find young people who are committed to research and start them on that road after a minimum time in practice,” Pesut says. “Then, those graduates will have a 40-year career in nursing research.”

Putting nurses on the PhD track straight out of their undergraduate programs can also help them avoid the transition problems that often accompany mid-career changes. “We don’t want those good students to get out of the mode of studying,” says McWhirter. “Plus, they’re used to living as a student with little money, so they don’t have to cut back so much later to be able to afford graduate school.”

The Right Option for You?

If you’re currently a BSN student or recent BSN graduate, is a baccalaureate-to-doctoral program something you should look into? The answer depends on what you want to do with your career. BSN-to-PhD programs focus heavily on research and are ideal for students who want to become nurse scientists. If, on the other hand, you’re not interested in research, you might be better served by a different degree. Students who are more interested in clinical practice, for example, might consider the new Doctor of Nursing Practice (DNP) degrees that are offered at a number of universities.

“Students who just want to teach might consider a master’s degree with an emphasis on nursing education, because most schools of nursing do still hire master’s-prepared nurses to do a lot of teaching,” says Jennifer Gray, PhD, associate dean of graduate programs at the University of Texas at Arlington School of Nursing. “The PhD degree is a research degree, so it may not be right for everyone.”

Furthermore, BSN-to-PhD programs are not for the faint of heart. While they may be only a semester or two shorter than the traditional route to a PhD, they are very intense, because students become involved in writing and research immediately.

“Students who did not enjoy the science classes in their undergraduate programs may not be prepared to do research right away,” says Gray. “You really have to have a strong background.”

The BSN-to-PhD in Nursing program at the University of Texas at Arlington is one of the newer ones and Gray anticipates evaluating the curriculum after a year. “This may have been more challenging for the students than we had anticipated,” she admits. “It is a full-time program with nine graduate levels in the fall and spring semesters and six hours in the summer. You might be able to work 10 or 20 hours a week, but it’s very difficult.”

Attracting Diverse Students

The UT-Arlington program focuses specifically on preparing nurse scientists to meet the health needs of diverse and vulnerable populations. It’s just one example of how nursing schools are reaching out to make sure minority students are well-represented in their BSN-to-PhD programs.

“We are working hard to attract more minorities to [the University of Florida’s] program,” says McWhirter, who is African American. As part of her job, she travels throughout the South to encourage nursing students of color to consider graduate school. The university has established relationships with historically black schools like Florida A&M University and Bethune-Cookman College that make it easier for alumni of those institutions to participate in the BSN-to-PhD program.

In her efforts to recruit minority students McWhirter finds herself constantly battling one fierce competitor: finances. “When you’re looking to recruit minorities, you have to prepare them financially, and we do [offer] some incentives,” she says. “Most minority students have financial responsibilities. They may have children. They have to have a stipend in order to attend.”

As with other graduate programs, research and teaching assistantships are competitive and coveted. They usually provide small stipends in addition to tuition waivers. Other types of assistance, like National Institutes of Health research training grants and private foundation money, are available at some universities to help students pay for PhD programs. However, many students must finance their education with loans.

While it’s usually impossible for nursing students in accelerated graduate programs to work, that rule doesn’t always hold true for baccalaureate-to-doctoral programs. The University of Florida, for example, has collaborated with local hospitals to allow BSN-to-PhD students to work weekend schedules. The students are able to earn some money while devoting weekdays to studies.

“Students [in these programs] do have an advantage, in that they are RNs,” McWhirter points out. “They can [work as nurses and] make money.”

How to Get In

While admission to BSN-to-PhD programs is competitive, most programs are eager to speak with potential minority students. Professional references are required and your undergraduate GPA should be at least 3.0 (on a 4.0 scale). Many programs require a 3.5 GPA.

“When I meet with [prospective] students, I tell them that their job is to get their grades up and get a good GRE (Graduate Record Examinations) score,” says McWhirter. “If you have that, people will come to you because you are good. Graduate school money is there for those students.”

She advises students to take the GRE seriously. As a general rule, graduate schools require a 1,000 composite score–i.e., 500 scored on both the verbal and quantitative reasoning sections–plus a 3.5 score on the analytical writing section. A higher score improves your chances of being awarded a scholarship or chosen as a research assistant,

“It’s documented that [many] minority students do have trouble with standardized exams,” says McWhirter. “Knowing that, I feel that we should by all means prepare ourselves for those exams. [A nurse] would never walk into surgery without preparing, so why would we take a test without preparing?”

She also recommends that minority students who hope to be accepted into a BSN-to-PhD program take a pre-GRE tutoring course, such as those offered by Kaplan Test Prep, even though some may cost as much as $1,000. “It’s worthy every penny,” she maintains.

In addition, an essay or a career mission statement is usually required. This is where applicants have the chance to rise above peers and perhaps recover admission points lost in other areas. Speak with an admissions advisor within the program to find out exactly what is expected in the essay, since requirements vary. At Indiana University, for example, administrators look to the essay to see where students want to go with their PhD.

“We look for career aspirations in our essays,” Pesut explains. “Some students want to tell us about where they have been in the past, but we’re most interested in where they want to go in their future.”

Choosing the Right School

The number of BSN-to-PhD programs being offered today is still small, but each one is different. Finding that ever-elusive academic “perfect fit” is perhaps nowhere more important than here. When researching schools, a good place to start is the American Association of Colleges of Nursing’s Web site, www.aacn.nche.edu, which has a fairly comprehensive list of schools offering baccalaureate-to-doctoral programs as of fall 2004.

Fortunately, deciding on a program will become much easier once you’ve chosen what your specialized interest will be. This is the area of nursing in which your studies and your research will be concentrated. It could be a specialty area of nursing, like geriatrics, or it could be related to a specific disease, like HIV/AIDS. It can even be as specific as using preventive care to delay aging in the Hispanic population.

Your area of expertise will narrow the possible choices down considerably, as you’ll want to find programs with faculty who are active in that area.

“We generally don’t accept students who are not in some way attracted by the set of expertise represented in our faculty,” Pesut says. To show how important this connection is, applications to Indiana University’s program must include an additional letter of reference: one from an Indiana University faculty member.

“This program involves a lot of mentoring, and the connection between a student’s interest and those of our faculty is vital,” he continues. “For example, if a student was interested in doing neonatal research, we have only one person on our faculty with that expertise and that faculty member is not currently doing research. The opportunities to focus on that area would be limited. We know students’ focus may change somewhat as they move through the program, but initially we want students who are interested in the special expertise our faculty offers.”

Pesut suggests nurses interested in BSN-to-PhD programs do a literature review and read the latest research in their chosen interest. “Find out where the best experts in that area are and try to go study with them.”

For minority nurses, another factor in choosing the right program might be the nursing school’s commitment to diversity. Does anyone on the faculty look like you? How successful have minority and male students been in various degree programs at that school, not just the BSN-to-PhD program?

“Everybody likes to see a role model who can be a source of inspiration and support as well as a strategist and mentor. [For example,] if you were the only male student in a program, you might feel isolated,” Pesut says.

Getting Yourself Ready

If you think a BSN-to-PhD program is right for you, here are some things you can do in advance to make sure you are prepared for the challenge.

Improve your computer skills. “Students must make sure their computer skills are very good before the program begins,” Gray advises. “You might even want to take a continuing education class in PowerPoint or MS Word. You’ll be using those skills a lot.” Database management programs, like Access, are also required. Find out which specific applications will be used in your program and get ready to use them.

Get a copy of the American Psychological Association stylebook. This could be considered the Harbrace Handbook for graduate school. In it, you’ll find the rules of writing papers, reports and even your dissertation. It’s not exactly an entertaining read. Topics, after all, include punctuation, source citations and capitalization. The sooner you blend these rules into your writing, the better.

Make friends with a librarian. Take a tour of the library at the university you’re planning to attend, as well as any nearby public libraries. Sign up for any workshops they offer on finding data. Learn what is available locally and what might be available in the not-quite-so-immediate vicinity. “Students are really going to have to retrieve and compile materials, so working with a librarian is a good start,” McWhirter says.

Line up your support system. Tell people at your church, your friends and your family about your goals. Don’t just tell them you want to get a graduate degree–tell them why you want a graduate degree. Tell them your dream. Take advantage of the chance to educate your non-nursing friends about the importance of recruiting more people like you into higher levels of nursing. Share that with your children, your nieces and nephews. Who knows? You might become an important inspiration for the next generation of nurses.
 

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