Implementation of Trauma-informed Principles in Nursing Education: An Appeal for Action

Implementation of Trauma-informed Principles in Nursing Education: An Appeal for Action

Exposure to traumatic stress can have a life-altering negative impact on student nurses. Traumatic stress can challenge effective coping, emotional regulation, and the ability to focus, retain, and recall nursing concepts. According to the Substance Abuse and Mental Health Services Administration (SAMHSA, 2014), the “3 E” conceptualization of trauma are Event (single or cumulative), Experience (neglect, abuse, betrayal), and Effects (anxiety, loneliness, depression, feeling unsafe ) are manifested in various ways in people with exposure to trauma.

An individualized student-centered approach is crucial in understanding and adapting teaching pedagogy in nursing education to realize, recognize, respond, and resist re-traumatization (SAMHSA, 2014)in student nurses with a history of traumatic stress.

This article discusses the concept of trauma-informed pedagogy in nursing education and its significance in promoting equity and inclusion. Trauma-informed pedagogy suggests that past experiences can negatively impact health outcomes and learning (Garfin D. R. et al., 2018). As a result, educators must be able to identify signs of trauma and adapt their teaching methods to meet their students’ unique needs. It discusses the impact of trauma on nursing students’ physical and mental health functioning, and it then delves into implementing principles of trauma-informed pedagogy in the classroom.


Trauma is defined as an event or set of circumstances that an individual experiences as physically or emotionally harmful or threatening, resulting in lasting adverse effects on their functioning and well-being (Bremner, J. D. 2006). College students, despite their excitement to succeed, often experience severe psychological distress, with 70% reporting such distress. Additionally, 35% of students were diagnosed with anxiety, and 29% had depression (American College Health Association, 2022).

Transgender and LGBTQIA students report higher levels of mental health issues than their straight counterparts. Microaggressions are also experienced by underrepresented students, creating a sense of unsafety on campus. Evidence suggests that Colleges should pivot to a learning space that promotes inclusion and equity. Only 40% of college students think colleges are doing enough to support mental health (Veneable, M.A., & Pietrucha, M. E., 2022).

The Universal Design for Learning ( UDL) recognizes that every student has different learning needs, and a one-size-fits-all approach is an ineffective instructional strategy. Similarly, implementing trauma-informed pedagogy principles within the nursing curriculum is a significant step toward meeting every student’s learning needs and experiences, promoting accessibility, equity, and inclusion in nursing education.

How Traumatic Stress Affects the Brain

Traumatic experiences can affect the brain’s development, structure, and function. It is critical to understand normal brain development to distinguish brain abnormalities. The areas of the brain responsible for stress responses are the amygdala, hippocampus, and pre-frontal cortex (Bremner, J. D., 2006). When an individual is exposed to traumatic stress, there is an increase in the level of cortisol and norepinephrine. Repeated exposure to stress increases the level of cortisol and norepinephrine and affects normal brain functioning and stress regulation, resulting in pathophysiological change(Bremner, J. D. 2006).

Students who are affected by traumatic stress may have difficulty learning concepts, focusing, and retaining information, resulting in course failures and higher attrition rates compared to their peers who have not experienced trauma. Traumatic experiences can cause anxiety and depression in some students. Past and current data suggest that trauma-informed care is critical for the promotion of equity in people with a history of trauma (Han et al., 2021).

Students’ sense of safety is disrupted, and the cumulative effects are difficulty adjusting to college experience, low grades, and high attrition rates. According to (Corello J., 2018), educators should adopt trauma-informed teaching and be compassionate and consistent in the learning environment. Despite the impact traumatic experience has on the brain, there is hope and possibility for students to be successful.

Implications for Nurse Educators

In the Four “Rs in the Trauma-informed approach to teaching student nurses(SMASHA, 2014), the nurse educator must convey empathy, possibilities, and hope to student nurses and focus on “what happened to you, instead of what is wrong with you’. Implementing trauma-informed principles is an issue of equity and inclusion and must be viewed through the lens of disability.


Research suggests that 66%-85% of youth report exposure to traumatic events by the time they enter college (Read et al., 2011). Additionally, approximately three-quarters of college students, 77 %, experienced moderate to severe psychological distress (ACHA, 2022). Understanding that traumatic experiences can affect the development, structure, and function of the brain, the nurse educator must acknowledge that trauma happened and provide a trusting teaching environment that emphasizes hope and transformation.

Realizing that trauma affects the student’s ability to function optimally, the nurse educator must stay involved in world events that may be traumatic to students: for instance, racism, disability, COVID-19, sexism, sexual harassment, and sexual orientation. Modeling emotional intelligence skills, self-reflection, and situational awareness, the nurse educator can convey trust and transparency when discussing and understanding sensitive topics in the classroom.


The nursing process is a framework taught in nursing education to provide care for diverse populations. It begins with an assessment. Likewise, the nurse educator must be able to recognize signs of traumatic stress and respond with empathy, kindness, and understanding. Some signs and symptoms are difficulty focusing on a topic, lack of engagement, absenteeism, anxiety, low grades, and difficulty adjusting to the college environment.

It is essential to acknowledge that the traumatic event happened, and an evidence-based action plan is activated to promote healing and agency to enhance academic success. The nurse educator must be knowledgeable about topics or events that may trigger traumatic stress and develop a lesson plan or teaching strategies to avoid triggers—for instance, disparities in healthcare outcomes for minorities. Nurse educators must adopt several strategies to effectively support students’ learning experiences in teaching sensitive topics. To this end, the nurse educator should consider the value of establishing eye contact with students and facilitating opportunities for them to share their lived experiences. The nurse educator must also demonstrate a genuine interest in the student experience. By applying these strategies, nurse educators can foster an environment that supports students’ learning journey and promotes their well-being.


When a student goes through a traumatic experience, their sense of safety can be severely affected. As a nurse educator, it is essential to demonstrate emotional intelligence while conversing with such students regarding traumatic stress. Using the student’s name and giving them enough time to contemplate and respond is crucial. In addition, the nurse educator should offer their presence to show kindness and compassion, which can provide comfort and support for the student.

As a nurse faculty member, you can support your student’s academic journey by referring them to the Office of Accessibility and Disability. The office provides essential services to students with disabilities, ensuring they have the resources to succeed in their studies. Letting your students know you are available for office hours and phone calls is essential, as this can help them feel more comfortable and supported.

Creating a respectful and inclusive learning environment is crucial to the success of all students. You can do this by promoting a culture of civility and respect in your classroom and being mindful of your students’ diverse needs. If a student is experiencing anxiety or stress, consider extending assignment due dates to help alleviate their concerns.

Finally, it is essential to recognize that some students may have a history of trauma that could impact their ability to learn. To increase the accessibility and inclusion of these students, incorporate multiple teaching modalities that address the cognitive, psychomotor, and affective domains of learning. Doing so can help ensure that all your students can succeed.

Resist re-traumatization 

In a nursing education culture that prioritizes diversity, equity, and inclusion, it is essential to recognize that some college students may have experienced trauma. By intentionally incorporating transformative, trauma-informed practices into nursing education, we can foster a sense of human dignity, promote academic growth, and help students thrive. To prevent re-traumatization, faculty and peers must have zero tolerance for discrimination against students. The learning environment must prioritize civility, human caring, compassion, and consistency (Corello, 2018) while avoiding punitive measures and implementing clear policies and procedures. Sensitive topics should be approached with empathy and understanding, and training modules focused on trauma and its effects can help create awareness and build a strong sense of community.  


Integrating trauma-informed practices into nursing education requires comprehensive changes across multiple levels, from micro to macro systems. At the micro level, nurse faculty must demonstrate empathy, benevolence, courtesy, and honor towards individuals who have survived trauma. They must also remain watchful in recognizing, validating, and averting re-traumatization for student nurses who have experienced trauma. By nurturing a learning environment that fosters personal development and transformation, faculty and students can collaborate to establish a warm and accommodating community open to everyone.


1. American College Health Association -National College Health. (2022). Assessment III: Undergraduate Student Reference Group Executive Summary Spring 2022. Silver Spring, MD: American College Health Association.

2. Bremer, J. D. (2006). Traumatic stress: effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-61.

3. Carello, J. & Thompson, P. (Eds). (2021). Lessons from the pandemic: Trauma-informed approaches to college, crisis, change. Palgrave Macmillan.

4. Garfin, D. R., Thompson, R. R., & Holman, E. A. (2018). Acute stress and subsequent health outcomes: A systematic review. Journal of Psychosomatic Research, 112, 107-113. doi: 10.1016/j.jpsychores.2018.05.017

5. Goddard, A., Jones, R. W., Esposito, D., & Janicek, E. (2021). Trauma-informed education in nursing: A call for action. Nurse Education Today, 101. doi: 10.1016/j.nedt.2021.105064

6. Han, H. R., Miller, H. N., Nkimbeng, M., Budhathoki, C., Mikhael, T., Rivers, E., Gray, J., Trimble, K., Chow, S., Wilson, P. (2021). Trauma-informed interventions: A systematic review. PLoS One, 16(6), e0253209. Doi: 10.1371/journal.pone.0253209

7. Kubala, J. (2020). Of Trauma and Triggers: Pedagogy and Affective Circulations in Feminist Formations, 32(2), 183-206.

8. Read, J. P., Wardell, J. D., Vermont, L. N., Colder, Ouimette, P., & White, J. (2012). Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college. Health Psychology, 32(7), 757-767.

9. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. (2014). HHS Publication No. (SMA) 14-4884. Substance Abuse and Mental Health Services Administration, Rockville, MD.

10. Veneable , M. A., & Pietrucha, M,E. (2022). 2022 College Mental Health Report, Best Colleges.

How St. Jude Keeps Nurses and Builds Culture With a Revitalized Nurse Residency Program 

How St. Jude Keeps Nurses and Builds Culture With a Revitalized Nurse Residency Program 

Recent nursing school graduates account for the highest number of registered nurses available for recruitment in U.S. hospitals. Yet, they leave the profession at a higher rate than long-term nurses. Many become stressed when they find themselves unprepared for the realities of clinical practice. Many experience additional stresses if they have relocated to a city without friends, are unfamiliar with the local culture, and need more time to explore their new

How a Residency Program Can Help Early Career Nurses

Before the pandemic, St. Jude Children’s Research Hospital had low nurse turnover and a large pool of applicants from which to choose

. Since then, despite the hospital’s efforts, nurses have been experiencing the same fatigue phenomenon seen at hospitals nationwide.

As a result, St. Jude invited its nurses to reimagine and reenergize the institution’s Nurse Residency Program (NRP), created in 2012 and focused on inpatient pediatric oncology. During its review, a planning team identified barriers to recruiting and retaining new graduate nurses.

The redesigned program, accredited as a practice transition program by the American Nurses Credentialing Center (ANCC), now onboards each resident into a generic graduate nurse role. This shortens delays in licensure, kickstarts their professional development, and helps the new nurses build friendships within their cohort from day one. Following onboarding, the residents participate in a week of NCLEX study preparations, which has resulted in pass rates well above state and national benchmarks.

Clinical Rotations

To ensure that residents find specialties that appeal to them, St. Jude created clinical rotations similar to those employed in medical school. Residents spend 6 weeks in clinical rotations, spending shifts in 12 to 40 patient care areas: inpatient, outpatient, surgical services, and ICU. These rotations introduce the nurse residents to the continuum of care at St. Jude, build relationships across the organization, and allow residents to see all the potential nursing opportunities.

After the clinical rotations, the new nurses are matched to a home unit using the National Resident Matching Program’s algorithm. The entire St. Jude nursing family meets the new team members on Match Day.

Afterward, nurse residents receive a unit-based orientation and complete a 12-month-long curriculum that brings the cohort together for monthly sessions of didactic lessons, simulation, and various activities to assist with transitioning from novice to competent nurse.

Growth of the Whole Nurse

Traditional simulations have been replaced with immersive experiences. NRP leaders built a curriculum that provides growth for the whole nurse, even outside work. Nurse residents learn patient assessment and emergency response skills while consulting with personal finance and wellness experts.

For many new nurses, the workplace isn’t a problem. Nurses relocating from other cities experience a disconnection from unfamiliar local cultures and social life. With a sizable percentage of out-of-state nurses joining St. Jude, the NRP team organizes regular social outings to tour Memphis’ cultural and entertainment venues. The new nurses also participate in community service projects to “pay it forward” and contribute to positive growth within their new environments.

Program Results

The revised program has successfully onboarded three groups of new nurses, bringing more than 60 nurses to the bedside with 100% retention of every cohort after one year, far exceeding the national retention benchmark. Changes to the hiring process allowed for earlier onboarding of high-quality candidates and an increase in cohort size, filling over 90% of RN vacancies with each cycle and allowing expansion into the surgical and ambulatory nursing divisions.

But the support for its residents continues. After the nurse residents graduate from the program, they transition into a mentor program where they obtain support from a senior nurse to help guide them through their second year of professional practice.

A welcome benefit of the revised NRP is the increased diversity within each cohort, bringing critical multilingual skills and new cultural perspectives to St. Jude.

This highly skilled, diverse, and, importantly, satisfied nursing workforce is vital to the St. Jude mission of providing top-flight clinical care while advancing cures and means of prevention for pediatric catastrophic diseases through research and treatment. 

Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.

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What to Look for in a Nurse Residency Program

What to Look for in a Nurse Residency Program

As in most things, getting off to a good start as a nurse can help ensure a long, successful, and satisfying career. With nursing shortages and nurse burnout still taking a tremendous toll on the profession, hospitals must do all they can to ensure new nurses have the tools to succeed.
Organizations help ensure success for new nurses through nurse residency programs, also called transition to practice or new grad programs. These structured learning experiences can be of great benefit.

One recent study found that

readiness for practice improved significantly for nurse residents, as did nurse retention perceptions, indicating that nurse residents were more likely to be retained at the study organization. The 1- and 2-year nurse retention rates during the 3 years of the study showed notable improvement.

In this article, we’ll offer specific suggestions on what to look for in a nurse residency program so that you can find a good fit. But first, let’s look at when you should start investigating those programs.

Start Early 

To discover if a nurse residency program is right for you, don’t wait until you pass your licensure exam. “Waiting until they pass their NCLEX many times is too late,” says Sheri Cosme DNP, RN, NPD-BC, director, Practice Transition Accreditation Program (PTAP), Advanced Practice Provider Fellowship Accreditation, American Nurses Credentialing Center (ANCC).

Nursing students should “use the time that they’re in school to start identifying those organizations that they want to work at sooner rather than later,” notes Cosme. Many programs start only two to three cohorts a year, so they have very specific recruitment timelines for when they accept applications from new graduate nurses, she says. “My biggest piece of advice to a new graduate nurse is not to miss that window.”

Cosme says to take advantage of your time at your clinical rotations and interview the facility. “That’s going to give them a good sense of what the organization is all about.”

In addition, Cosme suggests checking social media to learn what nurses say about the organization. Also, reach out to employees. You might also ask to speak to a nurse who has recently completed the program to find out how they balanced class time with working off-shifts, suggests Sara R. Grieshop, MHI, BSN, RN, practice excellence supervisor, American Association of Critical-Care Nurses. “Don’t hesitate to interview the programs as much as they are interviewing you,” notes Grieshop.

Make sure, says Cosme, that the organization has a specific plan in place for the program. For instance, the organization should tell you how much time you will spend with a preceptor or the milestones you need to hit to reach full competence.

What to Look for in a Nurse Residency Program

As you research nurse residency programs, consider the following areas:

Accreditation. Find out if the nurse residency program carries accreditation. As of mid-November 2023, some 250 programs in 831 healthcare sites were part of the ANCC Practice Transition Accreditation Program.

Accreditation helps ensure that programs provide a rich educational experience. “Accreditation validates that the programs are consistently following evidence-based standards that support nurses in their transition to nursing practice,” according to Christine Young, MSN, MBA, RN, NEA-BC, DNP, chief of hospital-based services and chief nursing officer, Akron Children’s Hospital.

Length of time. Cosme says a nurse residency program will run between 6 and 12 months. “A majority of the time, the programming is front-loaded,” she notes so that during the first part of the program, the nurse gets more concentrated professional development and support.

Seek programs that provide at least 6 to 12 months of program support and a preceptorship, which will help you acclimate to your intended specialty with a structured orientation and clinical training at the bedside, suggests Laura Douglas, MSN-Ed, RN, NPD-BC, CCRN-K, manager of the transition to practice programs (nurse residency, fellowship, and respiratory residency) at Memorial Hermann Health System.

While clinical orientation may last only 3 to 6 months, depending on specialty, a residency program supports the new graduate first through orientation, then through the initial phases of independent practice for up to a year, according to Young. Support into the second year is also ideal, she notes.

The nurse residency program should provide opportunities for participant feedback and evaluation, including regularly scheduled formal meetings to examine strengths and areas for growth, as well as provisions for individual self-assessment/self-reflection, according to Karen T. Pardue, PhD, RN, CNE, FNAP, ANEF, associate provost for strategic initiatives and professor, School of Nursing and Population Health, University of New England. Also, the program should dedicate attention to activities and interactions that build a sense of community and provide peer support, heightening the new employee’s sense of connection and belonging, she suggests.

Preceptorship. It would help if you were working with a preceptor, and ideally, one or two preceptors through the orientation phase of your residency program, notes Cosme. You should also check if you will have a mentor. While those two roles intersect, they provide different support, notes Young. The mentor, Young notes, could be a previous nurse resident who remembers what it was like to be a new grad in the specialty area they are working in and is willing to connect with the new nurse regularly to offer support, identify resources, and so on. The preceptor must evaluate the new nurse’s ability to demonstrate competency in practice and provide feedback during orientation.

Specialty experience. Determine if the nurse residency program will provide education in your specialty area, notes Cosme. If you’re unsure which unit is best for you, look for a residency program that allows you to work in various units, notes Grieshop. “This will allow you to broaden your horizons beyond what your clinical hours achieved,” she notes.

Never-Ending Learning

Nurses in a residency program, notes Cosme, should “be a sponge, soak it all up, wring themselves out, and soak up even more because they will be learning in nursing every day. I think the biggest blessing in healthcare is that things are constantly changing. We’re always learning.”

Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.

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Incivility in Online Nursing Programs 

Incivility in Online Nursing Programs 

Incivility in nursing education has become an increasingly bothersome problem; however, it has especially become a nuisance in online education. Suplee, Lachman, Siebert, and Anselmi (2008) indicated that a faculty witnesses daily encounters in classes and clinical settings. Incivility is defined as behavior that is unprofessional, rude, and disrespectful. It can result in burnout and psychological and physiological distress for the parties on the receiving end, especially if left unaddressed (Butler & Strouse, 2022).

Another term that has especially been seen in the online realm is bullying, which can occur student-to-faculty and faculty-to-student. Unfortunately, it can also occur in faculty-to-faculty (Butler & Strouse, 2022). There has been an increase seen in student-to-faculty students’ displeasure with their achieved grades. 

We must evaluate the reasons that the behavior is happening.

Stress from many walks of life can be the culprit, including working too many hours, mismanagement of work-life balance, stressful work assignments, financial strains, relationship strains, biases, and so on. Butler and Strouse (2022) also indicated that burnout and demanding workloads contribute to the greatest stressors. Personally, I have observed these behaviors displayed when providing constructive criticism. How can we, the faculty, help to ease the burden and create the traditional professional environment that many of us were able to participate in our educational journey? 

As a part of a nursing faculty for ten years, I feel it is my calling. I enjoy helping deploy educated and competent novice nurses and advanced practice nurses into the workforce. However, the stress and incivility sometimes make one feel burned out. Many of us ponder going back into the clinical setting, feeling unappreciated and undeserved. 

Caputi (2015) reported that the faculty can assist students in engaging in constructive evaluation of themselves and others. One factor is professional maturity, which can allow the students to analyze their own performance. As a faculty, providing feedback that is useful in the workplace and not hurtful can be helpful for growth and development. Self-reflection and guided introspection can be useful (Caputi, 2015). Discussing values, morals, attitudes, and the AACN essentials, pertaining to professionalism and leadership can be useful in developing students with incivility and assisting students in understanding (Caputi, 2015). However, the most important element is support from the administration and the appropriate follow-up and disciplinary actions. 


Butler, April M., and Susan M. Strouse. “An Integrative Review of Incivility in Nursing Education.” Journal of Nursing Education 61, no. 4 (2022): 173-178.

Caputi, Linda. “Certified nurse educator review book: The official NLN guide to the CNE exam.” (2019).

Suplee, Patricia D, Vicki D. Lachman, Barbara Siebert and Katherine Kaby Anselmi. “Managing Nursing Student Incivility in the Classroom, Clinical Setting, and On-Line.” Journal of Nursing Law 12 (2008): 68-77.

Nursing Education: Pipeline to the Future

Nursing Education: Pipeline to the Future

In the world of nursing, consistent rates of students graduating from nursing programs, becoming licensed, and successfully entering the workforce are critical to the long-term viability of the nursing profession and the healthcare system itself. As the true lifeblood of healthcare delivery, nurses are central to patient care, from long-term and public health to acute care and home health. In that regard, nursing education is a pipeline to the future.nursing-education-pipeline-to-the-future

Nursing School Capacity

In May 2023, the American Association of Colleges of Nursing (AACN) released data showing that student enrollment in entry-level baccalaureate nursing programs

decreased by 1.4% in 2022, the first decrease in 20 years. Overall, 844 colleges and universities offer a BSN education, and many turned away thousands of qualified candidates due to a lack of clinical training sites and faculty. In 2022, 66,261 candidates were rejected, and in 2021 applications by 76,140 candidates were turned down.

Alongside these disappointing numbers in the entry-level BSN category, the AACN identified other factors: 

  • Enrollment in RN to BSN bridge programs has been declining over the last 4 years.
  • Masters programs have seen a 9.4% decrease since 2021.
  • Nursing PhD program enrollment shrank 4.1% from 2021 to 2022.
  • DNP program enrollment is at a virtual standstill.

When it comes to nursing school capacity, theres plenty of evidence that something isnt right. This statement from an October 2021 article by National Public Radio says a great deal about one major hurdle: One of the biggest bottlenecks in the system is long-standing: There are not enough people who teach nursing. Educators in the field must have advanced degrees yet typically earn about half that of a nurse working the hospital floor.”  

Beckers Hospital Review reported in August 2023 that the California Hospital Association and the Service Employees International Union (SEIU) have teamed up to introduce a bill that would hold community colleges accountable for reserving 15% of enrollment slots for healthcare workers looking to advance their education and move into higher-paying career tracks like nursing. Whether this bill can make it through Congress and become law is unknown.

The U.S. Department of Labor has issued $78 million in grants to expand nursing school enrollment in 17 states. The state of Maryland has awarded its nursing program grants to boost schools and address the long-standing and worrisome nursing shortage. New Mexico is also expanding its nursing school capacity through support for increased enrollment.

Meanwhile, schools like the University of Florida and the University of Hawaii are addressing capacity in their unique ways.

Generating Interest in the Profession

While legislation, grants, and expanding nursing school capacity are all valuable strategies to increase the nursing workforce, we can also keep more grassroots efforts in our sights.

In families from many different backgrounds, a multigenerational tradition of service in the nursing profession is often the norm. Aunts, mothers, fathers, siblings, and others can profoundly influence younger generations career choices. When the value of being a nurse is communicated from generation to generation, a familial line of nurses can extend over many decades as additional family members join the profession.

As nurses, speaking proudly of the profession and our work can generate interest in those considering their options. While twenty-first-century nursing and healthcare have enormous challenges, we can also tell the story of how nursing provides endless opportunities and flexibility. Of course, there is the potential to travel and see other parts of the country and see ones education through to a terminal degree such as a PhD or DNP.

In communicating about the possibilities to be found in nursing, we can point out that, contrary to what the public and the media might think, not all nurses work in the hospital. There are expanding opportunities in the pharmaceutical, biotech, and medical device industries; public health; informatics; nurse entrepreneurship; medical writing; legal nurse consulting; nurse coaching; research; and many other fascinating areas. In the interest of our professions growth, we paint an expansive picture for those who think of nursing as solely hospital based.

Pipeline to the Future

Whether a new graduate nurse eventually becomes an operating room nurse, a biotech research nurse, or a self-employed legal nurse consultant, the nursing school remains the pipeline through which that individual must pass to realize their dream. No matter how one persons professional journey unfolds, it all begins with admission to an accredited nursing program, successfully graduating and passing the NCLEX®, and then receiving a license to practice. The nursing school is the funnel for future nurses of every stripe and interest.

When nursing school capacity is hobbled, our profession and society suffer. Decreased graduation rates translate to a shrinking nursing workforce, staffing shortages, nurses working under stress, and the potential for compromised patient safety and outcomes. Burned-out nurses are more likely to leave the profession and less likely to encourage younger generations to pursue the same career path.

Addressing decreased nursing school capacity is paramount, and we can use our collective genius to find solutions, whether through grants, legislation, and public relations or the direct recruitment of faculty through the offer of increased salaries and improved work conditions.

We must use every available means to secure the flow of fresh talent through the pipeline to the future. Our society and the lives of those within it depend on the quality and quantity of the nursing workforce, and its our responsibility to see that the pipeline remains filled with the talented nurses of tomorrow.

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Online Nursing Programs: How to Choose the Best Program for You

Online Nursing Programs: How to Choose the Best Program for You

For decades, online nursing education options offered nurses a different path to a nursing degree, but the choices were limited. Today’s nurses enjoy nursing degree program choices that provide variations in everything from how and when they take a course to the length of a

For many nurses, particularly those seeking advanced degrees, this expansion in online programs allows flexibility to balance work, school, and personal obligations. Despite the proliferation of programs, online coursework isn’t for everyone; some nurses work better in a more traditional classroom-based curriculum. The key is

assessing each program youre interested in, your learning style, and finding a match that sets you up for success.

For nurses considering this path, taking the time to find out essential details is time well invested. “There’s a growing number of online programs, so you have to know what you’re looking for,” says Patricia Bruckenthal, PhD, APRN-BC, FAAN, dean and professor at Stony Brook University School of Nursing, Stony Brook, New York. “You’re making one of the more important decisions in your life, and you have to place a high level of importance on how you’re going to fit that into your life and schedule.”

Assess the Program

Finding a program won’t be difficult, and they should be assessed carefully as any other program. “Students considering an online program should use the same criteria for selecting a program that they would use for assessing a traditional program, including choosing an accredited program, locating programs that will help you reach your professional goals, and finding schools that specialize in your primary area of interest,” says the American Association of Colleges of Nursing (AACN) president and chief executive officer Deborah Trautman, PhD, RN, FAAN.

In addition to considering the schools reputation and accreditation, students are encouraged to use all the available information about the school and faculty members, says Bruckenthal. “Look at the level of experience the school has with online learning,” she says. “Are there any faculty who are published in online learning? Faculty who are that engaged will know students have different learning styles.”

Evaluate Your Lifestyle

Undoubtedly, online programs give a level of flexibility that makes a degree possible for nurses to juggle many obligations. “Due to the work and family responsibilities, working RNs often benefit from being able to attend class and complete coursework during non-traditional times,” says Mashawna Hamilton, DNP, RN, associate professor and associate director, RN to BSN Nursing at Ohio University, Athens, Ohio.

If students believe online learning offers flexibility, they still have to plan how to fit the class time and all the required work into their day. “It’s important to know what you’re looking for,” says Bruckenthal.

Online learning takes as much discipline as in-class courses. Look at your habits, motivations, and realities to decide if an online program will provide you with more opportunities for success or with unanticipated roadblocks.

Students working remotely must be highly motivated to complete the work when they have other obligations. There are other potential obstacles to be aware of, says Bruckenthal. Do you have quiet and sufficient study space? Do you have childcare if you need it? Is your family willing to take on additional duties such as cleaning or grocery shopping so you can carve out time for school?

Be Ready for a Challenge

Flexibility also doesn’t mean anything is simplified. “The biggest mistake a student can make is assuming that online courses are less rigorous than traditional programs,” says Trautman. “These programs take discipline, strong writing skills, and keen organizational abilities. Students in online courses are expected to answer all questions, provide regular feedback through discussion forums, and complete just as many assignments.” 

If you’re looking for a program that fits your criteria, digging a little deeper into the school, the program, admission, and curriculum requirements will give the complete picture you need to make an accurate decision.

Here are some options to consider:

  • What is the program cost, and how will you pay for it?
  • What is the average program completion time?
  • Are online students ever required to be on campus? 
  • What is the curriculum delivery (is it asynchronous or synchronous)?
  • What do postgraduate career outcomes look like? 
  • What are the technology requirements?
  • What happens if you need more time to complete the program?

Knowing what happens for students postgraduation—from employment to alum networking—is critical to the whole program. “Students should consider the reputation of the online programs,” says Hamilton. “In doing so, consider comments from employers of previous graduates. What is the graduate employment rate? What accolades has the program received from national agencies?”

When you find a program that fits your learning expectations, schedule, and budget, some final details need clarification before committing to a program. 

Trautman recommends contacting each school to assess how the learning format, clinical experience, and academic and professional development supports offered will help you. “School advisors will know what options and assistance is available to offset costs, including scholarships and loan repayment programs,” she says. “The only way to fully know what institution-specific programs are available is to contact the nursing school.”

And when planning when you’ll have that degree in hand, remember the course schedule of each school can vary. An average program completion time can indicate the pace of courses and flexibility, but sometimes required courses are offered only once or twice a year. If you aren’t aware of the schedule, it can derail your expected graduation date. “Students should also inquire about the frequency courses are delivered, the expected time dedication for courses, and requirements for part-time and or full-time enrollment,” says Hamilton.

Evaluating Supports

During your research, find out what assistance is offered to online students. Because a program is online, it may seem more difficult to access help when you can’t just go to a physical office. “The strength of student support programs can significantly impact the student’s success during their academic journey,” says Hamilton.

Good online nursing programs will have support, including online office hours for faculty members, remote technology support, online study, social groups, and even one-on-one student support from the college. Students may want to ask about online libraries, learning labs, online writing help, skill-building webinars, wellness services, and opportunities for online student engagement as well, says Trautman.

And students also have options that are outside the campus to help them succeed in an online program, including professional nursing organizations. For example, master’s and doctoral program students can access a free membership to AACN’s Graduate Nursing Student Academy, which provides focused support opportunities for students in online and traditional programs.

For many nurses, remote degree programs open possibilities and help bring more nurses into the workforce. “Since these programs are generally directed toward individuals who are already licensed registered nurses, most students are working and trying to juggle life’s many demands,” says Trautman. “Online programs make that possible.”

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