Bridging the Gap: Preparing the Nursing Leaders of Tomorrow

The current health care crisis is multifaceted, ongoing, and incredibly significant to those within the profession. The reform the country is currently experiencing came as a result of several factors: high cost of treatment, ineffective payment methods, and millions of uninsured Americans in need. Though these problems have begun to enter the national conversation, there are still many issues that need to be addressed and fixed.

Nurses are often referred to as the front line of the health care system—meaning that the changes occurring on a national level will affect them directly, perhaps even first. With the coming reform, health care facilities and their nursing staff must account for slashed budgets, reduced personnel, and political pressure. Moreover, President Obama recently set aside more than $36 billion to create a nationwide network of electronic health records—a massive undertaking that will require a combination of proven communication skills and strategic management to implement, use, and manage.

In addition to these changes, the population is aging, Medicare funding is in jeopardy, and the nursing shortage is projected to grow to one million by 2020. As the public gains access to health care, the lack of nurses will be felt even more acutely.

Nurses must equip themselves with the skills necessary to manage and help solve these crises.

The next generation of nursing leaders will be charged with placing an emphasis on interpersonal and interdepartmental communication—translating and acting as a diplomat between the clinical and business sides of health care institutions. Nursing leaders must have a strong working knowledge of clinical practice and the business of health care, all within an everchanging political arena. Nurses holding both a Master of Science in Nursing (M.S.N.) and a Master of Business Administration (M.B.A.) will be better equipped to understand both sides of the equation.

This may be unfamiliar territory for the nursing profession. Executives must be able to identify key health care trends, watch regulatory rules and legislation—and be able to implement changes within their own organization based on these findings.

Dual degrees in nursing and business help nurses manage these responsibilities in more ways than one could count. Registered nurses are not generally educated in the business side of health care, and while a Bachelor of Science in Nursing is excellent preparation for nursing clinical practice, patient care is far removed from the fiscal responsibility of bringing consumption and cost to sustainable levels. A business-trained leader, such as an M.B.A.-prepared executive, may be able to provide financial analysis of factors associated with treatment, providing the cost in real dollars and highlighting areas of strength or problematic gaps. Yet, while that training may prove invaluable in discovering economic stopgaps, understanding financial problems is not effective in providing a cost benefit unless a clinical solution can be found as well. Therein lies the primary benefits of obtaining dual M.S.N./M.B.A. degrees—understanding and linking both sides of health care.

M.S.N./M.B.A. programs aim to prepare students for mid- to upper-level management roles in health care organizations, including chief nursing executives, nursing managers, nursing supervisors, nursing educators, nursing informaticists, nurse practitioners, clinical nurse specialists, and more. According to the Centers for Medicare and Medicaid Services, by 2015 health care costs will hit $4 trillion and account for 20% of the U.S. economy. By 2012, the number of nursing executives is expected to increase faster than most health care professions. Still, in today’s diffi cult economic environment, being as educationally competitive as possible is key to securing a position as a nursing executive.

Employers will be looking for nursing executive candidates skilled in communication and conflict resolution, leaders who have the ability to cultivate an ongoing conversation between patients, staff, and administration. M.S.N./ M.B.A. degree programs also generally provide more targeted business preparation, training students in areas such as relationship management, organizational leadership, business relations, and change management—skills which are more crucial now than ever.

Class work, prerequisites, clinical requirements, and other details of these dual degree programs vary widely. Students may obtain their dual degree at one school or through articulation agreements between two distinct schools of nursing and business. Accelerated programs often combine these studies even further, saving students both time and money. At Chamberlain College of Nursing, courses such as Leadership Role Development, Health Policy, and Informatics prepare graduates to serve as effective nursing leaders, able to understand the politics and decisions inherent in health care leadership. Business studies, including Managerial Accounting, Marketing Management, and Business Economics help students develop strong analytical abilities, understand health care economics, learn to resolve organization and business issues, execute health care strategies, and foster communication and interpersonal skills.

In order for the health care field to flourish in the face of a continuing recession and monumental policy changes, the profession must seek out and support individuals prepared for both the monetary and clinical challenges. The time for aspiring health care leaders to gather the knowledge and credentials they need is now. The industry’s success depends just as much on cost savings as on the finite resources vital to maintaining crucial care—namely, the people and practices that allow health care to function. Future nursing leaders must further prepare themselves to manage every facet of the coming changes to the industry, including attaining knowledge of both the business and the science of health care.

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

Making the Right Choice

When you choose your allied health graduate program, you want to make sure you get a great education and solid professional training. But let’s face it, you also want to make sure you get the most bang for your buck. With graduate school costs on the rise, your investment has to pay off in the long run. Each grad program offers different pros and cons, including varying tuition prices, teaching assistantships, financial aid packages, faculty, rankings and more. So how do you decide on both which program is best for you, and how it will affect your starting salary upon graduation?

There are many factors that impact one’s initial earnings. As you consider these points, always keep in mind the big picture. Remember that your starting salary is only the beginning and not necessarily an indication of your future earnings in the field.

Geographic Location

Where do you see yourself living and working during your professional career? Many people choose to look for jobs in the same region as where they attend graduate school. This often provides a leg up for job opportunities, since local recruiters tend to visit schools in their immediate area. Also, most programs require students to complete fieldwork and internships, and this will help you to build professional contacts that may lead to future job offers. These experiences are some of the best ways to make contacts that will lead to employment. If you are unsure about where you want to settle, consider schools that are more nationally known, rather than regional schools that only have employment contacts and alumni within that state or city.

Supply and Demand

It’s a basic law of economics: when supply goes down, demand goes up. Let’s say there is a region of the country that is short on physical therapists, where clients have to wait several weeks or even months to get an appointment. You can virtually guarantee that physical therapists will command higher salaries in that area as employers try to lure them to the location. Similarly, what do you think will happen in a city that is glutted with dieticians? Employers won’t recruit dieticians or offer higher starting salaries since they already have as many or more than needed to satisfy the population. Logically, starting salaries tend to be higher in regions that are short on specific allied health professionals to meet the needs of their residents.

Cost of Living

Not all starting salaries are created equal. The reality is that $40,000 in Boise, Idaho goes a lot further than it does in San Francisco. Numbers that seem low can be relative when you factor in the costs required for basic survival. Before getting discouraged, research the cost of living in each region. Determine what your average expenses will be including rent, utilities, food, transportation and entertainment. Utilize salary calculators to see what your offer translates to nationwide. Try the links at Home Fair and Best Places.

Experience/Personal Qualities

Just like all starting salaries are not created equal, neither are all new graduates. Allied health professionals enter graduate school with a variety of experiences and backgrounds. Some have worked for several years before applying; others come right from their undergraduate studies, and still others transition from one field to another with lengthy professional careers behind them. Grades, internships, volunteer work and the general impression made on the interviewer add up to a candidate’s overall value. As employers review resumes, interview candidates, proffer offers and put together new hire packages, they take the total composite of each candidate into consideration. There is usually a salary range set for each position, but often this range can vary by as much as $10,000 – $20,000. Whether you will be on the high or low end of that spectrum will depend in a large part on your prior experience and what unique personal qualities you bring to the table.

Reputation of Program


Rankings are not always an accurate way to determine which school is best for you, but they can give you insight into how programs may be viewed by employers.

Characteristics are rated such as faculty-to-student ratio and career placement. In some fields and some cities, rankings matter more than others. As you consider various graduate school programs, speak to professionals in your field to gain their perspective. Sometimes foregoing a big name school for one that will offer more personalized attention and a greater financial aid package can be beneficial. Ask yourself if you would rather graduate with a potentially higher salary, but greater debt. However, in other situations, a more competitive program may offer you access to more opportunities, such as networking with successful and well-connected alumni. Click here for more information.

Industry/Work Setting
Think about your professional goals. In what type of setting do you wish to work? Salaries will vary whether a hospital, private practice, clinic, public health agency or university employs you. Speak to professionals and professors to determine the typical ranges for each employment setting. Look at job listings to see if they list salary information. Professional associations are also an excellent way to determine starting salaries for each field. Useful salary links for allied health include the AMA, and

The Big Picture

Be sure to consider the whole picture as you make your graduate school decisions. There is no one overriding factor when it comes to predicting starting salary. Rather, a combination of aspects will determine which is the best choice for your future, as well as your wallet. Each graduate school offers different benefits that will make your experience worthwhile both personally and professionally. Just the same, each job has advantages that go beyond simply the numbers on your paycheck, including health insurance, vacation time, continuing education reimbursement and more. If you view each position as a stepping-stone on the ladder of your future, you can see your starting salary in the context of your career.

Mastering Master’s Entry Programs

Mastering Master’s Entry Programs

Peter Teboh, RN, MBA, MPHPeter Teboh, RN, MBA, MPH

The ever-increasing nursing shortage and the need for more nurses of color who can provide culturally competent care to an increasingly multicultural population has prompted colleges and universities to create alternative pathways into the nursing field. One such pathway is the master’s entry program in nursing (MEPN), an accelerated MSN program that enables people with non-nursing degrees to complete the requirements for RN licensure and earn a master’s degree in a clinical specialty, allowing them to become advanced practice nurses in two to four years (depending on their specialty).

In the first “bridge” phase of the program, students combine classroom study with practice of clinical skills in laboratory and real-life settings. At the end of this time, they are eligible to take the NCLEX-RN® and move on to the master’s phase of the program. The philosophy behind these programs, which essentially bypass the traditional BSN degree, is: If students have already completed their prerequisites by earning a degree in another field, why make them start from scratch and earn another bachelor’s degree in nursing?

Not that MEPN programs are new. The first was established at Yale University in 1974 as a three-year program for non-nursing majors. Since then, the number of schools offering similar programs has grown steadily.


“In 1999, there were about 10 or 12 programs of this kind across the country,” recalls Sharon Sanderson, director of recruitment at Yale School of Nursing. “There are now close to 40, and they’re all a little different.”

These differences run the gamut from the schedule and time frame required for completion of the RN and master’s courses to the name of the program itself. For example, at some schools MEPN programs may be called graduate entry pre-specialty in nursing (GEPN), direct-entry MSN or accelerated pre-specialty MSN.

Whatever academic institutions choose to call them, most MEPN programs require that prospective students have a bachelor’s degree in a field other than nursing (although some will accept students without a degree if they have completed a specified number of prerequisite courses). Admissions decisions are based on a combination of grade point averages, professional/life experience and Graduate Record Examination (GRE) scores. And because many schools are aiming toward a more culturally diverse student population that will ultimately lead to a more diverse nursing workforce, they are actively recruiting people of color and men for these accelerated programs.

Growing the Numbers

According to the Bureau of Labor Statistics, the health care industry will need to find more than one million new and replacement registered nurses over the next decade. To meet these projections, nursing schools must increase their number of both traditional and nontraditional students. The average ratio of minority students in MEPN programs tends to range from 11% to 28%, and a growing number of schools are trying to increase that percentage. For example, Vanderbilt University School of Nursing in Nashville, which instituted its two-year Pre-Specialty Entry for Non-Nurses program in the 1980s, began targeted recruitment of students of color in 1993.

Jose Pares-Avila, MA, LMHCJose Pares-Avila, MA, LMHC

“The nursing school received an academic enhancement grant from the Health Resources and Services Administration,” explains Jana Lauderdale, PhD, MSN, RN, assistant dean for cultural diversity at Vanderbilt. “Since then, each of our grants has always had a focus on minority recruitment as a part of the grant. For instance, there are a couple of training grants this year that are targeting minority students in areas of the United States that don’t have access to a master’s degree in nursing program.”

Partnerships with local agencies, professional associations, middle and high schools, and other universities can also help nursing schools attract students from underrepresented populations who might not have thought of an MEPN program as an option. “We involve all school stakeholders in recruitment efforts and in providing individualized follow-up to prospective students,” states Carolyn Chow, MA, director of admissions and multicultural student affairs at the University of Washington School of Nursing in Seattle. “We’ve also increased our involvement, partnerships and networking with minority affairs offices on campus and at other schools and with professional, academic and community organizations in communities of color.”

Catching students’ interest early is also important. “We work with health professions advisers, who are the people at colleges who encourage students to go on to other areas of health care,” notes Sanderson. “The majority are biology or physical science teachers.”
Unfortunately, these advisers often point students toward medicine instead of nursing, a choice that Sanderson feels is based on a skewed vision of the nursing profession. “It’s imperative that we change the image of the nurse from someone who’s subservient to an MD to someone who’s on the same health care team as the MD,” she emphasizes.

Learning at a Faster Pace

Diversity is the name of the game in master’s entry nursing programs. Students come from a broad range of cultures, educational and professional backgrounds, age groups and life experiences. Their previous education may have been in any field, from sociology to photography, and their degree levels vary from bachelor’s to master’s to doctoral. Although some MEPN students enter the program directly after completing their undergraduate degree, most are career changers who are in their mid 20s or older.

Janelle ZamoraJanelle Zamora

Peter Teboh, RN, MBA, MPH, went into the Graduate Entry Program for Non-Nurses at Case Western Reserve University’s Frances Payne Bolton School of Nursing in Cleveland with a background in biology, chemistry, business and public health. Married with three children, Teboh–who is originally from Cameroon–had worked in public health for a number of years but decided he wanted to move into direct patient care. He is now in his last year of study to become a geriatric nurse practitioner.

“You have to know what you want,” he advises prospective MEPN students. “The program is extremely challenging, and you have to put [the rest of] your life on hold. It takes a lot of advance planning and family support.”
The intensive academic load is universal in accelerated programs, and MEPN students need to have excellent study skills, a clear idea of what they want to accomplish and a strong dedication to their chosen field. As a former student and current faculty member (Foundations of Nursing course) in Vanderbilt’s pre-specialty program, Shawanda Clay, MSN, APRN-BC, has first-hand knowledge of the amount of work involved from both sides of the fence.

“The accelerated program is different than what students experienced in undergraduate school,” she explains. “BSN students complete nursing courses in four semesters, but this program allows students to complete them in three. The students have to be well organized and self-disciplined.”

The time commitment required means that most students find it difficult, if not impossible, to hold down jobs while they’re going through their pre-specialty year. Those with partners, children and other family commitments face the challenge of juggling those responsibilities along with the heavy course work.

Clefondrus Ashford, RN, was an LPN with a bachelor’s degree in biology before she entered Case Western’s graduate entry program. Now in her third year of the program (her specialty is geriatrics/adult care), she went to her instructors and adviser early on when outside family and financial commitments made completing course work difficult.

“When I first started the program, I was working because the financial aid wasn’t enough,” Ashford recalls. “Eventually I stopped because it was just too hard. Then two family members became ill, and the school worked with me so I could drop a class and retake it the following semester. The faculty were very understanding, and they can be flexible if you let them know right away that you have a problem.” Addressing problems early can help prevent a snowball effect that might make it impossible for a student to catch up with regular assignments.

To avoid burnout, students need to carve out time for relaxation and personal “downtime.” “We have classes six days a week, three of which are clinical days (nine- to 12-hour shifts),” says Janelle Zamora, a University of Washington student who is in the third quarter of her prelicensure program. She previously earned a bachelor’s degree in comparative religion and will now be working toward a master’s degree in community health systems nursing.

“It’s a balancing act,” she continues. “In my first quarter, I dropped everything and focused solely on the program, but at the quarter’s end I realized that there was more to life than just school. I learned that I have to take time for myself–spend time with my family, go to the gym, have dinner with friends. Self-care, that’s the mantra. And with only 20 students in our program, we’re really able to support each other. We have great cohesiveness.”

Perhaps because of the relatively small class sizes and the mutually supportive atmosphere common to MEPN programs, many students of color don’t seem to have as much of a sense of isolation as they would in other types of programs with similar minority ratios. “I’ve never felt marginalized,” states Marie Gonzalez, who has an undergraduate degree in interdisciplinary studies and is a second-year student at Vanderbilt University who will graduate in December with an MSN in nurse-midwifery. “My father and his family are from Cuba and my mother is from Florida. It actually feels like my input is more valued because of my background.”

Zamora’s classmate José Pares-Avila, MA, LMHC, a licensed mental health professional who worked in hospital- and community-based HIV programs for 15 years before deciding to pursue advanced practice nursing, has also found the friendships forged in his first year an important source of support. “I’m Latino, I’m one of three men in the group, I’m the only gay person and I’m older, so the feeling of isolation varies,” comments Pares-Avila. “I’m also new to Seattle, so there’s the matter of relocating to a new city and leaving my life in Boston behind. But my classmates are amazing, and I’ve become close friends with many of them.”

Providing Support

Because master’s entry nursing programs are so demanding, all of the schools interviewed for this article provide some sort of mentoring, networking or support groups for students. Some of these resources are designed specifically for minority students, while others are open to everyone; some are available exclusively within the school of nursing, and some are university wide.

  • The mentors available for students in Case Western Reserve’s graduate entry program include faculty advisers, alumni and current classmates, who provide peer mentoring. In addition, each class has a student representative who takes any identified concerns about the program to administration.
  • The University of Washington’s nursing school puts current and prospective students of color in contact with key minority leaders and health professionals in the community so they have access to professional support and mentoring outside of the school. As for on-campus support, minority graduate and doctoral students from across the university can participate in a support group that holds seminars and monthly meetings and provides networking opportunities.
  • Vanderbilt’s nursing school has developed an infrastructure of minority faculty, staff and alumni mentors to support minority students from their initial program inquiry through graduation. Such support can range from information sharing to academic counseling.
  • One of the goals of Yale School of Nursing’s Diversity Action Committee is to increase the number of minority faculty so students of color will be able to have mentors from similar backgrounds.
  • The University of San Diego’s Master’s Entry Program in Nursing has a Big Brother/Big Sister program in which all entering students are paired with a second- or third-year MEPN student who acts as a mentor.

Financial assistance can be a trickier subject. Master’s entry students are often ineligible for scholarships that are available to traditional BSN students. However, once MEPN students complete their pre-specialty work and enter the master’s phase of the program, they usually have the same opportunities as other MSN students. [Editor’s Note: The Minority Nurse Magazine Scholarship Program recently expanded its eligibility criteria to include students in MEPN programs.]

“Almost all of our students have to take out some loans for the first year of the program because they really can’t work,” says Sally Hardin, PhD, RN, FAAN, dean of the University of San Diego’s Hahn School of Nursing and Health Science. “We have a large grant from the Dickinson Foundation which is focused specifically on the MEPN program, and we have a series of loans and endowments that also are used to help the MEPN students. We’ve also just introduced a paid externship for students in the last semester of the program. We work with students and local clinical agencies so the externship can be done in a place the students choose, where they would like to get more clinical experience or think they might want to work.”

Although master’s entry nursing programs aren’t for everyone, they are continuing to gain popularity as an option to help increase cultural diversity in the nursing profession. Not only do they open doors to people who might not have the time or inclination to follow the traditional BSN route, they are also increasing minority and male students’ access to advanced practice nursing careers as clinicians, researchers and educators.

Despite the sacrifices involved, MEPN students all seem to agree that these accelerated programs are helping them fulfill what has become their mission in life. “You wouldn’t be in [this program] if you didn’t really want to be an advanced practice nurse,” says Clefondrus Ashford. “I knew this was my calling. I’m in it because that’s where my heart is.”