Advancing Nursing Education

The introduction of the Affordable Care Act, coupled with an aging population, is not only heightening the demand for nurses in the United States, but making the urgency for highly trained and specialized nurses much more evident.

In New Jersey, fortunately, colleges and universities have been "ahead of the curve" in educating the nursing workforce and preparing students to meet the needs of the ever-changing healthcare landscape.

Furthermore, a report released by the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) in 2010 titled The Future of Nursing: Leading Change, Advancing Health, suggests that by the year 2020, 80 percent of nurses should have baccalaureate degrees, up from approximately 50 percent today. Additionally, the number of nurses who have a doctorate degree currently hovers around 1 percent, with the report suggesting that number should double by 2020.

"What you see happening in the healthcare industry today is a reform of the healthcare system and looking at what system improvements need to be made," says Dr. Muriel M. Shore, dean and professor of the School of Nursing at Felician College in Lodi. "The healthcare industry is looking at how we can improve patient outcomes, and by having more nurses with advanced degrees, there is no question outcomes will improve."

At Felician College, there is a multitude of nursing programs available for students who are either coming out of high school and looking to become nurses, or are looking to further their education with an advanced degree.

The college's Bachelor of Science in Nursing (BSN) programs include a traditional pre-licensure BSN for high school graduates and transfer students, a cohort-based accelerated bachelor's to BSN program and a cohort-based Registered Nurse (RN) to BSN fast track program.

"We have a traditional bachelor's degree program, but what we have found is that with our accelerated bachelor's to BSN program, it is really targeting adults and, more specifically, working adults," Shore says. "It's aimed at people who already have a degree, but not in nursing. And, with the changes in the economy, people are always looking at other career options."

Felician also offers a Master of Science in Nursing (MSN) with programs that include: an online Adult-Gerontology Nurse Practitioner program; an online Family Nurse Practitioner program; and hybrid (online and on campus) programs in Education and Executive Leadership.

Additionally, Felician offers a Doctor of Nursing Practice Program (DNP), which also includes advanced practice and executive leadership focuses.

Shore says that the interest in the college's nursing programs from students and potential students has been outstanding. And, with 650 total students enrolled in the school's nursing programs, she is delighted about what the future holds for the profession.

"I am thrilled to see that the nursing community and society have recognized the need for a more highly educated workforce," she says. "Personally, I am gratified to see that nurses are returning in large numbers to get their bachelors, masters or doctoral degrees."

At The Richard Stockton College of New Jersey in Galloway, there are three different opportunities available in the field of nursing. The first is a four-year pre-licensure program for individuals coming out of high school looking to become nurses and to be eligible to sit for the licensing exam. The second program is a RN to BSN program, where the college trains people who are already RNs to receive a bachelor's degree.

The RN to BSN is available exclusively online and students must take courses ranging from Professional Nursing in the Community, to Issues in Nursing and Theory in Nursing, to name a few.

The third offering at Stockton is the MSN program, designed for the baccalaureate-prepared RN who "wishes to pursue a graduate degree with specialty certification" as a nurse practitioner.

"For students who hold a BSN and want to become nurse practitioners, there are many different tracks they can follow," says Dr. Bess Kathrins, Stockton's Schoolof Health Sciences interim dean. "We offer training as an adult-gerontology primary care nurse practitioner. We also have an offering for people who are already nurse practitioners, who wish to study pediatrics as well."

Kathrins mentions the IOM's vision of 2020 and says that because "it is suggested that a majority of nurses be baccalaureate prepared, current nurses that have associate degrees are interested in getting that RN to BSN degree, and then trend towards being a nurse practitioner or advanced practice nurse. That is driving the interest in our MSN."

Dr. Kathleen M. Burke, the assistant dean of the Nursing Programs at Ramapo College in Mahwah says, "There is a tremendous amount of research that exists demonstrating that the higher the education of a nurse, the better the patient outcomes. And, because of that, there are hospitals in the area right now - especially in Northern New Jersey - that will not hire a nurse unless he or she has at least a BSN."

Ramapo College has three major academic tracks in its nursing program: a generic four-year pre-licensor nursing program for individuals who are preparing to become a nurse, a RN to BSN track for nurses returning to school for a BSN degree and a MSN track to prepare future nurse educators.

"Our master's program is designed to prepare nurse educators," Burke says. "It is for anyone who would like to educate future nurses, in either an academic or clinical setting."

Burke mentions the healthcare industry is changing at such a rapid pace, while schools and colleges like Ramapo are continuously adding different programs and degrees to keep up with not only the healthcare demand, but with the demand of individuals who are looking to break into the nursing profession.

"Right now, enrollment is booming," she says. "The number of individuals at this particular point looking to become nurses, especially in New Jersey, is huge."

Burke mentions that salaries of a RN with a bachelor's degree in New Jersey can range from $45,000 a year to almost $70,000 a year, depending on the type of healthcare setting one works in. And, with an advanced degree, "a nurse can make well over $100,000 a year," she says.

"Ten years ago, numbers in nursing schools across the country were limited," Burke continues. "Students were easily able to get into programs and there really was not a tremendous demand for seats as there is now. With healthcare dramatically changing and with the industry being seen as a potential strong area for growth over the next 10 to 20 years, a large number of people are now beginning to enter nursing."

The W. Cary Edwards School of Nursing at Thomas Edison State College in Trenton has been educating students to become nurses since 1983. And, in 2001, the school moved to online learning for its RN to BSN program. Additionally, the school has a MSN program, which prepares students for careers as nurse educators, nurse administrators or nursing informatics specialists.

"About 57 percent of our students who complete our undergraduate program move into the master's program," says Dr. Filomela Marshall, dean of the W. Cary Edwards School of Nursing. "That program is also online in addition to our BSN program, so we have students from all across the country taking classes at our school."

More than 4,000 students are enrolled in a pursing program at Thomas Edison State College, and more than 500 of total enrollees are in a master's program, which, according to Marshall, gives the school the largest nursing program in New Jersey.

The college's newest program, which is in its third year, is the Accelerated 2nd Degree BSN Program. It is a one-year BSN aimed at adults who have earned a non-nursing bachelor's degree and are interested in becoming a RN.

"Our accelerated BSN program is a mixture of online and on campus courses," Marshall says. "It is a rigorous one-year program where, in addition to online classes, students are on campus two full days a week. Then they are out in a clinical setting or at our simulation lab an additional two days."

Thomas Edison State College'sSimulation Laboratory is a 635-square-foot lab at the school's Kuser Mansion Carriage House that provides interactive learning for nursing students. The lab features a control room where teachers can simulate different scenarios a nurse may encounter in a clinical setting. These scenerios include, for example, how a nurse should react if a patient is in cardiac arrest or if his or her blood pressure is rising.

"Our three high-fidelity simulators offer the ability for our students to practice skills such as critical thinking and real-life technical skills on high-tech mannequins," Marshall says. "Students don't get to see the wide array of problems that occur in a hospital setting sitting in a classroom. So, we are able to get them ready to face anything they may come across in the 'real world' and offer them a wider range of activity to be able to make on-the-job decisions."

Marshall mentions there is currently no shortage of nurses at any level of education - in the northeast region. However, multiple factors will see that trend changing soon.

"Right now, there is no shortage of nurses, and one reason why is because of the economy," she says. "When the economy tanked in 2009, what happened was many nurses who would generally retire chose not to for financial reasons."

"Nurses who would normally be retiring are not," adds Roseminda Santee, associate dean of the Trinitas School of Nursing located at the Elizabeth campus of Union County College (UCC). "So, graduates are having a bit more difficulty landing jobs and hospitals really aren't hiring many bed-side nurses. And, it seems to be a national trend."

However, Santee says that as 2020 approaches, "there will be a need for more nurses, because a lot more will be retiring. And, with an aging population and the effects of the Affordable Care Act, more people with insurance will be entering the healthcare system, which will greatly increase the demand for nurses moving forward."

The Trinitas School of Nursing, in partnership with UCC, offers a Cooperative Nursing Program in which students can receive a diploma in nursing as well as an associate in science degree from UCC. The diploma and associates degree gives students the ability to transfer to a BSN program right after they graduate.

"Our goal is to prepare entry-level nurses - nurses who provide basic primary care in a hospital setting," says Teresita Proctor, assistant dean of the school. "However, our mission also includes encouraging our graduates to go on with their academic progression and obtain advanced degrees. We also offer onsite BSN and MSN courses in partnership with the College of Saint Elizabeth (CSE). Educators from CSE come here and conduct courses for our graduates and make it easy for them to gain access to higher education."

Additionally, Trinitas has a Learning/Simulation Center with simulators that include "computer operated mannequins - or patient simulators - that have heartbeats, can breathe, talk and sweat. There are also birthing simulators called "Noelle," that simulate the birth of a baby and the complications of pregnancy and childbirth.

"We are an open access school and we don't require the usual entrance exam for nurses," Santee says. "A number of our students may not be able to enter a regular four-year program, so, we give a diverse group of students an opportunity to break into the profession."

All things told, Santee says the opportunities in the field of nursing are endless.

"When you become a nurse, it is a very versatile position," Santee concludes. "It is not just hospitals that need nurses, but places like schools, prisons, cruise ships and parishes - the list goes on and on. There is so much room for advancement and so much going on right now in our industry that it is such an exciting time. And, we can't wait to see what the future holds."