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Back to school


Going back to school can be good not only for an RN’s career, experts say, but also for the profession and the country.

As part of a 2010 report, the Robert Wood Johnson Foundation Initiative on the Future of Nursing, in partnership with the Institute of Medicine, called for improvements to nursing education and for RNs to climb the educational ladder. That conclusion stemmed from evaluations of the public’s needs, healthcare’s complexity, systemic gaps and the importance of nurses having educational parity with their peers, said Michael Bleich, RN, PhD, FAAN, a member of the Future of Nursing committee.

Although it may be a national imperative, pursuing an advanced degree is about personal and professional growth and “creating a set of experiences to enliven the cognitive capacity of a person, the spiritual and human dimensions of caring,” said Bleich, a professor and former dean at the Oregon Health & Science University School of Nursing in Portland. “Nursing is a discipline that is robust and expansive,” he said. “This isn’t for the faint of heart.”

Likewise, going back to school isn’t for the timid. Many returning students, who found becoming an RN hard enough, now have to factor in growing family and professional obligations.

Consider Christi Reeves, RN, BSN, who completed an online RN-to-BSN program at the University of Texas at Arlington. She was married and pregnant with her third child while completing the program. Her new degree already has yielded clear rewards.

“I had a lot of clinical experience after I did the ADN,” Reeves said, “but the BSN has helped me understand the whole picture of the patient.” It also helped her land a job as trauma program manager at Clear Lake Regional Medical Center in Webster, Texas, a larger facility than her previous one.

Reeves and educators who survived their own graduate education experiences offer their advice on going back to school.


According to the American Association of Colleges of Nursing, more than 170 U.S. educational programs are available to allow RNs to progress from a diploma or associate’s degree to a master’s degree, and more than 600 RN-to-BSN programs are offered. A majority of those programs include at least some online component.

Here are some key considerations in choosing a program:

Do your homework. Talk to colleagues about BSN programs they’ve completed, Reeves advised. Her colleagues didn’t seem to like their online programs, in part because they were difficult to navigate. But when UTA came to her hospital, she had a chance to evaluate the program and log on to explore more.

Bleich advised asking others who have been through a program about its difficulty, the quality of its professors, whether assignments were relevant and engaging and whether the program fostered personal growth.

Weigh online versus traditional options. Online programs are popular. For example, UTA’s enrollment for this spring’s online RN-to-BSN program reached 4,000. “If you know you like to have face-to-face contact, online may not be good for you,” said Ceil Flores, RN, MSN, CNE, student success coordinator at UTA’s College of Nursing. But online learners have a lot of scheduling flexibility and can pursue programs that might not be available locally.

Get the facts. Ask about a nursing program’s accreditation, clinical rotation opportunities and graduation rate. Be sure to learn admission requirements, such as whether Graduate Record Examination scores are required. And ask what students are expected to be able to achieve after completing the program, Flores advised.


Jane Dolan RN, MSN, would like to dispel the myth that there isn’t much money available for graduate nursing students. “There is money out there and students should take advantage of it,” said Dolan, graduate clinical and recruitment coordinator at Pace University’s Lienhard School of Nursing in Pleasantville, N.Y.

At Pace, Dolan said, the first stops are the graduate admissions office to review eligibility for merit scholarships and the financial aid office for information about loans or other assistance. A separate office is dedicated to helping RNs track down additional funding opportunities.

Start in human resources. Partial or full tuition reimbursement might be available from an employer, Dolan said, adding it’s important to explore this option up front, since it would affect financial aid options.

Understand scholarship and grant requirements. Many forms of aid have a grade-point average requirement (3.0, or sometimes 3.5, is common, Dolan said) and some specify thresholds of financial need.

Consider a trade-off. Federal scholarship and loan programs often require a commitment such as a requirement that family nurse practitioners work in certain high-need settings after graduation, or that nurses with advanced degrees teach in a college setting. Dolan said graduate assistantships can allow students to work with faculty on research and teach in a variety of settings.


Patrick Hopkins, RN, DNP, APRN, C-PNP, NNP, has lived the trade-offs that academic aspirations and family obligations create. When he decided to get a PhD, his youngest daughter, 9, asked if he liked what he was doing already and whether he needed the new degree to continue. “She said, ‘Please don’t go back to school, because when you’re in school you’re here but not here,'” recalled the program director of the University of Rochester (N.Y.) School of Nursing Pediatric NP Master’s Program.

He abandoned the PhD plan but seven years later began preparing for a DNP program. “She said, ‘That’s OK; we’ll see how it goes for one semester.'” Now Hopkins tells students they have to be prepared to sacrifice, but relationships are more important than anything else.

For example:

Create a family plan. Reeves’ husband — currently pursuing his own BSN — took up the slack while she was in school, she said. Now it’s her turn, according to the plan they laid out. “If your family’s not supportive, I don’t think you’ll be successful,” she said.

Make compromises. A rigorous, competitive program can be hard on students accustomed to being overachievers. Earning B’s, Hopkins said, may be a necessary sacrifice to balance school, work and family. “Some students will need to let go of living in a completely neat house,” Hopkins said. “You’ve got to make your choices and learn to live with them.”


Nurses returning to school should consider what skills they should brush up on, said Donamarie N-Wilfong, z RN, BSN, MSN, DNP, director of the Simulation, Teaching and Academic Research (STAR) Center for West Penn Allegheny Health System in Pittsburgh. Schools with a simulation lab can help freshen dormant clinical skills, for example.

Academic skills can be rusty too, said Wilfong, co-author of “Nursing School Success: Tools for Constructing Your Future.” Many returning students lack test-taking and organizing skills, she said, and can benefit from ongoing support in these areas.

In addition:

Learn test-taking strategies. Read up on strategies such as how words or phrases in a multiple choice test can provide clues to the correct answer. Also, Wilfong said, “Test preparation begins the very first day you enter a classroom. Everything you do from that point is how you prepare for the test.”

Know the technology. Nurses returning to school years later might find today’s educational technology intimidating. Computer skills are essential even for students doing a traditional program, Flores said, noting that coursework often is posted online, Internet abilities are needed for research, and students must grasp Microsoft Word and PowerPoint. “Even the basic writing of a paper has changed,” she said.

Organize study groups. Wilfong’s ideal group has three to five motivated members, selected by a leader for a range of knowledge and skills (such as math skills). Hopkins advised study groups to divide and conquer by divvying up long reading assignments and providing notes for the group. “More and more it’s about working collaboratively,” he said.

Study well. Scan titles and subheadings in reading materials, and skip to the back of chapters for key points and questions to see what’s most important. “It’s not how hard you study; it’s how smart you study,” Wilfong said. Students also should review notes on classroom material nightly, she added. “Absorb it, reflect on it, understand it.”

Look for on-campus support. Many schools offer extensive support by providing mentoring and writing and math assistance; academic or clinical coaching; and seminars to improve study and coping skills. •


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Karen Patterson is a freelance writer.
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