Monday, March 30, 2009

AACN Applauds Congress for Enacting the Stimulus Bill That Includes Funding Nursing Education

All three provisions for health professions training will provide an opportunity for nursing students and schools to receive funding. The Nursing Workforce Development Programs support the supply and distribution of qualified nurses to meet our nation’s health care needs. Over the last 45 years, Title VIII programs have addressed each aspect of nursing shortages – education, practice, retention, and recruitment. By investing in these programs, Congress has shown its strong commitment to reversing the national nursing shortage and filling vacant nursing positions.

The provisions authorized under Title VII are the only federally funded programs that support the education and training of individuals across the interdisciplinary healthcare team. Schools of nursing and nursing students benefit from many Title VII programs, such as the Scholarships for Disadvantaged Students and the Faculty Loan Repayment Program.

Finally, the National Health Service Corps provides scholarships and loans to nurse practitioners, certified nurse-midwives, primary care physicians, dentists, mental and behavioral health professionals, physician assistants, and dental hygienists.
In November 2008, AACN’s Board of Directors approved the organization’s request to expand AACN’s efforts to secure funding for nursing education in the stimulus package. In this difficult economic time for schools of nursing, the Board recognized this unique opportunity to act now and alleviate current funding concerns for nursing education and increase appropriations for the Nursing Workforce Development programs in fiscal years 2009 and 2010. Reacting to AACN’s call to action, nursing deans, faculty, and students rallied behind the stimulus legislation and sent more than a 1,000 messages through AACN’s online advocacy tool to Congress explaining the importance of supporting nursing education and funding for the Title VIII programs.

“Securing this funding is a tremendous feat for nursing education and a testament to the power of collaboration among nursing organizations,” added Dr. Raines. “AACN is grateful that our membership acted quickly, along with the thousands of nurses across the country, to encourage Members of Congress to include funding for nursing and health professions training in the final bill. Nursing united and prevailed.”
For more details on AACN’s advocacy effort on behalf of nursing education and research, see

Friday, March 27, 2009

Hospital or Private Practice - What Nurses Need to Consider When Making This Vital Decision

By: Grant Eckert

In any career, there are a number of decisions to make. Within the nursing path, there are a number of directions you can take when you are first starting out, often resulting in different career paths and positions. The first and most vital decision you will make is whether to enter the hospital setting or the private practice setting. Both have their rewards, as well as their limitations, so this is a choice you need to spend time on making.

When You Choose the Hospital Setting

Any graduate of nursing school is probably going to be flooded with offers from hospitals and hospital type settings. And with the hiring bonuses they offer, these offers can be quite tempting. Here are the main benefits of talking to these human resources departments:

· Often unionized workplaces - Once you're into these hospitals, you're nearly guaranteed steady work for the rest of your life. Your wages will be raised yearly and your benefits will be negotiated regularly.
· Possibility of promotion or transfers - In a larger hospital setting, you will be able to change your position as your experience increases. Most hospitals will post jobs in other departments with preference given to those already in similar positions or with more years on the job.
· Variety of work - You can start out in one position and then transfer to other positions as your knowledge increases or you simply want a change of scenery and patient care.

But as with any setting in which you would choose to be a nurse, there are downsides too.

· Problems dealing with seniority in the beginning - Since seniority tends to be rewarded, as a new nurse, you might find that positions are slim and the hours are poor until you have a few years of experience.
· Fast paced setting, high patient to nurse ratio - While this can also be a benefit, the fast paced setting and high patient ratio can be exhausting for some nurses, often leading to burnout.

When You Choose the Private Practice Setting

If you're looking at joining a private practice as a nurse, you will find that there are just as many benefits as there are problems with this arrangement.

The benefits include:

· Regular hours - Because you are only working when the doctors are there, you can establish a more regular schedule. This works well for nurses with families that need their care.
· More chance for patient interaction - When you're only dealing with one patient at a time, you can feel more connected to the patients you do meet.
· Smaller patient population - This allows you to learn and to remember patients that come in regularly. You also can have less stress than in a hospital setting.

But the disadvantages to this setting are:

§ Lack of unionization in many cases - This can cause your job to be at risk for termination at any time, regardless of seniority. Your benefits will also be decided by the practice management instead of being supported by a union representative.
§ The pay can be less - While some practices pay better than others, the pay is often much less in a private setting as the revenue can be smaller.
§ There are fewer jobs - You might not be able to get into a higher position as a private practice nurse, plus the number of jobs available is fewer.

Whether you choose the hospital setting or the private practice setting, you will still be able to do what you do best - care for patients. However, most nurses find that one setting is a better fit than another. And that decision is up to you.

Thursday, March 26, 2009

Certified Nurse Assistant’s Duties

Among the vast array of health care careers lies the area of direct care giving. These professionals are often Home Health Assistant (HHA) or Home Health Aides, Personal Care Assistants, Nurse's Aides, Patient Care Technicians and several other titles, depending on the work environment and the region.

Certified Nursing Assistants work closely with patients and provide assistance with daily living tasks, such as: dressing (according to patients' needs, ranging from minimal assistance to totally dependent); bathing (bed baths, tub baths, showers); feeding (serving meals, physically feeding patients who are unable to do so themselves); toileting (assisting with bedpans & urinals, help to the bathroom, provide incontinent care for patients who need it); vital signs (Blood pressure, pulse, etc); Catheter caring (emptying, upkeep of Intake & Output sheets when necessary); answering call lights in a timely fashion; assisting patients with ambulation, when needed; range of Motion Exercises, as prescribed by physical therapy; assisting residents in wheelchairs (a lot of heavy lifting at times); making beds and keeping the patients' rooms and belongings neat and organized; ensuring that bedridden patients are turned at least every two hours, to ensure comfort and to prevent bedsores; reporting all changes, physical and mental, of the patients to the nurse; Post Mortem Care; safety awareness - keeping an eye on wanderers and watching for potentially dangerous situations; Documentation - daily documentation on the care provided to each patient; and anything else that needs to be done.

Certified Nurse Assistants are required to lift patients, assist a patient that is falling and carry heavy medical equipment. They should have the physical dexterity to perform skills that require fine motor movement. Basic observations are made by the CNA; therefore they should possess the senses of sight, hearing, smell, and touch.

Certified Nursing Assistants can be found in nursing homes, hospitals, adult day health centers, assisted living facilities, even personal homes. Wherever there is a need for personal care, Certified Nursing Assistants are the ones who, for the most part, perform the most basic needs for patients, young and old alike. They work under the supervision of a nurse. Since aides have extensive daily contact with each patient, they are keys to providing vital information on the patients' conditions to the nurse.

A certified nursing assistant's job does not end with the physical needs of the patients. This is a job which requires compassion and a desire to make people comfortable and happy. Residents of nursing homes often suffer from depression and/or dementia, and the certified nursing assistant is often the closest human contact afforded to many of these people. A sense of humor helps in this field.

Tuesday, March 24, 2009

The ANA Continuing Nursing Degree Online

The American Nurses Association has made it easier for prospective nurses to earn a degree; easier still to recruit needed nurses in the US. The ANA has launched a nursing degree online available for those nurses seeking a continuing education in their field – an additional motivation for career-oriented nurses seeking to finish or keep with and make better of their profession.

The ANA continuing nursing degree online offers additional education for nurses through ISM’s or Independent Study Modules. This shall help nurses who aim to broaden their skills, knowledge, and abilities to cope with the changing field of health care asguided by the ANA's Scope and Standards of Practice for Nursing Professional Development (2002R), The American Nurses Credentialing Center's Commission on Accreditation Manual for Accreditation as a Provider of Continuing Nursing Education (2004-2005), and the ANA's Code of Ethics for Nurses with Interpretative Statements (2001). Through this method, the ANA continuing nursing degree online is able to provide more nurses with the opportunity to earn more contact hours in their lifelong continuing nursing education learning. This shall also allow the nurses to pursue their future career goals in the nursing profession while helping them meet the mandatory requirements for their certification, license renewal, or promotion in their workplace.

With the ISM’s / Independent Study Modules adapted in the continuing nursing degree online program, the enrolled nurses are able to learn and retain knowledge by completion of the course at their own pace, within their own time frame, and at the convenience of a computer access of their own choice. The nurses also become more fully engaged in the learning process through self-testing and immediate exams correction with immediate feedback explaining the rationale for the correct answers, re-reading of the lessons and re-taking the posttest as many times as necessary until a pass grade of 75% or more accuracy, better yet a hundred percent excellence, is achieved; plus also allowing the students to request their evaluation of the ISM to better improve the ANA online nursing continuing education approach.

Upon completion of the ISM assisted ANA continuing nursing degree online course, the ANA trained nurse is immediately provided with the Continuing Nursing Education Attendance and Contact Hour Certificate so he can meet the requirements of their employer, professional association, and credentialing and licensing boards, as well as fulfilling his own professional goals and personal fulfillment. The ISM design of the online course is highly recognized as it assures that a current, relevant, and significant learning content on nursing as a profession reaches various individual nurses in different practice roles, specialties, and settings, all important to ANA and the entire field of nursing and health care.

Monday, March 23, 2009

Nursing Educators: The "Other" Nursing Shortage

The following article deals with one of this blogs most serious issues; the nursing educator shortage. While the PHEF has shed light on this issue, much more attention needs to be paid to this crisis by the healthcare profession. Unfortunately, if you are in pretty much any other state but Pennsylvania, you may not have any organizations that provide financial aid for current nurses to become nurse educators.

The following article was written by Robert Beatson for the San Francisco Chronicle.

For many years now, much has been documented and reported about the national shortage of qualified clinical nurses in the United States. But what about the "other" nursing shortage? That is, the nursing educators responsible for training the caregivers of tomorrow.

Across the country, the nursing educator shortage is a serious issue that will continue through at least the next decade. The shortage of nurses with advanced degrees choosing teaching careers at nursing colleges, universities or teaching hospitals is due to a number of reasons: budgetary constraints, an aging faculty population and increasing competition from a wide variety of clinical sources. But for nurses who decide to take the classroom path, the career opportunities are abundant and the options for obtaining proper teaching qualifications are becoming increasingly flexible.

Bracing for the future

According to Joanne Pohl, associate dean of nursing at the University of Michigan, more and more nurse faculty members are nearing retirement in the next 10 years, and there's a strong possibility that there will be an inadequate amount of replacements to train future nurses unless something is done to combat the trend. What's more, the growing shortage of nursing educators also threatens to adversely affect the clinical side of nursing, slowing down the rate of students graduating from nursing programs.

"Out of 50 tenure-track faculty at the University of Michigan, 40 percent are 60 years of age or older and approaching retirement," said Pohl late last year. "These are the faculty preparing the next generation of faculty."

Recruiting nurse educators for the classroom is proving to be a challenge as well. Among the most critical issues faced by schools of nursing regarding recruitment and retention are a limited pool of qualified applicants, less than competitive salaries and high faculty workload.

Reinforcements on the way?

These downward trends will continue to confront the nursing education profession now and at least for the next several years, but at least one positive can be taken away - the time has never been better to pursue a career in nurse education.

Hundreds of nursing colleges, university nursing programs and teaching hospitals across the country are seeking to fill educator positions. And with help from national recruiting efforts and increasing government funding, efforts to attract qualified applicants and fill these positions are becoming much more creative, organized and widespread. Many of today's nursing educator programs, for example, are recognizing the importance of providing more flexible schedules, tuition assistance and innovative practicum/academic curricula to facilitate the needs of today's budding nurse educator.

Professional nursing organizations are championing the cause as well. For example, Nurses for a Healthier Tomorrow (NHT), a coalition of 42 nursing and health care organizations working to attract people to the nursing profession, recently launched a national outreach campaign to increase the number of nurse educators nationwide.

The American Association of Colleges of Nursing (AACN), the national organization for nursing education programs, representing more than 560 schools of nursing at universities and four-year colleges, is involved in numerous initiatives to secure federal funding for faculty development programs, collecting data on faculty vacancy rates, identifying strategies to address the shortage and garnering media attention on this important issue.

Ultimately, the nursing shortage issue will be resolved when "legislators, policy makers and the public understand" the critical, interdependent relationship between nurse educators and nurse clinicians, said AACN president Kathleen Long, Ph.D.

Educational requirements, salaries vary widely

Nurse educators who seek employment in an academic environment must possess, at the very least, a master's degree and preferably a doctorate if they expect to advance to higher, tenured academic ranks such as associate professor and professor.

Along those lines, a growing number of master's degree and post-graduate certificate programs are available to prepare nurses specifically for advanced educator positions.

Often offered online, these programs are designed to prepare advanced practice nurses to teach, develop curricula, counsel students and more. In addition, NHT cites dozens of "baccalaureate-to-Ph.D. programs" that consist of intensive clinical experiences and attempt to move students through graduate level studies at an accelerated pace.

Nationwide, a number of other innovative approaches to the nurse educator shortage are taking place:

- Schools partner with hospitals to cross-team teaching and clinical roles.

- Fast-track programs advance the most gifted undergraduate nursing students.

- In states like Kansas and Missouri, where the demand for nursing educators is especially high, nursing colleges and universities are adding more innovative, flexible programs to accommodate easier transitions into the profession. One school of nursing in Kansas City has even added junior faculty positions.

- Nurse educator certificates now exist that allow graduate nursing students the opportunity to specialize as both educators and clinicians.

- Many federal and private funding sources are available to help students who are pursuing graduate nursing education. The Nurse Reinvestment Act, for example, includes a student loan repayment program for nurses who agree to serve in faculty roles after graduation. Similar programs also are available through the National Health Service Corps and the Bureau of Health Professions.

- Compensation wise, NHT reports that nurse educators in academic settings can expect to encounter wide salary ranges owing to rank, education (master's degree vs. doctorate) and type of institution (university vs. small liberal arts college). In 2002, full-time nurse educators with nine-month appointments earned salaries ranging anywhere from $25,000 to $185,000. Those in leadership and administrative roles - nursing deans for example - typically earn more than $100,000. In 2002-03, associate deans with doctorates earned between $93,000 and $111,000, whereas assistant deans averaged between $71,000 and $93,000. In summary, the national nursing educator shortage is a reality facing today's nursing profession. Yet it's a challenge that eventually can be met through accelerated recruitment efforts across the country, increased funding from the government and other sources and collaborative academic and clinical programs designed to accommodate today's dynamic nursing profession. In the meantime, nursing education continues to serve as an attractive, achievable, well-paying and rewarding career option for nursing professionals who possess the right skill sets as well as the desire to make a positive impact on tomorrow's nurses.

Friday, March 20, 2009

Big Incentives to Attract New Nurses

Article written by Debra Wood, RN, contributor for Nurse Connect

Today’s nurses are in great demand and short supply, which has forced some hospitals to offer generous bonuses and other innovative incentives to recruit new nurses to their facilities and keep their professional caregivers at the bedside. From tuition reimbursements and longevity bonuses to flat screen TVs and mortgage down payments, nothing seems too far fetched to consider in the today’s health care marketplace.
“We are all pulling from the same pool of nurses,” said Vicki Wadman, RN, director of recruitment for Memorial Healthcare System in Hollywood, Florida. “Overall, the pool of nurses is limited. We are doing things to encourage people to go into nursing.”

Memorial operates six hospitals in South Florida and offers scholarship programs for employees who want to continue their education. The program pays for two years of nursing education—up to $6,000—in exchange for a two-year commitment to work at Memorial.

“Every organization is going to have some issues with the nursing shortage and have a hard time filling certain openings,” said Margaret Gibson, the manager of employment and employee relations at Mercy Hospital in Miami. “You want to retain experienced nurses. You want a committed, dedicated workforce. Ultimately, that will allow you to provide excellence in patient-care services.”

Experts predict that the hiring situation will remain challenging for hospitals in the coming years, giving nurses the opportunity to be more selective about where they work. The Bureau of Labor Statistics estimates employment of registered nurses will grow 23 percent between 2006 and 2016, from 2.5 million to more than 3 million.

Mercy, which currently employs more than 500 registered nurses and 60 licensed practical nurses, has initiated many inventive programs aimed at recruiting and retaining nurses and other health professionals. Gibson reports that the hospital’s aim is to not only improve patient care, but to also cut down on the high cost of turnover.

Consequently, Mercy now offers retention bonuses on a graduated scale. Nurses who have worked at Mercy for two years receive a $3,000 bonus, those employed for five years earn an extra $5,000, and those who stay on for 10 years receive an additional $10,000.

“It appears to be working and is well received by our nurses,” Gibson says.

For nurses with student loans, Mercy also offers a loan forgiveness program, paying up to $5,000 during a two-year period toward loan repayment.

In addition, all Mercy employees can participate in its commuter benefit as well as the hospital’s new “back-up care” program which helps employees find alternate care for a sick child or aging parent, 24 hours a day.

To offset Miami’s high housing costs, where median sale prices reached $365,000 in 2007, Mercy also offers a down-payment program for first-time homebuyers. Nurses can receive $10,000 toward the purchase of a home in exchange for a five-year commitment to remain at Mercy. If they leave early, they must repay a portion of the funds.

South Nassau Communities Hospital in Oceanside, New York, where the median housing price is $477,200, is helping employees in a different way. It built an apartment complex within walking distance of the hospital and offers the units to nurses at a reduced rent.

Trinity Medical Center in Birmingham, Alabama, has tried some unique approaches to recruiting. Last year, all new nursing graduates who joined the workforce received a 19-inch flat-screen television.

“It seemed to help,” said Angela Harris, clinical professional recruiter at Trinity Medical Center. “It’s amazing what a flat-screen TV will do.”

This year, the hospital offered a partial loan repayment program and 39 new nurses signed on. Harris also promotes the hospital’s Web-based “bid shift” program. Nurses earn points for each extra shift they work and can spend those points on everything from a car wash to a television or digital camera. Unpopular shifts offer more points and incentives.

“We don’t have a problem staffing those hard-to-fill shifts any more,” Harris said.

Memorial Healthcare also has instituted a free concierge service for employees, who can get their car washed, order flowers, have the dry cleaning taken care of, arrange for a house sitter or plan a trip while they are at work.

“We think of it as improving the quality of the work life. Clearly it helps with recruiting, and we hope it helps in retention,” said Ray Kendrick, chief human resources officer at Memorial.

Nurse residency programs are also being used to improve the work environment, keep nurses at the bedside and recruit new graduates who seek support as they transition into practice.

Ellen Whalen, RN, MSN, MS, chief nursing officer at USC University and Norris Cancer Hospitals in Los Angeles, reported that nursing professors are encouraging their students to look for well organized, theory-based, new-graduate programs, such as the Versant RN Residency program her hospital offers. It provides residents with preceptors, mentors and debriefing sessions.

“New grads are drawn to the program for these reasons,” Whalen said. “Our residents become well integrated into the culture and develop relationships quickly with their colleagues.”

Yvonne Brookes, RN, director of clinical learning and executive sponsor of the Versant RN Residency at Baptist Health South Florida in Miami, reports significant increases in the number of nurse applicants since the health system started offering the residency program.

“The reputation and description of the support is bringing in new grads,” said Brookes, adding that for the August cohort, the hospital received 225 applications for 126 positions.

The program also has helped Baptist Health keep its new hires. Turnover rates for new grads decreased from 22.3 percent to 11.8 percent in the first year. Altogether, Versant hospitals report turnover rates of approximately five percent during the first year and 11 percent at two years, compared to national averages between 35 and 60 percent at one year and 57 percent at two years.

The program also benefits preceptors, according to Brookes, who can see the results of their work and appreciate that the new nurses are more likely to stay.

“We have a supportive environment, and that will increase recruitment even more,” Brookes said. “It has increased the professionalism overall.”

As hospitals continue to roll out the welcome mat in new and inventive ways, job seekers can expect to reap the benefits of financial incentives, consumer-based perks and specialized on-the-job training.

Thursday, March 19, 2009

Teaching Effectively in Very Large Classrooms

A read a tremendous article that deals with the challenges and solutions to teaching in a very large classroom. Given that the Pennsylvania Higher Education Foundation (a non-profit organization concentrating on increasing nurses and nurse educators) is currently pushing for more nursing educators, I found this very helpful for any potential nursing teachers.

The following article was written by VickyRN, a staff member of The complete article can be found at:

There is a huge difference in teaching 30 students, as opposed to 140 students. Large classrooms can be noisy, crowded, and full of distractions. The students can be disrespectful and out of control, with pockets of students texting, carrying on private conversations, and coming and going at will. Sound familiar? Learning strategies that work well in small groups are often inappropriate for such large audiences. What strategies, then, can the nurse educator use to facilitate a positive learning environment in large classrooms?

First and foremost, the nurse educator must establish order in the classroom. This is critical, because without order, learning is hindered for all student participants, especially those who want to learn. The syllabus needs to include strict behavioral guidelines (“class etiquette rules”), as well as clearly defined consequences for not adhering to the behavioral guidelines. My university has just enacted the “Disruptive Student Policy,” which backs up consequential wording in the syllabus and allows educators to excuse disruptive students from the classroom. If the student persists in disruptive behavior, then the student may be expelled from the course entirely.

Tuesday, March 17, 2009

Benefits Play a Big Role in Nurses’ Employment Decisions

By E’Louise Ondash, RN, contributor

There’s no doubt about it. Benefits are important to nurses when they consider where to work or whether to remain with an employer, but the benefits they want can vary with age, marital status, health, family situation and career path.
“You need to have flexible benefits (because) there is a much greater emphasis now on balancing work life, and because throughout the life cycle of your career, you’re going to have a need for different benefits,” explained Veronica Zaman, RN. She is executive director of workforce development and talent management at Scripps Health in San Diego, California, a nonprofit community health system that employs more than 3,000 nurses. “We have an aging workforce and we also have a multi-generational work force—new grads who are coming to nursing as a second career.”

Scripps Health has given a lot of attention to benefits, she added, and it watches what the competition is offering.

“The trend a few years ago was to have huge sign-on bonuses, and there are some pockets where that is still a strong attraction. We offer a strong flexible benefits plan so we can focus our efforts on retention rather than bringing people through the door for signing bonuses.”

Ask nurses and they’ll tell you that they expect other benefits beyond major medical, according to Ric Spurgeon, RN, a Seattle nurse and caseworker for Medicare recipients for a large insurance company.

“The benefits are a huge deal, especially since many nurses are single mothers,” he said. “They want items such as subsidized child care, long-term care insurance, legal insurance, retirement accounts, pension plans, employee stock plans and several choices of medical and dental insurance.”

Although not a single mother, Spurgeon likes having six medical plans from which to choose. He said he picked one that meets his needs.

“Your choice will depend upon your state of health, utilization and where most of your expenses lie—whether it’s medications, hospital or doctor visits because of chronic conditions. I prefer a health savings account (HSA).”

Spurgeon uses pre-tax deductions from his paycheck to fund an HSA.

One St. Louis nurse who works part time as evening nurse manager at a large teaching hospital, continues to “toy with thoughts of retirement.”

“I look at it seriously every six months,” said Patricia, a 40-year-veteran who asked that her last name not be used. “But as long as working is still something I enjoy and I have a schedule I can manipulate, I find it hard to justify giving up the great medical coverage we have at the price we pay. So I suppose you could say that insurance is certainly a factor in keeping me working at the moment.”

Even though she works only two days a week—the minimum to receive benefits—Patricia has health, vision and dental insurance, vacation and sick time, tuition reimbursement and an employer-matched 401K. And although she has remained at the same hospital since her 1967 graduation, “I continue to get lots of recruitment-type mail from other hospitals,” she said. “The information I get always highlights benefits, so I can only assume it’s pretty important. Interestingly, the tuition reimbursement and the 401K seem pretty important to young nurses also.”

A national telephone survey of 250 nurses, conducted in October by Aflac Insurance, confirms that benefits play a big role in the decision-making process for nurses when determining where they should work. Nearly nine out of 10 of the nurses said a hospital's benefits package is one of the most important factors when determining where they choose to work.

More than half of those surveyed reported that they would switch jobs solely based on benefits.

Some nurses even want so-called “voluntary” accident and disability insurance; that is, they are willing to pay the full premiums if their employers offer it.

Monday, March 16, 2009

Step-up Programs Encourage Advancement from LVN to RN

Climbing the nursing school ladder is made easier by programs that offer a step up for licensed vocational nurses aiming to become registered nurses.

Climbing the nursing school ladder is made easier by programs that offer a step up for licensed vocational nurses aiming to become registered nurses.

Licensed vocational nurses, or LVNs, also known as licensed practical nurses, or LPNs, complete a one-year program, available at roughly 1,200 state-approved programs across the countrymostly in vocational or technical schools or community colleges, according to the United States Department of Labors Bureau of Labor Statistics (BLS). They are trained to provide basic bedside care, from taking vital signs to preparing and giving injections, applying dressings, preparing tests and assisting with patient hygiene. LVNs work under the direction of a registered nurse.
While the LVN is an important member of the health care team, the BLS reports that hospital employment of LVNs is on the decline, and many LVNs are being encouraged to pursue their RN education. Step-up programs provide LVNs a smooth transition into the RN curriculum.

At the College of the Siskiyous, in Weed, California, a new grant has allowed for the creation of a step-up program, which will begin in the fall of 2007. According to Kathy Gassaway, administrative secretary of the nursing program, the program fills a void that forced students to seek further education elsewhere.

A lot of the LVN students have gone to other schools to continue their education, Gassaway said. Because there is such a need for RNs, not only in this area, but all across the country, we received a grant from the chancellors to start the program here.

The College of the Siskiyous LVN-to-RN Step-up Program is two semesters, entering students into the last two semesters of the typical RN program. It requires pre-requisites, including human anatomy and physiology, microbiology, sociology, psychology and college composition and mathematics, among other courses, and requires a minimum cumulative grade point average of 2.5.

Although its only in its preliminary stages, Gassaway expects the step-up program to be a popular choice among the schools 26 or 27 LVN students.

We promote the program, but how many of them will do it, I dont know, she said. We started with a certified nurse aide (CNA) and promoted going on with the step ladder approach to the LVN. Of course, we want all of our students to go on and get their BSN and masters degrees!

Southwestern College, in Chula Vista, California, has had a step-up program since the beginning of timeat least 30 years, said Sandra Comstock, RN, director of nursing and health occupations at the community college south of San Diego, but interest has increased in recent years.

Its definitely more popular today, she said. There were a couple of years when nobody was enrolling, but the shortage has opened more opportunities to advance.
Although the program has a one- to two-year waiting list, which is similar to the RN program, Comstock explained that for many students, it provides a great opportunity for students to learn a different role. Students who have completed the LVN program take a summer transition course, which involves lecture and hospital learning, and then mix in with RN students who have already completed their first year of the RN program. After one year of hospital and classroom learning, they are eligible to take the NCLEX.

The step-up program is a good way to transition into the RN role for career advancement, Comstock concluded. The LVN plays an important role, but once theyve had that experience, most are very successful as RNs.

Friday, March 13, 2009

Burnout: The Effects Of Unavoidable Job Stress

By Douglas Hardwick, Ph.D.

Stress seems to be an inevitable part of any job. Even minor things can lead to feelings of stress. Petty arguments with supervisors and conflicts with co-workers are among the most common every day stressors. For some employees, however, the level of stress experienced goes far beyond job strain and the irritation of daily hassles. For some employees, the level of stress experienced on the job builds up until it is overwhelming and leads to a condition called burnout.

What is burnout? In general, burnout is described as emotional exhaustion. The most common symptoms associated with this emotional exhaustion include overwhelming fatigue, headaches, stomachaches, and impaired sleep. And, as burnout develops, it often leads to a deterioration in social skills. Individuals in the midst of burnout just do not interact with others as they did in the past. They often withdraw from others. They may lose patience more easily. They may become more abrupt and abrasive in their dealings with others. Their language on the job may become cruder. They may appear to be moody and depressed.

Over time, burnout has profound effects on job performance. Simply put, job performance suffers. Victims of burnout are likely to reduce the amount of work they do. They may avoid tasks that they find most stressful. Their absenteeism is likely to increase. In the worst case, they may suddenly quit their jobs with little notice to their employers. Supervisors may not be able to recognize burnout for what it is, but they certainly will notice the effects of burnout on job performance.

Burnout often occurs in those jobs we think of as the helping professions. Professions such as teaching, law enforcement, nursing, and social work are all potential breeding grounds for burnout. Interestingly, within these professions, burnout tends to strike the most dedicated and most idealistic individuals. While burnout has been observed for years in the so-called helping professions, it can occur in a wide range of jobs. The key seems to be the presence of inescapable, day-to-day frustrations which build up overtime.

The frustrations that lead to burnout can take many forms. Studies of professions such as teaching and nursing have suggested that burnout occurs when workers begin to believe that no one appreciates the work they do or the help they provide. Over time the difficulty of their task and the presence of ambitious, but ambiguous, goals may lead them to believe that their efforts have no real impact. When the feeling "it doesn't matter what I do" sets in, burnout is not far behind. Of course, these feelings are not limited to the helping professions. Anytime workers feel overwhelmed by the demands of their job and think that there is little support for their efforts, burnout becomes a threat.

Fortunately, there are several things that can be done to eliminate or reduce the development of burnout. First of all, it is important for supervisors to actively support their subordinates, to treat them fairly, and to provide them with appropriate feedback. Second, it is important for employees to develop a realistic view of what they can accomplish on the job. Unrealistic goals are a recipe for frustration and stress. Third, employees need to maintain a balanced lifestyle. Individuals who blur the boundaries between work and home are good candidates for burnout. Finally, employees need to learn specific techniques for reducing and managing their own perceived levels of stress. These techniques may include exercise and various relaxation procedures. Meditation, tai chi, and qigong are all examples of holistic health practices that might prove helpful. Practitioners have long argued that these disciplines enhance relaxation and reduce stress in the individual.

Thursday, March 12, 2009

Nursing School Faculty Shortage Solution? Have Nurses Teach

Article reprinted from Nurse Connect

By Glenna Murdock, RN, contributor

What three words pop up in nearly every conversation regarding health care these days? The nursing shortage. The insufficient numbers of nurses in our country is a problem that forces a look at nursing education with a creative eye, in an effort to find ways to produce more nurses and to better utilize the existing nurse workforce.
Due to its immense size and to the broad scope of services it provides, Cleveland Clinic in Cleveland, Ohio is the employer of one of the largest nursing staffs in the U.S. Those in nursing leadership at the Clinic, acutely aware of the expanding shortage problem, took a proactive step in 2005 by inviting area deans, directors and faculty of area schools of nursing to come together to discuss the problem and possible solutions. The meeting was labeled the Deans’ Roundtable Faculty Initiative.

Cleveland Clinic’s nursing leadership, along with the director of the Center for Health Affairs in Cleveland, focused their attention on the fact that, in the prior year, 1,500 qualified candidates had been denied admission to area nursing schools due to a shortage of faculty, particularly in clinical areas. In order to produce more graduates, formulating a strategy to increase the numbers of faculty would be essential.

A master’s degree is not required for a nurse to fill the role of a clinical instructor, so nursing leadership offered a proposal to the schools of nursing: “Use our nurses as clinical educators.”

“The idea was not well received initially,” said Joan Kavanagh, MSN, RN, director of nursing education at the Clinic. “The deans felt that nurses could not move easily from one program to another, given the differences and organizing philosophies of each school. But, we continued to meet and the Roundtable became a classic example of team building. Now we are friendly and cooperative with one another and laugh about the resistance to the idea that existed in the beginning.”

The idea has proven popular with the Clinic, schools of nursing, nurses and student nurses alike. Matching nurses with faculty positions is made efficient by the use of a database that keeps track of teaching opportunities and of the nurses who are seeking them. Nurses with BSNs can teach skills labs and clinicals. A master’s degree is required for teaching online and classroom courses.

The database went live in May 2007 and, to date, over 100 positions, 95 percent of them clinical, have been filled.

Because many of the nurses coming in as adjunct faculty have no prior teaching experience, the Clinic organizes a one-day Faculty Boot Camp orientation. The individual components of the orientation, including the roles and responsibilities of faculty, formative and summative evaluation, organization of the clinical day and critical thinking, are taught by experienced faculty from the schools of nursing.

Students are invited to voice their opinions regarding what they need and expect from clinical instructors. According to Kavanagh, the students are impressed that their views are sought and valued.

“Nurses who have accepted faculty positions tell us that teaching has truly re-energized and enhanced their nursing practice,” Kavanagh stated. “For many, it has also increased their interest in pursuing an advanced degree.

“Especially uplifting,” Kavanagh continued, “is the trust and goodwill that have developed among the Roundtable participants who had previously viewed one another as the competition. Now we know that all of us are in this together and we are working together to find solutions.”

Wednesday, March 11, 2009

Nursing Scholarship Programs Funding

Scholarships are financial aids provided on the basis of academic merit awarded to an institution or an individual for the purposes of furthering their education. They are offered by governments, colleges and private, and other outside sources. They are generally awarded based on the financial need, academic achievement, athletic achievement, community involvement, nationality or ethnicity of the individual. Like grants, they do not have to be repaid.

Nursing Scholarships and grants are provided to compensate for the critical shortage of nurses around the globe.

Many Nursing Scholarship Programs provide tuition fees, required fees, other costs including required books, clinical supplies, laboratory expenses, research facilities, etc., and other scholarship benefits. Preference is given to qualified applicants with the greatest financial need who are enrolled full-time in an undergraduate nursing program. Nursing scholarships or loans are not only granted to the needy and with the highest grades.

Nursing scholarships are given in exchange to: practicing full time as primary care nurse practitioner in a community, teaching in a nursing school, employment as a nurse administrator in health care agencies, working for the Department of Health, service for a period of 2 years at health care facilities, and/or assist in the area of mental health research.

The major sources of nursing scholarships for students are the state and federal governments. Some are sponsored by individual donors or private organizations. Since they often have more nursing scholarships funds available, more and more federal dollars are used to promote underserved areas for nursing students who can commit to service after graduation in a medically underserved institution or region.

Professional nursing organizations, such as the American Nursing Association (ANA) and other active political voices, and many colleges and universities with nursing program, have built up generous scholarship and grant funds for both undergraduate and graduate nurses because of the lack of funding across public and private sources. These grants are administered to nursing scholarship programs to help shore up flagging nursing programs, provide needed funds for new facilities, and provide money to hire more well-trained nursing faculty.

Nursing scholarship forms can be accessed online or you can obtain copies from schools’ financial aid offices. Requirements must be completed at favorable dates or deadlines. They are in first come first served basis. You can explore the web to be able to find what kinds of nursing scholarship programs are offered. You can also find them in private sector loans, grants and other assistance that your local service organization provides.

Tuesday, March 10, 2009

10 Benefits to Working as a Travel Nurse

Melissa Wirkus, a staff writer for, wrote a very interesting article concerning being a travel nurse.

Ms Wirkus writes:
Great pay, endless opportunities and limitless adventure are just a few of the reasons why nurses choose to travel. Whether you want to explore the four corners of the U.S. or find the ideal place to settle down, travel nursing provides excellent opportunities for adventure, career enhancement and personal fulfillment.

Along with this excerpt she also highlights the 10 benefits to working as a travel nurse, which are:

1. Discover new places

From the natural beauty of the Alaskan frontier to the thrills of New York City, there are no limits to where travel nursing can take you. Assignments are available in all 50 states, from quaint towns in the Midwest to every major metropolis. “I love being able to see the country and taking advantage of what each city has to offer,” said Mandi Smith, RN, who has been traveling with staffing company NursesRx for three years. Traveling provides nurses with the opportunity to live in any place they desire, something few professions can offer.

2. Freedom and flexibility

Travel nursing provides nurses with the unbeatable freedom and flexibility to choose when and where they want to work. Nurses are able to take time off between assignments to spend time with family and friends, or take an extended vacation. Annie Kennedy, RN, who is on assignment with travel staffing company Medical Express, recently took a trip to Guatemala to volunteer at an orphanage and clinic serving underprivileged youth. Her flexible schedule allowed her to take time off between assignments to pursue her interests and help others.

3. Professional growth

Working at different facilities, from top research and teaching facilities to rural hospitals, enables you to broaden your skill set and learn new techniques. "Travel nursing is a great way for nurses to expand their professional résumés while they enjoy exciting new experiences around the country," said Linda Gardner, recruiter for NursesRx. Not only does travel nursing showcase your adaptability, but it also proves you’re always up for a challenge and ready to learn from each new facility you visit.

4. Job security

The nursing shortage has RNs all across the nation in a very enviable position where their skills are in high demand. Healthcare facilities are in need of qualified nurses to fill permanent staff shortages and meet seasonal needs. “It’s the one job where you know you will never be out of work,” said Kathryn Madigan, RN, who travels with staffing company American Mobile Healthcare. Nurses who travel enjoy the job security of knowing there will always be another assignment waiting once their current assignment ends.

5. New friends

Getting to know new people, from your new colleagues at the facility to friends you make outside of work, traveling allows nurses from all walks of life to intertwine with new people and cultures. Travel nursing puts you in touch with people that you would otherwise never meet, from new neighbors to friends who share similar hobbies and interests. Establishing strong friendships as you get to know the city is one of the most rewarding parts of traveling, and something you can take with you for years to come.

6. Make more money

Travel nurses earn generous hourly pay rates and most companies offer shift differentials, overtime and some facilities offer completion bonuses. “Traveling nurses are compensated with excellent packages including competitive hourly wages, free furnished housing and health insurance starting on day one of their assignment," Gardner said. Some companies even offer referral bonuses to the RNs who refer their friends—just another example of how lucrative travel nursing can be.

7. No workplace politics

Travel nurses don’t become embroiled in politics or management issues. They go in, do their job and focus on patient care. “You can avoid hospital politics as a traveling nurse. All of your paperwork is done through us and you are not involved in the bureaucracy of the internal staff,” Gardner explained. “Through NursesRx, you have the benefit of our 24 hour clinical liaison support; experienced RNs who can address any clinical or workplace concerns you might encounter for the duration of your assignment." If a practice environment isn’t an ideal fit, a new assignment is just a few weeks away.

8. Find the ideal place to settle down

If you’re thinking of making a permanent move to a new location, working as a travel nurse is a great way to “test the waters” before committing to the move. Find out what it’s like to live in the charming countryside of New England and then switch gears to live the life of a beach enthusiast in San Diego. Comparing different cities and parts of the country by way of your assignment choices is an ideal way to find out where you want to establish a permanent residence before making a commitment.

9. Avoid burnout

Pursuing a career as a travel nurse is also a way to avoid the “burnout” that many permanent nurses experience. Whether you’re tired of hospital politics or feel as if your career is at a standstill, travel nursing can be just the revival you need. Experiencing new faces and places, while continuing to do what you love most—caring for people, is a priceless opportunity that few other professions offer.

10. Develop new interests/hobbies

Exploring new destinations can lead to new experiences, such as skiing if you’re near the mountains and surfing if you’re near the beach. “Traveling has allowed me to develop new interests,” Smith said. “I like to explore a new city either on my bike or by going hiking.” The options are endless when traveling and a new location almost certainly brings about a love for a new hobby or fun activity that you never expected.

This particular article has been reprinted from:

Monday, March 9, 2009

Nursing Spectrum Networking and Educational Event

On Tuesday, April 7, 2009, Nursing Spectrum will be holding a networking and educational event at Dave and Busters in Philadelphia.

> Free for RNs, Graduate Nurses and Nursing Students
> Free Parking
> Free CE Seminars (earn up to 4 contact hours)
> Free Coffee Break
> Free Wheel of Fortune Prizes and Caricature Artist *
> GRAND PRIZE DRAWING: Enter to win a $500 Visa Gift Card (Must be present to win!)
> SPECIAL DRAWING: Drop your resume off for a chance to win a Portable GPS Navigation System. Total of 3 will be given away. (Must be present to win!)
> Arrive any time between 8:00 AM - 2:00 PM
> Career Opportunities. You are encouraged to dress professionally and bring copies of your resume for on-site interviews.

To register, please visit:

Sunday, March 8, 2009

Nurses, Physicians Encouraged to Use Surgical Safety Checklist

The following article is from and written by Catherine Spader, RN, who is a contributing writer for Nursing Spectrum/NurseWeek

A surgical checklist study proved so successful at saving lives and reducing complications that the Institute of Healthcare Improvement is calling on every hospital in the country to use the checklist at least once before April 1.

The new study, published in the Jan. 29, issue of the New England Journal of Medicine, found the World Health Organization's Surgical Safety Checklist, a simple but comprehensive checklist used during major surgeries, significantly reduced incidences of surgery-related deaths and complications.

"You don't rely on memory to complete a complicated recipe, so why would you rely on memory for a complicated surgical procedure that is so critical to the individual lying on the OR table?" said Fran Griffin, RRT, MPA, director at the Institute for Healthcare Improvement, based in Cambridge, Mass.

The study collected data from 7,688 patients at eight hospitals in the WHO's six worldwide regions. Researchers found major complications that followed surgery fell from 11% in the baseline period to 7% after introduction of the checklist. Inpatient deaths that followed major operations fell by more than 40% (from 1.5% to 0.8%).

Outcomes of the checklist's use are so impressive the IHI is sponsoring the WHO Surgical Safety Checklist Sprint initiative. The goal is to have every hospital in the country test the checklist at least one time by April 1. The ultimate goal is for facilities to move toward full implementation of the checklist during all surgical procedures.

A Conversation Piece

Most checklists in use today tend to be silent paper exercises in which a lone nurse checks off boxes. In contrast, the WHO checklist is a tool of communication and functions as a list of team talking points.

"The most important thing the checklist does is make people think as a team about all the steps they need to ensure what will happen," said Atul Gawande, MD, coauthor of the checklist study and a surgeon at Brigham and Women's Hospital and associate professor at the Harvard School of Public Health in Boston.

This checklist concept does not revolve around a piece of paper but a conversation in which one person, usually a nurse, takes the lead. Everyone on the team has to verbally respond to the points on the list, including physicians, anesthesiologists, and other nurses.

The patient also is considered a team member and an active participant in the checklist conversation. During the preprocedural portion of the checklist, the patient must verbally confirm his or her identity, the surgical site, procedure, and consent.

Becoming A High Reliability Industry

Evidence from high reliability industries, such as nuclear power and aviation, has shown an oral check is more likely than a written check to capture and prevent errors, according to Alex B. Haynes, MD, MPH, lead author of the study and researcher at Harvard School of Public Health.

In fact, the checklist doesn't need to be documented on a piece of paper at all. The checklist conversation can be adapted to suit the needs and resources of individual facilities and can be followed from a poster visibly displayed in the OR.

"It's not intended to be a form of documentation or regulation," said Haynes who also is a surgeon at Massachusetts General Hospital in Boston. He adds that organizations have the option to adapt it to serve that purpose if they choose.

Making it Work

Adapting and implementing the safety checklist can require hurdling some obstacles, according to Jodi Bloom, RN, BSN, CNOR, staff nurse in the OR at University of Washington Medical Center in Seattle, the only U.S hospital that participated in the checklist study.

"Many of us thought the checklist conversation was just one more thing we had to do to get a case started," Bloom said. "Now we think it's an invaluable tool. It collectively forces everyone in the room to pay attention, focus on the patient, discuss the patient, and be on the same page."

The checklist conversation can take as little as two minutes to complete. "If you try it with one case, you learn very quickly how to best adapt it to your practice," said Bloom. "Our surgical teams were accustomed to performing timeouts, and this came to be incorporated into our practice as an extended timeout. Now it has become innate."

Another key to success is to test the checklist on a small scale first, such as with the cases of one surgeon who is enthusiastic about the concept. It also is a good idea to present the checklist concept to the entire OR staff before implementation and ask for and incorporate their input in adapting the list.

Wednesday, March 4, 2009

Stimulus bill gives nursing homes reason to smile

It’s OK to crack a grin now that Congress has reached a tentative agreement on the colossal economic stimulus package. Nursing homes have a lot to be happy about.
Here’s why:

—The biggest bang of the package, of course, is the $87 billion in increased Medicaid funding. The House and Senate agreed to an across-the-board increase in the Federal Medical Assistance Percentage of 6.2%, according to Susan Feeney, spokeswoman for the American Health Care Association. (That represents a compromise between the House and Senate versions, she said.) A bonus also will be paid to states that have high unemployment rates.

—Another piece of good news is that the bill delays moratoria for six harmful Medicaid rules that would limit funding to nursing homes. The delay buys Congress and the administration until the end of June to figure out a more permanent solution.
—Finally, the legislation contains a provision requiring prompt Medicaid payments to nursing homes and hospitals. Clean claims now have to be paid in 90 days. That alone is reason for providers to cheer.

Unfortunately, one battle nursing homes didn’t win was an amendment to the bill, introduced by Sen. Charles Grassley (R-IA), which would have prohibited states from reducing spending to providers even as they received Medicaid funds.

“Yes we would have preferred there was that Grassley amendment in there, but we understand Congress’ recognition not to tie the hands of the governors,” Feeney said.

All in all, there is more to praise than to criticize in the bill. So don’t be bashful about sharing your thoughts through letters to senators and representatives. And say “thank you.” It took a lot of work to reach this point.

Tuesday, March 3, 2009

Work Of PA Center For Health Careers Eases Pennsylvania's Nursing Shortage

The shortage of registered nurses in Pennsylvania is shrinking, in part, because of the efforts of the Pennsylvania Center for Health Careers, Department of Labor & Industry acting Secretary Sandi Vito announced.

The information is included in updates to the 2005 reports "The Registered Nurse Workforce in Pennsylvania" and "The Licensed Practical Nurse Workforce in Pennsylvania," released today and available online at

"I am pleased to see that our investments and efforts to address the need for nurses in Pennsylvania have reduced the shortage originally estimated in 2005," Vito said. "By helping academic institutions hire faculty and add classes, the Pennsylvania Center for Health Careers is helping to increase the number of skilled, qualified nurses in Pennsylvania."

According to the latest forecasts, the shortage of registered nurses, or RNs, projected for 2010 is between 8,000 and 14,400 of an estimated statewide demand for 146,000 RNs -- between 400 and 1,700 fewer than the shortage reported in the original 2005 report.

"The report's estimates also show the need for Licensed Practical Nurses, or LPNs, will nearly double -- due to Pennsylvania's aging population -- leading to an estimated shortage of between 7,100 and 8,400 in 2010.

"Our efforts have been positive and successful; however, the aging of residents makes it very clear that there is more work to be done," Vito said. "Having determined the commonwealth's nursing needs through 2010 and beyond, we must have the proper resources to continue our investments in programs that will close education and employment gaps, and ensure every Pennsylvanian has access to the high-quality care they need and deserve."

The forecasting model used to provide the updated information is a cooperative effort by the Center for Workforce Information & Analysis and the Pennsylvania Center for Health Careers. Data was collected by the Department of Labor & Industry on employment and occupational trends; the Department of Health's State Health Improvement Plan (SHIP) Survey on registered nurses and licensed practical nurse characteristics; the Board of Nursing on graduation rates, licensure examination pass rates and the career plans of nurses; as well as data collected from six regional round table discussions with health care industry professionals from around the state.

Additional information about the Pennsylvania Center for Health Careers, as well as reports and data about Pennsylvania's need for registered and licensed practical nurses, is available online at

Monday, March 2, 2009

Online Nursing Degree Programs in LPN to RN Transition Programs

Any LPN who feels they have established a good base of knowledge and nursing experience may wish to take the next step and become a Registered Nurse (RN). The difference between a LPN and a RN may seem small at first glance, but differ greatly in the education required to achieve each certification, and the opportunities afforded to each down the road are what really makes the difference. Many more options become available to a RN as they gain more experience, ones that will not be offered to a LPN regardless of experience or base knowledge. Without and RN certification, it is increasingly difficult for a LPN-certified nurse to continue to receive promotions or to further their career, especially financially. While the the money may be okay in the beginning of their career, an LPN will want to continue some education program so they can continue to grow in the future.

A LPN to RN transition program is designed for qualified Licensed Practical Nurses who wish to become Registered Nurses with a minimum amount of time and with a little repeat of course content and credits. Graduates of the program are eligible to become RN's after they pass the mandatory exam for all aspiring RNs. The National Council Licensure Examination for Registered Nurses (NCLEX-RN), is a standardized test for all RNs. The exam tests current medical knowledge, nursing competencies, and determines your eligibility to earn a RN license and begin your career as a Registered Nurse. To get the ball rolling and begin your work as a RN make sure you have satisfied all the requirements for the Transition Program.

First you obviously need to be a graduate from a State Board approved nursing program with a GPA of 2.5. You will also need to submit an official transcript of required courses and an interview with on of the program's faculty. Finally you will need to complete the Nursing and Allied Health application and submit it to the Division of Nursing and Allied Health, before the application deadline date for that semester's program. While it may seem daunting to a recently certified LPN, it is highly recommended that they continue on with learning and gaining new certification, and shooting for a RN status will open may doors for them in the future.

Visit the College Network to get more information on LPN to RN online degree programs.

Article from

Sunday, March 1, 2009

Nursing Education in the United States

Nursing education is a field that combines nursing with the teaching of students of nursing and, for some, with the administration of educational programs.

A high proportion of the teachers in nursing education programs teach in clinical situations, in which students learn to care for patients and families in hospitals, at home, and in other situations. Universities or associations usually offer teaching by nurses in staff-development programs of hospitals and other health agencies and in continuing-education programs. The basic educational program for nurses in many countries is scientific and humanistic in content. All educational programs include experience with patients in hospitals, homes, or other settings.

In almost all countries with nursing education there are at least two kinds of programs – those leading to diplomas and those that train auxiliaries, though a large portion of auxiliaries in some countries are untrained.

The development of nursing education in any country is affected by the developments in general education. In the United States and some other countries, for example, high school graduation or its equivalent has for many years been a requirement for admission to schools preparing registered nurses. In the United States this is also a requirement for admission to practical nurse programs. In some countries fewer years of previous education are required.

Nursing education in the United States has undergone tremendous changes in recent years. In order to prepare nurses for beginning and advanced levels of practice, educational programs also have undergone tremendous changes. Many curricula are creative and interactive, rather than rigid and proscriptive. Education is more learner-focused than teacher-centered. Clinical experiences for students reflect a greater emphasis on community-based care, health promotion, disease prevention, family involvement, and self-care. And the integration of technology and the use of distance learning strategies are more evident in nursing education programs.

Nurse educators are realizing that there is an art and a science to teaching nursing – just as there is an art and a science to practicing nursing – and they are seeking preparation in curriculum development and evaluation, creative teaching/learning strategies, student and program evaluation, and other areas that complement their clinical specialization and expertise.

Post-basic programs for nurses with diplomas have been established in the United States and in many countries. Some programs offer courses in general education, as well as nursing courses, and some, in universities, may become programs leading to a bachelor’s degree. The purposes of such programs vary and include the preparation of teachers, supervisors, or administrators and of nurse specialists in various fields, including midwifery, public health, and teaching of auxiliaries. Some augment the education received in other programs. Enrollment is generally small in relation to the need for their graduates.