By Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor
My daughter is about to start her nursing career. She’s got all her prereqs out of the way and she’s waiting to hear from the half-dozen colleges she applied to. Among them is the community college where I started my career 35 years ago. That’s right—a community college that confers an associate degree.
I hope she gets in.
Community colleges are seen by many as the bottom of the ladder of desired schools of nursing. Not only do they offer only a two-year degree, but they’re not seen as being as selective as four-year colleges and they don’t have the big name professors.
But community colleges can and do produce great nurses. Programs are rigorous, so a more liberal admission standard at the onset doesn’t necessarily change the caliber of student who graduates at the end. And once they graduate, they must meet the same standards as students from four-year schools to attain licensure as an RN—everyone takes the same NCLEX. At the time of my graduation, my school had a 98% pass rate, one of the highest in the country.
Community colleges even have some advantages over a lot of four-year programs. They may not have the big names—but really, how many of those big name professors actually teach full courses? At community colleges, teaching is the focus. Community colleges are affordable; students don’t leave burdened with astronomical debt to start a career that, while setting them down firmly, and often permanently, in the middle class, can also saddle them with a burden of debt on top of all the expected financial struggles. And in many places, community colleges are truly embedded in their community; this can provide a level of support and open up opportunities for students that is not possible at larger detached universities.
I agree that all nurses should have a BSN, eventually. There is a lot of evidence that it improves patient outcomes. But the two-year community college can be a great place to start—two years of reasonably priced education that gives you a solid base of skills and knowledge to practice while you continue to take courses toward a bachelor degree. I remember when I returned to school for my bachelor’s: the wonderful sense of discovery that I was not just a nurse but a professional, and part of a profession with its own history and body of knowledge.
We need more nurses. All the experts agree that there is a shortage just waiting for the rest of the Baby Boomer nurses to hang up their stethoscopes. An education that starts at a community college can take a nurse far. I know mine has, from acute care staff nurse to long-term care educator, from oncology to urgent care to the IV team. Here in the U.S. and in India and Africa. As a nurse scholar at the WHO in Geneva, Switzerland, and as an NP in the Adirondacks of upstate New York.
So yes, I’ll be happy and proud if my daughter gets into that community college. Who knows where it will lead her.
I was accepted at the state university but switched to community college because of the night class options, since I have young children. But I’m still in my application year, having done my “do not pass go” prereqs.
I believe currently approx. 50% of RNs in the US are AD-RNs. I remember in the mid-70s hearing about 2 year nursing degrees and feeling quite superior because I was in a BSN program. Never thought I’d ever be adjunct faculty at a community tech college school of nursing. Having 40 years of nursing experience to base my judgements on, I know that in nursing, as in any other profession, unfortunately, there is no guarantee that prestigious educational institutions always produce superior nurses. It saddens me when my students have told me of interactions with BSN students in the clinical setting during which some BSN students have made condescending comments. Wow! Right off the bat, animosity is bred among future nurses!
I address this issue head-on with my students. I tell them that there is no standing still in nursing–you are either moving forward or moving backwards. I tell them at least 25% of their knowledge will be obsolete in 1-2 years, so you must always read the nursing journals and the nursing websites and blogs and join our professional organizations, and plan on going on to obtain their BSN within 5 years. However, we are all members of the team. Despite snarky comments made on the job, or sometimes in journals, we are all valuable members of the team and can learn from and teach each other. Who would deny that more education is a good thing? No one. BUT, we all take the same board exam, and the national first-time pass rates differ only by 1-3 points among 3 year diploma grads, BSNs, and AD-RNs. Yes, more and more hospitals require or prefer new grads who are BSNs, but 50% of RNs are AD-RNs, so obviously there are plenty of places that will hire them.
The average age of my students is 30 yrs old. These are mature men and women, many of them married with children, who are deeply motivated and working very hard juggling family responsibilities, often part-time jobs, plus nursing school all at once.
These are good people, who are taking this path, rather than 4 year college at this point, for varied reasons. These are good nurses. Yes, more education is always the goal, but meanwhile they provide quality nursing care and deserve respect.
Thanks so much for this balanced and sensible comment on this sometimes controversial topic.
Just to weigh in, I have stair-stepped my career very successfully. My initial CC program offered the chance to become a CNA after the first 2 quarters, then take the LPN boards after the first year plus summer school. I then proceeded to get my 2 year ADN, followed by my BSN after a short working break. This worked very well for me as I was not only able to make a decent wage all the way through school, I also gained valuable experience above what a CNA can provide as I worked my way all the way through a BSN, mostly as an RN.
I agree that all RNs should have a BSN and I would encourage any one looking at nursing and potential hospitals or specialty areas to review job boards to see what is required for their chosen path. This applies to all careers.
I really don’t have a good response to the comment from the doctor as written above. I’ve found that most doctors, after they get some experience, are reasonable humans and usually highly respect the nurses they depend on- no matter the degree. Attitudes towards nurses have slowly changed over the years but have a long way to go- from doctors to the general public!
Even with the challenges in the job market I’d still suggest a nursing career to anyone with interest. I’d just advise them to do some research first, for nursing or any other career.
Thanks everyone for the great comments. Just to clarify, I am not promoting the associate degree over the bachelor degree. I’m saying that starting your education at a community college may be a good option and one that deserves respect.
Karen Roush
I have long heard that the reason there is a nursing shortage is that there are not enough spaces for students in nursing programs, and that the reason there are not enough spaces for students is that the universities don’t have enough faculty to handle more nursing students. Is this true? If it is, then what is not clear to me is why the universities are short on nursing instructors. Is it because nursing programs don’t have the budget to hire enough or is it because there just aren’t enough nurses applying for teaching positions? Karen, you make the point that there are excellent instructors to be found in the community college programs. It would be interesting to hear from these instructors, to get their perspectives.
This is exactly what has been on my mind for months. 4 of my 5 are raised, the only one home is 13 and disabled. I have been overwhelmed with ideas and trying to come up with a plan that makes sense. And this makes sense.
My nurse friends often complain about the lack of respect they receive from physicians. My physician friends tell me they have a hard time with respecting a profession that only requires two years out of high school to enter. They always throw back how much schooling and post-school work they had to do. How should we respond to that criticism?
I think it is unfair to continue to promote Associate degrees for nurses when just about every job is requiring a baccalaureate in nursing. The sad part is that there is value to an associate degree nurse and we haven’t changed our licensure requirements yet many people will work hard to graduate in those programs and not be able to earn a living to pay back their loans or find viable, exciting place to work.
Thank you so much for saying what has needed to be said for a long time. I received my Masters in Nursing Education from University of Phoenix. They do not have a rigorous admission policy either. However, the caliber of the their instructors was second to none. There has to be a way to meet the educational needs of nurses and be able to support the IOM recommendations.
Well stated! As a retired nursing faculty of both community college and university nursing programs I agree that this is a great way to get a sound nursing education.
There is a great program in Oregon called Oregon Consortium for Nursing Education (OCNE) where you start out at one of the many competitive community college programs in the state and get your associates. You are then are automatically accepted to Oregon Health & Sciences University (OHSU) to complete your bachelors if you desire. It is a fantastic and flexible option in this state.