Monday, September 20, 2010
Students Who Don’t Get Into Nursing
It’s a great question, but the answers aren’t easy.
At many community colleges, including my own, students don’t enroll fresh off the street into a Nursing program. Instead, they spend the first year or so taking prerequisite courses -- gen eds plus a generous helping of Biology, more or less -- and then apply on a competitive basis. The idea is that seats in Nursing programs are badly limited -- both by cost and by the number of clinical sites available -- so it makes sense to allocate them to students who are likely to succeed.
Even though the market for new Nursing grads isn’t what it once was, it’s still better than most other markets for new grads, so there’s a tremendous surplus of applicants. Students with GPA’s in the low threes typically don’t get in, at this point. These aren’t bad students by any means, but the bar is so high that even good students can be left in the cold.
(In what is otherwise an open-admissions institution, this island of hard selectivity can make for some awkward moments. Many students have been brought up short when “come here and succeed” abruptly turns to “go away, you aren’t good enough.”)
Some students will try to transfer to Nursing programs at other, neighboring community colleges, but that rarely works; they’re just as swamped as we are. They also tend to favor their own, just as we favor our own.
Some students switch fields entirely, deciding that if Nursing is cold to them, they’ll go where it’s warm. Assuming a genuine interest in that other field, that can be a perfectly valid choice. The 19 year olds tend to have an easier time with this than the 35 year olds, though, since the adults tend to be under more immediate economic pressure. And in this economy, there aren’t that many sure things at the two-year level.
The college can’t really expand its way out of the problem, since it loses boatloads of money on Nursing. The equipment requirements alone are staggering, and the tiny class sizes for clinicals are economically backbreaking. Even if we wanted to, the economics of growth are simply prohibitive.
Some colleges have dealt with that by partnering with for-profits that have Nursing programs. The idea is that they charge something like five to ten times the tuition, so they can cover their costs and more. I’m not a fan of this strategy -- the whole “express lane with lower standards for higher tuition” thing rubs me the wrong way -- but it’s out there. Others have taken what I consider a much more constructive approach, using a “career ladder” structure in which a student who stops out after, say, a semester or two will leave as a Certified Nurses’ Assistant, which can at least help her find work. It doesn’t pay Nursing-level salaries, but if you just need to cut your losses and bring in some cash, it can work.
I’d like to hear from folks in other settings to see how they handle this issue. What does your college do -- if anything -- to offer alternatives to the students who don’t get into Nursing?
Thank you for the opportunity to contribute to your thread and for all the great advice!
We've been importing a substantial number of nurses (almost the exact same as the number we produce), since 2010.
In our Faculty we offer a raft of Bachelor of Health Science majors that have common core papers. So students who have not have been accepted into Nursing might still have a chance to get into it, depending on their grades in the common papers. However, the shortage of placements is an Auckland -wide issue.
For those who don't get into nursing, Health Promotion is a popular choice because it prepares students for working in the community with a range of populations. There are specific populations who are being targeted with culturally specific interventions where the cultural expertise of the student would be hugely valued for example some of the programmes targeting obesity in Pacific communities. Having said that our current Government is averse to some of the Health promotion programmes (especially social marketing interventions)and has made election promises about reducing elective surgery lists..
A related area where we have serious national shortages is midwifery. Our Health workforce planning is being given some serious thought as our population ages and we have difficulty attracting people to the Health Professions especially nursing.
As Advisors, we largely did what you suggested. We'd encourage students to consider alternative health programs and apply to more than one program, hoping that if they didn't get into their first choice, they might get into their second. We'd encourage them to apply to more than just our college, hoping that if they didn't get into our program, they might get into a different one. And in the case of nursing, we'd often suggestion the ladder option of starting with a CNA or LPN before applying for an RN program. This was an especially good option for those whose grades weren't quite as good, as LPN programs tended to be easier to get into, and LPN->RN bridge programs subsequently also became easier to get into.
What's not mentioned is how the competitiveness of nursing programs actually exacerbated grade inflation. I've had students literally on their knees, begging me to give them a higher grade than they earned so they can get into the nursing program. I won't do it, but I'm sure other professors could be persuaded.
I think the idea of giving people CNA training or MA training as part of their nursing school prep is brilliant but many of the people applying to nursing in my area are second career so they wouldn't need that. Still - I wish they took the bio and chem for biology majors - that would give them a fighting chance of transfering into a 4 year science degree. Health science at my university was a catch-all for nursing drop-outs, not the best place to come from.
Ask your colleagues if they want to be sitting in a hospital bed and see that grade inflated former student calculating the dose of some medicine they are about to get.
Most nurses work locally.