Monday, September 20, 2010


Students Who Don’t Get Into Nursing

Maybe it’s the time of year, but I’ve received several variations on the same question recently: when a student doesn’t get into a Nursing program, what should s/he do next?

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?

Kia Ora from New Zealand

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.
These are students who not only can't become an RN but don't get into ANY kind of nursing program -- LVN, LPN?
We offer other health-related programs, such as Medical Assisting and Medical Office Technology. The demand and pay for graduates from these programs is not as high as for Nursing but still better than many other majors. If the student is genuinely interested in Nursing, they can earn a degree, get a job, accummulate valuable experience, and try again, if desired.
Back when I used to work at the local community college, this was a very real issue. Health science programs were extremely competitive, as the volume of applicants far exceeded the number of spaces available in each program.

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.
Very often, students aren't aware of the alternatives Dean and some of the commentators have mentioned. And, sometimes they're not offered in the colleges in which the student is enrolled and has been rejected by the nursing program.

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.
Our schools do one of three things for admissions. A small minority have competitive admissions but the majority either do a lottery with all qualitifed students or have a waitlist that is 4-5 years long. None of these solutions is entirely satisfactory.

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.
In my experience, working in a nursing department at a private 4 year and with cc programs. Steering those students who don't get in into human services/psychology related fields is a good use of talents. They all often say they "want to help people" and that is just a different avenue to do that. For those with the desire but without the math/science chops, it's also a great option. My sister is a nurse and I'm in human services for that exact reason. (And I really don't like needles and blood).
Justine -

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.
I don't know why almost every student wants to be a nurse where in fact they can be an engineer, computer specialist, and entrepreneur or business man. It is true that nursing has a higher pay but with the very high rate of unemployed nursing students, I think it is about to change track or else you will be one of those nursing graduates that are jobless until now.
The classroom curriculum includes classroom instructions and supervised clinical hands-on experience. The program course comprises of subjects such as anatomy, nutrition, first aid and emergency care procedures, pediatrics, gerontology, psychology, physiology, pharmacology, communication, computer skills, legal, ethical and vocational responsibilities.Career Options In California LPN Programs
All this hyped up crap about these over glorified "RN" programs makes me sick. Its mostly community colleges at fault for encouraging every little 18 year old to go for nursing cause its soooo great and in suuuch high demand. I see so many great students WASTE time on all the pre reqs and then turn around to be shat on and rejected.
6/13 - I am on my 2nd carrer and thought I wanted to be a nurse. I hear "oh you'll make a great nurse and people your age do great in school." Do I get in? No, I was rejected by the 2 schools i wanted to attend. Will I try again? Maybe, not sure. Too competitive..
I'm thankful I got in on my first try at the college I wanted, and just recently got hired at a major hospital as a patient care tech. This is what I'm meant to do and even if I didn't get in I would 've kept trying.
Can a student with a "D" and an "F", but repeated the courses and got a.better grade,still get in?
I live in Missouri and I have taken 3 years worth of pre-req's all of which I've maintained a 4.0 GPA for the past 2 1/2 years. I'm an older 41 year old women, who decided to go back to school and fulfill my lifelong dream of becoming a nurse. Unfortunately, I can't say that's going to happen now. You see I was in the 1st semester of nursing when my brother died unexpectedly, and I removed myself from the program since the school decided not to work with me, if I left for his funeral in another state. I decided it would be okay, I'd go to another college since my GPA was good enough, but I recently found out after being turned down for the 2nd time at this new college that's not the case at all. I am heart broken to know that I did all this in vein, but I realize that there has to be something better out there if this isn't meant to be for me?

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