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?