Lots of nursing school questions
March 23, 2010 6:56 AM   Subscribe

Help, we need a nurse! Or someone who hires them or teaches them or is learning to be one. My 18 year old, HS senior niece wants to study nursing...lots more situational stuff and numerous questions after the jump. We're in the US, Colorado.

My niece has an opportunity to go to school at IntelleTec College free because a relative works there. Apparently she would come out of it as a Medical Assistant with an Associate of Occupational Studies Degree. The school is accredited by the Accrediting Commission of Career Schools and Colleges. Is the IntelliTec program a waste of time or a good first step? She was thinking maybe she could get a job with this certificate with a hospital and get them to pay for the rest of her education. Would anyone hire her with this sort of training? Am I just being a snob?
She wants to be a nurse. Is it worth going to the tech school or would she be better off going to Front Range Community College (not free, but doable) it's supposed to have a good nursing program and is accredited by the Colorado State Board of Nursing and she'd come out of it as an RN or she could transfer to a 4 year University here in Colorado for her last 2 years and a BSN.
She was hoping to go to the University of Arizona and got a $7,000 partial scholarship but it's still more expensive than she was expecting, like $26,000.
The UA College of Nursing is nationally accredited by the Commission on Collegiate Nursing Education, approved by the Arizona State Board of Nursing, and affiliated with the American Association of Colleges of Nursing and the Western Institute of Nursing and she would have a 4 year degree (BSN). She would have to get a student loan to pull it off but she would get the "college experience".
Let's throw one more twist in: she's also interested in early childhood education but we all tell her she won't make much money at it. She loves kids and as a nurse she's thinking maybe pediatric oncology. She's spent the last few summers as a day camp counselor.
She's a mostly A's, some B's sort of student, good in math and language arts but she says that her High School is one of the lowest ranked in Denver, Colorado. Her guidance counselor seems kind of useless and I'm really not sure what kind of education she got at school. She's a voracious reader and intelligent and I have no doubt that she can be successful in college but I wonder about throwing her in a big university environment direct from a not so great high school. Home life isn't great but she seems to be able to study there and she would be there for her 15 year old sister.
I'm leaning towards recommending that she go to community college for 2 years and transfer to an instate university for a BSN. The community college has a good nursing program and an agreement that guarantees transfer credits to our state colleges and universities, some of which are said to have great nursing programs. She could also take some early childhood ed classes and check that out. Am I wrong in steering her away from E C Education because of the salary? Can she double major in nursing and early childhood ed or is that ridiculous?
Any thoughts?
How important is it where you go to school?
Is the education that much different or is it just the networking?
How important is networking in nursing?
When they say there is a waiting list for a program do you have to be ready to enter the program or can you be getting your basic courses out of the way while you're on the list?
Any other tips for an aspiring nurse? Things to avoid? Things to consider? Any wonderful opportunities, like for financial help or travel or interesting places to work or different subsets of the profession you wish you'd known about when you were 18, single and with no ties?
posted by BoscosMom to Education (10 answers total) 2 users marked this as a favorite
I'm not a nurse, but as I understand it, that for-profit college would be a waste of time. I'd do the CC route and if she wants to transfer to a BSN, great!
posted by k8t at 8:20 AM on March 23, 2010

Some thoughts for you.

Usually, public community colleges and/or technical colleges, whichever you have in your area, will be aligned with local hospitals and other medical facilities. This is because students need places to do their clinicals. This is true for nursing students, PT assistant students, radiology tech students, etc. Call the best hospital in your area and talk with the HR department about the "where should she get training" question. You will also probably find that the slots for training are limited and will go to the students who have excellent grades in the life sciences as well as prior volunteer experience in healthcare. Slots are limited, again, because of the number of students local hospitals can accept for clinicals. In my area, we have technical colleges, and all of the healthcare programs are highly competitive, with waiting lists and committees for admission interviews.

I would not pay a private school for training I could obtain at a lower cost (or even free) through a state community or technical college.

That being said, if I had the choice between an associates degree in nursing, a bachelors degree in nursing or being a vocational/practical nurse, I'd go the BSN route. Why? The pay is better and you have a bachelors degree if things don't work out--OR if she wants to do a masters or other advanced training programs.

Being an MA will mean she will either work in a doctor's office, taking BPs and weighing people, or she'll work in a hospital or nursing home/skilled facility empying bedpans and so on. There is not a lot of clinical opportunity. The pecking order in hospitals typically goes: physicians, charge nurse (RN)/nurse manager (RN), nurse (RN), nurse (LPN/LVN) and MA or even patient tech. The physician issues the orders and the nurses asses patient condition, execute the orders and observe the patients. There is very little independent decision-making when it comes to patient care if you are an LPN/LVN and absolutely none if you are an MA.

Before she applies to any program it will be a good idea to take basic first aid and CPR classes. Volunteering at a nursing home or hospital, if just to get used to the environment, would be a good idea, as well. I have met many nurses who just didn't realize that the first job they'd get out of nursing school would be 7 pm to 7 am at the county hospital and they'd actually have to put in catheters, start IVs, etc. Just like any other discipline, some people thrive in theoretical applications of nursing and others in the application of theory. Knowing which one of those people you are before you get started in training is a good thing.

There are so many fascinating jobs in nursing that she doesn't even know about now. I think the coolest thing I have ever heard of is how pacemakers are placed. Nurses in cardiac cath labs are busy and they make a nice living. It's specialized work, but the need for cardiac cath labs is growing with our aging and longer-living population, so the need for staff is growing, too. Another good area to look into would be getting a BSN and then becoming a certified diabetes educator. Type 2 diabetes is on the rise and RNs with CDE credentials are going to be in great demand as well. CDEs help people adjust to living with diabetes, so there's a lot of education involved vs. procedure. I get that she might be interested in helping people learn because of the early childhood education mention. Compare this to jobs like pediatric oncology or NICU where there are more applicants than jobs available (typically) and where the units are smaller--less of a need for staff.

Best of luck. I come by this knowledge by having worked in the healthcare industry for several years in a major city. I hope this helps.
posted by FergieBelle at 8:37 AM on March 23, 2010 [2 favorites]

I am not a nurse, I am a librarian at a state college that has a nursing program. She should not bother with the for-profit college, she should go to the community college and get required courses aced, yes aced, and out of the way. I have a niece who is doing this now. Your niece might also want to start volunteering at local hospital or clinic.

She can either go for the RN and then transfer for a BSN or just go to work with the RN. There is such a shortage of nurses right now that she won't have any problem finding work.
posted by mareli at 8:39 AM on March 23, 2010

There is such a shortage of nurses right now that she won't have any problem finding work.

There is a shortage of *experienced* nurses right now. There are far more new graduate nurses in many areas than there are new GN jobs.

I'm in nursing school right now (though I'm twice your niece's age - I'm in a second-career BSN program). From where I sit, my first nursing job will not be easy to get. It may take several months after graduation, relocation to another part of the country, and/or accepting any shift or type of work that I can find. That said, I'm thrilled to be going into such a great field and can't wait to start helping patients, wherever they are!

For your niece, I would definitely suggest starting at community college, and she should certainly check out the early childhood education courses as well as nursing. Is there a hospital near her where she could shadow nurses for a shift? That can be a great opportunity for her to learn more about hands-on nursing. Basically, the more exposure she can get to everything she's interested in right now, the better. Many times, people her age are convinced they know what they want to do in life, only to completely change their minds once they're exposed to the realities of the field. (This is not a slam on young people!)

I wish her all the best, whatever she ends up doing.
posted by shiny blue object at 9:31 AM on March 23, 2010

Am I just being a snob?

Not at all. It sounds like a waste of time, even though it would be free. She's not really going to learn any skills with a Medical Assistant program, and it would be useless towards any other degree. She's just as likely to get the same MA part-time job as an Assos. of Nursing student as she would be with that certificate.

Community Colleges are perfectly acceptable, and can have better Nursing programs than 4 year places because they have more students and faculty. Where you went to school factors in even less with nursing than other professions. Your work history will matter the most. Networking is a factor in any job, but nursing programs help you start with clinicals in different local places. All in all, nursing is an in demand job, hiring practices are usually formulaic (years of experience=less likely to flake out) and she'll probably have a job offer before graduation if the demand is high enough in her area.

A good plan for now sounds like CC for an RN, at that point she can decide to take the NCLEX and get a job, or continue on to BSN. An important factor in that decision will be the benefit of 2 years experience vs the pay bump with having a BSN. It may be negligible for whatever field she chooses at that time. Many BSN positions have an element of management to them, and would prefer an experienced nurse, or else put an experienced RN in the position of being managed by a fresh out of school BSN. Like any job, a degree does not always = knowing how to work.

Also, small (or bad) practices may be more eager to hire an RN, because their pay would be lower than paying for a BSN. In general, pediatric oncology would likely prefer the BSN, but theres no reason she couldn't take a few years to work in between and save up or find funding for the BSN. She may also need to start out in a different specialty and work her way to a more desired place.

As far as heading into a 4 year college, I have seen the "big fish in small pond, becomes small fish in big pond" effect in several friends in various majors. It's rough, and only 1 out of 5 or 6 graduated on time, and 2 dropped out completely. The one that did graduate on time knew what he was in for, recognizing that a class of 10 people in a small farming town wasn't going to best prepare him for a school of 20,000, even though he got straight As. The others that did graduate had a rough first 2 years, but realized they needed to catch up, and really put their noses to the grindstone by the time they were heavily involved with in-major classes. The ones that dropped out weren't willing to accept that the minimum work required for an A in their small/poor high school wasn't going to = an A in college. Family support made a large difference, as well as realistic expectations. In general, if the appeal of a "job" now outweighed the appeal of busting your butt for the next 3 years, they were less motivated.

Mixing nursing with other majors is difficult because of the large in-class time requirements with clinicals and practicals. Anything is possible if her advisors are willing to work with her, but it will take more time to graduate as their likely won't be much overlap in classes. Also, this may not make sense towards a job if her goal is working as a nurse.

A disclaimer, I'm not a nurse, but my mom returned to school and earned her RN. She's still considering her BSN, but it isn't needed for her current position (pediatric office). She was more concerned with getting experience starting out at age 45, which may be less of a factor for someone 20 or 21.
posted by fontophilic at 9:32 AM on March 23, 2010

I am a BSN, and I went to an Ivy League college, so my opinion will be biased due to my experiences.

The different levels of nursing degree are all acceptable and valued by various levels of nursing practice. I agree with the previous posters who basically said an MA degree is useless for her interests. I think also she's going to have a very hard time finding a job that will pay for her education. Most places that hire an Associate's Degree Nurse (ADN) will be perfectly satisfied for her to remain one. I am one of the few (less than 10%) at my job that went beyond certification/ADN status and they aren't really great at encouraging nurses currently working there to improve their level of education unless those nurses are already a part of management.

If she is truly interested in education, she will probably find the most satisfaction in getting a BSN. I did my minor in business and although it was an incredibly dense course load, I came out of it with a lot more to offer my current employer than "just a nurse". An ADN is pretty much certain to make her "just a nurse". A nurse that will get paid and improve along the same trajectory as a BSN, but limited in scope of focus. I went through my residency with two other ADNs who are just as good (if not better) at their day-to-day job but I have excelled at organizing a committee and navigating the web of management. So her requirements in terms of education depend on her goals in her career.

Nurses spend a majority of their time educating their patients. We generally know more about the disease processes, medications, tests, etc. Our patients rely on us to break it down to whatever level they will understand, whether they are six years old or 80 years old with a PhD. We have to take into account their fears, pain, previous experiences, learning strengths and weaknesses and so on. It is teaching at such a depth with great responsibility as often our patients will make decisions based on our descriptions. You have to have a great love and appreciation for teaching to be a good nurse. I have found that this is where my extra time spend pursuing education paid off compared to the ADNs. I have a greater breadth of knowledge allowing me to explain everything as fully as possible. I know my patients appreciate this because they tell me over and over that they one thing they really want is to understand what is going on and how it will affect them.

If she is interested in such a specific area like pediatric onco, she will almost require a BSN. Pediatric hospitals and specialized clinics prefer nurses with a Bachelor's level education due to the sensitivity involved in dealing with parents and their sick children at such a critical time. Not to mention she will have the opportunity to obtain a minor or at least some extended time in childhood development classes.

I'm out of writing steam at this point but please feel free to me-mail me or ask more questions in this thread. You asked a lot of them in your original post and I'm pretty sure that I have not addressed a majority of them.
posted by nursegracer at 11:14 AM on March 23, 2010 [3 favorites]

I actually work as an admissions coordinator for a BSN nursing program - in Washington though, so take any state-specific advice with a grain of salt.

I agree with other posters that the MA isn't going to be relevant to her interests if she's set on nursing or education - it's a fundamentally different type of practice. The skill-sets may overlap a bit in terms of base knowledge (prerequisite courses and the like), but the nature of the work likely won't ease a transition into nursing. It might be a means to earn money while she pursues further education, but it strikes me that it will mostly just slow her down if she has a different end goal in mind - again though, grain of salt here.

The ADN programs are great, although it sounds like she's really looking at the BSN down the road. If that's the case, I would probably recommend just starting directly in a BSN program. Reasons not to go for a direct BSN, perhaps: the ADN to BSN route is likely less expensive and it may have her working as an RN in a shorter amount of time. Having the BSN is nice though in that it opens the door to quicker advancement in the career, as well as the possibility of graduate education down the road (if she wants to become a nurse practitioner or some other advanced practice, for example).

The limiting factor either way is likely to be the admissions process. Despite (and because of) the much publicized nursing shortage, most schools aren't able to admit as many qualified applicants as they'd like. By way of example, my program receives 350-400 applicants each year for no more than 95 available places in the class. It's a competitive field to enter at any level - start talking to schools now about ways to prepare.

Networking is important to some degree or another for any profession, but I don't have the sense that it's make or break for nursing. RNs are in demand, so she shouldn't have an unusual amount of difficulty in finding a job (assuming some flexibility on her part regarding scheduling and specific clinic, of course). Where she goes to school probably isn't all that important either - an RN program is an RN program. It may have some minor influence if she does eventually seek further education, but not right away I wouldn't think.

Finally, look into repayment programs. Around here (Washington state) many of the local hospitals will arrange to pay a significant portion of tuition in exchange for a few years of employment after school. These programs are competitive as well, but it would definitely be worth asking around. There are federal programs that forgive student loans for years of service in under-served areas as well (I'm thinking mostly of NELRP here).
posted by owls at 1:02 PM on March 23, 2010

My wife earned an ADN. At the CC she went to, it was a three year program. Some BSN programs can run in to five years, especially if you start throwing in unrelated double-majors/minors. The waiting list (they have them at CCs, too) ran while she was taking gen eds her first year but the list wasn't just about waiting. There were some modifications made based on grades in certain classes.

She's worked in a few hospitals, and on her floors there is no difference between ADN and BSN nurses. They're all paid the same and have the same duties. As others have mentioned, BSN nurses have better advancement opportunities and flexibility.

If she's got the stomach for nursing, she's going to be able to make a comfortable middle/upper middle class income (at least for a single person) in two or three years time. It's not unusual to get a three days on/four days off schedule. Even with a day built in for recovery, there's a lot of room there to build a college-like experience if that's what she wants, with the added advantage of having some money to spend. I've wasted a dozen years and six figures on higher education to get to that point (minus the schedule). I'd tell her to get the ADN relatively cheaply, get a job, and then get in to an RN->BSN program. Work might even pay for it. And skip the medical assistant training. Even though it's free, it seems like time wasted if her goal is to become a nurse. I think it would be extremely rare for an employer to pay for a medical assistant to go to nursing school.
posted by the christopher hundreds at 6:02 PM on March 23, 2010

I spent 2 years in nursing school before I decided it wasn't the career for me.

As a high school senior I took a vocational Health Occupations class. It was a terrific program that taught me medical terminology, universal precautions, got me certified in CPR, and got me a CNA license. If the tech program teaches medical terminology, it might help in that she wouldn't have to pay for a college course in it.

First semester, my books/supplies alone cost $900 (I was required to buy a bunch of stuff I'd eventually use from the bookstore, like a catheter set, saline, etc). This doesn't count the scrubs and stethoscope & sphygmomanometer I had to buy.

She should know that no matter what field she wants to specialize in, she has to take classes in all the fields. While I wanted to be a labor & delivery nurse and was delighted by my OB nursing course, some wanted nothing more to do with it.

She'll need a strong stomach for not only sights but smells too. And please be sure to eat breakfast every morning before clinicals... the one time I almost fainted (watching a baby boy get circumcised - he was laying there screaming and I just couldn't make myself believe he was numb) it was almost certainly because I hadn't eaten breakfast that morning.

At the time I went to nursing school I was young and had trouble dealing with the concept of death... I should have taken my advisor's advice and taken an elective thanatology course. Listen to your advisors... that's what they're there for and they know what they're talking about!

When she gets around to doing care plans... IMO they are a bear. A friend and I would spend hours each night on them and still inevitably not get it 100% correct. Get a tutor if need be.
posted by IndigoRain at 10:35 PM on March 23, 2010

Response by poster: Thanks for all of your input and advice, I am passing it along to my niece.
posted by BoscosMom at 4:20 PM on March 31, 2010

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