Fast-track nursing plan questioned

[Chellyse]

After reading the article describing Tommy Thompson's proposals I came across this article and wanted feedback, what do you think of the fast track approach?

http://www.detnews.com/2002/careers/0210/04/b01-604114.htm

Fast-track nursing plan questioned

Development Center offers tutorials, but not degrees

By Sarah A. Webster / The Detroit News

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SOUTHFIELD -- There's a new fast track to becoming a nurse in Michigan, but it costs between $15,000 and $20,000, depending on educational experience, and some officials question how the program is run.

Medical Career Development Centers Inc., which recently opened an office near Evergreen in Southfield, is capitalizing on the need for nurses and the desire of some students to get a nursing degree.

There are more than 2,000 vacant nursing jobs in the Metro Detroit area and about 125,000 nationwide, hospital associations report. The problem is contributing to decreased quality of care and higher labor costs. A new nurse makes about $40,000 here, and signing bonuses up to $10,000 are not uncommon because of competition.

Despite a new Michigan scholarship program to boost nursing school enrollment, state hospital officials have complained there aren't enough slots available within colleges and universities here for potential students.

So the Development Centers aims to graduate more nurses quickly.

The Development Centers do not grant a nursing degree, said Karen Grobson, executive director of the Southfield location.

Rather, the new company offers an intense tutorial program that helps students earn an associate nursing degree through the Albany, N.Y.-based Excelsior College, a distance learning degree program, at an accelerated pace of about one year. Students can then take the state board exam to become a registered nurse.

While she acknowledges the program is not cheap, Grobson, who has been a nurse for 24 years, said the evening and weekend classes are convenient and the pace is accelerated.

"There are a lot of nursing students on wait lists," Grobson said. "They can be out in the work force within a year."

Bill Stewart, a spokesman for Excelsior, said the college has no formal affiliation with the Development Centers or similar companies. He said that earning an associate degree in nursing through the college costs about $6,000 overall and usually takes about three years. Excelsior is accredited by the National League for Nursing Accrediting Commission.

Grobson said she hoped Excelsior might someday partner with tutorial services, but as it stands, Development Centers helps students enroll in Excelsior and then complete the course quickly.

Denise Jacob, a spokeswoman for the Michigan Nurses Association, said Excelsior is respected but that she had concerns about the Development Centers program.

"It suggests becoming an RN is an easy thing to do, and that's not at all true. It's misleading," she said.

Carol J. Bickford, a spokeswoman for the American Nurses Association, also was not familiar with the Development Centers program but said Excelsior is well-regarded.

"The course work can be very tough," she said.

Indeed, that's why the Development Centers was started in the first place, said Chris Bouwens, director of program development. He said the tutorial service, which is provided by master degree-level nurses, helps provide students with the support they need to succeed.

Stewart of Excelsior said the three-year completion rate for the nursing program is about 52.7 percent and their students pass RN licensing exams at the same rate as other students. He also said that Excelsior provides all the necessary educational support to its students.

Development Centers, which has enrolled eight students in its current tutorial class, predicts the need for their program will only grow. Development Centers was founded in February and also has a location in Sparta, outside of Grand Rapids, and Utah.

By 2020, the federal government projects nationwide RN shortages of between 300,000 and 650,000.

"We see the potential for growth as enormous," Bouwens said.

You can reach Sarah A. Webster at [phone] or [email protected].

[RainbowSkye]

Hmmmm.... very interesting. I'm not exactly sure what I think of this solution to the nursing shortage yet, but try substituting the word doctor or airline pilot for the word nurse in the above article. I wonder what the public would think of that?

[llg, PhD, RN]

I think the proof will be "in the pudding" as the expression goes. Will the graduates of the fast track program perform as well on the job? That remains to be seen.

I have some doubts, but I am open-minded about it. If they meet the graduation criteria of an accredited ADN program and pass state boards at the same rate as other students, maybe their education is equivalent. Perhaps "intense tutoring" by nurses with Master's Degrees is even better than being one of a large group taught by someone less qualified. I know that their are some excellent ADN instructors out there, but where I live now, a lot of the ADN clinicals are being taught by staff nurses with BSN's who have had virtually no orientation/training for their teaching role. A week or two before class starts, the schools don't even know who is going to teach the clinicals yet! Then, at the last minute a staff nurse agrees to do it. With 10 students per clinical group ... I'm not sure that's such a great education. Perhaps this intense, one-on-one program would do at least as well.

With that said ... it is kind'a sad, isn't it?

llg

[fergus51]

I have huge doubts about programs like this, unless the students are all coming from other health care fields. I wouldn't have a problem with say an LPN getting her RN in one year, but I think for the average person that is not nearly enough time to learn what you need to practice competently.

[sjoe]

"an intense tutorial program that helps students earn an associate nursing degree through the Albany, N.Y.-based Excelsior College, a distance learning degree program, at an accelerated pace of about one year. Students can then take the state board exam to become a registered nurse. "

Yeah, right. A one-year cram course in passing the NCLEX. No pre-reqs? Apparently clinicals will be all but nonexistent, etc. Just what we need to "solve" the nursing shortage.

I can see having a one-year course that encompasses CNA and other skills, but not having the grads be crammed for the NCLEX and be called "nurses," because they wouldn't be. Being called something else could work. Something that would indicate a skill level between CNA and LVN.

IMHO.

[SharonH, RN]

In light of increasing focus on medical errors and the frightening things we all see in practice everyday, I'm wary of any push to "fast-track" nurses. I also agree that it cheapens the profession; it makes it seem like anyone can become a registered nurse and in just one year nonetheless, as long as you have the dollars. We will never have professional respect if there is no standardized educational format for nurses.

[rncountry]

Howdy Michelle!

For all of you who do not know I live in Michigan, and part of this article is incorrect. There is no nurse scholarship program here yet. There is a bill that has passed the senate and one that has passed by the house, it is just a bit different, however the two have not be reconciled yet. Plus the money to do it was supposed to come from the Tobacco settlement money that Michigan received, 4 million of it anyway. And at this time that money is up for grabs. A lobby group went to court to have the issue of where the Tobacco Money is to go be placed on the ballot. Initially when Michigan received the Tobacco Money the Governor had pledged the money would go to help with healthcare costs, but then reniged on that pledge. Instead it has been going to scholarships, not nursing at this time. Michigan offers a MEAP scholarship.

The MEAP is the standardized test that all Michigan seniors have to take, and if one does well on it than the state gives the student a $2500 scholarship to be used at a Michigan college, if the student goes to an out of state college than they receive $1000. My oldest child that went to Western Michigan University this fall received the scholarship and that $1250 a semester helps. It is only good for the first year, it is not an ongoing scholarship. If the ballot proposel passes than the MEAP money may not be available. Plus the 4 million earmarked to give scholarships for new nurses will drop to $800,000. It remains to be seen what will happen.

The nurse scholarship program was also initiated by a physician who is also a senator for Michigan, Sen. Swartz. He practices in Battle Creek, at the hospital my hospital leases the top floor from. He is universally scorned by the nurses at Battle Creek Health System because he is one of those physicians that is a butthole. There were hearing by the Senate in regards to the nursing scholarship program here, with nurses from the Michigan Nurses Association testifying. While each believed a program is necessary they all questioned the use of Tobacco Money to fund it, because even at the time hearing were going on there was rumblings about the Tobacco Money being used for purposes besides the health of Michigan residents, as the Governor had first said it would be used. The argument of course is that having more nurses will increase the health of Michigan residents, however it was known then that there would likely be a fight over the money.

The other thing that was said at the hearing is that there was much that could be accomplished in the retention area if the state would pass legislation that improved the workplace, and would not cost the state any money. Starting with banning mandatory overtime. The recomendations of the MNA was discounted, and the scholarship program remained the focus. Until the election in November and the ballot issues are done the scholarship program is in flux, no further work is being done at this time to reconcile the two bills until it is known whether the citizens here want the money to go to health related illnesses or to scholarships, as well as other things.

The Govenor has played dirty politics to try to force the residents of Michigan to vote no the the ballot issue. A couple months ago he removed the state money the goes to cities and townships for emergency services. Fire fighting, EMS etc... stating that without the Tobacco Money in the teasury the state could not afford to give the cities and townships money for such needed services. The outcry was severe and nasty. Within a couple weeks the legislature had overrode this and the money was restored for the emergency services. However it left a bad taste in the mouths of many who are really angry with the Governor. He cannot run for reelection because of term limits, but the Republican candidate for Governor now is his Lt. Governor, who is taking the bite for this fiasco. Current polls indicate the ballot proposel may pass. And currently the Democratic candidate is well ahead in the polls.

The Democratic candidate is the state Attorney General, she has busted more nursing homes for fraud and poor care than any previous Attorney General, and is on the record as stating there is nothing in state law that supports the use of mandatory overtime. Many nurses I know are planning to vote for her and the scholarship for new nurses be damned. They feel workplace issues should be at least as important. Otherwise the rate of nurses leaving will not decrease.

As far as Excelsior college, I knew there was a big push from them but didn't realize the reason. They are fairly aggresive in their marketing to those that even look into it. Have a friend who is an LPN that looked into the program to get her RN, and they kept calling her at work until she got flat nasty with the rep. She had been looking at different avenues, but the rep for Excelsior was incredibly aggressive in trying her to sign up with them. I am going to have to look into this a bit more. My own personal opinion is that this is a poor way to educate people to become nurses. From what I understand it is very expensive for one, and they do not set up clinicals for you. You set up your own clinicals. I may be wrong, but I know that is how it was supposed to work for my friend. However she is already an LPN so that may be different for a person with no nursing education at all. Something for me to chew around a bit and do some investigation into. Thanks Michelle!

I put some spacing in for my tired eyes. Karen

[-jt]

In NY, the new tax on cigarettes (bringing the price of a pack to $7.50) & a one time payment of millions from Blue Cross Blue Shield was supposed to go to funding solutions to the "nursing" staffing shortage. Our incumbent Republican governor who wants another term in office signed this law in record time, overnight, & bypassing certain usual procedures, & then immediately received the endorsement of the traditionally-democratic SEIU/1199 union - the largest union of healthcare workers in this state. Not surprisingly, the money has been going not to improve RN salaries or RN working conditions, or to fund RN recruitment & retention initiatives to ease the NURSING staffing shortage as it was presented, but to the ancillary workers & aides that 1199 represents. Granted home health aides & CNAs should be paid more than $6/hr & should receive a piece of the pie, but to promote the tax to the public as being necessary to solve the NURSING shortage & then NOT apply any of it to recruiting or retaining NURSES is a bit of a misrepresentation to say the least. Our state nurses assoc is now in a battle at the state Capitol trying to get some of that tax to go where it was supposed to go in the first place - RN recruitment & retention.

[sjoe]

-jt--Well, at least it was a good object lesson in how politics ACTUALLY works. Now if the RN union (whatever it is in your state) had managed to contribute a substantial sum to this esteemed gentleman.... Or managed to convince him that it could control a certain number of votes for him....

It is all but upfront in my state, California, and often appears on the front page of newspapers--just who paid how much for what and to whom. Business as usual.

[-jt]

Yeah but we dont work that way with our dues money. And even though he has finally made some headway in response to nurses issues, after much education by our union & our RNs, I dont know if the members of my union (our state nurses assoc - the largest RN union in the state) will recommend we endorse him for re-election. He did squash our whistleblowers protection bill that had passed both houses every single year for 4 years, refusing to sign it into law until just this year. And then played this game with "the nursing shortage".