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05/17/02, by Wendy Y. Lawton
Nurses urge education shake-up
Oregon nursing leaders are proposing a bold and controversial change in nursing education: Team up willing community colleges with Oregon Health & Science University to create a new, four-year program by 2004.
Supporters say the plan would accomplish two urgent goals: Turn out better prepared nurses and turn out more of them.
As the population gets older and more diverse -- and as more medical care happens outside hospitals -- registered nurses need fresh skills, backers say. More students, meanwhile, need to pump through the higher education pipeline. A 2001 study released by Northwest Health Foundation shows that one in five Oregon nursing jobs will go unfilled by 2010 -- a shortage that would erode patient care and drive up health costs.
Yet the state's nursing schools turn away hundreds of qualified applicants each year for lack of teachers and classrooms. By sharing scarce faculty and resources, including as many as three proposed regional training sites, the state's public nursing programs
could enroll more students and ease the staffing crunch.
This week, the Oregon Nursing Leadership Council sent invitations to the state's 13 community college nursing program directors asking them to join the partnership. Two-year nursing faculty meet today at Clackamas Community College to discuss the plan.
Deborah Burton, director of the Oregon Center for Nursing, says the public education partnership is in its infancy. Although a few colleges have expressed serious interest, none has officially signed on. And key questions -- such as impact on tuition -- remain unanswered. But here's how the consortium would work:
Community colleges would join voluntarily. If they did, students would be accepted by both OHSU and the college for the fall 2004 term. Most, if not all, courses would be given at the community college. But some would be taught by professors at OHSU or branch campuses via the Internet or real-time video and audio feeds.
If federal grant money comes through, nursing leaders plan to build shared classrooms where students would get hands-on training -- some of it on computerized patient "simulators" -- in Portland, Ashland and La Grande.
Already, the proposal has raised concerns.
In private, some community college officials call the move a power grab by the OHSU School of Nursing, which stands to gain additional students and tuition dollars. Others say it's an elitist idea founded on the view that a four-year program can build a better nurse.
Most, however, are concerned about students. Portland Community College President Jesus "Jess" Carreon says tacking more time onto an associate's degree would discourage some students and delay graduation for others.
"If we're facing a huge shortage of nurses, why would we tell people, 'Oh, you're not a real nurse until you get a bachelor's degree?' " Carreon said. "We need to bring more people into the workplace -- not keep them out. I'm baffled by this."
The plan comes from the nursing council, the same group trying to solve the staffing squeeze.
Made up of nurse educators, executives, union officials and regulators, the council has worked for years on employment and education issues. But when the health foundation's report on the nursing shortage came out, the group galvanized.
Members last summer unveiled a plan to combat the shortage, which affects the largest slice of Oregon's health care work force. One proposed solution: Double nursing school enrollment by 2004. In January, the group founded the Oregon Center for Nursing at the University of Portland to push the plan forward.
If the OHSU community-college model works, backers say every community college would sign on. Paula Gubrud-Howe, nursing program director at Mt. Hood Community College, says collaboration makes sense.
Already associate and bachelor degree programs have moved closer together, Gubrud-Howe says. Two-year programs, for example, pack in more topics. And community colleges require students to complete math and science courses before they enter -- which often stretches completion time to at least three years.
With widespread budget cuts in higher education -- and from 24 percent to 41 percent of Oregon's nursing faculty retiring in three years -- Gubrud-Howe says schools must work together to produce more caregivers. "We need to use our resources wisely," she said.
But some college leaders say the partnership is just a new battle in an old turf war between two-year and four-year nursing programs. If two-year programs disappear, many low-income and minority students would be shut out, they said.
"A lot of our students have work and family responsibilities, so they want a program that is fast and affordable," said Kay Carnegie, nursing program director at Chemeketa Community College. "While there are some positives to this plan, I see that as a real roadblock."