Nursing Schools Need to Reconsider Their Admission Policies

The author, who was rejected from nursing school, thinks there’s a bias toward 1st degree, younger and less experienced applicants
The Lund Report

July 19, 2011 -- I appreciate your no-holds approach to the problems in our healthcare system, and applaud your recent coverage of the nursing shortage.

Your article mentioned the looming retirement of our nursing workforce, and the problems retaining quality nursing instructors. I was disappointed that the process to get into nursing school wasn't given more coverage.

I recently stepped away from my plans to add an RN to my MPH due to multiple barriers that are present in the application process for nursing school. Until recently, I’ve been completing prerequisites and working on applications to OHSU, Linfield, University of Portland, Mt. Hood, PCC, Clark College and Clackamas College. It is very frustrating to keep hearing about the RN shortage while being denied the ability to apply for RN school. I have at least three other colleagues in public health who will not be applying to nursing school for similar reasons… two of these colleagues have advanced degrees and are fantastic leaders and would be great nurses.  

RN Schools Give Preference to the Inexperienced

In addition to there being way more applicants for nursing programs than open spots (the acceptance rate is around 10 percent of qualified applicants), there’s  also a strong bias towards 1st-degree, younger, less experienced applicants for nursing schools. This bias does not bode well for the future of leaders in nursing over the next decade.

The criteria for being accepted hinges more on your application G.P.A. than on any other aspect of an applicant's potential for nursing. For instance, one program takes into account your cumulative G.P.A. of all college courses for life (which for me covers approximately 15 years of classes in a variety of subjects in five different universities). The application process does not accept letters of recommendation, work history or resumes. This means the ‘D’ in theater appreciation I got at age 17 counts more than my seven years in healthcare, my certificate of management, or my Masters in Public Health!

Furthermore, there are no part-time RN programs in Oregon (unlike in many other states). Mount Hood College had a single class accepted into their part-time program before it was shut down due to budget issues. This lack of part-time or evening options effectively removes many of us from the application pool since we have mortgage payments, full-time jobs, and family duties that prevent us from going to school from 8-5 (plus time for clinical rotations on weekends).

At this point the only people who can apply are either without these life obligations or are able to do school full time and not work longer than 20 hours per week, or those who can manage to work nights and go to school all day. I posit that earning a ‘B’ in anatomy while working full-time in a demanding professional job, and holding down a mortgage while raising children should be the equivalent to earning an ‘A’ in anatomy while living in your parents’ house and working as a barista. 

Is there even any evidence that getting an ‘A’ versus a ‘B’ has any relevance on how good of a nurse you will become? While the RN shortage will create increased need for leaders with strong backgrounds and life experiences, the application process give heavy preference to young applicants with little or no experiences to draw upon. This adds to the 'brain drain' and may decrease the ability of our RN workforce to handle the increasingly complex world of healthcare... a field that has long-since moved away from the original role of nurses changing bedpans and acting as the ‘doctor’s helper.’

RN Schools Have no Standard Set of Prerequisites

A large barrier to entry is the wide the variety of requirements to apply. Of course each school has the usual:  1 year of anatomy and physiology, 1 term of microbiology, classes in human development, psychology, nutrition, math and reading. There is still a wide variety of how those credits are considered. 

Despite many Oregon RN schools being part of the OCNE curriculum (which tries to standardize the RN application process in Oregon), each school has slightly different general education requirements to apply so students applying to more than a few RN schools are stuck taking a crazy mixture of pre-requisites, thus taking longer to complete and incurring more out-of-pocket costs. Of the schools I was considering:  One school wants two additional social science classes and an American history (political science or world history does not count). Another wants an additional year of lab sciences, above the 1.5 years of anatomy and microbiology. One school wants math 95 or statistics 243, but does not count biostatistics 524… while the others do. To make it even more complicated, each school has a different timeline for how long credits will last before they expire.   

Despite having a Masters in a health-related field, and a Bachelors in a social-science, and a Graduate Certificate in Management, I found myself taking a list of 100-level courses that are not remotely related to the field of nursing… only for the privilege of hedging my bets and paying application fees to multiple schools in hopes of being accepted by at least one of them.

RN Schools Should Turn Leaders Into Nurses

As it is now, the hope for replacing our quickly-retiring nurses and clinical instructors hinges on a bet that at least some of the new nursing graduates will fill in that gap. This means that we will be dependent on newer nurses taking over leadership roles that are better filled by nurses who have more experience.  It also means that those newer nurses will be asked to accept the lower pay and, generally, less exciting roles of nurse educator and nurse administrator.

I find these assumptions to lack a solid foundation. It is more likely that newer nurses will desire the higher wages and more exciting roles of clinical settings and the shortage will be felt even more strongly in the nurse leadership roles than it is already. This self-repeating cycle will continue until the career of nursing will be demeaned by a lack of strong leaders, educators, and mentors and a burgeoning bottom-heavy group of inexperienced nurses will struggle to keep up with the changing definitions of their career. As the shortage grows, nurse leaders that remain in their posts will be overburdened, dragged down, and eventually tempted to join the ranks of the clinical providers rather than remain in the fight. 

A potential solution to this dilemma is to attract and recruit persons who are already leaders in their careers (be it health care or not) and incentivize them to becoming nurses by making their experience count in the application process. I suggest creation of an application process that gives consideration for an applicant’s current leadership roles, or somehow accounts for other indicators of being a successful nurse. 

This solution would not only leave room for our many new nursing graduates in some of the more clinically-focused areas, but would stock the leadership circles in nursing with persons who bring a wealth of experience and connections with them.

Bryan earned his Masters of Public Health with focus in health policy and non-profit management from Portland State University.  He works as a program coordinator for the Oregon Health Authority and worked as an EMT in New Mexico for several years. 

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You are correct on all counts. I have seen if first hand having coached over 4,000 people how to bypass the waiting lists & archaic demands of traditional nursing schools. We need registered nurses on the floor NOW. I have written a book on various strategies to speed up earning an RN: It's time for people to TAKE CONTROL of their nursing education. The educational institutions are not able to change - they are dinosaurs. Find another way and win without their "permission".

Well said, Mr. Goodin. As with teaching, where some programs bring in content experts and teach them to teach, nursing could benefit by "turning leaders into nurses" as you suggest. You are not suggesting dumbing down the requirements, by a long shot. If we want effective clinical leaders, factors other than youth, raw IQ or GPAs are important. Just as they are when it comes to physicians and many other health professions.

Thanks for this commentary! I have applied two years in a row, and decided to pursue the LCSW instead of wasting another year waiting around. Adding to my injury, I know two students who were accepted over me.... neither had a previous degree (I have a MSW) and neither was working while they did all the required courses to apply.

Thank you for saying so well what really needs to be said about the selection process for new nursing students, Bryan! What a sad loss for the profession, and even sadder, not the only intelligent, experienced, well rounded candidate lost. In my 32 years as a RN, I have written countless recommendations for wonderful candidates, including yourself, many who were not accepted. I must add, Bryan also serves as the Coordinator for the Oregon Immunization Coalition. In this role, he continues to demonstrate his dedication, leadership, and organizational skills to furthering the Coalition's goals of improving the health of Oregonians by improving their immunization status.

Mr. Goodin, You're definitely not a nurse! But what a gift to nursing you would be. You have truly pegged it!! Nursing schools are still way, way in the past. The definition of "nurse" is so much more than even nurses are willing to acknowledge. Nurses are held back in practice by being limited to the 'essential functions of a job' description, regardless of their education or experience. Thank you for speaking out so eloquently!

I hope this article is read by whatever powers out there can make the correct changes in the application process. Some schools do have an accelerated option, but even it takes 18 months of full-time classes... way too long to leave my career. A part time, or at least evening/weekend full-time option would be ideal. For students with a degree already or with work experience that shows strong leadership qualities, it seems like some sort of consideration or points should be available on the application. I was also very discouraged by the wide differences in program requirements, in some cases the Community Colleges had more strict pre-requisites than OHSU (which is a teaching hospital and medical school). Why doesn't the Board make all schools use the same requirements? Or even better... make one online application for all accredited schools in Oregon and let students mark which they would be willing to attend on the application. This desperation to get into a school is why the predatory quasi-schools are gaining such a hold, which can't be helping out the strength of the profession. Applications for Spring Quarter 2012 online/hybrid nursing program will be accepted after October 23, 2011. The deadline for complete application materials to be considered is December 23, 2011. This is a part-time program that runs over 12 consecutive quarters. Didactic is onlilne, class cohort meets for lab and/or clinical every other Friday, Saturday, Sunday.

You need to tell your friends in public health that there is and never was a nurse shortage. (But you must know that there is an RN AND an MPH glut.) The "nurse shortage" a myth pushed on laypeople to get money for the glut of nursing programs and to keep a fresh supply of cheap new grads willing to put up with the abuse hospital load onto RN's. If there really were a nurse shortage the feds simply have to start allowing the MASSIVE importation of foreign low paid easily abused nurses as they did in the 90's. Millions of already educated nurses are waiting for the visa restrictions to be lifted once again. Get the word out: THERE IS NO PRESENT AND WILL NOT BE A FUTURE NURSE SHORTAGE!

Agree completely! I wish they would take a poll and see how many unemployed nurses there are! Someone needs to print the truth. We have an excess of hospital beds and as more care is in the community we have an excess of other facilities. Until this is corrected there will continue to be fewer jobs as closures continue. There will not be a shortage for about 20 years.

You keep talking about RN leaders, but why can't you be a leader with the MPH and business certificate you already have, plus work experience. It seems like going backward if you ask me. Plus working as an RN is hard, physical work. You are labor there to do a job. If you want to be a leader I don't see how getting an RN will improve things. You'll be going backward, having to prove yourself as an staff RN and then try to get promoted. Why can't you apply for the same type of management programs with the degrees you already have? Seems like that would be the most logical and cost effective route to go.

1st- There is no nursing shortage in Oregon. While I understand your frustrations in the application process, I applied for 3 years to programs before I was accepted and had earned 2 associate degrees with all of the credits I had accquired while trying to meet all the admission requirments. If you are left frusterated trying to get into a program imagine how you are going to feel when faced with rejection after rejection for jobs once you pass the boards all because you are lacking the magical 1 year of acute care experince. Out of all the hospital systems in Portland only 1 offers a new grad training program. Legacy has a new grad internship program after years of a hirring freeze. The first time around they hired 40 new grad nurses, but they had 750 apply and interviewed close to 500 people. .

You keep talking about RN leaders, but why can't you be a leader with the MPH and business certificate you already have, plus work experience. It seems like going backward if you ask me. Plus working as an RN is hard, physical work. You are labor there to do a job. If you want to be a leader I don't see how getting an RN will improve things. You'll be going backward, having to prove yourself as an staff RN and then try to get promoted. Why can't you apply for the same type of management programs with the degrees you already have? Seems like that would be the most logical and cost effective route to go.

First of all there is no nursing shortage. No one is retiring and the bulk of nurses are around age 46 with no retirement in sight for 20+ years. Let's get that straight. It is a media propaganda that has brought people rushing to the field in the hope of jobs. Second of all, a D is a D. Nursing school is demanding. They need high standards, if anything they need higher standards than ever to keep people who are only in it to make a buck out of the profession. We have enough burned out nurses without people who don't even want to be there but are just doing it for lack of work elsewhere. We save lives. We are never important until you need us. Lastly, nursing school is an intense immersion into a new way of thinking. It is not something that works well as part-time study. You need to be on the floor, in the lab, or hitting the books every day. It is like football. You have to practice constantly until your skills are up to par. Most of us take out a loan and work part time for the brief two years or so that we need to get through the boot camp of nursing school. It is not for the meek. Your letter is whiny for someone who has all these degrees. You don't need to be a nurse to go into management. Many hospital managers are not nurses. Feel free to reconsider.

I am an RN an I will echo what all RNs who are actually working will say: THERE IS NO NURSING SHORTAGE!!!! None! We have a glut of new grads throughout this country who are waiting over a year trying to find work. Oh, and try going full time to nursing school as a single mom. Then talk to me about grades. I still got a 4.0. Not everyone is living at home with mom and dad. Some of us ARE mom and dad. This boils down to grades. If you are careless and lazy enough to get a D in theater appreciation then what will you be lazy or careless with as a nurse? Nursing is hard, hard work and laziness and carelessness play no role in our profession. We need smart, hard-working people in our field. There are MORE than enough qualified applicants who have worked hard at good grades, and they get first dibbs on entry to nursing school.

"As it is now, the hope for replacing our quickly-retiring nurses and clinical instructors hinges on a bet that at least some of the new nursing graduates will fill in that gap." No, you will still have to pay your dues by working for at least a year as a med-surg nurse, and then branch into some other areas, such as ICU or ER, to make yourself more experienced at the bedside. Then, you'll have to take a full-time job somewhere to establish a bit of seniority and continuosly play kiss-the-butt of the one person in charge (before they get reassigned/fired) who can give you that "leadership" position that you feel you deserve based on your years of college and mortgage paying ability...good luck... and remember, nurses don't eat just their young, but the old ones too...

I think nursing schools still want young, inexperienced candidates because they tow the line better than an older student with life experience. It's a reflection of hospital administration- they like the young, clueless ones too. Nursing schools in many ways are throwbacks to an earlier time. I had plenty of instructors who didn't like you if you weren't under 30, female and white. I personally had no problems but have heard instructors make racist comments or comments about males in nursing. God forbid if you had to work while you were in school- I worked full time but kept that fact as secret as I could. It's a sad situation, that's for sure. Oh, and someone said you need a year on the floors before you can go into a specialty. Not true.

*sniff, sniff* What's wrong? Are your sciences expired and you're outraged that you'd be asked to retake them while belittling people who CAN make it? I never see you really tell why you didn't cut the mustard.....

There is no nursing shortage. "Nursing shortage" is a term used by the uninformed and those who have something to gain by perpetuating this myth (think colleges, book publishers, etc.) Nursing school, with it's pre-requisites and then the two years of just nursing courses dominates your life, and there really isn't much time for a full time job. Your life is spent in class, in lab, in clinicals and in the books, reading many chapters of complex and highly detailed information that you must digest and understand. Of course this is difficult to conceive if you have never been in nursing school.

If it makes you feel better, all of those young inexperienced nurses can't find jobs because they didn't work while they were in school and they have no background. The hospitals want nurses with previous medical experience, and excellent grades, and in this economy, they can have it.

Wow, an ad for a How-to-get-your-RN-faster snake oil salesman. That just adds insult to injury. Okay, where is the data that shows nursing schools only accept young, first degree students? I am in a community college nursing program in Oregon and while most students are in there mid-twenties, a good third of the students are over the age of 30, have families, and I would say that well over half have jobs to support themselves or families. So we have a wrong assumption here. Also, there are about a half-dozen in my cohort who have prior degrees and they got in. Don't worry Mr. Goodin, there are thousands of great leaders among the nurses already employed by the hospitals and long-term care facilities. There is absolutely no need for nursing schools to pull in people who have organizational skills from work experience. Maybe you need to retake the class you got a "B" in. I have classmates who have retaken classes to get the grade necessary. Apply to a college that has a point system so your old GPA is weighted so heavily. Yes, young people don't always get good grades, I understand that. I just don't have a ton of sympathy when I have classmates who worked as CNAs for years, getting good grades in all of their pre-requisites, and performing well in nursing school even while working and raising kids. Nursing school is an immersive, all-consuming process and not just a half-dozen classes to add RN to your long list of degrees.

Why would anyone listen to a rant about nursing school by a rejected applicant who is so ignorant as to believe there is a shortage? The truth is nursing applicants far outstrip program spots before considering the lack of demand for new grads in the saturated market. There is exactly zero incentive to remove arbitrary hurdles and every reason to put up more barriers to entry. Whiners with high opinions of themselves who think the world should change for them.... people with that attitude fare poorly in nursing school.

I got my nursing degree at age 55, and got hired right away. I realize this makes me lucky, but I also worked VERY hard to get here. Few of the courses I took to get my original Bachelor's 30 years ago transferred and I found myself taking college algebra, American history and psychology. And, yes, it's almost impossible to work while you're going through the nursing program because of the endless rounds of clinicals, presentations, classes and studying. My point is that a) I'm not young and inexperienced and b) many of my younger classmates didn't make it. Experience in working and in life do make a difference, and leadership qualities help you make it through what I can only call a grueling process.

Nursing is a demanding profession. Most schools require students to work no more than 16 to 24 hours per week for good reason. I went to nursing school over 30 years ago. It was difficult to get accepted in 1978. There were 500 applicants for the 40 openings at my University. Those who got accepted had a GPA of 3.7 or higher in Anatomy, Chemistry, Physiology, Psychology, Nutrition, Microbiology and Math. It requires a lot of dedication. Nursing school was truly one of the most demanding things I've ever done.

I'm sorry but Wah. Your second degree means SQUAT. I'm 32, male, 3 girls, work full time, school full time, clinicals full time, when I have a day off I watch my girls. I am in the last semester of nursing school. I have a 4.0. My previous degree was in microbiology... not as rigorous as "Public Health" I know, but somehow, I managed a 3.89 for that degree. Guess what? I got into every college I applied for. Perhaps you should do something they may not have taught in MPH school.. critical thinking.... Do you see, YOU are the one that didn't get in to your schools... I know you want to think the common denominator here is the nursing schools, but it is not... its you! Lastly, your VAST and NEVER ENDING 'experience' in healthcare should tell you, as mentioned above, there IS NO NURSING SHORTAGE!

Wow. As a Professor of Nursing I am saddened and embarrassed at the tone in some of these responses. I have worked with the author of this piece for more than 5 years, and have been bugging him to apply for our Nursing school the entire time. Regardless of the commentary, he is exactly the kind of applicant we need. He teaches my students each semester and has put on huge community clinics to provide them clinical hours. I have seen him go way beyond the minimum and have seen him handle some very hard situations with aplomb. I notice many of the comments disagree with the nursing shortage, which is the article that the author responded to ( whether you agree with the shortage or not, his opinion is more related to the admissions process than an argument of a shortage. I fully agree that the RN application process needs to be revamped to better consider things other than lifetime GPA (as is done for OHSU's Accelerated BSN) or how long ago one took Math. I also agree that all RN schools should have the same application standards... why do we care about a Theater grade or History grade? Why wouldn't Biostats trump basic algebra? We have often had the discussion of how to sift through the applications in a way that chose life experience over pure grades-- I don't see much correlation between straight A students and good nurses. In many of my classes I notice students who have little live experience and/or critical thinking ability and wonder how they got there and who was turned away in the application pool. In specific response to some comments: I have a very high opinion of Mr. Goodin. I consider him humble, dedicated, and a loss to our profession if he doesn't reapply (I think he only applied for one school so far). I have discussed his rationale for wanting an RN and find him to be doing so for all the right reasons. Shame on those of you being rude.

I also have to agree with the comment from the nursing professor. I have found many young RNs or RN students to be very rude, crude and obnoxious, esp. on line. As a FNP for 13 years and a current DNP student at OHSU I was appalled at the response i got from mostly undergraduate students when they accused me of "spamming them" with what I thought was useful information--i was offering up the services of an editor who was looking for a job helping students with editing papers. The nasty emails i got were absurd. I didn't just let it go-- i responded to each one letting them know i was 'keeping a list and checking it twice" and to never darken my door asking for ANY help or a job or a clinical placement. the amount of wining and nastiness on this topic is way over the top and anyone who is to chicken sh*t to post their name ought to just hit the delete button. Do you realize that the world can see what you write. Do you really want your comments coming up on a google search one day? Embarrassing for our profession indeed and shame on those of you who feel the need to put down a fellow human being in this regard. Teri Bunker, FNP

Haven't you heard? Nurses and nursing students eat their own. LOL Deep breath! We're all people. I have not graduated yet, but with the amount of stress I see in my class, I can see why RN students still in school, while bankrupting themselves and hearing stories about no jobs out there freak out. Same for the faculty that occasionally lose it. Be grateful for what you now have, your education finished, experience and a job and be humble towards others. BTW I see a lot of intelligent debate here on an emotional topic, nothing nasty. Depends on your perspective though. I tend to be a listener, but when I see an FNP waging threats I have to wonder why the kettle is calling the pot black.

wow. lots of comments. there is maybe not a RN shortage but there is a PCP, FNP shortage. So if you can get out and get some experience then go to graduate school for your FNP that is where the real opportunities are going to be. also, think outside of the "hospital" box. Think community. Think--what can i do to create a job for myself. what are the needs of the community. Not everyone is going to hand you a JOB. for example---if someone did the leg work for a project at my clinic that would bring influenza vaccination into the school--I would back that with my money and grant money. Look at the public health issues. Find innovative ways to address them. Approach partners in primary care. Learn how to write a business plan. there are a million needs for nurses and jobs--and this will only worsen as the public ages--we will be providing care to people in the community more and more and--btw. any ambitious RN who cant find a job and wants to take me up on my offer feel free to email me quit expecting everything to fall into your lap. Make it happen. also--some of you may need to consider moving to more rural areas to gain experience and then be able to write your ticket with regards to what you want to do Teri bunker, FNP

When I got my nursing degree, I had to walk to clinicals up hill (both ways!) in the blinding snow, and I didn't complain every time some pack of yetis crushed my skeleton. In fact, I also held down NINE full-time jobs, raised 14 petulant children and ran a marathon every morning after 20 minutes of sleep the night before. While sleeping I also knitted socks. I have a 4.9 in my rocket science degree, but I went back to nursing school because I got sick of being so rich and successful. Oh, and I only applied to schools on THE MOON, and I got into them ALL because I'm from the future. As much as I appreciate the work it takes to become a nurse, I think some here are taking this a little too personally. Try and keep those egos under control before your complex spreads to the next generation. The seemingly arbitrary hoops and requirements set up by nursing schools certainly do turn away a lot of people who would make great nurses, I don't think there's any question about that. However, I'd imagine that schools would rather have students paying with loans than those who are trying to work, as not only are loans a more reliable funding stream, but it likely also increases the chances for the student to complete the program and do so more quickly. Nursing school is demanding on one's time and is fairly challenging academically. It will test your character, composure and dedication repeatedly. However, I wouldn't assume that the application process as it stands is actually effective in selecting those students who are best suited to overcome these challenges. One only need to accompany a sick relative to the hospital once in a while to witness some of the incompetent morons who managed to graduate nursing school and be hired into jobs with seemingly high levels of responsibility. Obviously, some hospitals are better than others and luckily, even in the worst, every department always seems to have at least one all-star picking up the slack. Some have mentioned that there isn't now and never will be a nursing shortage in Oregon, and while more than a few peer-reviewed, unbiased, clinician-authored studies would say otherwise, you are welcome to maintain your anecdotal, region-biased opinion. At the very least, I think you may be able to admit that there is a shortage of highly competent nurses with a modern understanding of medicine. Admissions processes that don't account for clinical merit and instead rely on arbitrary hoops with little relevance to nursing aren't going to thin the herd of sycophants anytime soon.

That book is about as well-received as this article has been. I think the part about one's private life being taken into consideration when awarding grades is about the most obnoxious things I've ever read. I find the pompous, elitist attitudes of most second-degree nursing students to be grating on my nerves. Mainly because it is an evaluation made by the prospective nursing student themselves about their journey to fabulous that makes them ever so much more special than that 20 year old thing who's only other job was at the local Sonic. Because of this arrogance they feel their prior education gives them the right to tell anyone who can stand to listen to it things like "you nurses need to remember that families don't always understand medical jargon" etc like they are the I Have Worked In the Corporate World for 10 years Ten Commandments.Moses. Hate to break it to ya but you and that 20 year old are at exactly the same place. That would be the starting line. Humility will get you far . . .nobody likes a know-it-all newbie.

I've searched the archives of this site and can't find the articles on a so-called nurse shortage that Mr Goodin referenced. I'd like to read them.r

To the poster right below with such a low opinion of nurses and so MUCH "peer-reviewed" proof of a shortage of RN's in Oregon. You have no clue what you're talking about. Many RN/BSN's are waiting for us to lift visa restrictions as we have done twice before. There is a glut of RN's and will be for many years.

Much of the anger reflected on this commentary is related to his comments on a nursing shortage. I'd like to point out that he was responding to an article about the nursing shortage ( which cited a study showing a decrease in Oregon nurses by 25% over the next 10 years. Maybe you crank-pots should be flaming on the comments to that article instead. I have also posted some citations that reflect a gradient of evidence that there actually is a shortage, so maybe you all should learn to follow an evidence base, like they are teaching in RN school these days. Some of the Oregon-specific studies even detail many of the issues with the application process he discussed and point out that there are barriers to people coming into nursing as a 2nd career. His opinion was responding that if a shortage is true then they could help fix it by changing admission processes. I agree that there are too few entry-level RN jobs out there right now, I'm already nervous about finding my 1st job as an RN. But one of the reasons my school claims to not have larger cohorts is a shortage of RN Instructors. The hospital I work at just sent started a large recruitment for RN Administrators because they cannot fill those positions. The President of OHSU got people outraged a few months ago by making a statement that he wished 'more of his health workers had an MBA background' because of the changing nature of the health field. The Oregon Center for Nursing just did an article about the imminent retirement of nurse managers. U of P just got funding to create a Clinical Nurse Leader program because of the shortage in Master-level nurses. All of these support the opinion article that if there truly is a shortage it is in leadership levels and RN schools should stop trying to pump out young nurses and instead focus on getting people who are leaders in health to get their RNs soon so they can get back into management. I don't think he ever said it should be easier to get into nursing school, only that they should have standard (and sensible) requirements to apply if they want to attract people other than recent high-school grads. He already took all the A&P, math, nutrition, redid his biology classes, etc... he just was frustrated when some schools wanted more social sciences, or didn't count grad-level math, or had a wide range of how long credits would last between programs. He was also frustrated that they canceled the only part-time program due to budget (he didn't actually get rejected, they returned all the application fees for those applicants) and it was too late to apply to other programs by the time he was notified. I think too many of you are falling for the same "you're not a nurse so why would you know anything about it?" attitude that made him want to be an RN in the first place. We really should try to find ways of changing the system to bring health administrators into RN school so they have more of an idea what their crazy policies are doing to the front-lines. He's worked as a manager in the Health Division for years, part of that job dealing with hiring/training/supporting nurses. He also works with a lot of RN schools and students, including with students in my program. Read some of the supporters of this op ed, there are several nurses and nurse instructors who give him praise… and support what he wrote about. I don't think all his opinions were written in a vacuum, they are probably a true picture of what his application experience has been. I think it's wrong that he does so much for RN and RN students and gets so little support from them (both in this comment section and in the application process). Citations from recent studies that reflect a growing nursing shortage: Allen, Linda. 2008. The nursing shortage continues as faculty shortage grows. Nursing Economic$, Jan/Feb2008, Vol. 26 Issue 1, p35-40 Bertell TL, et al. Who gets in? Pilot year data from the Nursing Student Admissions Database. Portland, OR: Oregon Center for Nursing; 2009. Buchan, James; Aiken, Linda. 2008. Solving nursing shortages, a common priority. Journal of Clinical Nursing, Dec2008, Vol. 17 Issue 24, p3262-3268 Burton DA, et al. When, not if. . . . A report on Oregon's registered nurse workforce. Portland, OR: Oregon Center for Nursing; 2005. Clark, Rebecca; Culver; Allison-Jones, Lisa. 2011. An academic service partnership to address the nursing shortage. Nursing Education Perspectives, Jan/Feb2011, Vol. 32 Issue 1, p18-21 Council ONL. Oregon Nursing Leadership Council strategic plan. Solutions to Oregon's nursing shortage, 2005?2008; 2006. Fox, Rebekah L.; Abrahamson, Kathleen. 2009. A critical examination of the US Nursing Shortage. Nursing Forum, Oct-Dec2009, Vol. 44 Issue 4, p235-244 Kelly, Karen. 2010. Is the DNP the answer to the nursing faculty shortage? Nursing Forum, Oct-Dec2010, Vol. 45 Issue 4, p266-270 Lewis, Laurie. 2010. Oregon takes the lead in addressing the nursing shortage. American Journal of Nursing, Mar2010, Vol. 110 Issue 3, p51-54 Lotas, Lynn; McCahon, Cheryl; Kavanagh, Joan; Dumpe, Michelle; Talty, Maureen; Knittel, Kathleen; O'Malley, Cheryl. 2008. Policy, Politics & Nursing Practice, Nov2008, Vol. 9 Issue 4, p257-263 Moscato SR, et al. Dedicated Education Unit: an innovative clinical partner education model. Nurs Outlook 2007;55(1):31?7. Morris BA, et al. Oregon's nurse faculty workforce: a report from the Oregon Center for Nursing. Portland, OR: Oregon Center for Nursing; 2009. Northwest Health Foundation. Oregon's nursing shortage: a public health crisis in the making. Portland, OR; 2001 April. Issue Brief No. 1. Oregon Center for Nursing. About us. History. n.d. Siela, Debra; Twibell, K. Renee; Keller, Vicki. 2009. The shortage of nurses and nursing faculty. Critical Care Nurse, Feb2009 Supplement, p17-33 Tanner CA, et al. The Oregon Consortium for Nursing Education: a response to the nursing shortage. Policy Polit Nurs Pract 2008;9(3):203?9. Tanner CA. Education redesign in Oregon. Presented at the Nursing Education Capacity Summit, February 4?5, 2009. Baltimore, MD. 75th Oregon Legislative Assembly?2009 Regular Session. A bill for an act relating to a loan repayment program for nurse educators. 2009.

On your proof of a "nurse shortage" could you provide citations that aren't 2 yrs old and ones without dead hyperlinks. There is in fact a now and will be a future glut of nurses.

Sorry about the dead links. I copied the citations from scholarly journals that had full-text articles, so didn't need to use the links themselves. As anyone who actually follows an evidence-base would point out, none of this is 'proof' since this isn't a math class. This is simply way more evidence that there is a shortage than I have seen from any of the anti-shortage people on this site. I'm not going to spoon-feed you when it is clear that no amount of actual evidence will override your preference for anecdotes. You can use those citations and find all the info on most peer-reviewed database searches. It is easy to look them up and read all the studies from all sorts of places. My keywords were "Nursing" and "Shortage" and "Oregon". It took less than 5 minutes to find, of course then you have to be willing to read something that flies in the face of your cemented thoughts on this issue. Since you prefer newer studies to discredit with your superior understanding of all things nursing, I've done another quick search for only articles published in 2010. I've removed most hyperlinks so you don't have a hissy fit and expanded my search to include global rather than just Oregon. American Association of Colleges of Nursing (AACN). (2010). Nursing shortage fact sheet. Retrieved from Why are nurses leaving? Findings from an initial qualitative study on nursing attrition.(Research for Practice)(Report).Carol Isaac MacKusick, and Ptlene Minick. MedSurg Nursing 19.6 (Nov-Dec 2010): p335(6) Yenna Salamonson, Elizabeth J. Halcomb, Sharon Andrew, Kath Peters and Debra Jackson. A comparative study of assessment grading and RN student perceptions of quality in sessional and tenured teachers Journal of Nursing Scholarship 42.4 (Winter 2010): p423(7). Christine Walker. Raised occupancy levels in neonatal units criticized: charity report highlights shortage of nurses for infants with critical needs. Paediatric Nursing 22.10 (Dec 2010): p5(1) Governor signs bill tackling California’s nurse shortage. Nursing Education Policy Newsletter 7.6 (Oct 2010): pNA How staffing shortages put you at risk. Vermont Nurse Connection 13.3 (August-Oct 2010): p3(1) Tamsin Snow. Cuts to training numbers prompt fears of long-term nursing shortage. Nursing Standard 24.39 (June 2, 2010): p9(1) Report on Michigan nurse shortage. Nursing Education Policy Newsletter 7.4 (June 2010): pNA. Sandra Nettina. Nurse practitioner legislations removes barriers to care in Maryland. Maryland Nurse 11.3 (May-July 2010): p6(1) The impact of the national nursing shortage on quality nephrology nursing care. Nephrology Nursing Journal 37.3 (May-June 2010): p321(2) Examining the global shortage of nurse educators. Nursing Standard 24.33 (April 21, 2010): p6(1) Baker, S.J., & McGowan, N. (2010). Rounding for outcomes; an evidence-based tool to improve nurse retention, patient safety, and quality of care. Journal of Emergency Nursing, 36(2), 162-164. Carol Isaac MacKusick, and Ptlene Minick. Why are nurses leaving? Findings from a qualitative study on nursing attrition. MedSurg Nursing 19.6 (Nov-Dec 2010): p335(6)

I was a second degree student with a weak academic past. I didn't have a D in Theater appreciation but several Fs from being stupid and irresponsible. I was looking at several schools with slightly different prerequisite requirements. What did I do? I buckled down and kicked butt on my prerequisite courses and focused on schools that would look more closely at my last 60 credits or my prerequisite courses than my cumulative GPA. I organized my prerequisites in a way that I did the common ones first and saved the unique ones for last when I'd *hopefully* know which school I was going to. I had major stress over whether or not I'd get in anywhere and cried with relief when I got my acceptance letters. The competitive nature of nursing school admissions motivated me to work hard at school in a way I never thought I was capable. The hard work I did in prerequisites prepared me for the hard work of nursing school and I do not think I would have been as successful as I was in nursing school without that fear of not being good enough to get in anywhere. It's too bad Bryan seeing only barriers rather than challenges to improve himself.

Why do you want to be a nurse when you already have the degrees in other fields? You really have no idea how hard it is to survive nursing school once you get accepted. Based on your article, I do not think you have what it takes to be a nurse and make it through clinicals let alone lecture. There is a huge difference in being a staff nurse on a unit and being in management like you have. Nothing in the nursing profession is handed to you on a silver platter with out hard work. Lastly, if you earned a "B" in anatomy then that is what you earned. Plenty of my friends worked a full time job, have children and still made it through nursing with GPA above 3.0 so you statement about accepting only the young and inexperience is absolutely incorrect . Please do yourself and the nursing profession a favor and stop applying for nursing school.

I disagree completely. I agree strongly to the fact that the acceptance into nursing school is so strict and very hard to get into. And that hopefully one day there will be some changes in the acceptance process in colleges. Yes, I totally agree that we may not know how hard nursing school is. But, the reason for that is because we don't get to even experience it. We don't even get a chance to experience nursing school. I am applying for nursing school for next year in just a few weeks. I am hoping for the best. I have a 3.4 GPA currently but i hope to raise it even higher this next semester. Also, I disagree on the fact of "why do you want to be a nurse when you already have the degrees in other fields." That is the joy of school. And an instinct of humans. We keep trying and pushing further to know the world. She wants to be a nurse. There should be NO limits to education. I love that feeling. I have that feeling a lot. That feeling of "no one can stop me I can be whoever I want to be." When we continue to discover new things in the world we also learn something about ourselves. And are you a nurse? A nurse or any person for that matter SHOULD NEVER discourage someone's dreams! A good nurse will know that our physical self is just as important just as our emotional self. I would hate for you to be nurse and discourage me and tell me something for example, that I can't do something. A nurse should always be motivating. Its a nurse who can make this world a better place. I feel like I may be going on and on but this is important to me and I hope you may see that.

Very well written Bryan. You made excellent points and your struggle with the nursing school application process deserves respect and kindness, instead of the ignorant, rude and cruel comments as seen above. The nursing world would only be so lucky to have your managerial and leadership skills on their team. I can attest to that. Please don't give up!

Just wanted to let all of you know that the whole thing about getting into school, passing nursing school, graduating, passing NCLEX and then getting hired as a nurse is all a bunch of hooey. I got into a 4 year program with a prior BS in Biology and a 3.2 GPA. Had repeated A&P and Micro because they were too old and got straight A's. Went thru school and at the age of 57 graduated with 3.5 GPA and nursing dept honors. (So much for schools only wanting the young.) However, that was in May 2010, and til now I cannot find a job! I have now returned to medical transcription which I did in the past. I have been told by local hospitals that my GPA is not good enough and they want a 3.9 to 4.0. (However, for those people who were already working there as CNA's prior to grad, they are obviously willing to accept much less. I know this because 2 of my colleagues flunked out of nursing school as they failed Med Surg I. They were bounced out of the day program and banished to the accelerated program at night. But they still graduated and both of them were the ones who got the jobs and not me.) In fact, I tutored one of them to help her get a leg up in school, but despite that I was told "no dice" by hospital admin. (And my age did not play a role, as I was never called for an interview, my age was not on my resume, etc). As far as nursing classes only being offered during the day, and seeming to be geared to the young who live at home with Mommy and Daddy and who have no responsibilities, this has always been the case with the sciences. When I was doing my Bio degree, all those classes were only offered during the day. I have always suspected that the reason for this is that it is a weeding mechanism. The thinking is, if you are going to become a doctor or med researcher, you need to come from a certain social class. If you have to work during the day, and are either not young and supported by someone else or are older and must work to support yourself), then you are cut out. I had to quit my job and tighten my belt to finish my Bio degree and I had to do the same with my nursing degree. Neither of these, unfortunately, has produced a full time job with a living wage that I was trained to do.

Some colleges say they are not part time but my program only requires 9 credits per term (in the 2nd year) after all our pre req's are done. We only do clinicals 7-2/3 or so 2 days a week. We know our schedule many weeks to months in advance so time to prepare. That leaves lots of time for people to work, but if you want to go to nursing school only when you want to - i.e. at your convenience while you work 40 hours and raise a family, you really shouldn't be going to school at all. You won't learn the quantity of info needed in a short enough time period to allow you to way lay into practice and be confident. You really should look at the curriculum and not get caught up in words like full or part time. I also have a BA and MS degree. Also, most of the girls in my program work. Some full time, some have 4 kids - they fare well and survive like the rest. But they also realize our program is a privilege not a right, and they do need to be flexible. That is the same for any college program. As for your statistics class - I had an odd statistics course long ago and they accepted it for both my math requirement and towards the statistics requirement for my BSN (I'm doing the ADN first to get the RN, & I am dually enrolled in a BSN program, i start this right after the 1st degree is done - only a few terms extra for it). You should have the school you're interested in look at your transcripts or go directly to the head of the math dept. at the school you want to go to and have him/her evaluate it to see if it's equivalent. I did not think mine would transfer because it was taken in the psychology dept., but it more than covered what they expected and I even received extra credit towards math because it was a semester course, not a quarter. Be will all come together. That being said, I cannot wait to get my RN after graduation this spring!! The whole ordeal for the BSN - 5 years w/ prereq years included (and a term or two off here and there within). I couldn't imagine doing this "part" time over 10 yrs. Now you see why there are no "one class per term" programs.