NURSING TASK FORCE FINAL REPORT

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1 NURSING TASK FORCE FINAL REPORT Recommendation The Nursing Task Force recommends that Western Washington University consider offering a completion RN to BSN self-sustaining program. This recommendation comes with a number of caveats. A primary need is a thorough market analysis assessing the fiscal viability of such a program. Another need is a survey assessing the depth of the potential applicant pool. These studies need to include sound metrics on employment and comparables on earning power to student debt load. Relatedly, the issue of nursing program faculty needs to be carefully examined. A survey or study of potential instructors would be a prudent consideration. The University also needs to instigate an open and detailed conversation with Whatcom Community College (WCC), Bellingham Technical College (BTC), and local healthcare stakeholders like Peace Health/St. Joseph s Medical Center (PH/SJMC). Topics need to include (but not be limited to) admissions requirements, articulation agreements, and curricular and logistical issues. In addition, the University would need to instigate conversations with administrative personnel from the nursing program at the University of Washington, Bothell. The primary topic of these conversations would be the degree and nature of the support Western might expect to receive from these personnel if Western moves forward with a nursing program. Introduction The task force met five times during winter quarter. We heard from numerous stakeholders, including Ron Kleinknecht and Terry Williams, authors of Western Washington University, Proposed RN to BSN Program, Substantive Statement of Need. In addition, Dr. James Antony, Associate Vice Provost of the Graduate School, University of Washington, an expert on and successful developer of fee-based (self-sustaining) academic programs, gave a presentation at Western during the winter quarter. Notes were taken at that presentation and were later discussed by the task force. The task force also heard presentations by and input from representatives associated with many local healthcare agencies and organizations: Cindy Hollinsworth, Director of Nursing, Bellingham Technical College. Gabriel Mast, Grant Coordinator, Bellingham Technical College. Annette Flanders, Nursing Program Director, Whatcom Community College. Steve Brinn, board member of the Family Foundation. Mauri Ingram, Whatcom Community Foundation. Diana Meyer, RN, MSN, CCRN, CEN, FAEN, Clinical Nurse Specialist, PeaceHealth/St. Joseph s Medical Center. Faye Lindquist, Vice President, Patient Care Services/Chief Nursing Officer, PeaceHealth/St. Joseph s Medical Center. Nursing Task Force Report 1

2 The task force also read a number of reports on nursing programs generally, and the viability of a nursing program at Western specifically. 1 Overall these reports were informative; however, many also presented information not germane to contemporary BSN nursing programs. For instance, the contemporary RN to BSN degree program would not require a faculty-to-student ratio of 10:1, but rather could accommodate a much higher ratio. Neither does a contemporary RN to BSN degree program require extensive medical training equipment or space. RNs are trained for hands on nursing; BSNs are trained to understand overall healthcare systems, quality and safety issues, and a team approach to problem solving. Technical preparation and education in the natural sciences are incorporated and mastered by students in Associates Degree Nursing (ADN) programs. A contemporary BSN program is more aligned with the humanities and social sciences, emphasizing such issues as empirical research, information technology, public health, and leadership, plus enhanced skills in communication, critical thinking, case management, and problem solving. The community representatives the task force heard from all strongly urged Western to offer a BSN degree program. So one obvious question the task force felt it should address is why? Quality of care turns out to be the primary reason. Studies indicate that the more educated a nursing staff, the better the patient outcomes. 2 According to statements made by local healthcare representatives, nurses with BSN degrees show better leadership, better decisionmaking, and other positive traits. Nurses with BSN degrees also have a broader range of career opportunities. They are highly sought by hospitals, hospice centers, clinics, etc., and they more easily advance to specialized areas such as nurse anesthetist, palliative care nursing, and managerial positions. Discussion The task force believes that the following points support our recommendation: Fits Western s Mission To paraphrase slightly, Western mission states that it will serve the people of the State of Washington by developing the well-being of communities. Furthermore, in its strategic plan, the first bulleted item states that Western will build upon its strengths to address critical needs in the State of Washington. Indeed, the tenor of Western s updated mission and strategic plans have placed specific emphasis on commitment to local communities. 1 These reports included: Brilla, L., and Knutzen, K. Nursing. A white paper. Kleinknecht, R., and Knutzen, K., (June, 2009). Health Professions at Western Washington University. A white paper. Kleinknecht, R., and Williams, T. Western Washington University, Proposed RN to BSN Program, Substantive Statement of Need. All the above reports are available for download at: 2 A sampling of these studies includes: Aiken, Linda H., et. al. (September 24, 2003). Educational Levels of Hospital Nurses and Surgical Patient Mortality. JAMA. Estabrooks CA, et. al., University of Alberta, Edmonton, Alberta, Canada (April, 2005). The impact of hospital nursing characteristics on 30-day mortality. Tourangeau, Ann, et. al., University of Toronto (January, 2007). Impact of Hospital Nursing Care on 30-day Mortality for Acute Medical Patients. Journal of Advanced Nursing. Nursing Task Force Report 2

3 Based on initiatives like the 100 Conversations, Western has promised to listen to community needs and to respond accordingly. To further underscore this commitment, Western has applied for and received recognition from the Carnegie Foundation as a Community Engaged Institution, and for recognition on President Obama s Higher Education Community Service Honor Roll. Based on what the Nursing Task Force has heard from community stakeholders, a completion RN to BSN program would align well with Western s mission and strategic goals. Meets community and regional need. There is little arguing that the region Western serves needs a BSN program. As noted in the white paper cited above, Health, illness prevention, and healthcare will be increasingly critical social and economic issues in our state and in the nation. Our local nursing workforce is characteristic of the demographic across Washington State: the average age of RNs employed by PH/SJMC is 48, of which approximately one-third are age 55 or older. 3 The local need includes advance practice nurses (ARNP) who function as primary care providers. Their master s-level training most often involves a transition from their BSN preparation. Similarly, but of greater significance and despite a laudable increase in the rate of RN and BSN graduates during the first half of this decade, there is a dearth of nurse educators: individuals charged with meeting the projected shortage of nurses in the coming years. Although ADN graduates are produced per year in Whatcom and Skagit counties, approximately only 10% matriculate within five years into master or doctoral level programs. The capacity to educate the nursing workforce in the long-term should be included in planning considerations. 4 Would create/reinforce positive community relations. Western learned from the 100 Conversations, and again in the meetings of the Nursing Task Force in Winter 2011, that the University is often perceived by the local community as aloof and unresponsive to community needs. Within the Western community, the extraordinary amount of time and resources that Western s faculty, staff, and students return to the community are well understood. Unfortunately, many programs that Western counts as commitment to community engagement for instance, internships and student teaching are seen by the community as simply part of a student s required coursework. Western is faced with the task of continuing to find new and evolving ways of supporting the community as the economy and culture changes. Instituting a nursing program would go far in showcasing Western s commitment to community needs. A BSN program would also reinforce strong community relations by helping the local healthcare community with its aspiration to increase the number of BSNs. The Institute of Medicine (IOM) recommends that 80% of the RN workforce hold the BSN by Across Washington State, 43% of RNs have this level of training, and at PH/SJMC only 37% of RNs 3 Meyer, Diana, RN, MSN, CCRN, CEN, FAEN, Clinical Nurse Specialist, PeaceHealth/St. Joseph s Medical Center. Personal communication. 4 Skillman, SM, CHA Andrilla, L.G. Hart. Washington State Registered Nurse Supply and Demand Projections: Final Report. Seattle: WWAMI Center for Health Workforce Studies, University of Washington, Nursing Task Force Report 3

4 have earned their BSN. Additionally, PH/SJMC aspires to attain Magnet Recognition Status from the American Nurses Credentialing Center, the gold standard for hospitals. 5 To achieve that status it must substantially increase the number of BSNs on its staff. Indeed, if submitting their Magnet application in 2012, 75% of nurse managers would be required to hold a BSN degree; if submitting in 2013, that figure would be 100%. 6 Representatives from PH/SJMC estimate that it would take at least 5 years to bring their nursing workforce up to the level required for magnet status. Helping local healthcare agencies with their aspirations would certainly reflect positively on Western s commitment to serving its community. Willingness from BTC and UW Bothell to help develop the BSN program Mary Baroni, RN, Ph.D., UW Bothell, indicated her interest in consulting on the development of a RN to BSN completion program at Western. Dr. Baroni also spoke of the possibility of partnering UW Bothell curriculum and faculty to facilitate the program s startup. Cindy Hollinsworth, MSN, Director of Nursing at BTC, also indicated she would also be available to participate in a work group or task force should Western opt to move forward. The Primary Challenges Finding qualified faculty, as well as a qualified administrator. Just as there is a projected shortage of nurses, there is an equally important shortage of qualified nursing faculty. The American Association of Colleges of Nursing reports that the vacancy rate for nursing faculty is 8.1%. According to a 2003 report by ADVANCE for Nurse Practitioners magazine, the primary reason for the faculty shortage is the disparity between nurse practitioner salaries and nurse professor salaries. Nurse practitioners with advanced degrees make more money than nurses with advanced degrees who teach. This report also maintains that faculty salary is mostly constrained by larger institutions guidelines for paying faculty, to ensure pay equity across disciplines. 7 In order for the program to move forward, the issue of faculty would need to be addressed at greater length, including in-depth discussions with local healthcare stakeholders. A survey of potential instructors might be prudent. Finally, and quite importantly, the staffing challenge would extend to finding a qualified program director. The position of director would be key to the success of a nursing program. (For a detailed analysis of faculty issues as they pertain to nursing program accreditation, please see Appendix A.) 5 Currently, the only hospital with Magnet Recognition Status in the State of Washington is the University of Washington Medical Center. 6 American Nurses Credentialing Center, Magnet Recognition Program FAQ page. 7 This material is paraphrased from: Hong, C., and Kircher, A. (February, 2010). Developing a Baccalaureate Program in Nursing. The Education Advirsory Board. The Advisory Board Company, Washington D.C. Nursing Task Force Report 4

5 Solving the curriculum conundrum. The task force discovered that RNs with an ADN degree have deficiencies in both GURs and pre-requisite courses that must be completed either prior to or during a RN to BSN completion program. These deficiencies included courses in math (statistics), the humanities, writing proficiency, microbiology, and nutrition. In addition, most of the nursing workforce has been trained in a culture that is different from that cultivated at Western. Given that a significant portion of the pool of potential students is currently employed with numerous competing responsibilities, it is reasonable to anticipate that GURs and other pre-requisites required for admission to Western would be a significant barrier for most students related to both time and financial considerations. Furthermore, Western and WCC likely cannot accommodate 25+ students in GUR and pre-requisite courses as traditionally offered during the academic year. (Please see Appendix B for more details.) Fiscal viability. Because of the current challenging economic climate in the State of Washington, the task force was concerned that the timing for starting a nursing program or, for that matter, any new program might be inopportune. For instance, what would be the source of start-up funds? Yet if sufficient start-up funds could be found, available information indicates that once up and running, a nursing program could be self-supporting, potentially recovering the initial investment within a reasonable number of years. In a self-supporting scenario, a firewall would need to exist between the nursing program s budget and the budgets of other academic programs. Because viability will equate with affordability, the market analysis and survey of potential program applicants would be crucial. Both studies need to focus on the two markets that are being considered: 1) already practicing RNs, and 2) student nurses currently in RN programs. At the risk of stating the obvious, viability will also require that this program be carefully designed and effectively administered. Educating Western faculty and administrators about contemporary nursing education. For most, nursing education conjures up images of small groups making bedside rounds, reading charts, and monitoring high-tech medical equipment. Contemporary nursing education at the BSN level, however, has changed dramatically from nursing education of twenty years ago. Nurses graduating with BSN degrees now learn how to be leaders in health promotion and disease prevention, how to function in complex and unpredictable environments, and how to demonstrate critical reasoning and flexibility. A contemporary BSN program teaches more than just how to keep patients alive, but also how to help people live fuller lives. In today s healthcare systems, BSN nurses are being asked to participate in and contribute to the organization s continuous quality improvement; they are being asked to perform as effective players and leaders within given healthcare systems; and they are being asked to address concepts found within populations of patients, not just individual Nursing Task Force Report 5

6 patients. The shift is away from the medical diagnosis model to a model that stresses competence in applying critical concepts to multiple patients with multiple diagnoses. At the BSN level, the panoramic view is taught, one that encompasses healthcare systems, quality and safety, and a team approach to problem solving. 8 As a result of this paradigm shift, humanities and social science are emphasized, not physical science. This paradigm shift has also changed the faculty-student ratio needs. Whereas previously a nursing program needed a ratio in the 8-10:1 vicinity, the faculty-student ratio for a contemporary BSN program can be much higher. Indeed, courses could easily accommodate twenty-five to thirty students. It would be crucial that a BSN program at Western not impact existing classes or curriculum. Just as a firewall would need to exist between a nursing program budget and the budgets of other academic programs, so too would a firewall need to exist between nursing program courses and traditional course offerings. Integration into Western s structure. To be successful at Western, a nursing program would need to be part of a unit s strategic plan, and to be treated the same as a state-supported program, including matters of student financial aid support and assessment metrics. The task force recommends that at least one Western faculty member be willing to support and champion such a program. That faculty member would need to be innovative and entrepreneurial, flexible and far-sighted. Moreover, it would be preferable to have a group of faculty willing to provide oversight and/or input on curriculum, evaluation of faculty, and program concerns such as accreditation. Key Considerations The task force has the following specific recommendations: The program should be a cohort design. Moreover, it should be viable for a cohort of 20. At that number, $250 per credit, a preliminary figure found in the Kleinknecht and Williams report, is too low. Similarly, Dr. Baroni (UW Bothell) felt that the $262,000 start-up funding noted in that report was too low. In addition, the program needs to have a tightly-controlled prescriptive set of classes, all offered in the program. No traditional Western classes should be necessary. To flourish, it is vital that the program meet and sustain its enrollment marks. Beyond an adequate pool of possible applicants, the program s viability would also require that its students are carefully chosen. Conversations with the local stakeholders brought these suggestions and ideas for developing strong cohorts: 8 Some of this material was adapted from Overhauling Nursing Education, (Stokowski, Laura A., RN, MS). Posted at Nursing Task Force Report 6

7 o o o o Careful attention would need to be paid to the letters of reference. An essay component was recommended as a writing assessment. A face-to-face interview with potential BSN students was recommended. The program should consider a balance between an applicant s grade point averages and experience. Local healthcare representatives offered insight into the level of employer support for potential nursing program applicants. These included: o o St. Joseph s, as well as other local healthcare agencies, are highly motivated to increase their numbers of BSNs. In turn they will be accommodating in terms of work schedules and other support to their employees who enter the program. In terms of nurses leaving the area, the county does not see a lot of turnover. This is especially true at St. Joseph s, as it is the county s only hospital. Therefore, the pool of potential nursing students from the private sector should be relatively stable. To encourage participation in advisory and/or logistical roles, monetary incentives for existing Western departments and colleges should be built into the nursing budget. The program needs to meet all of Western s high academic standards, including standard curriculum review. Even though the program would be self-supporting, academically it should appear no different to potential applicants than a traditional state-supported program. One way to achieve this quality is to have a combination of tenure-track line(s) and non-tenure track faculty, evaluated the same as regular faculty. A face-to-face content delivery model might work well at Western; however, innovative and nontraditional content delivery models should also be considered. Futher considerations should include how Western might need to serve its native population of students with a desire to entering a nursing program. SCOT Analysis Please find in Appendix C a SCOT (Strengths, Challenges, Opportunities, and Threats) analysis. Task Force Committee Members Debra Jusak (chair), Lorrie Brilla (PEHR), Hart Hodges (Economics), Janice Lapsansky (Biology), Barbara Lehman (Psychology), Michael Massanari (Critical Junctures), Gary McKinney (VPUE), Gerry Prody (Chemistry), and Jay Teachman (Sociology). Nursing Task Force Report 7

8 SCOT Analysis Template criteria examples Advantages of proposition? Capabilities? Competitive advantages? USP's (unique selling points)? Resources, Assets, People? Experience, knowledge, data? Financial reserves, likely returns? Marketing - reach, distribution, awareness? Innovative aspects? Location and geographical? Price, value, quality? Accreditations, qualifications, certifications? Processes, systems, IT, communications? Cultural, attitudinal, behavioural? Management cover, succession? Philosophy and values? Strengths Fits WWU s Mission. Meets community and regional need. As a RN-to-BSN program, students enter program with all necessary science course requirements fulfilled. A robust source of potential students, coming from WCC, BTC, and SVCC RN programs, plus already-employed RNs at local hospitals, etc., looking to upgrade their skills. Challenges Finding qualified faculty. Getting buy-in from a WWU department. Developing a hybrid-styled content delivery system (on-line, flexible course scheduling, etc.) to compliment a traditional face-to-face design. Finding enough start-up dollars in a tough economy. Achieving certification asap. Maintaining a firewall between nursing budget and general academic budget. criteria examples Disadvantages of proposition? Gaps in capabilities? Lack of competitive strength? Reputation, presence and reach? Financials? Own known vulnerabilities? Timescales, deadlines and pressures? Cashflow, start-up cash-drain? Continuity, supply chain robustness? Effects on core activities, distraction? Reliability of data, plan predictability? Morale, commitment, leadership? Accreditations, etc? Processes and systems, etc? Management cover, succession? criteria examples Market developments? Competitors' vulnerabilities? Industry or lifestyle trends? Technology development and innovation? Global influences? New markets, vertical, horizontal? Niche target markets? Geographical, export, import? New USP's? Tactics: eg, surprise, major contracts? Business and product development? Information and research? Partnerships, agencies, distribution? Volumes, production, economies? Seasonal, weather, fashion influences? Opportunities Revenue: not only could the program be revenue neutral, it could be revenue positive, especially as it matures and expands into certification offerings. Community relations: would create/reinforce strong community relations. (WWU sometimes seen as remote, aloof from the community). Once certified, there are plentiful sources of dollars in the form of federal grants. Threats Without Western faculty and department buy-in, there could be resentment that might undermine the programs viability. If Western decides not to offer the program, it risks furthering the perception as aloof and unresponsive to regional needs. criteria examples Political effects? Legislative effects? Environmental effects? IT developments? Competitor intentions - various? Market demand? New technologies, services, ideas? Vital contracts and partners? Sustaining internal capabilities? Obstacles faced? Insurmountable weaknesses? Loss of key staff? Sustainable financial backing? Economy - home, abroad? Seasonality, weather effects? 8

9 APPENDIX A: NOTES ON NURSING PROGRAM ACCREDITATION Barbara Lehman Commission on Collegiate Nursing Education This accrediting agency for a Wisconsin nursing program is also the agency associated with the American Association of Colleges of Nurses (AACN) described in the white paper. WEBSITE: Parts of their guidelines relevant to the requirements of instructional BSN program faculty include: Expected faculty outcomes in teaching, scholarship, service, and practice are congruent with the mission, goals, and expected student outcomes. Elaboration: Expected faculty outcomes are clearly identified by the nursing unit, are written, and are communicated to the faculty. Expected faculty outcomes are congruent with those of the parent institution. Must follow: The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008). WEBSITE: The chief nurse administrator is a registered nurse (RN); holds a graduate degree in nursing; is academically and experientially qualified to accomplish the mission, goals, and expected student and faculty outcomes. Elaboration: The chief nurse administrator has budgetary, decision-making, and evaluation authority that is comparable to that of chief administrators of similar units in the institution. He or she consults, as appropriate, with faculty and other communities of interest, to make decisions to accomplish the mission, goals, and expected student and faculty outcomes. The chief nurse administrator is perceived by the communities of interest to be an effective leader of the nursing unit. The program provides a rationale if the chief nurse administrator does not hold a graduate degree in nursing. Faculty members are sufficient in number to accomplish the mission, goals, and expected student and faculty outcomes; academically prepared for the areas in which they teach; and experientially prepared for the areas in which they teach. 9

10 Elaboration: The full-time equivalency (FTE) of faculty involved in each program is clearly delineated, and the program provides to CCNE its formula for calculating FTEs. The mix of full-time and part-time faculty is appropriate to achieve the mission, goals, and expected student and faculty outcomes. Facultyto-student ratios ensure adequate supervision and evaluation and meet or exceed the requirements of regulatory agencies and professional nursing standards and guidelines. Faculty are academically prepared for the areas in which they teach. Academic preparation of faculty includes degree specialization, specialty coursework, or other preparation sufficient to address the major concepts included in courses they teach. Elaboration: While faculty teaching in the nursing program ostensibly need to have a graduate degree, the program also provides a rationale for the use of any faculty who do not have a graduate degree. Faculty who are nurses hold current RN licensure. Faculty teaching in clinical/practicum courses are experienced in the clinical area of the course and maintain clinical expertise. Clinical expertise may be maintained through clinical practice or other avenues. Faculty teaching in advanced practice clinical courses meet certification and practice requirements as specified by the relevant regulatory and specialty bodies. Advanced practice nursing tracks have lead faculty who are nationally certified in that specialty. Washington State Requirements. The emphasis of this document is on teaching faculty requirements for a BSN program. Other criteria, including the purpose of the nursing program, standards and evaluation, resources and facilities, student characteristics, etc., are also available online. Additional guidelines are (WAC through WAC are available online. WEBSITE: WAC Standard II. Organization and administration for approved nursing education programs. Overall requirements for nursing programs, and BSNs are shown here: WEBSITE: The nursing education program shall be an integral part of the accredited governing institution. (1) The governing institution accreditation must be by a commission-approved accrediting body. 10

11 (2) The relationship of the nursing education program to other units within the governing institution must be clearly delineated. (3) The nursing education program must be organized with clearly defined institutional authority and administrative responsibility for the nurse administrator. (4) The nursing education faculty shall be involved in determining academic policies and procedures of the nursing program. (5) The nursing education program must allow student participation in committees in the determination of program policies and procedures, curriculum planning and evaluation. (6) The nursing education program shall be administered by a professionally- and academically-qualified registered nurse currently licensed in this state. Amendment to WAC Standard II. Organization and administration for approved nursing education programs. The following page contains an amended version of the state requirements for nursing programs, and addresses faculty standards for BSN programs. WEBSITE: In a program offering the baccalaureate degree in nursing faculty must have (i) A minimum of a masters degree with a major in nursing, a doctoral degree preferably in nursing from an accredited college or university; and (ii) Preparation in education and administration; and (iii) At least five years of experience as a registered nurse including two years of experience in nursing education at the baccalaureate level. The nurse administrator shall be responsible for creation and maintenance of an environment conducive to teaching and learning through: a) Facilitation of the development, implementation and evaluation of the curriculum. b) Communication with central administration and other units of the governing institution. c) Facilitation of faculty development and performance review consistent with the policies of the institution, and encouragement of faculty to seek ways of improving clinical skills and methods of demonstrating continued educational and clinical competence. 11

12 d) Facilitation of faculty recruitment and appointment. The administration of the program is encouraged to establish a goal for acquiring faculty with diversity in ethnicity, gender, clinical specialty and experience. e) Recommendation of faculty for appointment, promotion, tenure, and retention consistent with the policies of the institution. f) Facilitation of the development of long-range goals and objectives for the nursing program. g) Facilitation of recruitment, selection, and advisement of students. h) Assurance that the rules and regulations of the state nursing commission are effectively implemented. i) Notification of the commission of any major changes in the program or its administration. The nurse administrator shall have sufficient time provided to fulfill relevant administrative duties and responsibilities. [Statutory Authority: RCW , , filed 10/16/95, effective 11/16/95.] Although the amended version does not address faculty size or faculty to student ratios, the following standard contains relevant material. WAC Each nursing education program shall have a sufficient number of professionallyand academically-qualified faculty with adequate diversity of expertise in nursing to meet the nursing education program purpose, outcomes, and quality improvement. The maximum ratio of faculty to students recommended in clinical areas involving direct care of patients or clients is one faculty member to ten students. 1 A lower ratio may be required by the nursing commission for students in initial or highly complex learning situations, or when student/client safety warrant. A higher ratio may be allowed with use of trained preceptors for students. 1 Note that there is no listing for a BSN program. This recommendation is for clinical programs, such as those offering a degree in Registered Nursing. 12

13 Appendix B: Admission Requirements and Articulation, Associates Degree in Nursing (ADN) to BSN Bridge Program Janice Lapsansky and Gerry Prody Time and credit investments in coursework leading to ADN: Both BTC and WCC require a significant investment to achieve the ADN. Upon completion of coursework, students from both colleges have earned well over 100 credits in lower-division classes. A maximum of 90 credits from a community/technical college are transferrable to a BSN program, but these credits will not satisfy many of our GUR requirements. (See below.) WWU policy: no more than 105 quarter (70 semester) credits may be at the lower division (100 and 200) level. This means that more of the credits earned at BTC or WCC will not count, and will require bridge program students to take/pay for more lowerdivision courses to satisfy the GURs. Minimum grade requirements in GUR and pre-requisite courses for admission to other bridge programs: Highly variable. Minimum cumulative GPA 2.0, 2.5, 2.8, or 3.0. Minimum GPA in pre-requisite courses 2.0, 2.5, or 2.75 (e. g. English Comp, Statistics, Nutrition, Human A/P, etc.) WWU transfer policy: All transfer courses should be completed on a lettered or numeric grading scale, not pass/fail. English 101 must be completed with a grade of 2.0 or better. GUR and other minimum course requirements: The Natural Sciences and Social Sciences requirements are met by the RN bridge programs BTC now requires Introduction to Statistics as part of their RN program SPU, WSU, UW-GB, the Oregon Consortium of Nursing Education (OCNE), & UW Bothell ALL require a Statistics course as a pre- or co-requisite Note: WWU pre-nursing advising sheet lists Statistics as a required course. 13

14 BTC and WCC bridge program students will need at least one more writing course AND meet the WP requirement of 3 WP points in upper division classes at WWU (hopefully within the BSN bridge program). Note: St. Joseph s Hospital representatives identified writing ability as an important consideration. Nutrition and Microbiology are required pre-requisites for WSU, UW Bothell and OCNE. o HLED 350 Nutrition at WWU may be an option. o Bio 245 Microbiology at WWU may be an option. o WWU pre nursing advising sheet lists Nutrition & Microbiology in 2nd year. Neither BTC nor WCC incorporate CGM or Humanities coursework into their RN programs. BTC does not offer these courses. o Statistics and some GURs may be satisfied by courses currently offered through Independent Learning at WWU. * o Students may be able to take some GURs through WCC. Summary of credit requirements: 180 credits required for graduation. Students may transfer 105 lower division credits (but only 90 may be applied toward the BSN?). To complete GURs, students may have to complete beyond their ADN courses. 60 credits must be upper division. Note: Other BSN bridge programs tend to grant 45 credits for having successfully completed the NCLEX exam and WA state licensure. By convention, it appears that some of these may be applied toward the graduation requirement for 60 upper division credits. An additional 30 credits must be earned to complete the minimum 180 credits. (Of these, 15 must be upper division and 15 could be applied to GURs.) Typical bridge programs require completion of 45 credits of upper division coursework (30 nursing non-nursing elective credits), with a residency credit minimum of (WWU is 45 credits.) Other Admissions Considerations: * 14

15 Liability insurance National/State criminal background check Computer/Software competency Summary and suggestions regarding admission requirements: RNs with an ADN have deficiencies in both GURs and pre-requisite courses that must be completed either prior to or during a BSN bridge program. This is likely the most significant challenge to starting a successful program at WWU, for at least three reasons. First, most of the nursing workforce has been trained in a culture that is different than that cultivated at WWU, and the educational opportunities that a BSN program provides are not well understood and undervalued (an opinion shared by SJH reps as well). Second, potential students have already taken 3 or more years of coursework at the college level, and would be required to take an additional year (if full-time) or more of coursework prior to admission to WWU if GURs and other supporting courses are required as pre-requisites. Third, WWU and WCC likely cannot accommodate 20+ students in GUR and prerequisite courses during the academic year The bridge program could be designed to schedule some of these courses in summer sessions and/or utilize existing Independent Learning courses. It is reasonable to anticipate that requiring these as pre-requisites to admission would be a significant barrier for most students, with respect to both time and financial considerations. It may be more attractive if GURs and other required courses were satisfied during the course of the program with their cohort (at WWU or before?). Planning and cooperation among all three schools (BTC, WCC, and WWU) would be essential for development of a successful program. Prospective students are likely in a better position to prepare for a BSN bridge program during their community college training; building a cohort of students that completes GUR and pre-requisite courses as a component of their ADN, saving time and money. Establishing a consortium similar to OCNE appears to be the best way to recruit and support students. Regardless of the source of program applicants, WWU should carefully consider any minimum GPA requirements, so that students have the best chance of success in the program. 15

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