The profession of nursing has been undergoing considerable change during the past 25 years, particularly in the areas of educational preparation and in the expectations of the public (Fagin, McClure, & Schlotfeldt, 1976). Along with the shift in occupational outlook for all female workers has come a push for registered nurses from two- and three-year programs to continue their professional education at the baccalaureate level.
The need among nurses for additional credentials has increased (Lysaught, 1981). The situation is particularly difficult for registered nurses who are tied down with jobs and families in remote geographical areas. One possible solution might be a locally-based baccalaureate program specifically designed to facilitate the pursuit of higher education credentials for such registered nurses.
The purpose of this study was to describe and evaluate an innovative locally-based baccalaureate nursing program designed to provide a baccalaureate degree with a major in nursing for registered nurse graduates of associate or diploma programs. The expectations of the study were that upon completing the program: (a) there would be an increase in enrollment for the degreegranting institution; (b) the program would provide a needed service to the profession and to the community; (c) there would be a positive growth in professional skills and attitudes among the registered nurse candidates; (d ) the program would result in increased monetary benefits and employment status; and (e) the candidates would achieve a higher level of personal need satisfaction in education and in lifestyle.
Subjects and Instrument: The participants in this study were the students who had been enrolled in a locally-based baccalaureate program in nursing during the first two years of its operation. This group of 53 RNs were geographically located in a semi-urban area some 70 miles from the parent college. They were admitted to the program on a monthly basis throughout this two-year period, rather than just in September and February.
The 53 enrolled RNs included 52 females and one male, with ages ranging from 21 to 48 years. They were all currently registered in New York State; 11 were graduates of an associate degree program, whereas 42 graduated from diploma programs. Fortytwo were employed full time in various areas of nursing practice and 10 were employed on a part-time basis. Further biographical and enrollment data on each student were collected, including their rate and means of fulfilling program requirements.
In addition, for a sub-group of 19 students who had completed baccalaureate requirements during the third year of the program, exit data were collected following their graduation. This included a questionnaire concerning some of their personal reactions to the program. Of the 19 graduates, 16 completed the questionnaire. Data were also collected on each candidate from records on file at the College of Nursing.
The findings supported the expectation that for the degree-granting institution such a program would result in increased enrollment. During the two-year period of the study, the enrollment of the College of Nursing increased by 53 RNs as a direct result of the locally-based program.
The second expectation, that such a program would result in service to the profession and to the community, has been generally supported with regard to the profession, but only indirectly supported with regard to the community. First, assuming that the intention to seek further education within the field of nursing would benefit both the profession and the community, the results of several items on the questionnaire and some of the specific written responses were relevant.
In answer to the question, "Are you now or do you intend to enroll in a master's level nursing program?," only two of the 16 respondents indicated that they did not have such plans, while four were already engaged in this pursuit. Further support is indicated by the following specific comments:
"I gained a greater appreciation of the nursing profession and a broader overview of the potential of nursing personnel to effect positive change in all aspects of the community."
"My completion of this program has been a stepping-stone to help me have a greater impact on the health field."
"I now see the role of the nurse as a generalist who is more autonomous than before, and capable of initiating change rather than just reacting to it."
The third expectation was that such a program would result in positive growth in professional skills and attitudes for RNs. When requested to affirm ways in which they felt this program had resulted in positive professional growth, nine of the 16 respondents selected the areas of assuming more independent roles in nursing practice and of increased teaching abilities. Samples of written responses are:
"There is a greater appreciation of the need for RNs with higher education in the field. This gives a broader outlook on the profession and makes one more aware of the need for continuing growth and change."
"I personally feel more qualified."
Equally supportive of this expectation were the responses to the questions, 1As a baccalaureate nurse, in what ways do you actively apply nursing research to the nursing process?" Ten respondents replied that they attempted to use results of nursing research in their own practice and also were able to identify nursing problems which would benefit from further study. In addition, 12 respondents listed the teaching of clients, other staff members, and students. A typical response to this query further illustrates the positive support:
"I attempt to identify needs of elementary school students and to find ways to meet physical, social, and psychological needs."
The fourth expectation was that such a program would result in increased monetary benefits or employment status. This was only modestly supported by the results of the questionnaire. Eight respondents indicated no change in employment status, while eight had received promotions. Salaries increased for the nine graduates and stayed the same for six.
The final expectation, that such a program would result in achievement of personal needs or goals in education and lifestyle, was strongly supported. Eleven respondents indicated achievement Jn the areas of professional advancement, six reported increased job satisfaction, and five indicated the realization of long-range objectives. Most importantly, 13 reported increased self-esteem. This was exemplified in the following statements:
"In completing the BSN I accomplished my desired goal. I had always wanted this and was glad of the opportunity to do so."
"I feel that my degree has assisted me a great deal in personal and professional growth."
This analysis has shown positive support for most of the expectations of the study and has suggested the need for implementation of similar programs in areas where only the diploma or associate degree programs are available. Indirectly related benefits to the degree-granting institution include the enrichment of the existing generic program. While such an intangible item would not seem within the scope of this evaluation, it could prove a fruitful area for future study.
Service to the profession and to the community has support on two levels. Assuming that increasing one's educational credentials within the profession enhances one's ability to perform with more expertise and greater effectiveness, then the larger the number who do so, the more extensive the benefit to the community. Concomitantly, the more knowledgeable and expert the practitioner of nursing, the more the public will perceive the profession in a positive light.
That the RN candidate would grow in professional skills and attitudes was most positively affirmed in the areas of teaching and of assuming more independence in nursing practice. Since these skills are two of the keystones in baccalaureate education in nursing, these results are indicative of the success the program had in imparting such principles. Likewise, since research is stressed as an integral part of such an education, the number of graduates adopting the research orientation to their practice is a positive result.
That completion of such a program would result in monetary benefits or increased employment status received questionable support. The suggestion that local area employers sometimes did not recognize the attainment of a baccalaureate degree is cause for concern.
The expectation that the locally-based program would result in higher achievement of personal goals or needs received especially positive support in the area of self-esteem. Considering the many obstacles which these students encountered in their pursuit of this particular goal, this finding is particularly significant.
- Fagin, C.M., McClure, M., & Schlotfeldt, R-M. (1976). Can we bring order out of chaos in nursing education? American Journal of Nursing, 76, 98-107.
- Lysaught, J.P. Í1981). Action in affirmation: Toward an unambiguous profession of nursing. New York: McGraw-Hill.