Kitsap County is located on the Olympic Peninsula in Washington State, in a geographically isolated region that has limited access to baccalaureate education. This problem gained the attention of state legislators who actively sought opportunities to provide baccalaureate nursing (BSN) education in the region. Educational access was linked to political and economic issues, so legislation enabling community colleges to offer baccalaureate education required industry demand and support (Session Laws of the State of Washington, 2005). This article describes how Olympic College (OC) and the University of Washington Tacoma (UWT) partnered to develop an RN-to-BSN program, which met the intent of new legislation that offered funding for baccalaureate education in community colleges. This article also discusses the development of an academic partnership, milestones in the process, initial and ongoing challenges, and program successes. For those considering developing this type of BSN program, recommendations are included for starting an RN-to-BSN program in the community college setting, as well as suggestions for obtaining administrative support.
Baccalaureate education in the community college setting has existed since 1970 (Glennon, 2005). In some cases, baccalaureate institutions have offered RN-to-BSN coursework via distance learning or on community college campuses. The Engrossed Second Substitute House Bill 1794 (2005) was passed by Washington State Legislation in 2005, and provides funding to four community colleges to initiate baccalaureate education programs. The legislation aimed to provide access for place-bound students and to increase baccalaureate capacity in the state, focusing on high-wage, high-demand jobs. Olympic College made the decision to seek one of four state-funded baccalaureate degree awards. This new model was innovative and provided opportunities for future growth.
Key stakeholders strongly advocated for OC to offer an RN-to-BSN program, supported by a partnership with UWT. Harrison Medical Center (HMC), the largest health care facility in the region, validated the need for an RN-to-BSN program. HMC was actively pursuing Magnet status, which requires 100% of the nurse managers to be baccalaureate-prepared by 2013, further supporting the need for a BSN program (American Nurses Credentialing Center, 2012).
With the combined support of legislators, industry, and UWT, OC competed to secure one of the four baccalaureate degree awards allotted by the legislature and proposed to offer an RN-to-BSN degree in the community college setting. The closest on-ground RN-to-BSN programs were separated from students’ homes by 50 to 100 miles and a bridge toll or ferry ride. To eliminate geography as a barrier to the BSN degree, and because there was an opportunity for community colleges to offer baccalaureate degrees, OC strongly preferred to develop and offer an RN-to-BSN program on its own campus in Kitsap County.
Approval Process Milestones
In a competitive process to secure one of the state-funded baccalaureate programs in community colleges, OC was the only applicant in the state seeking to offer the RN-to-BSN degree. The OC Board of Trustees approved the request to pursue this option in March 2006, deeming it congruent with the OC mission “To serve and enrich all our communities by providing quality education and training for all who seek to improve their lives through learning.” (Olympic College Catalog, 1999). The demanding process required written proposals, oral presentations, and question-and-answer sessions for OC, HMC, and UWT representatives before the Washington State Board of Community and Technical Colleges and the Washington State Higher Education Coordinating Board. The State Board of Community and Technical Colleges awarded approval to offer the degree in April 2006, and approval from the State Higher Education Coordinating Board soon followed in July 2006.
Olympic College applied to the Northwest Commission on Colleges and Universities to become a baccalaureate degree-conferring institution. Olympic College submitted a substantive change report, receiving candidacy status in December 2006, and program development progressed (Table 1).
Table 1: RN-to-BSN Program Milestones
Developing a Partnership
Development of a new academic program required support from key stakeholders, most notably UWT, which had a longstanding articulation agreement for academic progression of OC associate degree nursing (ADN) graduates to the RN-to-BSN program at UWT. In addition to this institutional relationship, the individual faculty of the two programs maintained collegial relationships. This provided the basis for embarking on a new, complex, and publicized partnership.
The financial and legal implications of this partnership required a written agreement of work to be undertaken. A memorandum of understanding (MOU) between OC and UWT outlined the tenets of the unique partnership, including the roles and responsibilities of each institution, costs, and operational details, such as courses to be taught and faculty mentoring. One aspect of the MOU focused on concurrently admitting the first cohort of students to both OC and UWT. Thus, the MOU ensured that students were enrolled in an accredited program while OC sought accreditation. The MOU provided for faculty development through coteaching; UWT mentored OC faculty over three quarters, as they co-taught four courses on site at OC and one at UWT. At the end of the three quarters, students had the option to continue their RN-to-BSN studies at either OC or UWT.
The designated planning year for the RN-to-BSN degree development was 2006–2007. The year included OC infrastructure development to support the RN-to-BSN degree, the initiation of financial aid related to upper-division baccalaureate courses, and work on admission and graduation policies. The planning process revealed a need for expanded library sources and resulted in an acquisition plan for materials on community health, research, and leadership.
BSN Program Development
An intense period of joint recruiting and advising, as well as infrastructure and program development, preceded admission of the first cohort of part-time RN-to-BSN students for fall 2007. Four faculty volunteered to support this pioneering effort at OC. Olympic College asked for volunteers from the nursing faculty interested in developing and implementing an RN-to-BSN program. The core group of volunteers became known as the BSN team. The BSN team enrolled in UWT graduate nursing education courses as a vehicle for faculty development. The BSN team had multiple curriculum development workshops with UWT and developed the proposed OC curriculum as a component of a graduate curriculum course.
The proposed curriculum (Tables 2–3) reflected the unique characteristics of the region—largely American Indian, active duty, and retired naval populations. The service area covered both urban and rural areas; 20% of the population is economically disadvantaged. The BSN curriculum was built on the existing ADN program and on the gap analysis of associate degree outcomes versus the American Association of Colleges of Nursing’s The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 1998). The BSN team was committed to developing and offering an academically rigorous program that was consistent with accreditation standards.
Table 2: Upper Division Nursing Coursework for the RN-to-BSN Program
Table 3: Upper-Division General Education RN-to-BSN Electives
During program development, OC hired an RN-to-BSN recruiter to focus on reaching potential students. Olympic College and the RN-to-BSN recruiter worked with the UWT recruiter to develop strategies, information sessions, admission processes, and other necessary program supports. During the planning year, OC actively recruited doctorally prepared faculty.
Joint Course Offerings
In the 2007–2008 instructional year one, students were admitted to a 2-year, part-time program. The BSN team chose to offer required nursing courses on a schedule designed for working adults; the classes were scheduled 1 day per week, with some Web-enhanced components. Electives were similarly scheduled. Ongoing curriculum development throughout instructional year one focused on syllabi development for year two courses and on program evaluation. At the end of instructional year one (2007–2008), with both UWT and OC having fulfilled the tenets of the MOU, OC assumed full responsibility for the RN-to-BSN program. Although the formal partnership reflected in the MOU was completed, the relationship continued to be supportive and collegial.
The BSN team conducted and wrote the self-study during the 2007–2008 academic year, and the CCNE accreditation visit occurred in spring 2009. The program earned full accreditation from CCNE for the RN-to-BSN degree, retroactive to spring 2009. The first cohort of RN-to-BSN students to graduate from an accredited program completed their degrees in June 2009.
The Northwest Commission on Colleges and Universities made an accreditation visit in fall 2009 and approved OC as a baccalaureate-conferring institution. This was a milestone for OC.
A Unique, Successful Partnership
Several factors contributed to the success of the partnership. The most important were OC’s and UWT’s mutual commitment to providing access to baccalaureate education to place-bound students, increasing the RN-to-BSN workforce in the region, and providing excellent nursing care to all clients. The BSN team at OC also made a commitment to meet the inherent challenges of program development. Finally, the initiative benefited from the significant experience the BSN team and other involved faculty had in nursing education, curriculum development, program evaluation, and nursing accreditation. The faculty were award-winning teachers and experienced clinicians.
At OC and UWT, there had been a history of positive working relationships. This trust laid the groundwork for the success of the partnership, which depended on open communication as well as confidentiality. Olympic College and UWT responded jointly to questions from colleagues, the Council of Nurse Educators in Washington State, review boards, and students. Olympic College had two crucial advantages as it embarked on this project: a well-established ADN program and the support of the OC president and the UWT chancellor, who wished to meet the need for baccalaureate education.
The BSN team faced challenges in titling the degree and in curriculum and infrastructure development. Early in the development of the RN-to-BSN program at OC, members of the Council of Nurse Educators in Washington State objected to the proposed degree being an “applied baccalaureate.” Responding to this concern, the State Board of Community and Technical Colleges instead approved the BSN degree. This titling was important to ensure that the BSN at OC was seen as equivalent to those offered by other colleges and universities.
Another challenge related to the time lines for the competitive process and program development. During a 2.5-year period, OC submitted a proposal for the RN-to-BSN to the State Board of Community and Technical Colleges and the Higher Education Coordinating Board at Washington State and received approval. The BSN team developed the curriculum, implemented the program, and sought CCNE accreditation. These activities required a tremendous amount of time and effort from the faculty, who were still maintaining their regular teaching responsibilities. The burden that this placed on faculty should not be underestimated as a challenge of developing the program.
Developing the academic infrastructure and transfer processes presented a third challenge. Olympic College and UWT found creative solutions for enrolling students concurrently at OC and UWT, for sharing records, and for facilitating the transfer of credits. Expanding the curriculum required augmenting the library collection and databases for the 300- and 400-level courses and seeking approval for new courses from the OC Instructional Policy Council. The Instructional Policy Council sought justification for courses that fulfilled more than one requirement, such as a 300-level nursing course in diversity that simultaneously meets both a social science and nursing distribution requirement. Doctorally prepared faculty taught 300- and 400-level courses in their areas of expertise, including medical genetics, anthropology, and health policy. Granting academic credits for passing the NCLEX®, which is standard practice throughout Washington State, was another feature of the RN-to-BSN degree. Through meetings and communication across OC, the RN-to-BSN program developed admission and graduation policies, residency requirements, financial aid principles, and standards for academic honors at graduation. These decisions will serve as precedents when other baccalaureate degrees follow at OC. Significant considerations included creating a schedule and curriculum that met the needs of the working RN learner (Altmann, 2011), potentially affecting the sustainability of the RN-to-BSN program.
The last two challenges related to recruiting doctorally prepared faculty. Because starting salaries in the community college were significantly less than those at public universities, it was difficult to compete for talented candidates. In addition, doctoral programs may not steer graduates toward careers at community colleges. The divided focus for faculty teaching in OC’s RN-to-BSN program—across the BSN, ADN, and practical nursing certificate programs—was unattractive to some candidates. The final challenge was whether to support differential salaries for teaching upper-division courses. The administration decided to use a single salary, rather than a two-tier pay structure, which would have required union approval.
Although many of the ongoing challenges may be similar to those faced by any RN-to-BSN program, several are unique to the community college baccalaureate (Delaney & Piscopo, 2004). The primary ongoing challenge is maintaining the excellence of the curriculum. An RN-to-BSN curriculum committee addresses this challenge by overseeing systematic program evaluation based on the new Essentials (AACN, 2008) document. The collaboration between OC and UWT continues, as faculty from both institutions work together to solve problems related to curriculum, evaluation, and teaching. The BSN team continually strives to maintain the integrity and rigor of the program while respecting faculty members’ academic freedom.
Developing students’ writing and public speaking skills requires ongoing efforts. The BSN team adopted and implemented competency benchmarks and rubrics in both areas. RN-to-BSN faculty strive to improve individual courses in response to changing needs and trends.
Faculty workload continues to be a challenge. At OC, the usual faculty workload does not take into account the differences between teaching lower and upper division courses. Additional challenges are associated with teaching learners who are RNs (Delaney & Piscopo, 2004; Robertson, Canary, Orr, Herberg, & Rutledge, 2010). For example, these individuals are likely to juggle multiple professional roles and work shifts, and they persistently challenge faculty to plan content applicable to practice.
As recruitment and retention of doctorally prepared faculty remains difficult, the College has supported existing faculty who wish to pursue doctoral education. Faculty have been granted flexible schedules and have received educational funds from the OC Foundation.
Implementation of the RN-to-BSN program has resulted in many positive outcomes—some expected and some unexpected. The major success of the RN-to-BSN program is reflected in the 51 BSN graduates in the region in the last 4 years. The BSN team has developed flexible program plans to meet the needs of working RNs, thereby facilitating access to baccalaureate education. Currently, options are available to complete the degree in 1, 2, or 3 years.
Achieving CCNE accreditation without recommendations was a major milestone. As hoped, many graduates have assumed leadership roles, enrolled in graduate programs, and been instrumental in evidence-based policy changes in workplace settings. Several of the RN-to-BSN graduates have presented their community health fieldwork projects at public venues, including the Washington State Public Health Conference.
The RN-to-BSN program has galvanized local partners to strengthen their relationships with OC. Harrison Medical Center, an industry partner, initiated a $2,500 annual tuition reimbursement policy for their RN workforce. Community members responded generously, donating scholarships that provide access to baccalaureate education. Another strong partnership is with the Kitsap Public Health District, which supported OC in ways that go beyond funding. For example, the Kitsap Public Health District director taught the community health course and has been instrumental in the development of related fieldwork sites.
The number of applicants to the RN-to-BSN program has steadily increased. Additional successes extend beyond the OC program and include more BSN-educated RNs practicing in the region. Those who earn a BSN degree now have the opportunity to pursue graduate education.
In addition, OC faculty served as fieldwork facilitators for UWT graduate students, and some are clinical affiliate faculty at UWT. Representatives from each institution serve on the other’s nursing advisory boards.
The most unexpected outcome of the RN-to-BSN program has been the positive trickle-down effect on the other OC nursing programs. For example, writing competency requirements have been implemented in both the practical nursing and ADN programs.
Suggestions for Obtaining Administrative Support
Because some administrators fear that a community college RN-to-BSN program poses a risk to ADN program sustainability, they must be reassured that it does not diminish the value of ADN education. It is important to emphasize that RN-to-BSN education is constructed on the basis of a strong ADN program. The community college RN-to-BSN is a cost-effective way to increase the number of BSNs to meet workforce demands.
Recommendations for Those Who Follow: What Is Needed
The Institute of Medicine’s report, the Future of Nursing (2010), has encouraged the goal of achieving an 80% baccalaureate-prepared workforce by 2020. On the basis of our experience, those planning an RN-to-BSN program should strive to ensure:
- Legislative support.
- Community support from industry and local health districts.
- Sustainable student enrollments.
- A program of learning that meets student and community needs.
- Flexible scheduling.
- Knowledgeable and supportive administrators and staff.
- Faculty are willing to accept the arduous challenges of program development.
- Institutional commitment of time and energy required to sustain an accredited program.
- Experienced colleagues in nursing education, program start up, and curriculum development.
When considering the creation of an RN-to-BSN program, faculty and staff should strive to eliminate potential obstacles, such as inconvenient class times, travel time, distance, and unnecessary duplication of courses—all of which are impediments (Altmann, 2011). Students should receive credits for passing the NCLEX, which signals to potential applicants that their past successes will be acknowledged (Spencer, 2008). Finally, it is helpful to have a professional partner, similar to UWT, willing to jumpstart the new program with faculty development, curriculum development, and a shared commitment to increasing access to RN-to-BSN education and excellent client care outcomes.
The OC and UWT partnership met the intent of the Washington State legislation to improve access to baccalaureate education for place-bound students in a high-wage, high-demand field. The partnership achieved its goals—making RN-to-BSN education opportunities available to place-bound students and developing and successfully implementing a CCNE-accredited program. For the OC faculty and their colleagues at UWT, the process was demanding and professionally stimulating. It required the investment of time and effort beyond normal workload expectations, spurred by a commitment to provide excellent nursing education. The venture resulted in more BSN-prepared RNs providing excellent nursing care, supporting the Institute of Medicine’s goal of having 80% of the RN workforce baccalaureate prepared by 2020. As a result of the RN-to-BSN program, OC is now accredited as a baccalaureate-conferring institution, facilitating the development of future baccalaureate degrees for place-bound students.
- Altmann, T.K. (2011). Registered nurses returning to school for a bachelor’s degree in nursing: Issues emerging from a meta-analysis of the research. Contemporary Nurse, 39, 256–272.
- American Association of Colleges of Nursing. (1998). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
- American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
- American Nurses Credentialing Center. (2012). Magnet Recognition Program® FAQ: Data and expected outcomes. Retrieved from http://www.nursecredentialing.org/FunctionalCategory/FAQs/DEO-FAQ.aspx
- Delaney, C. & Piscopo, B. (2004). RN-BSN programs: Associate degree and diploma nurses’ perceptions of the benefits and barriers to returning to school. Journal for Nurses in Staff Development, 20, 157–161. doi:10.1097/00124645-200407000-00001 [CrossRef]
- Engrossed Second Substitute House Bill 1794. (2005). State of Washington, 59th Legislature. Certification of enrollment. Retrieved from http://apps.leg.wa.gov/documents/billdocs/2005-06/Htm/Bills/Session%20Law%202005/1794-S2.sl.htm
- Glennon, K. (2005). Community college baccalaureate degrees: A review of issues, policies and other states’ programs. Retrieved from http://www4.nau.edu/insidenau/bumps/12_7_05/Four_year_degree_report.pdf
- Institute of Medicine. (2010). The future of nursing: Leading change, advancing health report recommendations. Washington, DC: Author. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx
- Olympic College. (1999). College catalog mission statement. Retrieved from http://www.olympic.edu/Campuses/AboutOC/mission.htm
- Robertson, S., Canary, C.W., Orr, M., Herberg, P. & Rutledge, D.N. (2010). Factors related to progression and graduation rates for RN-to-bachelor of science in nursing programs: Searching for realistic benchmarks. Journal of Professional Nursing, 26, 99–107. doi:10.1016/j.profnurs.2009.09.003 [CrossRef]
- Session Laws of the State of Washington. (2005). Baccalaureate Degree Programs. Chapter 258, Laws of 2005, 59th Legislature, 2005 Regular Session. Retrieved from http://www.leg.wa.gov/codereviser/documents/sessionlaw/2005pam1.pdf
- Spencer, J. (2008). Increasing RN-BSN enrollments: Facilitating articulation through curriculum reform. The Journal of Continuing Education in Nursing, 39, 307–313. doi:10.3928/00220124-20080701-12 [CrossRef]