ABINGTON, Pa. — Jennifer Matton is going to college for the third time, no easy thing with a job, church groups and four children with activities from lacrosse to Boy Scouts. She always planned to return to school, but as it turned out, she had little choice: her career depended on it.

Ms. Matton, a nurse, works at Abington Memorial Hospital, one of hundreds around the country that have started to require that their nurses have at least a bachelor’s degree in nursing. Many more hospitals prefer to hire those with such degrees.

That shift has contributed to a surge in enrollment in nursing courses at four-year colleges, particularly at the more than 600 schools that have opened “R.N. to B.S.N.” programs, for people who are already registered nurses to earn bachelor’s degrees. Fueled by the growth in online courses, enrollment in such programs is almost 90,000, up from fewer than 30,000 a decade ago, according to the American Association of Colleges of Nursing.

The need is so great that nurses without bachelor’s degrees are still in demand. But experts say that may change in years to come, particularly at hospitals, the largest segment of the profession and one of the best paid.

Enrollment in community college programs, the typical path to becoming a nurse, remains strong, but many of those schools are looking for new arrangements, like partnerships with four-year schools, to keep their graduates competitive.

Ms. Matton, 37, first went to college for an associate degree in radio and television broadcasting. By the time she returned to school for an associate’s in nursing, she was a wife and mother — she gave birth to her youngest a few days before taking an exam. Now she is weeks away from her third degree, a bachelor’s in nursing from Drexel University in Philadelphia, with most of the work done online.

“I wanted to get the bachelor’s at the start, but I needed to start earning some money,” said Ms. Matton, whose husband, Joel, is a computer programmer. “Now I need to do this for job security, to have opportunities down the road.”

Schools like Drexel have seized the opportunity. Its online R.N. to B.S.N. program began in the late 1990s with a few dozen students and today has 650. Over all, its College of Nursing and Health Professions has doubled over the last decade, to about 2,400 students, making it one of the nation’s largest.

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Nuring offers something for everyone, but too few nurses gravitate to the mental health field. "We can always use more qualified psych nurses," said Benjamin Evans, RN, DD, DNP, APN, PMHCNS-BC, associate vice president of behavioral health services at Bergen Regional Medical Center in Paramus, N.J. "But not a lot of folks come out of nursing school with an interest in psych."

Robin Krajewski, RN, MSN, NPP, director of network development and management at PSCH in Flushing, N.Y., has found people fearful of working in behavioral health.

"There’s still a stigma about mental illness, and people are afraid," Krajewski said.

However, she adds, the field needs more people with the skill to understand what others are going through and the ability to coordinate all aspects of the patients’ care.

"Nurses look at the whole person and have an advantage in working with people," Krajewski said. "I’d say to nurses, give it a try."

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Amy Robbins, RN, BSN, started blogging in 2006 to document her experience as a travel nurse. "I grew up writing in a journal and decided to start keeping at least a portion of my journal in the form of a blog," Robbins said. "I had a ton of pictures from different nursing assignments on my computer and wanted to put them on the internet and give them some context."

Robbins, author of the blog "Travel Nurse Aim" (www.TravelNursingJob.BlogSpot.com), still writes about her adventures as a travel nurse, but makes sure to omit patient and hospital names to abide by HIPAA laws.

Nurses blog for many reasons, including to educate and connect with others and for business reasons, said Nurse.com’s Donna Cardillo, RN, MA, who blogs on her website www.Nurse-Power.com and is an expert blogger on www.DoctorOz.com.

Blogging is an important marketing and credibility tool for nurses who start businesses, offer services or hold political positions. It’s a communication tool to connect with others — whether they are nurses in general or in the same specialty, patients or others.

"For some nurses, it is strictly a pastime — a form of self-expression," Cardillo said.

Getting started
To launch a blog, nurses first have to find or build a template. An easy approach is to use ready-to-go blogging platforms or templates. A few popular sites offering those are Nurse.com (www.Nurse.com/Blogs), Blogger (by Google, at www.Blogger.com) and the blogging option at www.WordPress.com. All are free.

Nurses who want to own their blogging domain names, or Web address, instead of having a space on an established blogger site, can buy their blogging homes. Robbins, who owns www.TravelNurseAim.com, said she pays about $8 a year for her domain.

To set up a domain name, bloggers must visit a domain registry site, such as www.GoDaddy.com. After purchasing a domain, they will have to decide where to host it and download a blogging platform, which is software to manage the blog such as www.WordPress.org.

Once you have a blogging home, the next step is to start writing.

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How have nurses responded to the rapidly changing health care system? By harnessing the power of advanced education, such as clinical simulation nursing, modern practitioners are taught to combine innovativeness, critical thinking, and insight with the age-old heart of the profession: the need to provide care and advocacy to the sick and vulnerable members of their communities for positive outcomes.

As hospitals, clinics, and care centers face challenges such as staffing and budgetary constraints, concern over cost of care, and a growing population of elderly and chronically ill patients, the role of nurses is expanding. No longer simply serving as caregivers, nurses are thought-leaders, publishing scientific research, addressing policy, and collaborating with colleagues to shrink knowledge gaps. They apply knowledge and their skills.

Technology is there to help guide the way. Nurses and patients alike are using mobile medical applications to track, train, and educate. And more and more tasks are going digital: test results, blood work, X-rays, and prescription fills can be completed with the touch of a screen. Even basic medical instruments are getting smarter, adapting to the needs of a single patient, while electronic medical records (EMRs), teleconferencing systems, and cloud computing systems allow nurses to examine trends via health information databases and multiple sources of patient information. Today's nurses have tools undreamt of by past generations and benefits of clinical simulation nursing training.

As the practice of nursing becomes more complex, these tools are essential. Education, which includes and clinical simulation nursing technology grant practitioners the ability to be caregivers as well as innovators, both learners and instructors. And in a world where patients are proactive in researching their own health and symptoms, nurses must be receptive to personalized need -- to guide users to trustworthy applications and websites, nurses must first educate themselves.

Clinical simulation nursing  education is critical to the evolution of the profession because it allows them to practice rare events repeatedly in a safe environment. Advanced degrees prepare nurses for unique challenges, and allow them to make difficult, on-the-spot decisions. But with sensitivity and an eye for innovation, modern nurses make a big difference in the care and safety of patients

Also read the article by Dr. Charles Tiffin, Provost, Capella University, who speculates on the changing role of today's nurses.

In 2007, Kurt Edwards figured he would be stacking and racking 80-pound boxes of dog food and celery in the back of a grocery store for the rest of his working life. And he was fine with that.

But that June, after nine years on the job, layoff notices arrived on the warehouse floor at the Farmer Jack store in Detroit where he worked. His employer, Great Atlantic and Pacific Tea Company, closed the Farmer Jack chain. Today he still does a lot of lifting, but of people, not boxes. Mr. Edwards joined the ranks of former warehouse, factory and autoworkers trading in their coveralls and job uncertainty for nurses’ scrubs.

At 49, divorced with no children, he now tends to patients on the graveyard shift at Sheffield Manor Nursing and Rehab Center, a two-story, gray brick building in a ramshackle neighborhood on Detroit’s west side. Interviewed last month, he says he is making about $70,000 annually, $20,000 more than he did at the warehouse.

The story of how he made the transition is one that men like him appear to be telling with increasing frequency, and the demand for their services is what is setting so many of them on similar paths.

Hard figures are elusive, but the Michigan Department of Energy, Labor and Economic Growth estimates a shortage of 18,000 nurses in the state by 2015 — and the labor force is adapting.

Oakland University in nearby Rochester, Mich., has established a program specifically to retrain autoworkers in nursing — about 50 a year since 2009. And the College of Nursing at Wayne State University in Detroit is enrolling a wide range of people switching to health careers, including former manufacturing workers, said Barbara Redman, its dean. “They bring age, experience and discipline,” she said.

David Pomerville brings a few more years than Mr. Edwards. A 57-year-old nursing student, he spent most of his career as an automotive vibration engineer, including almost 10 years at General Motors. His pink slip arrived in April 2009.

At the time, Mr. Pomerville was earning almost $110,000 a year at the General Motors Milford Proving Ground in Milford Township, Mich.

But having watched another round of bloodletting at G.M. three years earlier, he had already decided on nursing as his Plan B. “I thought, ‘Well, I worked on cars for this long, now I’m going to work on people for a while,’ ” he said.

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As more nurses, pharmacists and physical therapists claim this honorific, physicians are fighting back. For nurses, getting doctorates can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients. But so far, the new degrees have not brought higher fees from insurers for seeing patients or greater authority from states to prescribe medicines.

Nursing leaders say that their push to have more nurses earn doctorates has nothing to do with their fight of several decades in state legislatures to give nurses more autonomy, money and prescriptive power.

But many physicians are suspicious and say that once tens of thousands of nurses have doctorates, they will invariably seek more prescribing authority and more money. Otherwise, they ask, what is the point?

Dr. Roland Goertz, the board chairman of the American Academy of Family Physicians, says that physicians are worried that losing control over “doctor,” a word that has defined their profession for centuries, will be followed by the loss of control over the profession itself. He said that patients could be confused about the roles of various health professionals who all call themselves doctors.

“There is real concern that the use of the word ‘doctor’ will not be clear to patients,” he said.

So physicians and their allies are pushing legislative efforts to restrict who gets to use the title of doctor. A bill proposed in the New York State Senate would bar nurses from advertising themselves as doctors, no matter their degree. A law proposed in Congress would bar people from misrepresenting their education or license to practice. And laws already in effect in Arizona, Delaware and other states forbid nurses, pharmacists and others to use the title “doctor” unless they immediately identify their profession.

The deeper battle is over who gets to treat patients first. Pharmacists, physical therapists and nurses largely play secondary roles to physicians, since patients tend to go to them only after a prescription, a referral or instructions from a physician. By requiring doctorates of new entrants, leaders of the pharmacy and physical therapy professions hope their members will be able to treat patients directly and thereby get a larger share of money spent on patient care.

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Foundations in Newborn Care: Neonatal Care at the Moment of Birth: Using Simulation to Prepare the Nurse
By Deborah A. Raines PhD, RN, ANEF
Linda Ikuta
Advances in Neonatal Care, 2010

 Abstract 

Successful transition of the neonate from the intrauterine environment to
the extrauterine world is a complex and unique process. The assessments
and interventions of the nurse during these precious moments following
birthhave a dramatic impact on the well-being of the neonate. This article
reports on the development and implementation of a nursing situation
simulation focused on educating nurses for this role. Clinical simulation
has been shown to increase confidence and competence of nurses. Use
of simulation allows nurses to gain experience without placing the
patient at risk.

Read the entire article courtesy of NursingCenter.com