On my volunteer shift in the Emergency Room recently, I (along with many other staff members) overheard a heated discussion between a male patient and one of the charge nurses behind patient curtains. The patient was trying to clarify he wasn’t demanding a white nurse, but that he insisted on having an older female nurse. He did not want the black male nurse assigned to him. After the charge nurse explained his request would not be granted, he passionately responded that he wanted someone with more experience; to him, that implied an “older” nurse. The charge nurse assured him that his nurse had many years of experience. The patient assumed his nurse would be a woman because he thought all nurses were women. He argued he had been to the hospital numerous times and proclaimed, “I’ve never had a male nurse!” After some back and forth, the patient confessed he didn’t want a man handling his penis to insert a urinary catheter.
The whole interaction was interesting to me because I am an an older nursing student. When I become a new BSN grad, I will have relatively little experience but will be older than many new graduates. Age does not correlate to relevant work experience or skill-level. Many working nurses I encounter while volunteering may be younger than me, but have many more years of nursing experience. This patient erroneously believed an older nurse would automatically have more expertise in a common procedure than a young nurse.
The encounter was not only an example of ageism, but sexism. Yes, there seems to be more female nurses than male nurses. The patient was adamant that he never knew male nurses existed. The patient was an older man, so it’s quite possible his earlier experiences with nurses in a doctor’s office or hospitals were with female nurses. The demographics are changing, however, and quite frankly, I think that’s a good thing. We need healthcare professionals to be as diverse as the patients they serve. This patient needed a gentle reminder that experience, not gender, make nurses more skilled at procedures.
The black male nurse eventually did what needed to be done for the patient. A while later, the man graciously reported to the charge nurse, “He did a great job!” The patient continued to loudly and excitedly share what a surprisingly wonderful experience he had with his nurse. The same staff that overheard the earlier conversation and I looked at each other and smiled in amusement. Happily, it was a great teaching moment for the patient, but also for myself.
I’ve read about patients getting discriminated against or experiencing implicit bias from their providers, but healthcare professionals also experience discrimination from their patients, and the interaction I witnessed was a reminder of that. I have yet to have a patient make discriminating remarks directed towards me, but I know that may happen one day. I’m not quite sure how I’ll react, and I wonder if I’ll learn anything about this in my ABSN program. I want my patients to have the best experience and outcomes possible, but does that mean I should ask to be removed from their case if they don’t like me and are therefore uncomfortable due to my race, age, gender, or orientation? In accommodating a prejudiced patient’s request, are we enabling discrimination or giving them better care by making them comfortable? It’s a complex issue.
Luckily, the interaction I witnessed de-escalated and had a good outcome. What if the patient became more hostile instead of agreeable? Would he have been assigned another nurse? What if the patient thought his nurse did a terrible job? Are there hospital policies for situations like this? I really respect the charge nurse and nurse in the situation, who remained professional and respectful throughout the whole interaction. For me, I learned how a nurse should respond to a prejudiced patient: Be respectful but firm, and assure the patient they are in good care. I hope to maintain my composure and act the same way, should I ever encounter a similar situation with a patient.
I went to church Sunday morning with my family and saw the devotional booklet “Our Daily Bread” offered in the vestibule. I hadn’t seen one in a while, but became familiar with them through my mother and relatives from the Philippines, who used them regularly as a daily devotional. The booklet highlights a bible scripture each day and provides a reflection based on that reading. Feeling like I needed to focus more on my spirituality beyond church (it’s so hard sometimes to focus in mass with a rambunctious defiant toddler!), I grabbed one. The bible passage and reflection for that day (April 28, 2019) spoke to me. Because of that, I wanted to share it and invite you to read it at https://odb.org/2019/04/28/gods-retirement-plan/# .
At this moment in your life, what might God be calling you to do for His greater purpose? What new plans has He placed in your path?
Our Daily Bread (April 28, 2019)
The reflection was a great reminder of my second-career journey. Becoming a nurse is the new plan God has placed in my path. I feel I am called to become a nurse to better utilize my talents for His greater purpose. Do you ever feel like you’re on the right path because of the all the “signs” God places before you? You may not have the sign of a burning bush like Moses, but do you feel called to do something, even though you’re uncertain of how exactly you’ll accomplish what you sense you must do? Are you continuously driven towards a vocation without knowing how or if you can really make it happen? And, somehow, a path reveals itself? I feel this way about Nursing – really, I do!
Every step of the way, I feel like God has aligned things for me to allow me to get into Nursing school. If I had waited even one month to look into pre-requisites, I wouldn’t have been able to take the classes I did or complete them before the application cycle. If I had waited one week before researching how to get volunteer clinical experiences, I wouldn’t have become a COPE Health Scholar in a local hospital. If I were in a different volunteer program, I wouldn’t have been able to take patients’ vitals, witness biopsies, circumcisions, C-sections, vaginal deliveries, or perform chest compressions on patients who have coded. God placed people and experiences in my life, to allow me to grow in my compassion, abilities, and skills as a future nurse. Somehow, things aligned or confirmed and re-affirmed my choice to purse a career change. God placed the desire in my heart to consider nursing years ago, but He did not call me into action until now -when I have the social, emotional, and financial support I didn’t have before. His timing was perfect. I prayed to be able to serve God in whichever way He willed, and nursing is where I have now been lead. I have a peace and joy in my heart when I think about my [future] career, but I am still open to God’s vocational plans for me in my life.
Are you called to something new or to continue when you were about to quit? I encourage you to be open to new possibilities or to where God might be calling you. Explore what or where that is, and if you’re called to act, pursue it whole-heartedly. Like Dr. Warwick Rodwell discovering the ancient statue in the Lichfield Cathedral in the “Our Daily Bread” reflection, you could be surprised with the treasure you uncover.
Attended my nursing school orientation yesterday and had uniform fittings… we will wear white scrub tops but black scrub bottoms (thank goodness it’s not all-white)!! I’m so excited to be moving forward in this journey!
When I decided to become a nurse, I researched various nursing schools and programs and quickly discovered before I could even apply or be eligible to attend a program, I needed to complete pre-requisites (classes required BEFORE Nursing school entry). The nursing programs I considered required anywhere from 7-12 pre-requisites. Common pre-requisite courses include Anatomy and Physiology (with lab), Microbiology (with lab), and Chemistry. However, some schools require Public Speaking, Ethics, Religion, or other courses unique to their program.
While some schools take into consideration courses completed as part of a bachelor’s degree, other nursing schools do not accept any courses if they were not completed within the last 5 or 7 years. So even though I took numerous chemistry classes as part of my Chemical Engineering degree, since it was greater than 5-7 years ago, I had to retake chemistry! Overall, while I was annoyed at first, (re-)taking chemistry was helpful because it introduced me to some cool classmates and teachers and provided a nice review to help prepare me for the TEAS (more on that in another post!).
It is CRITICAL for applicants to know what schools and specific programs they wish to attend because pre-requisites vary – even within the same school – across different programs. As I shared, I took Chemistry with Lab at my local community college to satisfy a pre-requisite requirement for a state university. However, the community college offered two different Introductory/General Chemistry courses and some nursing programs require the Introduction to General Chemistry course instead of the Introductory Chemistry course. After spending an entire summer in Introductory Chemistry lecture and lab, my lab partner discovered the course we completed was not eligible as a pre-requisite to her desired nursing program. The community college guidance counselor had told her that the course was accepted at her school of choice. Even the course description for our chemistry class stated “This course is designed for Nursing and other Allied Health majors”. Unfortunately, when the class ended, my friend discovered that her program did not accept the chemistry class we worked hard to complete.
She called me in a panic when she learned of the news because I planned to apply to the same school. My heart stopped when she told me – I had spent so much time researching the classes I was taking and ensuring they counted as pre-requisites – could I have been mistaken? My ability to apply to nursing programs in the Fall was contingent upon the completion of my carefully scheduled pre-requisites. After some back and forth, we discovered the accelerated BSN program at the state university accepted the chemistry course we completed, while the traditional BSN program (at the same school!) did not. I felt terrible for her. Fortunately, she did well in our class, so her GPA was not adversely affected, and I’m sure the knowledge she gained will only help her when she takes the other General Chemistry course. She shared she was in no rush to apply to nursing programs, so having to take an extra chemistry class did not affect her plans too much.
Unlike my friend, I couldn’t afford taking classes that did not count as pre-requisites. I was working hard to complete as many pre-requisites as possible in order to apply to Nursing programs by Fall 2018. It was tricky and definitely not easy, but I completed thirteen pre-requisites within a year while either working or volunteering. I got accepted into three different accelerated Nursing programs, so my hard work and meticulous planning paid off. Below are some steps that I recommend and used myself to navigate what pre-requisites to take for nursing:
Step 1: Identify the specific nursing programs in which you are interested in applying.
Knowing where you plan to apply dictates which pre-requisites to take and possibly when to take them. Many programs will not allow you to apply unless you complete all science pre-requisites. Some programs will allow you to apply without completing pre-requisites so long as you show progress that you will complete the rest of the pre-requisites before the program begins. However, even if you can apply to programs without completing all pre-requisites, having more pre-requisites completed (and obviously doing well in them) makes you a more attractive applicant than others who have not completed their pre-requisites.
Step 2: Understand the pre-requisites for each nursing program and list them in a spreadsheet
I listed all the programs in which I was interested and listed all the pre-requisites required for each program. Like a typical nerd-engineer, I created a spreadsheet with this information. By doing this I was able to quickly identify which program had the least or most requirements and which programs had overlapping pre-requisites. I also used the same spreadsheet to compare program costs, duration, and other entrance requirements. It gave me a good overview that I could reference periodically.
Step 3: Before taking a class, check with your prospective program if they accept the class as a pre-requisite
Of course you can take pre-requisites from the college or university which offers your prospective nursing program. Doing so guarantees that your program will accept your pre-requisites. To save money, however, many opt to take their pre-requisites elsewhere, such as a community college. Or, some students, like myself, may need to take pre-requisites at a college that offers evening and weekend classes to accommodate work or family schedules. If you take a class offered elsewhere than the college where your nursing program belongs, ensure the classes transfer and can count as pre-requisites for your program.
Some colleges have links or list what classes they accept to fulfill pre-Nursing requirements. Others will allow you to specifically contact them to ask if a class meets their requirements. Contact the program administrator or director to inquire if they accept a class as a pre-requisite. Be prepared to share the accredited school’s name where the class is offered, the course name and number, the number of units, and course description. You can also follow this process to verify if any previous course you completed counts as a pre-requisite.
I recommend verifying pre-requisite equivalency and printing out proof of this for each class taken as a pre-requisite. Sometimes equivalencies change, but at least you’ll have evidence that the class you took was considered equivalent when you took it. Plus, doing this for myself gave me a quick reference and peace of mind in moments of doubt and panic (like when my friend contacted me about our chemistry class).
TIP: Keep your pre-requisite syllabi. My Anatomy & Physiology II professor recommended keeping syllabi from all my pre-requisites. Luckily, I didn’t have to resort to using any past syllabi, but having syllabi is helpful to have on-hand in case your prospective school wants to review a class you took and needs more than the general catalog description.
TIP for Californians: Use http://www.assist.org . It’s a helpful website “that shows how course credits earned at one public California college or university can be applied when transferred to another”. If you plan to apply to public college or university in California for your nursing program, you can verify if the pre-requisites you are taking at a California public college/university are accepted by your program.
Step 4: Determine where and when the classes are offered, and create a corresponding class schedule
I created a GANTT chart outlining when certain classes were offered and the schools that offered them. This was important in realistically understanding the earliest I could apply to nursing programs and how much it might cost me to complete all the pre-requisites. I knew I wanted to complete 13 pre-requisites in one year, but not all classes are offered throughout the year nor do they perfectly stagger with one another. I had to figure out if I could take classes online (some nursing programs do NOT accept online courses for certain pre-requisites), which schools offered the courses I needed, and when my schedule would allow me to take in-person classes.
After considering my budget and schedule, I limited myself to taking pre-requisites at my local community college and at National University. Both are great options that I recommend to others. At the community college, I appreciated knowing exactly what courses transferred from the college to other state schools via assist.org and the extremely affordable tuition. Some community college courses even used free online textbooks! At National University, I liked the small class size, that each course was only 1-2 months, the evening and weekend schedules for in-person classes, and the fact that most all my classmates were pre-Nursing. In addition, most of the National University students had worked before or were currently working, so could appreciate pursuing Nursing as a second-career.
I evaluated each of my pre-requisites and figured out when they would be offered at either the community college (preferred, cheaper choice) or National University (approximately 10 times the cost of community college courses). Some classes offered at the community college (Anatomy & Physiology) required pre-requisites (Biology), so it was easy to choose National University for such classes. Using the GANTT chart, I calendarized each pre-requisite class I planned to take, the school offering the class, and the specific discussion section(s) I wanted, once the class schedule became available.
Step 5: Execute according to your planned schedule, and adjust as needed.
As soon as I was able to register for classes, I immediately enrolled prior to the semester, quarter, and/or month. I never had a problem getting into the classes I needed. (Although, a friend shared whenever she had the issue of being wait listed at her community college, she would still attend class and eventually get enrolled). I also captured the anticipated nursing school application deadlines in the GANTT chart, so it would be clear which pre-requisites would be completed before applications were due.
By creating my GANTT chart, I could get a sense of my anticipated course load throughout the year and see where my classes overlapped. I was able to see that I had the opportunity to take the Chemistry class earlier than I originally planned as well as some Philosophy courses (pre-requisites unique to one program). Instead of taking Chemistry in the Fall semester, I took it in Summer. This allowed me to squeeze in an extra Philosophy class in the Fall and gave me a good review of Chemistry before taking the TEAS in November. (TEAS TIP: Completing your pre-requisites before the TEAS makes TEAS preparation easier)!
Due to work and my overall schedule, more often than not, I ended up taking condensed courses. Even though National University offers classes that are only 1-2 months in duration, the community college also condensed classes. Classes normally a semester long were only 4-6 weeks when I took it. I would not have purposely scheduled my pre-requisites this way, but 1) it allowed me to complete thirteen pre-requisites in only one year, and 2) this prepared me for the rigor I will likely experience in my accelerated Nursing program.
While my schedule was rigorous, I had the full emotional and financial support of my family. With their support and understanding, I was able to study enough to get A’s on my pre-requisites while either working or volunteering in a hospital. My undergraduate GPA barely met minimum Nursing school requirements, so I knew I had to do well in my pre-requisites to stand a chance in getting accepted into any prospective programs. With God’s grace and a lot of hard work and effort, I was able to excel in my pre-requisite courses which helped me get into several accelerated Nursing programs.
Overall, you will need to decide what you can or cannot handle and what resources you need to stick to your schedule. Keep in mind that many nursing programs will not consider applicants with C-grades for their science pre-requisites. Additionally, accelerated nursing programs are extremely competitive, so having a good GPA on pre-requisite courses is advantageous. Maybe you’ll need to cut back on work hours or find childcare to give you time to study. If neither is possible and you’re drowning in schoolwork and unable to do well, perhaps consider a lighter course load. Not only do you want to complete the correct pre-requisites, you want to do well in them, so adjust your schedule accordingly!
I want to share a prayer/meditation a dear friend shared with me, right before she told me she would change career directions from Law to Medicine. This prayer/meditation, “Your Heart’s Desire” helped motivate her as she discerned moving and leaving Southern California to attend medical school in Poland. I love this prayer/poem, but neither my friend or I know who wrote it.
“Your Heart’s Desire” is inspiring and speaks to the idea that we all have a calling in life. Your “vocation” might be your occupation or profession, but per its Latin roots, your vocation is also your “calling” or your “summons” in life. I feel like this calling to become a nurse was clear for me only recently – it could have been God’s timing or perhaps my stubbornness and inability to listen – but I truly feel called and drawn to nursing after many years of working as an engineer. Maybe I needed to fulfill my calling to become a wife and mother before becoming a nurse, who knows? Either way, I hope you enjoy this prayer/meditation and that maybe it speaks to you, too:
“Already in your past life from time to time, God has whispered into your heart just that very wonderful thing, whatever it is, that He is wishing you to be, and to do, and to have. And that wonderful thing is nothing less than what is called Your Heart’s Desire. Nothing less than that. The most secret, sacred wish that lies deep down at the bottom of your heart, the wonderful thing that you hardly dare to look at, or to think about–the thing that you would rather die than have anyone else know of, because it seems to be so far beyond anything that you are, or have at the present time, that you fear that you would be cruelly ridiculed if the mere thought of it were known–that is just the very thing that God is wishing you to do or to be for Him. And the birth of that marvelous wish in your soul–the dawning of that secret dream–was the Voice of God Himself telling you to arise and come up higher because He had need of you.”
If you have wondered about becoming a registered nurse (RN) but have not started to really look into it, you may not know what kind of education or degree you need to become an RN. There are various pathways to nursing. Each individual must consider which path is best for his or her unique situation. However, all pathways (in the US) eventually lead to the National Council Licensure Examination (NCLEX), which is the exam that ultimately determines whether or not someone becomes a registered nurse. Regardless of your background or degree, all aspiring RNs must pass the NCLEX in order to become a licensed registered nurse. Now that you know the NCLEX is the common gateway to obtaining an RN license, let’s discuss the three pre-licensure degrees you could obtain prior to taking the NCLEX: the Associate Degree in Nursing (ADN), the Bachelor of Science Degree in Nursing (BSN), and the entry-level Masters Degree in Nursing (MSN-E).
You do not need a BSN in order to become a nurse; you may become an RN with an Associate’s Degree. Many ADN programs are only a couple of years long and are a fraction of the cost of BSN programs. Unfortunately, many ADN programs are known for their two-year waitlists and are just as competitive to enter as any other nursing degree program. If you can get into an ADN program, however, this is a great affordable option to become a nurse.
Many wonderful and established nurses I know have ADNs. Numerous facilities and hospitals do indeed hire new-grads with ADNs. However, certain hospitals have (or desire) magnet status and require a large percentage of their nurses to have a BSN, and thus prefer BSN graduates. Other hospitals may require nurses with ADNs to pursue a BSN within a certain timeframe from their date of hire or require 20 years of experience for ADN graduates. Some hospital nurses with ADNs acknowledge that they are able to work in their hospital or hold their supervisory role because they have many years of experience. They notice that most of the new hires in their hospital are BSN graduates.
ADN to BSN
As a result of this push to have a nursing workforce filled with BSN degree-holders, there are many RN to BSN programs designed specifically for nurses with ADNs. There are hospitals that will reimburse or partially pay for their nurses with ADNs to pursue BSNs. If you do not mind working while going to school or extending the time you spend in school to get a BSN, getting an ADN first may be the most economical way to eventually getting a BSN. It is not necessary to have a BSN to work as a nurse, but having an advanced degree may make you a more attractive candidate when applying for competitive jobs against those with similar work experience.
If you decide to get a BSN directly, you can apply to traditional 3-4 year programs. Program costs vary and depend on whether or not you attend a public or private school. There’s a general sentiment that nursing programs in public schools have lower acceptance rates than their more expensive private school counterparts.
If you have a bachelor of science in a non-nursing field, consider applying to an accelerated BSN program, which lasts only 1-2 years. The shorter program time can be worth the cost if you start working as a nurse sooner. Your opportunity cost of income lost while you are in school could be minimized with a shorter program length. However, such condensed programs are intense and “accelerated”, as their name implies.
If you have a non-nursing bachelor of science degree, you also could consider applying to entry-level Master of Science in Nursing (MSN-E) programs, which are typically two years duration. Maybe you don’t want to spend time getting a bachelor degree in Nursing; you’d rather go straight into a master’s program because you ultimately desire to be an advanced practice nurse. If you want to be a nurse educator or clinical nurse leader, many entry-level master’s programs are perfect for you. However, if you want to become a nurse practitioner, entry-level master’s programs that I’ve reviewed are not applicable towards becoming a nurse practitioner – a second graduate degree would be required.
If you want an MSN, do not feel pressured to obtain one immediately. You can become a registered nurse with a lower degree. Just as ADN graduates can get their BSNs after becoming an RN, BSN graduates can also further their education after obtaining their license to get advanced degrees in nursing.
Begin with the End
It’s important to think about your longer-term goals as you consider the various pathways to Nursing. Always “begin with the end in mind”, as Franklin Covey suggests. If you want to work in a magnet hospital as a new grad, perhaps you will want to bypass the ADN option for nursing. If you want to work as an RN as quickly as possible, consider the ADN or accelerated BSN options. Take into account private schools without waitlists. Research the job requirements for RNs at the places you would like to work or the requirements for your dream nursing job. Job postings typically list education and experience required for each position and can give you an idea of the degree(s) you should target.
Very simply, an RN is someone who has passed the NCLEX with either an ADN, BSN, or MSN-E. You now know there are many degree programs that can lead you to become an RN. Knowing what you want to do as a nurse, how quickly you want to get there, and how much you are willing (or able) to spend will help decide which route may be best for you. Regardless of what route you take, please ensure the nursing program you choose is accredited. Good luck on your journey!
Disclaimer: I speak only from my own personal experience and am not an expert in all things Nursing. If you know of other pathways to nursing and becoming an RN, I would enjoy your feedback. I invite readers to share any information or comments that would be helpful to others!
I created “The Mature Student Nurse” because I found it complex to navigate the journey of becoming a second-career nurse. I had worked for many years as an engineer and scientist before deciding to pursue Nursing as a career change. While I had years of discernment and thought about changing careers before, I had no single resource to guide me in how to become a nurse let alone how to apply and get into nursing schools once I decided to make that leap into Nursing. I had not been in school for many years and had no guidance counselor to turn to for advice; I had to advocate for myself and figure things out on my own. I am a wife and mother and an only child to aging parents – I had to carefully consider how my choices would affect my family. Ultimately, my family has been very supportive, and I couldn’t have pursued this career change without them.
In 2018, I completed thirteen pre-requisites, began volunteering at a hospital, and applied to various accelerated Nursing programs. I have been accepted into a couple programs so far, and I hope to hear from the rest this Spring! I plan to start a Nursing program Spring/Summer 2019.
Throughout my journey, I frequently thought about how it might be helpful to others to share what I’ve learned. While I know it won’t be perfect, I wanted to take a first step to share what I know with others. To quote Robert Schuller: “It’s better to do something imperfectly than to do nothing perfectly”.
If you are an aspiring nurse, I hope this site inspires you or that you’re able to find something useful for you here. It is my privilege to offer some encouragement or guidance to others on a similar path. Good luck to you on your journey!