How do you manage stress? Attending school as an older student or pursuing a second career can be stressful. Being a caregiver for aging parents or other family members while working and taking classes can be stressful. Trying to balance parenting and being a nursing or pre-nursing student can be stressful. Do you have a strategy for handling such stress?
My work enrolled me in training last year, where this stress buster wheel was presented and discussed. The stress buster wheel captures evidence-based strategies for toxic stress intervention. The training was for caregivers and healthcare workers to screen and treat patients for Adverse Childhood Experiences (ACEs). However, the stress-buster strategies are an excellent reference for anyone experiencing stress. Do you employ any of these strategies for yourself? Are there ones you’d like to try or implement more?
I like combining several stress busters by going on garden walks or hikes through nature with friends. I connected with a friend (outside of school or class) at least weekly during nursing school to maintain supportive relationships. This helped bring balance into my life, especially when I sometimes felt consumed by my intense 15-month accelerated BSN program. Now that I’ve graduated, I continue this practice to connect with friends regularly.
I viewed this coaching/motivational video (https://www.youtube.com/watch?v=oDzfZOfNki4) by Duke Women’s Basketball’s Kara Lawson about how we need to “Handle Hard Better.” I share this post and video to motivate you as we reflect and head toward the weekend. Things get more challenging as we grow, develop, and learn. We become more skilled and adept at facing what’s in front of us. Again, things didn’t get easier – we just got better! We learned to handle hard better.
Another way to look at it: Walking was once difficult, but once I mastered that, I learned to use the stairs, jump, and eventually run. Once we become comfortable handling what we once thought was a challenge, it’s time to take on a new challenge to continue our growth and development. I didn’t even get “comfortable” with my old job or feel like I “mastered” it, yet I left and started a new one! I left my previous NICU (Level 2) to move to a higher acuity NICU (Level 4) because I knew I wanted to be able to handle more seriously ill patients.
I completed my first week with my preceptors at my new job, and it was a little overwhelming. Moving from a Level 2 NICU to a Level 4 NICU feels like a big jump. There’s so much to learn! In some ways, I feel like a new grad nurse all over again and have to familiarize myself with new equipment, processes, and diseases for my higher acuity patients. The video is a reminder to “handle hard better.” The way I handle hard better is to practice and expand my skills and to be willing to learn and open to coaching. I reflect on my performance and search for ways to improve. The way I handle hard is to do what I can to make myself better.
What does that look like for me? I am making report sheets or brains that work for me on my new unit and make me more efficient. I am learning about different disease processes by reading about them and watching YouTube videos. I am giving shift report even though I don’t feel like I’m ready because “doing” is better practice for me than “watching”. I’m learning the new charting system and what my new hospital requires for each shift. I’m learning about the workflow and general day-to-day schedule and expectations. I’m reflecting on my week by writing this post…and I’m giving myself grace that I’m still learning and will improve with more practice and time.
You may be hesitant to pursue a new job or career. You may be reluctant to go back to school. I am here to encourage you. I have met many second-career nurses, older students, and moms returning to college or joining nursing school since I became a nurse. My story is not unique. I share my life as a second-career nurse hoping to inspire others to pursue their dreams even when circumstances may seem hard. You can do it – you can “handle hard better”! Good luck on your journey!
NICU nurses in my hospital are responsible for putting IVs in our neonatal patients. We don’t have an IV team to do it for us, and often, our nurses are called to other units when other units have difficulty putting IVs in babies. Regardless, IV placement is an essential nursing skill, and putting IVs in infants is different than putting IVs in adults. For adults, I can usually see or palpate (feel) veins. For babies, it can be difficult to see veins, and I’ve never been able to palpate them. It had been a while since I placed an IV in a baby, so I asked and volunteered to do it for a colleague needing to replace an IV in her patient on my last shift.
I placed the IV in the patient, but not without almost giving myself a needle stick (I dropped the needle, and it rolled away from me before I could retract it) and having some blood splash from quickly releasing a used hub on a bedside table. I’ve never come close to giving myself a needle stick, nor have I created such a mess from attempting to place an IV. Senior nurses were present to help me hold down the baby and hold up a vein finder. I felt like I was fumbling through the process with an audience. I hadn’t worked with these nurses before to place an IV because I was still new to the night shift. And while I eventually got the IV in, I felt foolish with how long it took and how I splashed blood on the table. I’m embarrassed that this is the first impression I’ve given these nurses on my IV skills. In a way, however, it was confirmation that I needed the practice.
While I was placing the IV on my colleague’s patient, the IV on my patient stopped working and needed replacement. As soon as I placed the IV on my colleague’s patient, I hurried to my patient’s isolette. I attempted to put a new IV on my patient, got it during my second attempt (the vein blew during the first attempt), but then accidentally pulled out the catheter as I tried to remove the tape and Tegaderm to retape the IV. It had stopped flushing smoothly, and the other nurse and I thought we could retape it to prevent it from getting kinked or occluded. As a guideline, a different nurse should take over the IV placement after two unsuccessful attempts. I stopped with further IV attempts on my patient beyond my two tries but got the lesson to remove tape individually so as not to pull out an entire catheter when retaping. (I had initially tried pulling off the tape before the Tegaderm, but it was hard to separate it from the Tegaderm). My colleagues eventually got a new IV in my patient. I appreciate the teamwork, but I still feel embarrassed by how I kept “messing up.”
I wanted IV practice on my last shift, and the universe gave me multiple chances! As humbling as my previous shift was, I realize the only way to improve my nursing skills is with experience and practicing essential skills: I will be more consistent and successful at putting in IVs only by putting in more IVs. Luckily, NICU nurses support each other and help and assist one another during IV placements. However, there are times when the unit is busy, and nurses may not always be available to help each other. I want to feel more confident with doing IV placement alone. I will have to request to do IVs whenever there is a chance.
Sometimes, it feels weird to be older and yet so new in work experience. I must remind myself and give myself the grace that I am still relatively new to my profession. There’s a lot I’m still learning to do that senior nurses do effortlessly and automatically. And even the most experienced nurses make mistakes or are sometimes unable to get an IV placed on the first try. I can’t expect perfection, but I can at least aim for improvement.
Across the country, the school year has started for many college students. Students might wonder how to stay organized or manage their time. When I began the journey to become a second-career nurse, I was balancing school, work, parenting, and my personal life. Having a planner was critical for me to manage my time. Below is a list of seven things I included in my planner and recommend students to include in theirs – the last one may surprise you!
Class times. Put in all your scheduled lectures, discussion sections, clinicals, & labs.
Class dates of quizzes, exams, and project due dates. Take the syllabus at the beginning of the semester or quarter and jot down when all the quizzes, exams, practicums, & project deadlines are taking place. Use a different color or shape to identify these in your calendar quickly. I would use blue for quizzes and red for exams or significant projects. The color coding allowed me to easily see when something was coming up and when I needed to study or prepare for something that would impact my grade.
Commute time. I live in Los Angeles, and sometimes commutes can take an hour or more to/from school or work. It’s important to factor this in if commutes can be lengthy in your area, especially if you are responsible for daycare or preschool drop-offs & pickups. Remember to factor in parking as well since that may add to the time it takes to get to a destination. Some people have to park in a garage or lot far from the building where they work, have classes, or have clinical. One of my clinicals took place in a hospital that was a 15-20 minute walk through a tunnel and stairways from the parking lot where we were assigned. If you forget to factor in the extra time it takes to park and walk to your destination, you can end up being late.
Other family members’ schedules. Your family’s schedule is essential. I put in when my parents need me to give them rides to doctor’s appointments or dental procedures. I also add my husband’s business trips (meaning I’m single-parenting my daughter while he travels) or when my daughter has dance, sports, religious education, classmate birthday parties, or school events.
Meals, sleep, & shower/hygiene schedule. If you need 6-8 hours of sleep to function, make sure you schedule it in your calendar. I say this because my targeted bedtimes would sometimes surprise me based on how early I’d need to get up for my commute, etc. Sleep schedules are also important to note if you have children or other family members who require your help to get ready for bed or to get ready for their day.
Study time. The other mom in my nursing program and I found it challenging to study at home once our kids were out of school. I sometimes booked a private room in a library or computer lab to study. Mostly, I would use my spare time to read or do homework between classes or before class if I arrived at school early. I recommend scheduling studying time to realistically determine how much time you have to study, especially if you have other competing obligations such as family or work.
Events or activities that nourish me or bring me joy. I also color-coded these events or activities to quickly glance at my calendar and see that I planned something fun each week. This one activity was not an obligation or part of a busy to-do checklist of duties. It was something I looked forward to doing and had nothing to do with school. I recommend including at least one weekly activity that replenishes you and brings you joy or comfort. Make it happen. The activity could be family game night, happy hour, facetime with a long-distance friend, attending a party, reading a book, yoga, hiking, painting, baking, massage, seeing a musical, or going on a mini-retreat. Each person has different interests and things that bring them joy. Make sure you know what that is for yourself. Ensure you are doing something for yourself at least once a week that helps you reset. You may be a student balancing many things in life, but you’re not a robot. You are a human and have other interests and desires outside of school. Make sure you regularly do things that light you up!
When I had my baby, my husband and I struggled to feed our newborn. I wanted to breastfeed my baby exclusively, but she would not breastfeed well. Influenced by various sources and committed to breastfeeding, I refused to pump or bottle-feed my baby while in the hospital. My baby and I roomed in together while I tried to breastfeed. My husband recalls having to travel with my baby somewhere for light therapy. I vaguely remember this too, but I was tired, delirious from lack of sleep, and recovering from a C-section. I only remember sleeping while my husband and baby were out of the room. In retrospect, my baby most likely went to the NICU because she was jaundiced. She may have been there for only a few hours because I remember waking when my baby and husband returned from wherever they went. Thankfully, the hospital did not admit my baby to the NICU, and we could leave the hospital together. However, our struggles to feed our newborn continued when we got home. Looking back at our experience as new parents, I wish I had known some things about feeding our baby that I know now as an experienced mom and NICU nurse.
Photo by Helena Jankoviu010dovu00e1 Kovu00e1u010dovu00e1 on Pexels.com
Fed is Best
As a NICU nurse, I see term or late pre-term infants (born at 34-37 weeks gestation) who come to our NICU for hypoglycemia (low blood sugar) or hyperbilirubinemia (seen as jaundice/yellowish skin). Often, these term babies come to our unit because they are not eating well. For some babies, parents refuse to feed baby formula while postpartum, and the mom may not have established her breastmilk supply yet. This description reflected us as newborn parents and a likely reason why my baby needed phototherapy.
A build-up of bilirubin in a baby’s body can cause jaundice. Bilirubin is usually processed by the liver and leaves the body as waste. A newborn’s liver may not yet efficiently function, but the baby should be eating/drinking something to produce waste and encourage processing out bilirubin. A newborn baby drinking breastmilk or formula helps curtail jaundice. If a baby is not feeding well or is still jaundiced despite attempted feedings, however, hospitals can treat elevated bilirubin levels (hyperbilirubinemia) through light phototherapy.
Jaundice is normal in newborns, but the hospital monitors bilirubin levels and treats when levels rise above certain thresholds. If the baby’s bilirubin is too high, brain damage can occur. In our hospital, if a postpartum baby needs phototherapy, the baby is admitted to the NICU. Phototherapy in the NICU only happens after multiple attempted feedings and when bilirubin levels exceed treatment thresholds.
Frequent feedings are how parents can reduce bilirubin levels in otherwise healthy babies (and hopefully prevent hyperbilirubinemia that requires NICU care). However, frequent feedings can also help prevent another common condition in our NICU: hypoglycemia, or low blood sugar. If an otherwise healthy baby born to a non-diabetic mom takes enough breastmilk or formula, the baby can usually avoid hypoglycemia. However, if the baby is unable to feed adequately, the baby can develop low blood sugar.
Before a baby goes to the NICU for hypoglycemia treatment and monitoring, the mother and the postpartum staff will attempt to feed the baby. If the mother consents, the baby can be offered formula. If bottle-feeding is still insufficient, a sugar gel is given to the baby orally. The postpartum unit will attempt several feeding and sugar gel administrations before the baby goes to the NICU. If the NICU admits a baby for hypoglycemia, we will place an IV to deliver sugar to the baby as IV fluids. Once the sugar levels in the baby are sufficient, and the baby is drinking adequately, we can reduce the IV fluids and eventually remove IV fluids if the baby can orally consume the needed calories and fluids while maintaining healthy blood sugar and hydration. In the NICU, we try feeding our babies breastmilk if it’s available and not contraindicated (i.e., substance-abusing mother). If breastmilk is unavailable and we need to feed a baby orally, we will give provider-ordered formula to our babies.
For babies admitted for hyperbilirubinemia or hypoglycemia, I sometimes hear the baby barely drank anything because the baby was unable to breastfeed from a mom who wanted only to breastfeed exclusively. Before doctors send the baby to the NICU, the nurses can offer the baby formula if the mom consents or requests it. However, by this time, the baby may have worn themselves out or be too tired to drink from the bottle. It makes me and other NICU nurses wonder, “If the parent or nurses fed the baby from the bottle sooner, would the baby still need to go to the NICU? Is the mother promptly informed of her options if her milk supply hasn’t come in or the baby cannot latch or breastfeed?”
While I’m glad my husband got to go with my baby and accompany her for phototherapy, I would have preferred that my baby not leave my postpartum room at all for treatment or tests. To prevent my daughter from needing to leave our room, I would have pumped sooner to encourage my milk supply and produce milk that my husband or I could bottle-feed my baby. We did not learn until weeks later that my daughter was tongue- and lip-tied, which may have initially made it difficult for her to breastfeed. From my perspective, it’s better to feed a newborn some formula to keep the baby with mom and out of the NICU than to rely solely on breastmilk that may not be available yet or difficult for the baby to access.
Pumping is Okay
I was offered to pump in the hospital but refused, thinking I would breastfeed. My doula recommended not to pump until after the first month, so I tried holding off on pumping in an attempt to have my baby latch, help establish our breastfeeding rhythm, and set my breastmilk supply.
I didn’t want to feed her from a bottle because I didn’t want to cause nipple confusion and have my baby prefer the bottle over breastfeeding. When we got home, I thought I was doing okay breastfeeding, but when we brought our baby to her 1-week checkup, she wasn’t gaining enough weight. We brought her to her 2-week checkup, and her pediatrician still didn’t think she was gaining enough. My daughter fell in the 2nd percentile on the growth chart. (I did not discover until months later that my husband and his siblings were so small as newborns they were not even on the growth chart). We were strongly encouraged to start bottle feeding her formula.
Wrought with guilt, we decided to feed her some formula, and I began to pump. By this time, I had developed mastitis (Mastitis is a painful infection in the breast caused by bacteria introduced by breastfeeding. It also caused me to have body aches, a high fever, and chills. Imagine dealing with this while trying to care for a newborn!) My supply was woefully insufficient, and most of my daughter’s caloric intake was formula once I started to pump while battling mastitis.
Formula is Okay
It is okay to use formula if you are not producing breast milk or enough breast milk/colostrum to feed your baby. I wanted to exclusively breastfeed because I learned about the benefits of breastfeeding and how it’s the best, natural, and easiest way to feed my baby. It’s great for baby bonding and helps provide passive immunity to the baby. However, I got mastitis TWICE within the first month or so of my daughter’s life. We also learned my daughter was tongue-tied, making it difficult for my daughter to breastfeed. Not until later did I meet other mothers who breastfed AND bottle-fed their babies or moms who exclusively pumped. (Moms who exclusively pump only feed their babies breastmilk from a bottle). Had I not been so attached to exclusively breastfeeding, I could have adapted and explored these other options earlier as a new parent.
Do What’s Best for You and Your Family
Aside from taking antibiotics, the way to clear a mastitis infection from the breast is by breastfeeding or pumping. My daughter preferred the bottle by this time, so I relied on pumping to clear my infection. Pumping (and antibiotics) eventually relieved the pain and released the mastitis in my breasts, but the repeated infections impacted my supply. Encouraged by my doula, I remember three days where I spent about 9 hours pumping (diligently pumping 45 minutes every 2 hours, per her recommendation) only to produce about 1 ounce of breastmilk daily. I was so exhausted and upset by the results of my efforts. I also felt cut off from my daughter while I pumped (Because I couldn’t figure out how to safely hold her with all the pumping tubes hanging from my body, my husband or parents would take her while I pumped). After the three days dedicated to pumping round-the-clock, I decided it was not worth it to continue to pump. It was more important for me to be with my baby than to try giving her my pumped breastmilk.
I still held out hope for breastfeeding. Once my infection cleared, I tried to breastfeed my daughter using an SNS (supplemental nursing system – a tube placed on the breast but connected to a bottle to measure and ensure the baby has adequate intake). She was already used to the bottle nipple and did not take to the SNS. I attempted multiple times, but she would refuse to feed through the SNS, and I would end up with formula spilling all over my chest.
I share a bit of my breastfeeding journey to emphasize that there are many ways to feed and nourish a baby. In the end, so long as the baby is healthy and safe, parents decide what works best for them and their family. The caregivers’ mental health and well-being are as important as the baby’s. The way you choose to care for your baby may not resemble how other families do things, and that’s okay. I was ashamed for not breastfeeding my daughter for as long and in the way I hoped, but I felt my attachment to breastfeeding distanced my baby from me and caused so much anxiety and distress. Parents should not be ashamed of doing what is best for them and their families.
In the NICU, I meet moms who feel nervous they cannot directly breastfeed, yet they can pump and produce enough breastmilk to meet their baby’s needs. I meet parents who are ashamed they don’t have a separate nursery for their baby. We live in Los Angeles – not every family can afford to pay for a home with different bedrooms for each of their children! Many of our parents rely on WIC because they can’t afford to purchase formula. Getting formula from WIC is better than diluting formula or not feeding the baby enough nutritious calories. I try to assure the parents I see they can do what works for their family – it doesn’t need to match other families.
I felt defeated when I finally gave up pumping and breastfeeding. I wish I gave myself a little grace as a newborn mom and wasn’t so hard on myself. I felt so much grief over my inability to mother and feed my child as I thought I should that it made me feel inadequate as a mom. I was separated from my baby while I pumped, trying to salvage any breastmilk I had. I cried every day when I was pumping or trying to breastfeed. Ultimately, I fed my baby adequately, thanks to formula, and my child is now a healthy school-age girl. She still falls on the low end of the growth chart, but her father and I are not tall, so my daughter’s standard is the tenth percentile or less.
As I reflect on my experience as a new mom, I hope to impart grace and support to other new parents now that I’m a NICU nurse. If a caregiver is feeding their baby adequately, caring for and bonding with them, and keeping them safe, I want them to know they are doing a great job! I also want them to know it’s okay to make adjustments as needed or change their minds about how they want to do things. Parents can adapt their plans according to the family’s needs.
I originally wrote this post to give insight on how to lower the likelihood of hyperbilirubinemia or hypoglycemia (and admission to the NICU) through frequent feedings. If this information helps reduce NICU admissions and prolong in-room bonding between caregiver and baby, I would be ecstatic. Ultimately, I hope this post reassures parents (and serves as a reminder to myself) that there are many ways to care for a baby. There are no perfect parents; there are no perfect children. We’re just doing our best with the information and resources we have. Good luck to you on your journey!
I have faced tough days as a student, mom, or nurse…Beyond prayer, music helps restore me and surrender my circumstances to God. What restores you? What do you do to bring peace or rebuild your confidence when you face uncertainty, have no control, or have had a rough day?
St. Augustine said, “Those who sing pray twice.” I love to sing, and music helps inspire me. Personally, songs from church help bring me peace. Below is the link to my Spotify playlist of songs that I listen to or sing to motivate me on tough days. May it inspire or encourage you.
They say when you begin a journey (or a big project) to start with the end in mind. Before I even switched careers, I did an online job search for the job I wanted. This preliminary job search helped direct and guide what I did to prepare me for my career change.
Do this before you pursue a bunch of training and education for a career change. Look at what your dream job requires. An old co-worker of mine became a nurse while she was working full-time and tried to apply to her dream job with a government organization. Unfortunately, she wasn’t qualified because her program was not accredited. She shared how her entire motivation to become a nurse was to work for this employer, and how devastating it was to discover that she couldn’t even apply to the organization.
To be honest, I *still* search for other jobs to this day to motivate me in getting the training, certifications, or experience I need for my next possible position.
If you are a career switcher, what advice do you have for people considering changing careers? Share in the comments below!
It’s the time of year when many students are getting acceptance letters to nursing schools, and I’ve seen posts on discussion boards asking for advice on choosing a nursing school. Since I lived in an area where there were many Nursing school options, I had to filter through and determine which programs were the best fit for my family and me. In this post, I offer advice on what to consider when choosing nursing schools and insight into how I chose my nursing program.
Accreditation & BRN Approval
First and foremost, ensure the programs you are applying to are accredited and approved by the Board of Registered Nursing. In the US, you can visit your state’s Board of Nursing “Education” section to search the list of approved nursing programs. The BRN divides the list of programs by pre-licensure programs (LPN, ADN, BSN, and entry-level Master’s of Nursing program) and advanced practice programs. If you’re even wondering which schools offer nursing programs, the BRN list is an excellent overview of approved programs in your state.
You do not want to spend tuition and time at an institution that the BRN hasn’t approved because you won’t be able to sit for your licensure exam (NCLEX). The BRN will list programs with full and conditional approvals. Consider how a conditional approval may affect you if, for some reason, the BRN removes their program approval before you graduate. Can you ask the school or program why they received conditional approval and what they are doing to ensure full approval? I shied away from newer programs and didn’t apply to conditionally approved ones. I sought only fully approved and established programs because I didn’t want to take my chances with enrolling in a conditionally approved program or a program that could easily dissolve.
NCLEX Pass Rates
While visiting your state’s Board of Registered Nursing website, search for NCLEX pass rates (For California, where I obtained my degree and license, the website is https://www.rn.ca.gov/education/passrates.shtml). The pass rates provide a sense if the program you’re applying to adequately prepares its students for the NCLEX, the exam required to earn a registered nurse license.
Graduation Rates
Consider on-time graduation rates for your potential schools/programs. Per the amended Higher Education Act (HEA) of 1965, colleges must publish information regarding graduation rates, retention rates, and student diversity.1 Due to the National Center for Education Statistics (NCES) definitions, graduation rates for people with second degrees or who have already attended other postsecondary schools aren’t necessarily part of a school’s published on-time graduation rates.2 However, whether you are pursuing Nursing as a second or first degree, I think graduation rates are something to consider and request from your potential school or nursing program. If your nursing program does not readily share graduation rates, you can also view graduation rates at the following NCES website: https://nces.ed.gov/collegenavigator/.
Graduation rates are essential to consider to manage your expectations. If you’re choosing a nursing program because it’s shorter than others, but their on-time graduation rate is 50% or less, you run a 50% or greater chance of spending more money and extending the amount of time to earn your degree to get your nursing license. There is a private, for-profit university known for not having a waitlist for their nursing program here in Southern California, so many students apply and attend. They can start nursing school quickly instead of getting waitlisted or possibly rejected from other less expensive, competitive programs. The program is over $100,000 for the projected three years it takes to get a BSN from this for-profit, private university. The three years are appealing over traditional four-year bachelor programs despite the cost. However, the for-profit university’s on-time graduation rate is as low as 38% for their Los Angeles campus. When talking to nursing alumni from this university, many agree that it’s easy to get held back a semester and that the program can take longer than expected. However, the additional cost and time are worth it for program graduates because it was an avenue to get their nursing degree when other options were limited.
I’m not saying to shun schools with low graduation rates. Consider graduation rates, so you know what to expect. It’s better to be aware of potential costs up-front than to be surprised when you need to spend more time and money than what the program advertised.
Tuition
An obvious consideration when applying to schools is tuition. How much of a student loan will you need to attend school, or can you avoid taking a loan? For what kinds of financial aid are you eligible? (Second-degree holders do not qualify for pell grants). Can you afford private schools? Public schools are far more affordable but can also be more competitive.
Do you have grades, work, or volunteer experience that make you a competitive candidate? Do you need to repeat pre-requisite courses to increase your GPA and become a more desirable applicant? The extra time to repeat pre-requisites might be worth it if it saves you tens of thousands of dollars in tuition fees. (CAUTION: Be careful with re-taking courses or exams because some schools only accept a certain amount of repeats or will only accept a repeated course or entrance exam like the TEAS if it’s after or within a specific timeframe).
Program Length
The duration of the program is an important consideration. If you’re not working while going to school, that extra time in school is potential income lost. It is ACTUAL income lost for people with a prior career like me. Like most people looking to switch careers, I wanted an accelerated program to work as quickly as possible in my newly chosen profession. I didn’t want to be in school for four years to switch careers. Since I already had a bachelor’s degree, I was eligible to apply to accelerated Bachelor’s of Science in Nursing (ABSN) programs. In my area, these ABSN programs range from 12-24 months.
Location
Consider the location of your nursing school. Are the programs to which you’re applying local? Will you need to spend an hour or more commuting to school? Some of my classmates moved from one part of Los Angeles to another part of Los Angeles to avoid traffic that would add to their commute. Can you carpool with someone to allow you to take the carpool lanes and make your commute more bearable? Other cohort mates moved across the country to attend our ABSN program. All the nursing schools I applied to were within a reasonable drive from my home.
The school I chose happened to be the farthest from my house. When I started nursing school, I was lucky enough to discover one of my cohort-mates lived in my neighborhood, so we agreed to carpool. She became one of my best friends, and we used the carpool time to study and quiz each other (or vent about our lives as the only moms in the program).
Clinicals
If you can, try to find out where the schools do their clinicals. You can ask the program staff or alumni. Doing clinicals at hospitals or areas you wish to work offers excellent exposure to potential employers. The pandemic limited clinical rotations, so the recent years’ clinicals may not represent what is typically provided in a nursing program. However, you know a program is decent if they were able to send their students to good clinical locations amidst a pandemic. Also, keep in mind the places of clinicals may add time to your usual commute to school, and some may occur during the evening or night shift. Knowing this information upfront helps manage expectations.
Impressions of Alumni & Working Nurses
Talk to alumni about the programs you’re considering. Some questions you could ask:
Do they recommend going there?
Did alumni feel adequately prepared by their program?
How long did it take to graduate?
How much did it cost them vs. the advertised tuition?
What attracted them to their program?
What do they feel were the pros and cons of their program?
Talk to working nurses you trust and respect. How is working with new grads from particular schools or programs? Do some nurses seem better prepared than others? What are working nurses’ impressions of students from that school/program when they do clinicals? Do they have program recommendations? Would they recommend their alma mater?
As I shared in a prior post, I networked with others before I applied to ABSN programs and before I accepted the offer to attend my school. Talking to others about the various schools assured me that the schools I applied to were a good fit for me. My top choice school would change from time to time, but all schools I applied to were great options for my family and me.
My Choices
After working hard to make sure I’d be a competitive nursing school applicant and getting straight A’s on all my pre-requisites, I got accepted into three ABSN programs lasting 12 months, 15 months, and 24 months. The cheapest program was the 15-month program from a public university, while the 12-month program at a private university was more than twice the cost of the 15-month program and the most expensive, by far. The 24-month program tuition was slightly higher than the 15-month program but had the longest duration. I chose the 15-month program to save money and time and figured the additional three months it would take to earn my degree over the 12-month program would be worth my sanity. Additionally, the 12-month program had much lower NCLEX pass rates, making my choice even more straightforward.
Although this post was prompted by someone considering nursing school offers, ideally, all the above considerations would be made BEFORE applying to nursing programs. Whether you’re sifting through nursing school offers or selecting which schools to send applications to, I hope this post helped. Please share in the comments below if you have other considerations or advice to contribute when selecting a nursing program. Thank you for reading, and good luck on your journey!
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Footnotes:
Per the National Center for Education Statistics, “The overall graduation rate is also known as the “Student Right to Know” or IPEDS graduation rate. It tracks the progress of students who began their studies as full-time, first-time degree- or certificate-seeking students to see if they completed a degree or received a certificate within 150% of “normal time” for completing the program.”
The National Center for Education Statistics (NCES) notes that “students who have already attended another postsecondary institution, or who began their studies on a part-time basis, are not tracked for this rate.”
The Mature Student Nurse 