Career Advice: Making the Decision to Get an Advanced Degree in Nursing
Wow, it’s August already! Of course, that means we’re nearing the end of summer (in the Northern Hemisphere) and getting ready to go back to school. Nursing students may have taken the summer off, but many take classes through the shortened summer semester or summer quarter sessions.
For many nurses, August will mark the start of a new journey — to an advanced degree. The Institute of Medicine (IOM) has pushed for nurses to get advanced degrees. The IOM recommendation that 80% of bedside nurses be baccalaureate-prepared by 2020 has increased the number of RN-BSN programs in schools of nursing across the nation. Many of these programs are online.
Another IOM recommendation was to double the number of nurses with doctorates, currently less than 1% of the nursing population, also by 2020. Other societal and professional forces advocating for advanced nursing degrees include the increasing complexity of patient care, the aging population, a need for increased access to qualified healthcare providers, national professional organization mandates and ethics codes, and the quest for Magnet® recognition (Wolff, 2017).
For those who are just contemplating advancing their nursing career by getting an advanced degree, this post will help you think about the questions to be answered so that you can take the steps needed to start the “back-to-school” process.
Decision Making and Motivations
Making the decision to go back to school can be nerve-wracking and anxiety-provoking! It’s such a big decision with so many factors to work through, especially if you have a family to care for. But as Debra Wolff says in her book Advancing Your Nursing Degree: The Experienced Nurse’s Guide to Returning to School, “Why wait? Make the Decision!”
“The longer you wait to pursue the next degree, the less time you have to enjoy the benefits and opportunities it provides”
(Wolff, 2017, p. 4).
According to Wolff (2017), there are many different motivators that propel a nurse back to school. Internal or intrinsic motivators are those that fulfill an inherent need or personal desire. Personal satisfaction, self-improvement, the “right time,” a desire to be a role model, and a professional imperative to improve the nursing profession were themes related to internal motivations that emerged from Wolff’s dissertation research (Wolff, 2017).
External or extrinsic motivations for returning to school included a desire for career advancement (“a stepping stone … to the next level of practice,” Wolff, 2017, p. 12); positive or negative financial incentives (e.g., higher salary with new position or potential loss of income because a higher degree is needed to stay at the clinical level one is at); a change in status (e.g., marital/health/relocation/caregiving/retirement) for which an advanced degree allows one to be self-supporting, have job choices, or be location independent; changing a career path; and job security (e.g., to meet societal or employer expectations).
My Motivations to Advance my Career
My impetus for going back to school to get my BSN was both intrinsic and extrinsic. I always planned to go back to get my BSN after I got some nursing experience – personal satisfaction and a desire for self-improvement motivated me. But an external motivator for career advancement and job security was the final push when I realized that my unit teacher position (that I loved!) was going to be re-posted as a clinical nurse specialist position with a required master’s degree in nursing! Despite the fact that I was doing a good job (“for a nurse with an associate’s degree” as my master’s prepared nurse manager once said to me!), the skill set needed was really beyond my educational preparation.
My excuses for putting off going back to school were really just holding me back from greater knowledge and opportunities. So I gave up my position, switched to weekend nights, went to school during the week, finished my BSN, and continued on for my MSN. Six years after I finished my MSN, I graduated with my Ph.D. I have never regretted one minute of the path to each nursing degree.
Questions to Ask When Planning for an Advanced Degree in Nursing
There are many questions to ask yourself before making plans to get an advanced degree in nursing.
Answering the question, “What do you want to be when you grow up?“ will help you decide which advanced degree to pursue.
You may be a licensed practical/vocational nurse (LPN/LVN) who wants to obtain a registered nurse (RN) license. Your options are to enter a 2-year associate degree in nursing (ADN) or associate of science in nursing (ASN) program, a dual enrollment program, or a 4-year baccalaureate degree in nursing (BSN) program. (I’ll explain more about dual enrollment programs in the next post.)
Are you are a diploma nurse, ADN, or ASN who wants a BSN? As I said earlier, the IOM recommendation of 80% BSNs by 2020 is one factor fueling the proliferation of RN-BSN programs across the country. These programs last from 9 months to 2 years of full-time course work. The American Association of Colleges of Nursing (AACN, 2017a) reported that “RN to Baccalaureate (BSN, BS or Bachelor of Science in Nursing) programs provide an efficient bridge for diploma and ADN-prepared nurses who wish to develop stronger clinical reasoning and analytical skills to advance their careers” (p. 2). There are bachelor’s in nursing administration degrees also.
According to AACN (2017a), of the 747 RN-BSN programs, over 600 have online offerings. The list of RN to BS/BSN programs may be downloaded from AACN’s Web site.
If you want to go for it and decrease the hassle of applying for a BSN and then an MSN program, there are also 230 RN to master’s degree level (MSN, MS or Master of Science in Nursing degree) programs in the US (AACN, 2017a). RN-MSN programs can take up to three years to complete. “The baccalaureate level content missing from diploma and ADN programs is built into the front-end of the RN to MSN program. Mastery of this upper level basic nursing content is necessary for students to move on to graduate study. Upon completion, many programs award both the baccalaureate and master’s degree” (AACN, 2017a, p. 1).
Roles for MS/MSN-prepared nurses include those in administration (nursing administration, health leadership), teaching (academic and clinical educators), health policy consultants, and research assistants. Clinical Nurse Leaders (CNLs) are master’s-prepared unit-based clinical experts. Degrees for advanced nursing roles such as informatics, community health, and public health are also available. The four recognized advanced practice roles include clinical nurse specialist (CNS), nurse practitioner (NP), certified nurse midwife (CNM), or certified nurse anesthetist (CRNA).
The list of RN to MSN programs is also available on the AACN Web site.
“For nurses interested in teaching careers, RN to MSN programs can be an important first step in their education en route to doctoral preparation. AACN recognizes the doctoral degree as the appropriate and desired credential for a career as a nurse educator. Though master’s level nurses with additional course work are prepared to teach in clinical capacities and entry-level nursing programs, the doctoral degree is necessary to fulfill the full nurse faculty role in senior colleges and universities and to achieve parity with faculty in the other health professions” (AACN, 2017a, p. 2).
A master’s degree in nursing is the stepping stone to doctoral education – the Ph.D., and the DNP. Again, the IOM recommendation is to double the number of doctorally-prepared nurses by 2020. This recommendation is really a professional imperative. We are in the midst of a severe nurse faculty shortage – that is only going to get worse unless we prepare more nurses for academic teaching careers. The proliferation of RN-BSN and RN-MSN programs is great – but not if we don’t have nurse faculty to teach these students! We need more Ph.D-prepared nurses to conduct nursing research, too. The increase in DNP-prepared advanced practice nurses will promote evidence-based practice and process improvement initiatives in healthcare institutions to improve patient, nurse, and organizational outcomes.
Other Important Questions to Consider
Of course, deciding on what you want to be is only part of the process. There are many other questions to consider when planning for your advanced degree in nursing. Questions about what type of financial, family, and social support you will need; logistical considerations; and how you will “balance” work, school, and life are good to consider before you apply for school.
Questions regarding financial support will loom large:
- Do you have money saved to return to school? or for emergencies while you are in school?
- Are you still going to work while in school and, if so, how many hours per week? (Will you be allowed to work? For example, because of the rigors of the CRNA curriculum, CRNA programs usually forbid students from working.)
- Will you have administrative support from work to go back to school? Will you have a job when you get done?
- Will you have support for days off to attend required classes and clinical? Will you have to take vacation days or paid time off?
- Does your employer offer tuition reimbursement?
- Can you get financial aid from your college of choice?
- What kind of scholarships are available? (Look for scholarships offered by your school of choice. Plus, which professional nursing organizations do you belong to?The ability to apply for scholarships are benefits of professional involvement and membership in professional nursing organizations. Find out if they offer a scholarship for advancing your nursing degree!)
Questions about the level of support you’ll get from family and friends should be asked.
- Is your spouse or significant other on board with you going back to school? Do they realize the financial and time commitment and are they willing to work with you to realize your dream?
- Do any of your family members or friends have skills that could help you through school? For example, is there another healthcare provider in your familial or social circle that you could call upon to demonstrate advanced assessment techniques or explain physiologic or psychologic concepts that you might be finding difficult? Does anyone have knowledge or expertise in statistics, stress management techniques, or test taking strategies for which you could request their assistance?
- Can you count on family or friends to help out with household tasks, babysitting, elder care, or other family responsibilities?
- Can you prepare family members for times when you might need extra support, such as when a major assignment might be due or when required clinical hours might keep you from dinner, sporting events, or school activities?
Debra Wolff’s (2017) book has an extremely helpful chapter on Family/Social preparation. Practical suggestions and strategies to garner family and social support from nurses who made the decision to return for an advanced degree are included.
Questions for Balancing Work, School, and Life mesh with the other questions we’ve already talked about, of course. The big questions relate to whether we can plan our lives so that the immediate responsibilities of school can fit into our already full lives.
In my post, The Quest for Work-Life Balance, I talked about finding work-life harmony – that you need to be able to live with some uncertainty when you are trying to achieve your goals. The goal of advancing your nursing degree is a noble one and one that will open your mind and expand your opportunities.
When I was researching the topic of work-life balance for the blog post, I noticed discussions in the blogosphere about whether work-life “balance” is really a valid idea. The fact is we all have to work and we all have other responsibilities that are a part of life. Is balancing the real goal or should we be thinking more about integrating the various aspects of our lives?
Work-Life integration is the thought that there are blurred boundaries between work and life (and therefore school). We need to be flexible and innovative so that the work that needs to get done, gets done at the same time as everything else. As I said in this previous post, “Competing demands are not at odds with life – you just have to be creative as to how they all fit.”
So, I think, the major question to ask yourself is whether you are willing to be innovative and creative when you need to to make room in your life so that you can focus on the work and effort needed to be successful in school. That integration may mean that you need to temporarily postpone (or outright eliminate) tasks or other desires so that there is room to concentrate on school. The advanced degree and the opportunities it will present will be your reward.
Still On the Fence? Take this Advice!
When you are still struggling with the decision to get an advanced degree, Dr. Wolff’s (2017) advice is to make a list of the pros and cons of going back to school. Your answers to the questions above will help you populate that list. If the pros outweigh the cons, you are probably ready to return to school. (So buy Dr. Wolff’s book to help guide you through the process!). If the cons are greater than the number of pros – perhaps you need more time to get your mindset focused on what you need to do to get ready (Wolff, 2017). If you are on the fence, answering the following question may help you decide what to do:
“Imagine yourself 5 years from now. Would you rather be 5 years older with a degree or 5 years older without a degree? Either way, you will be 5 years older” (Wolff, 2017, p. 33).
For this post, and some of the future posts on returning to school, you’ll notice that I used information from Dr. Debra Wolff’s new book, Advancing Your Nursing Degree: The Experienced Nurse’s Guide to Returning to School, a lot! That’s because it is a great book! It covers everything you have to think about when deciding to return to school with practical suggestions and strategies shared by nurses who have returned to school for advanced degrees. I highly recommend this text!
American Association of Colleges of Nursing. (2017a, June). Degree completion programs for registered nurses: RN to master’s degree and RN to baccalaureate programs [Fact Sheet]. Retrieved from http://www.aacn.nche.edu/media-relations/DegreeComp.pdf
American Association of Colleges of Nursing. (2017b, June). Accelerated baccalaureate and master’s degrees in nursing [Fact Sheet]. Retrieved from http://www.aacn.nche.edu/media-relations/AccelProgsGlance.pdf
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: Author.
Wolff, D. A. (2017). Advancing your nursing degree: The experienced nurse’s guide to returning to school. New York, NY: Springer Publishing.