Dear Joyce: I am thinking about going to a community college to study to become a registered nurse. Nurses rarely lose their jobs even in a recession, do they? S.L.
An associate degree in nursing (ADN) preparing graduates to become registered nurses may be the nation's best education buy for the career consumer. I can think of no other occupation where salaries for two years' study are as rewarding. But a faculty shortage is causing long lines at some community college programs.
A quick recap: RNs obtain education through: (1) a four-year college program, receiving a bachelor of science in nursing (BSN) degree, (2) a two-year community college program, receiving an associate degree in nursing (ADN), or (3) a three-year hospital training program, receiving a hospital diploma.
The big shift has been away from hospital programs to academic institutions, particularly to the inexpensive two-year ADN programs. Starting pay is often the same, or virtually the same for two- and four-year nurses. There's little economic incentive to take the four-year preparation; in fact, as few as 15 percent of students at four-year colleges graduate in only four years, largely due to rising costs that are forcing more students to prolong and support their education through employment. Even then they may graduate with onerous debts.
But in the long run, it is the baccalaureate-prepared nurse who gets promoted and who earns more, so if you value career mobility and start out as a two-year RN, find out what you need to do to transfer your credits later to a baccalaureate program.
The nursing shortage that began in the mid-1980s has softened because of dramatic increases in nursing students and graduates. But it is far from over for a multitude of reasons too complex to explain briefly.
B6 The shortage raised wages -- starting pay at hospi
tals is now averaging about $25,000, with a maximum of about $38,000 for staff RNs in hospitals and medical centers. At hospitals in some major cities, RN starting pay is topping $35,000 with a wide range of perks from four-day weeks to sign-on bonuses.
But as pay scales rise, so does vulnerability to layoffs. As one New York hospital official explains, "Back when RNs were earning $18,000, they weren't likely to be laid off. But now, when many are making $35,000 to $50,000, those positions have to be census-sensitive." Still, nursing does remain a career in which the threat of unemployment is rare.
The two-year program is attracting a preponderance of students who are older, married and have children, compared with the baccalaureate programs where students tend to be younger and single. At the moment the ADN has enormous economic value. Grab it! In the future there may be substantial starting salary differentials if recommendations by major nursing organizations are adopted. They say health care will benefit by a two-track nursing system.
Baccalaureate-prepared or professional nurses would perform the full range of nursing practice, including direct patient care, case management and patient counseling and health education, as well as supervision of nurse's aides, licensed practical nurses and other nursing personnel.
Associate-degree or technical nurses would provide patient care under a more narrow scope of procedures and protocols.
The idea's been around for a decade or more, but as health care grows more complex, it may well take hold.