Abstract This article describes the result of an academic-practice partnership between a School of Nursing (SON) and a University Medical Center (UMC) for the purpose of promoting BSN education in response to the Institute of Medicine’s recommendation that 80% of RNs hold a baccalaureate degree or higher by 2020. The mutually beneficial partnership worked together to offer a pilot online RN-BSN nursing program, increase the number of BSNs in the workforce, and to collect information from RN-BSN students returning to school about their challenges, recommendations for future programs, and why they were interested in returning to school. The BSN graduates reported a renewed interest in nursing, opportunities for advancement, and the importance of a support system for RNs planning to return to school. The BSN graduates identified barriers for returning to school included finances, lack of knowledge related to technology, and challenges of maintaining work-life balance.

BACKGROUND: This presentation concerns the evaluation of an additional clinical experience in case management for senior baccalaureate students. During their final leadership course, nursing students can elect to do an additional 80-hour precepted clinical experience focusing on case management in primary care clinics. As part of that experience, they rotate through seven nurse-managed rural primary health clinics in Tennessee. METHOD: As part of the evaluation process, students and preceptors were asked to review the experiences that students had participating in the clinical. RESULTS: For the most part, students were highly satisfied with the case management experience and thought it provided an additional skill set for them as they were completing their final year in nursing school and preparing to enter the nursing workforce as graduates of the Bachelor of Science in Nursing program. CONCLUSION: A community case management clinical opportunity in primary care allows a community experience for students that provides them with an opportunity to witness an RN practicing to the full scope of the license.

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Enrollment in registered nurse-bachelor of science in nursing (RN-BSN) degree completion programs have increased in the last several years. Due to this increase, many programs have begun to offer their RN-BSN programs completely online or in a hybrid format. Often times, students who choose to pursue their degree online come from various cultural and ethnic backgrounds and speak English as a second language (ESL). There is limited research about the experiences of these students in this unique learning environment. The purpose of this study was to explore the lived experience of RN-BSN ESL nursing students who are engaged in learning online and understanding their process of cultural integration. Vygotsky’s sociocultural theory served as the theoretical framework and underpinning for this study. Ten individual interviews were conducted incorporating van Manen’s (1990) methodological steps for exploring the lived experience. Through phenomenological reflection, five major themes emerged: (a) understanding the online classroom, (b) expressing culture online, (c) alone but not lonely, (d) writing as a surmountable barrier, and (e) faculty role in the online journey. RN-BSN ESL nursing students who choose to pursue their degree completion completely online or in the hybrid format do so mainly for convenience and flexibility. Exploring their lived experiences offered insight into their personal challenges and triumphs with online cultural integration, writing, and obtaining the support needed to be successful.

The critical shortage of registered nurses (RNs) in the United States has led to increased enrollment in nursing schools, but the number of graduates is still decreasing, as nursing students struggle and fail in upper division courses. There is a significant gap in knowledge concerning students' self-efficacy (SE) as a factor directly influencing students' academic performance. The problem examined in this correlational study was the impact of collaborative learning in an innovative classroom setting on Bachelor of Science in Nursing (BSN) students' SE and academic performance. Framed by Bandura's theory of SE, the research questions examined the relationship between students' SE scores at the beginning and end of the innovative course, and their end-of-course grade. The sample included 22 students from one nursing class (N = 22) in an undergraduate-level nursing program in Texas. Data sources included disaggregated student grades and an anonymous, online survey. Analyses included Chi-square and Pearson's r correlation of the data. Results indicated SE scores at the end of the course were higher than they were at the beginning of the course, which provided an initial understanding of the impact of the innovative learning environment on BSN students' academic performance, but were not statistically significant and could not, therefore, disprove the null hypothesis. This study indicates that student nursing courses could increase student self-efficacy, which would result in a positive impact in hospital and clinic support for United States citizens.

Discussion continues about requiring a Bachelor of Science in Nursing (BSN) as the minimum requirement for entry into registered nursing practice. A Magnet-® recognized hospital located in the Northeast United States is requiring all registered nurses without a BSN (n=284 or 28%) to obtain their BSN by 2022 as a condition for employment. The purpose of this project was to quantify the potential number and rationale of nurses who are not planning to return to school. The 2 practice focused questions are (a) What is the rationale for nurses who do not plan to pursue their BSN degree and (b) What is the potential cost to the organization due to projected gaps in the workforce by 2022. The theory of reasoned action was utilized as a model of decision making. A total of 29% of non-BSN nurses responded to a questionnaire, with 54.55% replying that they plan to obtain their BSN by 2022. The primary barriers for not planning to return for a BSN were a perceived lack of the degree's value and financial issues. More than 1/3 of those respondents not planning to obtain the BSN are planning to retire, which is consistent with national trends. An extrapolation of data showed the nursing turnover rate rising to 10.62% as 2022 approaches, significantly higher than the normal rate of 5.3%. The turnover rate may increase recruiting and orientation costs for the hospital facility over both the short and long term in a state where nearly 38% of graduates have either a diploma or an associate degree in nursing. The social change implication is a need for a re-examination of roles for various levels of registered nursing or a consensus on the BSN for nursing licensure.

Basic nursing education is no longer sufficient to meet the escalating demands of today's complex healthcare environment. Recognizing the need for the advanced cognitive skills incurred by these demands, increasing numbers of registered nurses (RNs) have been enrolling in online Bachelor of Science in Nursing (BSN) programs. The problem identified in the RN to BSN degree completion program at a large Midwestern university was the lack of information as to how online teaching and learning strategies were experienced by students. Research has demonstrated that the online community of inquiry (CoI) model facilitates higher order thinking through collaborative learning strategies and the interaction of teaching, social, and cognitive presence. The purpose of this sequential explanatory mixed methods study was to investigate the perceptions of RNs enrolled in the program about a recently completed course utilizing a 34-item CoI survey and semi-structured interviews. The data from 109 completed survey responses were analyzed via descriptive statistics and indicated that student perceptions of social and teaching presence were lower than perceptions of cognitive presence, meaning that the perceived establishment of online relationships and instructor engagement were not as high as were the perceived experiences of higher order thinking. Interviews with 15 purposefully selected students were analyzed for emergent themes and suggested limited online collaboration, which is considered to be fundamental to higher order learning. Based on these findings, a faculty development workshop was designed using the CoI model to encourage collaboration. A potential increase in RN proficiency in higher order thinking fostered by the CoI model will optimize the quality of patient-related decisions, minimize medical errors, and provide the impetus to challenge the status quo in health care.