Whatever It Takes
Faced with tight competition for limited school slots, nurse hopefuls put personal lives on hold to pursue their professional dreams

By Heather World
November 29, 2004

Julie Hannum wants to be a nurse.

Last year, the college sophomore applied to Southwestern College in Chula Vista, Calif., Grossmont College in El Cajon, Calif., and city colleges in San Diego. She applied to San Diego State University’s School of Nursing five times only to be told this year that her application was lost.

She then moved 500 miles away from her fiance in San Diego to attend a private college in the San Francisco Bay Area, the only school that had space for the CNA with a 3.1 grade point average and volunteer experience at the Department of Veterans Affairs.

The school’s tuition has put her $23,000 in debt, and now she must quit and work for a year to catch up.

Then she’ll start the application process again.

“I’m not looking forward to that,” Hannum says. “But when push comes to shove, I have to do what I have to do.”

Hannum’s story is just one of many tales of determination to get into the nation’s crowded nursing schools. Enrollment is up at nursing schools across the country — by as much as 22.2% in the North Atlantic states — yet schools still turned away 14% of qualified applicants, according to the American Association of Colleges of Nursing.

Constricted by a faculty shortage and limited clinical rotation space, nursing schools cannot provide enough seats to accommodate the number of students who want to enter the field.

Robert Rosseter, director of public affairs for the AACN, says desperate students have e-mailed him to find schools with openings.

“I have gotten e-mails from people saying they will travel anywhere in the country, but none of our members are standing up and saying, ‘Send students our way,’” he says.

“We’re afraid people will lose interest and go to other fields and we don’t want to lose these folks.”

Waiting game

High grade point averages and work experience may not help students find openings, as both associate and baccalaureate degree programs are swamped by qualified applicants.

Furthermore, community colleges, which educate the majority of nursing students in California, Colorado, Washington, and Arizona, maintain a commitment to educating anyone who wants to learn, and many choose waiting students randomly or on a first-come, first-served basis.

“The community college mission is to provide access to higher education, so we tend to set the qualifications and take all who are qualified instead of ranking them,” says Patricia Harris, RN, MS, director of health care education for Maricopa Community Colleges in Arizona, the largest associate degree nursing program in the nation.

Also, work experience is hard to evaluate and a low grade point average may reflect more on a student’s life — new baby, lost job — than on nursing ability, she says.

Last year, 1,221 qualified students who met the requirements applied for 743 openings in Arizona’s Maricopa County program, she says.

The remaining students are placed in a lottery and will wait one to two semesters to get in — a wait time that seems to be growing, she says.

Before the randomized system was put into place in 1999, students desperate to get into the nursing school would camp outside the night before enrollment, she says.

“We had students who would pitch a tent and sleep on the sidewalk so they were well in time for the line Monday morning,” she says. Those who did not get in had to reapply.

Some students are positioning themselves ahead of the pack by finding work at one of the four local hospitals partnering with the school.

“When hospitals fund our programs, we give back employees,” Harris says. “We have students who, to get ahead in the line, go to work for a particular hospital qualified for reserved employee spaces.”

For spring, the school has 102 of 364 spaces reserved for employees of its partner hospitals, she says.

At least one hospital recruits from the school’s applicant pool by letting students know they have 30 reserved spots at the school.

The hospital pays tuition, too. In return, students are usually obligated to work at the institution for a defined period of time.

Colorado changed its wait list policy from acceptance according to grade point average to acceptance according to time on the list about three years ago, says Mary Ann Wermers, RN, MSN, CNS, CNAA, nursing program coordinator at Pikes Peak Community College in Colorado Springs, Colo. Before that, students reapplied each year, she says.

The plan has its critics, but on the positive side, students have a better sense of how long they will sit on the list.

“They can plan their lives,” says Wermers, who has seen an increase in students seeking a second career and out-of-state transfers.

Wermers says she has heard many pleas from students trying to get around the state-regulated system — everything from “I flunked only one class” to a man who brought her a folder of work experience 2 inches thick that he thought should count toward nursing school credits.

Linda Forkner, director of health program administration for Colorado Community Colleges, says 3,400 students are waiting for LPN or associate degree nursing spots at 11 colleges in the state.

The actual list is smaller, she notes, because some students have signed up on more than one school’s wait list.

“Our wait lists are horrendous,” she says.

Another route

Larry Booher looked at five schools in the Sacramento, Calif., area when he decided on a career change to nursing. A businessman, Booher saw immediately that the laws of supply and demand were not on his side.

“The only people you talk to are career counselors, and some of those don’t call back,” he says.

Booher was given a sheet of paper with course and grade point requirements that applicants must meet before being thrown into a lottery.

“It got very discouraging,” Booher says.

So the father of four decided he would pay the $60,000 to $70,000 required for an entry-level master’s program at a private school.

“For me, it was a way of surpassing the lottery,” he says.

Going for a higher degree in nursing also confers benefits above getting into school quickly, Booher points out. But others have noticed a rise in baccalaureate and higher-prepared nurses as the competition to get into nursing schools has increased in the past few years.

Teri Gwin, RN, MSN, GNP, associate professor at the Samuel Merritt College School of Nursing in Oakland, Calif., says applications to the accelerated master’s program have tripled in the past two years. She adds that students do seem willing to pay higher private school tuitions to get into classes.

“Samuel Merritt has a good reputation, but [also] I think people look at a five-year wait list at a community college and say, ‘I’m going to pay the fee for a private college because [I] have a higher chance of getting in,’” she says.

Gwin has seen students make other sacrifices, as well.

She’s had students commute daily from Tracy 50 miles through traffic to the Oakland campus, and one student flew home to Los Angeles to be with her husband every weekend.

Chiyieko Salinas drives 850 miles a week from Stockton to Oakland to attend the school.

“Some mornings it takes three hours to get to school,” says the single mother of two who relies on her boyfriend to take her sons to school in the morning.

Salinas says she could get an associate’s degree in Stockton, but she wanted a baccalaureate degree from a school with a strong reputation that would allow her to choose a focus in her senior year.

“When I got accepted, I almost didn’t accept it because of the strain,” she says. But then her younger son told her not to be a quitter, so now she spends much of each day in her car.

Salinas tapes her classes and reviews the tapes in her car.

She watches education videos before going to her reading because she is often too tired from the drive to grasp concepts through reading alone.

“The hardest thing I’m finding is that I don’t participate in a lot of study groups,” she says.

“I’m not willing to make the drive on the weekends because I do it every day of the week.”

On the edge

While Salinas’ commute may set her apart from her colleagues, her status as a mother does not.

Wermers in Colorado says rising unemployment coupled with effective advertising for the field of nursing may account for the increase in older students who tend to have more responsibilities in their lives.

“I’m seeing an increase in those with prior degrees coming in,” says Wermers, who has arranged for more of the “15-year waivers” required for students to get credit for courses taken long ago.

She knows that pre-nursing students also are taking advantage of new child care centers that opened on two of the college campuses, she says.

To meet the needs of this new batch of students on the edge, the school of nursing has started a crisis fund fed by the local nursing district and health care organizations.

Students who might have had to leave school because they couldn’t pay gasoline bills or mortgages or for books now can get funds, she says.

“I’ve paid a light bill, car repairs, mortgages [using money from the fund],” Wermers says. “I had an LPN last year who says that’s what kept her in school.”

Older students with families and other obligations often sacrifice time with young children just to get through school.

Michael McEwen, a senior in the University of Portland’s baccalaureate program, sold his house and moved his family into a rented townhouse in January when he began the nursing portion of the program.

The father of three — all younger than 5 — works part time to maintain job benefits while attending school full time in the school’s 20-month program.

“The true sacrifice is less time with my young family right now,” he says. “I’m only home one night for dinner during the week and weekends.”

And McEwen knows he is not the only one paying the price to go to nursing school.

“My wife says my long weeks are her long weeks,” he says.