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RN-to-BSN Students

Diane Graham Webb, MSN, RN, CNE, and

Ann Deshotels, MSN, RN, CNE

1 Why do RNs return to school to earn their BSN?

Although nurses have their individual reasons for returning to school, most say they return to:

• Advance their knowledge or professional growth or increase their salary.

• Increase their career and promotion opportunities, i.e.,for management positions.

• Meet entrance requirements for graduate programs.• Meet current position requirements.

2 What is the difference between a student who is already an RN and

the generic baccalaureate student? We typically use the term “generic” baccalaureate student to refer to young people straight from high school whousually do not have any clinical nursing, hospital, or patient care experiences. They often do not work so they canattend school full time, whereas the typical RN student is licensed, works in a health-care setting, and often takescare of a family. The RN student is fulfilling two rolessimultaneously: the role of expert clinician at work and

the role of student at school. The RN student has beeneducated in an associate degree (AD) or diploma program

3

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knowledge of nursing and can draw on experiences from

health-care backgrounds. The RN student is used to work-ing in the “real” world and wants immediate applicationof what is learned in the classroom.

3 What barriers, educational conflicts, and stressors do RN-to-BSN

students encounter?

Because many RN students typically occupy multiple roles(spouse, parent, employee), several factors are perceived as

hindrances to continuing their education that may include:

• Time management issues: limited time must be balancedamong home, work, and school.

• Work schedules: work schedules often conflict withclass schedules.

• Financial strain: tuition, books, and time off from work can deplete resources.

• Role conflict: the “expert” at work becomes the student

at school.• Fear and anxiety related to academic performance.• Resistance from coworkers who question their decision

to return to school.

4 How can I encourage RNs to return to school?

One of the best ways to encourage nurses to return toschool is to talk with them before they graduate from their AD or diploma programs. You will probably meet these

students and nurses in the clinical setting and will have theopportunity to plant the “continuing education” seed early and encourage them to take courses that will apply to their BSN degree. Schools may have articulation agreements with schools that facilitate transfer of credits betweenprograms and make academic progression smoother. Thereceiving school may have mechanisms for awarding academic credit for previous knowledge and experience. These mechanisms may include credit by examinations,

blanket credit, or portfolio review. It is important to keeprepetition of previously learned skills/knowledge to a min-

34 MASTERING THE TEACHING ROLE

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very important as is collaboration with health-care facili-

ties in regard to tuition reimbursement, educational pay differential, and employer support.

5 Where is the best place to recruit RNs into baccalaureate programs?

Recruiting RNs to advance their degrees is best done in thehealth-care settings where they work. Recruitment days at local colleges that have associate degree and diploma pro-grams are successful as well. Other potential recruiting

sites include your school’s Web site and state and special-ty nursing organization newsletters, magazines, and con-ferences. (The authors’ school has a nursing continuing education department, so RN-to-BSN program brochuresare included in all CE packets. “Word of mouth” has alsobeen one of our most successful tools. We always say that our graduates are our “best recruitment tools.”)

6 What can I offer in the way of support and advice for the RN student?

Helping the RN student assess his/her reason for returning to school and discussing the demands that will be placedon his/her personal and professional life are the first steps.In our experience, RN students want to graduate in theshortest time possible and therefore often overload them-selves in academic credit hours per semester. We advisedetermining how quickly a student wants to graduate, plana schedule for this time frame, and discuss the feasibility of

such a schedule. Having the student set realistic goals can-not be overemphasized. No matter what time frame a stu-dent decides on, an entire proposed schedule, from the first course to graduation, should be planned and discussed.Support for RNs include:

• Offering orientation programs• Arranging mentors (students currently in the program

or recent graduates)• Giving prompt, constructive feedback from instructors

• Making the student an active participant in the learn-ing process

C HA PT ER 3 R N- to -B SN S tu de nt s 35

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• Making application assignments

• Providing a syllabus that includes a course calendar with assignments and due dates

• Providing explicit guidelines and evaluation tools for all assignments

• Offering a “friendly ear” to listen to feelings and frus-trations

Because of work schedules, RNs may not be able to accessresources such as the library during regular school hours;

therefore, remote access to such resources should bemade electronically on a 24-hour, 7-days-a-week basis.

7 Is teaching RN students really different from teaching traditional

baccalaureate students?

Yes. As mentioned, RN students can relate to health-carescenarios in more depth and with more expertise than cantraditional students. RN students have health-care work

experience that can result in critical thinking at clinicaland management levels.

8 Do course requirements differ between the RN-to-BSN program

and the generic BSN program?

The answer depends on your BSN program and how well you think that program meets the needs of your RN-to-BSNstudent population. For example, in our school’s pro-

gram, several courses such as pharmacology, critical carenursing, and skills labs are not a part of our RN-to-BSNprogram. Other courses such as health assessment, leader-ship and management, research, and nursing informaticsare the same between the RN-to-BSN program and thegeneric BSN program.

9 Does the teaching format and style differ between RN-to-BSN and

generic BSN programs?

It is important that faculty members adjust adult learning i i l di h i h RN d


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have had in their clinical settings as well as introducecritical thinking and reasoning methods of decisionmaking. The generic student often needs the “ideal” sit-uation presented in order not to be confused by themany problems of reality. Active learning, in which theRN learns through taking part in determining content of courses, is also important. Teachers act as facilitators,often utilizing and building on the clinical expertise of RNs in learning experiences.

10 How should classroom assignments differ for RN students and

generic BSN students?

Classroom assignments for RN students are aimed at developing their professional roles; mastery of technicalskills is assumed. Assignments that are applicable tothe RN workplace are preferred and serve a twofoldpurpose: a learning experience for the student and an

improvement in nursing care for clients. RN studentsoften collaborate with faculty members and preceptorsto identify areas of real concern in their clinical settings.Generic students need more foundational assignmentsthat develop their basic understanding of health-carescenarios.

11 How do clinical assignments differ for RNs compared with generic

students?

RN students are usually employed in a health-care setting, working under their own state license. Their technicalskills were accomplished in the basic RN program; there-fore, clinical assignments are geared toward individuallearning needs that have been identified by the studentsand their preceptors. Their assignments are designed tobuild on their current knowledge base; it is important that they not spend time on what they have already mastered.

Generic BSN students require clinical supervision relatedto technical nursing skills as well as decision-making and

i i l hi ki i


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12 Can RN students function independently under their own license as

students in clinicals?

Yes. This ability is one reason to require a minimum of 1 year’s experience as an RN before enrolling in clinical nurs-ing courses. In a clinical setting related to school assign-ments, the RN student works with a mentor who collabo-rates with the student and faculty. In our school, we requireRN students to purchase professional liability insurance.

13 What are some of the challenges in finding/selecting meaningful

clinical settings for RN students?

Clinical settings are shared by many nursing students ineach community. RN students have the distinct advan-tage of being able to fulfill many assignments in their clinical setting. If an RN student needs to complete anassignment that is not possible to do in a present worksetting, then faculty, supervisors, mentors, or the student

can make contact with another facility to complete theassignment.

14 Should I prepare clinical preceptors/mentors to evaluate RNs

differently than other students?

Fortunately, many health-care agencies have preceptor programs in order to orient newly hired nurses, so precep-torship is not a novel idea. At our school, we orient pre-

ceptors to the purpose and objectives of each clinicalexperience, emphasizing the focus of that particular expe-rience. Collaboration between faculty and each preceptor aids in troubleshooting or problem-solving individualsituations. The RN student usually does not require directsupervision by the clinical preceptor.

15 How can I validate basic nursing knowledge as well as clinical skills

for the RN student?Basic, safe nursing knowledge is validated by the RN’s


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completion of the NCLEX-RN examination. Clinical pre-

ceptors can be utilized in specialty areas for additionalknowledge required for safe, competent practice in thoseareas.

Other validation methods include:

• Self-assessment • Checklists completed by supervisors• Credentialing documentation• Portfolio review

16 Because the RN student is already licensed to practice, should I use

different evaluation methods?

Traditional objective testing is usually not part of the eval-uation of RN students. Assignments related to develop-ment of critical thinking and clinical reasoning skills may be done with the use of clinical projects. Application of knowledge is emphasized. Traditional objective testing

can be a portion of evaluation in specific courses such ashealth assessment and pathophysiology.

17 How can I promote professional socialization of RN students?

Classroom discussion about professional behavior is very helpful in students’ socialization. Encouraging students tobelong to professional organizations or volunteer for com-mittee or community work is emphasized. Faculty mem-

bers acting as role models and introducing students toothers who embody professional socialization are impor-tant. Collegial relationships between faculty and studentsin which students are recognized for their areas of exper-tise facilitate socialization.

18 What challenges are encountered in teaching RN students who are

highly specialized in an area of nursing in which the faculty may

not have experience?Nursing faculty members are facilitators of acquiring new


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you may find yourself intimidated by such students, but

this is a wonderful opportunity to identify and utilizestudents’ strengths and utilize their expertise. Let themfulfill a teaching project in class or with their col-leagues. Such an assignment lets students realize that weall have individual strengths and can learn from oneanother.

19 Can any nursing program instructor teach in an RN-to-BSN

program? The most effective teachers are those who:

• Philosophically believe in RN-to-BSN education and who recognize AD and diploma graduates as adult learners who want to build on their previous educationand experience.

• Believe the roles of the teacher are facilitator, collaborator,consultant, and coach in the educational process.

• Can form warm, caring relationships.• Act as role models for professional socialization.• Respond constructively to student frustration and

anger.• Are flexible and have a good sense of humor.

20 How can I prepare myself to teach in an RN-to-BSN program?

Review the principles and techniques of adult learning

and active teaching. Examine your philosophy of educa-tion, teaching, and nursing. Stay abreast of current nursing knowledge. Be an active participant in the nursing com-munity; volunteer for community services. Make nursing informatics a priority. Be a role model for professionalsocialization.

21 What do you see as a model for RN-to-BSN education?

RN-to-BSN education involves an active, collaborativelearning process between students and teachers who bring


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in an interactive relationship, with focus on the “real” world and in such a manner that fosters socialization andtransformation. Figure 3–1 depicts such a framework.

The model for RN-to-BSN education involves two setsof variables. The student enters the learning environment


L e a r

n i n g E n v i r o n m

e n t

BSN

Transformation

RN-BSN Faculty

Clinical Expertise

Educational Expertise

Adult Learning Theory

Role Model

RN-BSN Faculty

Clinical Expertise

Educational Expertise

Adult Learning Theory

Role Model

F a c i l

i t a t i o n

F le xibility C o l l a b o r a t i o n

S oc ializa t io n

Active CooperativeLearning Process

Credit for Prior Learning

Relevant Assignments

Adult Learningand Empowerment

Feasible GoalsResource Access

Figure 3–1. Model for RN-to-BSN education. (Copyright 2007 Diane

Webb and Ann Deshotels.)

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ical experience and expertise, and a professional identity,an identity in which he or she is the “expert.” As a result, when the “expert” becomes the student, the person oftenexperiences role conflict and role strain. Teachers bring their own clinical and educational expertise, their knowl-edge of adult learning theory, and their ability to act asrole models to the scenario.

These two sets of variables meet in an active learning environment that involves flexibility, collaboration,socialization, and facilitation. Students are given credit for prior learning assignments relevant to their clinical prac-tice and access to necessary resources. Teachers apply active learning techniques, and students are empoweredto set and achieve feasible goals.

Within the context of this active cooperative learning process, a transformation occurs, and the student emerges with a different perspective on professional nursing andthe role of the nurse. The student is transformed into abaccalaureate-prepared nurse.

Resources

Billings, D.M., & Halstead, J.A. (2005). Teaching in nursing: A guide for faculty, 2nd ed. St. Louis: Elsevier Saunders.

Cangelosi, P.R. (2006). RN-to-BSN education: Creating a context that uncovers new possibilities. Journal of Nursing Education45(5), 177–81.

Delaney, C., & Piscopo, B. (2004). RN-BSN programs: Associatedegree and diploma nurses’ perceptions of the benefits andbarriers to returning to school. Journal for Nurses in Staff Development 20(4), 157–63.

Eckhartdt, J.A., & Froelich, H. (2004). An education in service part-nership: Helping RNs obtain baccalaureate degrees in nursing at their practice sites. Journal of Nursing Education 43(12),558–61.

Jacobs, P.M. (2006). Streamlining an RN-BSN program. Nursing Education Perspectives 27(3), 144–47.

Lillibridge, J., & Fox, S.D. (2005). RN to BSN education: What doRNs think? Nurse Educator 30(1), 12–16.


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