In the mid-1970s, when unemployment was on the rise, Bob Contino decided to pursue what was then an unconventional career path for a man. He enrolled at the Pilgrim State Hospital School of Nursing in Brentwood, New York. His choice paid off. Today, Contino is the chair of the department of nursing at Wesley College in Dover, which is marking its 50th anniversary.
Angela Steele-Tilton followed a similar path. Steele-Tilton, who also attended a diploma school affiliated with a hospital, is now chair of the RN to BSN program at Wilmington University.
Both educators reflect the dramatic changes in nursing education since the 1970s. They each pursued bachelor’s and master’s degrees in nursing specialties. Contino also has a doctorate in higher education leadership and innovation.
Such advanced degrees aren’t limited to nursing educators. Due to rising accreditation standards, many healthcare employers now want to hire nurses with a four-year degree. The role of nurses in a variety of fields, including public health, also requires more education than ever before.
Though the need for nurses, especially those with advanced degrees, has increased, the supply is lagging. Most nurses today are 50 and older. By 2025, the shortfall is expected to be twice as large as a shortfall in the 1960s.
It’s easy to see why the profession interests traditional and nontraditional students who, like Contino, want the assurance of a job after graduation. In 2017, the University of Delaware received 1,900 applications for the traditional four-year bachelor of science in nursing program, 193 of which were approved. Wesley College has 200 students enrolled in its program.
“It’s expected that the demand for admission will continue to increase over the next five years,” says Emily J. Hauenstein, senior associate dean for nursing and healthcare innovation and Unidel Katherine L. Esterly Chair of Health Sciences at UD.
As a result, local nursing schools are working to meet employers’ and students’ needs while offering courses relevant to the ever-changing field of healthcare.
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The modern nurse
Local nursing schools like UD are working to meet
At one time, most hospitals in Delaware had a nursing school. Milford Memorial Hospital’s program, for instance, began in 1907. St. Francis Hospital in Wilmington established a school at about the same time. In Lewes, Beebe Hospital Training School for Nurses opened in 1922. In 1960, Beebe built the Jean Ellen duPont McConnell Nurses’ Residence to expand its program. The 1965 merger of Delaware, Memorial and Wilmington General hospitals created one entity, the Nursing School of Wilmington, which graduated its first class in 1967.
With the demand for nurses on the rise, technical and community colleges began offering two-year degrees. But even as early as the 1970s, many educators predicted that registered nurses would eventually need a bachelor’s degree. The University of Delaware graduated its first class in 1966. Wesley College’s first was graduated in 1969.
Between the two- and four-year degrees in nursing, hospital-based programs took it on the chin. The Milford Memorial Hospital School of Nursing closed in 1976, despite graduating its largest class of 28 students that year. The Nursing School of Wilmington closed in 1985, leaving Beebe’s program, now the Margaret H. Rollins School of Nursing, as the only diploma program in the state.
Behind the baccalaureate
Wesley College has 200 students enrolled in its nursing
Since the turn of this century, the demand for a bachelor of science in nursing has only increased. From hospitals to nursing homes, healthcare facilities must adhere to high standards to meet accreditation requirements, says A.M. Richardson, chair and associate professor of nursing at Delaware State University.
In 2010, the Institute of Medicine strongly recommended that 80 percent of the nursing workforce have a baccalaureate degree by 2020. According to the American Nurses Credentialing Center’s highly coveted Magnet accreditation program, nurse leaders with a rank between manager and chief nursing officer must hold at least a bachelor’s degree in nursing.
As the programs at UD, Delaware State and Wesley College demonstrate, some students decide to become nursing majors at the start of a traditional four-year college experience. Some schools do not offer nursing classes until the sophomore or junior year. That’s not the case at Wesley, where students start in the spring semester of their freshman year. According to state requirements, students in a RN program must complete 400 clinical hours. Wesley’s students do 1,040.
But there are still other options, including an associate’s degree, such as the one offered by Delaware Technical Community College. Once they’ve earned their degree, graduates can sit for the licensing exam and get a job. Often, employers will then foot the bill for the new nurses to continue their education. “It’s the perfect segue for our students,” says Justina Sapna, vice president for academic affairs at Delaware Tech.
In 2016, the Margaret H. Rollins School of Nursing signed an agreement with the University of Delaware. “Students can apply for dual enrollment at Beebe and the University of Delaware,” says Karen Pickard, program administrator. “They can take their general education courses through UD and come to us for nursing classes.”
After finishing the three-year program, graduates can take the licensing exam for registered nurses. They can then work and pursue a bachelor’s degree through UD’s online baccalaureate program for the registered nurse, offered in the College of Health Sciences.
Recognizing a market for nurses who have been in the field but who want a baccalaureate degree, several schools—including Wilmington University and UD— have started RN to BSN programs. UD also has an accelerated program for students who hold a bachelor’s degree in another field but want to switch careers.
In January 2017, Delaware Technical Community College launched its RN to BSN program—the college’s only bachelor’s degree. “As our mission drives us to do, we need to meet the workforce need,” Sapna says.
Delaware State University is expanding its undergraduate offerings in nursing and plans to reactivate its graduate
Steele-Tilton, head of Wilmington University’s RN to BSN program, didn’t stop with a bachelor’s degree. She also has a master’s degree from Wilmington University. She’s not alone. As the field of nursing develops specialties—much like any area of medicine—advanced nursing degree and certificate programs are on the rise in Delaware schools.
Like Steele-Tilton, many nurses who opt for an advanced degree want to better care for their patients. Many also realize the career advantages. “Graduates of our MSN program and the post-master certificate program have a 100 percent employment rate six to nine months after graduation,” says Contino of Wesley College.
Wilmington University offers an accelerated track for the RN to BSN students who plan to pursue a master’s degree. The students can take master’s-level courses as part of their bachelor’s degree requirements. The option requires careful planning with an academic adviser.
Master’s programs, meanwhile, vary, and some are folded into doctorate programs. Wesley College, however, has one master’s degree program for nurses. “You have to find out what you do well and your niche,” Contino says. For Wesley, that is a clinical nurse specialist program in adult-gerontology.
Wilmington University has seen a significant increase in enrollment for a doctor of nursing degree, says Aaron Sebach, the program chair. There is a track for nurse leaders, such as nurse executives or public health experts. There is also a track for nurse practitioners.
UD also has two doctoral programs. The doctor of nursing practice, which began in fall 2016, is a three-year full-time or five-year part-time program for nurses who want to be practice experts. Students with a bachelor’s or master’s degree can take the DNP track.
UD’s doctorate of nursing science is a four-year full-time program focused on scientific research in nursing and health. “Students completing either degree are eligible for a variety of advanced roles in health systems, including faculty positions in academic positions,” Hauenstein says.
UD also offers a post-master’s certificate for nurse practitioners in psychiatric mental health. UD is currently reviewing two master’s programs, including one jointly offered by the Alfred Lerner College of Business & Economics that will prepare nurses for leadership roles.
Expect more programs in the future. Delaware State University, which is expanding its undergraduate offerings in nursing, plans to reactivate its graduate studies in nursing.
Creating space to increase supply
The number of possible programs and the cap on student enrollment are limited by space. Many schools must expand to thrive. The Margaret H. Rollins School of Nursing in Lewes, which opened in 2015, cost $10 million to build. The 18,000-square-foot building has classrooms with high-tech equipment and clinical laboratories.
Before the expansion, the school had two low-technology mannequins. Today there are six high-fidelity simulators that can show the symptoms of chronic disease, acute illness or medical event. One simulates a cardiac arrest, and one simulates the birth of a manikin baby. A two-way mirror allows other students and faculty to watch how the students respond to a crisis.
Since the building opened, the school has managed enrollment to ensure small classroom sizes—a hallmark, Pickard says. In fall, there were 59 students enrolled in the program, the largest number to date.
Similarly, Wesley College in 2016 opened the renovated William and Susan Johnston Hall, a $2.2 million project that boosted enrollment by about 35 percent.
Each Delaware Tech campus has made improvements in its health science facilities. In Stanton, where nursing enrollment has nearly doubled in 10 years, a 40,000-square-foot addition was designed with labs, clinical simulation space and classrooms.
The new classrooms and programs around the state reflect a greater emphasis on technology, critical thinking and decision-making, Contino says. But some things have not changed over the years.
Many nurses are still on the front lines of patient care. They offer the personal touch. “As a critical care nurse, I prefer to eyeball my patients rather than a computer screen,” says Contino, whose master’s degree is in cardiovascular nursing.
Nursing still involves taking a holistic view of each patient, such as talking with families and rec0gnizing other important details about the patient.
Nurses also honor their roots. Without fail, most women in Wesley College’s graduating class elect to wear the traditional white dress and cap at their graduation and pinning ceremony.
“It’s probably the only time they wear the cap,” Contino says. “They still receive the unique pin. We recite the International Council of Nurses’ pledge by candlelight, which represents one of the leaders of nursing, Florence Nightingale. That tradition still holds.”
No doubt, Nightingale would be happy to hear it.