Building the Nursing Workforce One Student (Veteran) at a Time
When Shannon Beebe began working on her CNA as a 16-year-old high school student in Virginia, her ambition was to someday become a nurse. This past May, the 41-year-old mother of five reached that milestone as one of the first two graduates of the University of Kentucky College of Nursing’s MedVet-BSN Option.
Beebe worked full-time as a certified nursing assistant (CNA) for many years, trying to knock out her prerequisites one at a time while raising a family. Frustrated with the slow progress and financial strain, she joined the U.S. Army as a combat medic in 2005. She saw her enlistment as a way to serve her country, get more experience in health care and pay for nursing school upon leaving the military.
Her unit was based out of Lexington, Kentucky, and after finishing her service in 2012, Beebe earned her associates degree at Bluegrass Community and Technical College. She was searching for a baccalaureate degree program when she heard about the new MedVet-BSN Option at the University of Kentucky College of Nursing.
“When I found out I was super excited,” she says. “I’d been sending applications to nursing schools everywhere. Between working full-time and raising kids, my GPA wasn’t as high as I would have liked, but they were willing to also look at my life experience and military service as a combat medic.”
The MedVet-BSN Option is one of UKCON’s two more recent BSN tracks for non-traditional students. The second program, the RN-BSN Option, provides a pathway for ADN nurses to come back to school and earn their BSN online. The two new programs join a third, the Second Degree BSN Option, which the College started 10 years ago for graduates in the workforce seeking a new career in nursing.
“We are transforming our BSN curriculum to ensure second career students such as military medics have the appropriate resources to support academic success,” says Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, dean and Warwick Professor of Nursing.
“One quarter of our students now are non- traditional,” notes Assistant Dean of BSN Program Studies Darlene Welsh, PhD, MSN, RN. “We’ve seen a lot of growth over the past three years in this area, particularly in the online RN-BSN Option.”
By providing additional BSN options geared toward non-traditional students, the College can not only help deliver more highly educated nurses into the workforce but also offer its students a broader look at the world.
“Having been out in the [workforce, military or both], our non-traditional students add new ideas about the way we do things based on their own experiences,” says Dr. Welsh. “Younger students hear a viewpoint different than their own. Ultimately, it brings a richness to our College.”
This translates into better patient care, she says. By being exposed to a larger range of ideas and people in college, graduating nurses are more prepared to deal with the diversity they encounter in the workplace and among patients.
A Push for a Better Educated Nursing Workforce
Offering more opportunities for non-traditional students to earn their BSN means more highly skilled nurses, which is exactly what the workforce needs, according to the National Academy of Medicine (formerly the Institute of Medicine [IOM]).
In 2010, the organization set a goal that by 2020, 80 percent of registered nurses should have their BSNs to meet the growing complexity of health care. Four years later in 2014, the American Nurses Credentialing Center (ANCC) picked up the mantle. As part of its criteria for Magnet status (a national designation that recognizes nursing excellence), the ANCC requires hospital organizations demonstrate quantifiable steps toward increasing their number of BSN-prepared nurses.
With research showing that better educated nurses lead to better patient outcomes, UKCON adopted the online RN-BSN Option in 2015. Previously, the College had been offering a hybrid program where nursing students came to Saturday classes on campus.
“We transitioned to totally online, recognizing that nurses are so busy,” says RN-BSN Option Coordinator Jessica Wilson, PhD, APRN.
They work every day of the week on different shifts, and we wanted it to be more accessible for them to come back to school. Also, prior to this, nurses had to be local to this area. Now we have a much farther reach, including rural areas of Kentucky.”
Dr. Wilson says they’ve also developed specific partnerships with national hospital organizations, which pay tuition for their nurses to seek higher degrees.
Dr. Wilson cites a partnership with Select Medical, which operates long-term acute care hospitals across the country and graduated its first UKCON RN-BSN Option cohort this spring. At any given time, as many as 50 of its nurses are enrolled, and currently, those in the program come from 20 different states. But they all treat high-acuity and medically complex patients.
“It’s neat that we’ve been able to partner with them because they really need their nurses to have a lot of expertise to properly care for critically ill patients,” says Dr. Wilson.
Part of that partnership is recognizing what that expertise requires.
“We try and make sure the students’ clinical projects meet their professional development needs and the needs of their organizations,” she continues.
The core curriculum is still the same for everyone, she adds, but the nurses can share their experiences and challenge each other to think outside of the box. “They benefit from each other’s expertise and knowledge because they are learning with and from each other,” says Dr. Wilson, mentioning tools such as online discussion boards, Zoom conferencing, sharing online presentations about their clinical projects and discussing what each other’s experiences on the job teach them.
From Military Medic to Nurse
Implemented and supported through a U.S. Health Resources and Services Administration grant for the past four years, the program for military medics is designed to support the specific needs of student veterans, who are often older and have other life obligations, says former MedVet-BSN Coordinator Fran Hardin- Fanning, PhD, RN, principal investigator and grant author (one of 20 awarded) who laid the groundwork for the program.
“Some are still active in the military or have other jobs and families,” says Stephanie Fugate, MSN, ACNP, instructor and new MedVet-BSN Option coordinator.
Also, having been out of school for several years, many of these students must adjust to studying again.
“We noticed there was a reluctance for them to reach out; these veterans are used to achieving without help,” says Fugate. “We had to get them out of that mindset. Nursing is a rigorous program, and everyone needs assistance with study skills. Now, we go on the assumption they need help, and we make sure they have it.”
This includes access to peer tutors, small classes, a designated study space in the library and a 101 class for all student veterans taught by Lt. Col. Anthony Dotson, coordinator of the Veterans Resource Center. Fugate says veterans who take his class have higher retention and graduation rates and avail themselves of the many services offered by the Veterans Resource Center.
Military medics also often bring a trauma-triage mindset that is different than what’s required in nursing. After noting this, she and Angela Ballard Grubbs, DNP, ARPN, NP-C, created a three-day Clinical Reasoning Bootcamp for MedVet-BSN students before classes begin. Fugate says students who take the boot camp learn about clinical reasoning and critical thinking in the decision- making process. “They learn to think like a nurse rather than in terms of triage,” she says.
Upon the graduation of its first two students in May, Fugate praised the input given by Beebe and fellow graduate Matthew Eubank. In fact, she says, it was their input that helped lead to shortening the MedVet-BSN Option from five semesters to 24 consecutive months, beginning in 2019, to better fit GI Bill requirements.
“It was a learning curve because we didn’t know what to expect,” she says. “Their experiences taught us a lot. They both were very good about providing feedback.”
Fugate says Eubank, an Army medical specialist and mental health specialist who has been awarded the Army Commendation Medal, two Army Achievement Medals and a Campaign Medal with Valor, was instrumental in founding the UK College of Nursing Veterans Nursing Council and served as its co-chair.
Beebe, who now works in the Medicine Pulmonary Progressive Care Unit at UKHC, says going back to school in her 30s was well worth it.
“I am so thankful I stuck with it,” says Beebe, who in addition to utilizing the GI Bill, received a Women Leading Kentucky scholarship and the Linda Bowers Gorton Military Veteran Scholarship. “It was hard to handle at times, but with everyone’s support at the College, and the support of my husband and kids, I succeeded. I realize I’ve become a much stronger person and will be a much stronger nurse in the end.”
