Reviving the Heart of Nursing

Nursing students at Borough of Manhattan Community College (above) and LaGuardia Community College (below right) are preparing for careers at New York City medical centers, where the need for highly skilled nurses is great. LaGuardia's graduates scored highest statewide on the 2007 licensing exam.

For college students, the uncertainty of the economy has aggravated an age-old dilemma: How do I merge my need for a decent-paying job with a desire to do good in the world?

For many, the answer has the resonance of a healthy heartbeat.

"You see, nurses are in demand," notes Edilberto Calamanan, a 55-year-old immigrant from the Philippines who earned his associate's degree in nursing from LaGuardia Community College in December, 2007. Calamanan, an even-tempered man who loves helping people, began working at Elmhurst Hospital while a student at nearby LaGuardia in Queens. Since then, he has climbed the ladder and earned significant pay raises along the way. A former high school teacher in his native Philippines, Calamanan is proud of his college, which last year had a pass rate of 97.47 percent for its 79 graduates who took the licensing exam. It was the highest pass rate in the state, surpassing that of even four-year colleges. The combined average pass rate of all University graduates taking the so-called NCLEX—or National Council Licensure Examination—was 86.3 percent. That was considerably higher than the rate for other colleges in the region.

The health industry is one of the strongest sectors in the local and national economy, with 400,000 jobs in New York City alone; RN's (Registered Nurses) make up the largest single category within the industry, comprising 15 percent of those jobs. But with that strength comes a concern. According to federal estimates, New York City will have a shortfall of almost 37,000 nurses by 2015—and nationally a shortage of a million nurses is anticipated by 2020. New York State legislators are calling for action to boost enrollment at college nursing programs, which the University sees as a challenge and an opportunity.

According to Dr. William Ebenstein, University Dean for Health and Human Service, the University in the last five years has graduated more than 3,500 nursing students who went on to pass the NCLEX. And the number of nursing grads (from LPN, or Licensed Practical Nurse programs, as well as associate, bachelor's and master's programs) jumped from 847 in 2002-03 to 1,487 in 2006-07.

A key to the University's plans to further boost the number of nursing graduates is the creation of a new doctoral program in nursing, the only such public program in the region. "The shortage is pretty much based on a lack of faculty," said Dr. Keville Frederickson, director of the Doctor of Nursing Science Program at the Graduate Center. "The beauty of our program is its two primary focuses—one, our concentration on health disparities, how to identify them in certain ethnic groups and how to correct them—and that we prepare nurse researchers who will also be educators."

The University began focusing on the nursing issue in 2002, when a task force convened by Chancellor Matthew Goldstein came up with recommendations. A key feature of the Nursing Task Force Report, Dean Ebenstein noted, was the suggestion, later approved and carried out, for increases in the number of faculty to be hired. "Another feature," he added, "was the embrace of technology, including offering more online courses and the creation of nursing simulation labs on several of our campuses."

Today 13 colleges offer nursing programs, with three—College of Staten Island, Hunter and Lehman—offering master's degrees in various specialties. Lehman College in the Bronx has had nursing students since its opening in 1968 and is proud of its efforts to turn out nurses who can work easily in the city's diverse communities. Lehman has a program that trains immigrants who have received a nursing education overseas, schooling them in English and other necessary skills. Thanks to a grant from the Robin Hood Foundation, Lehman has been working with about 20 such immigrants a year. Graduates are passing the licensing exams at a rate of about 80 percent, according to Michael Paull, Dean of Adult and Continuing Education.

The college also has an "MD to RN" program dealing with "doctors who had been trained abroad and who were working out of title in this country, doing anything from medical technology to more menial tasks," Paull said. Lehman turns those doctors into nurses with American bachelor's degrees.

The problem of finding good nursing professors is compounded by the fact that the recommended student-faculty ratio is so low, 10 to one. This means that the average associate-level nursing course will cost $6,800 per student, as opposed to $2,400 per student for a non-nursing class. Another costly feature of nursing education is the laboratory. The simulation labs at Queensborough Community College, Borough of Manhattan Community College and New York City College of Technology are especially outstanding. According to City Tech's website, its laboratory "contains hospital and home health equipment, training mannequins, and basic medical supplies that simulate the clinical/home setting and help students learn a variety of skills."

Nursing education has gone through enormous changes since the mid 20th century when some of the oldest current practitioners were trained. Back then, the teaching and certification came through hospitals and other so-called diploma institutes. But by the 1960s, a realization developed that nurses—like professionals in other fields—needed a broader intellectual grounding. So colleges took up the call to provide skills that went considerably beyond on-the-job, the-needle-goes-here lessons. Hospitals and other healthcare institutions now determine placement and promotion, in large part, on the degree level of candidates.

Calamanan, the associate's degree holder from LaGuardia, says he very likely will pursue a master's degree while he works in a medical-surgery unit at Elmhurst Hospital. Having recently passed his registered nurse exam, Calamanan moved from a yearly LPN pay base of about $35,000, to an RN line, where the salary is as much as $70,000 a year in the city.

As a male, Calamanan is among a distinct minority in the nursing field. Of the three dozen or so students enrolled or accepted into the University's doctoral program, only two are men, program director Frederickson said. "Men are afraid to go into nursing because it's seen as a very caring, nurturing profession, and those are seen as feminine traits," he said.

But one would think today, with lines blurring between science and art, that men as well as women would see the beauty of a profession that a famous practitioner, Florence Nightingale, described this way:

"Nursing is an art; and if it is to be made an art, it requires an exclusive devotion, as hard a preparation, as any painter's or sculptor's work... It is one of the Fine Arts; I had almost said the finest of Fine Arts."