By Lauren Proudfoot
Baltimore Watchdog Staff Writer
When Rachel Blaché learned that she could graduate from nursing school early as part of the state’s efforts to stem the nursing shortage and fight the coronavirus pandemic, she jumped at the chance.
The 21-year-old Towson University senior, who was scheduled to graduate in December, said she is excited to exchange her student ID for her Registered Nurse badge and head to the front lines once she finishes school this Friday to begin her career and care for the sick.
“Being given the chance to exit early from the nursing program relieves a lot of stress,” said Blaché, who joined 46 other Towson students who opted for the early exit option this year to help fill the nursing shortage. “Knowing that I can successfully go out and be a nurse without even having to complete the entirety of a semester gives me the utmost confidence.”
Towson’s decision to offer nursing students an early graduation option came at the request of the Maryland Higher Education Commission (MHEC), which sent out a notice on Sept. 23 urging nursing programs throughout the state to graduate eligible students early in an effort to boost the nursing workforce in Maryland amidst the coronavirus pandemic. It was the third request issued by the state since Spring 2020.
At the time the request was made this fall, MHEC Secretary James D. Fielder insisted that early graduation was not a signal that each school’s nursing curriculum was changing or that the quality of nurses entering the workforce was being compromised.
“All learning outcomes, course objectives, and program outcomes must be preserved,” Fielder wrote in a letter to nursing school administrators. “Additionally, Maryland nursing programs must continue to meet accreditation requirements. We must maintain that the nursing field is of high-quality and that students are aptly prepared to enter into the workforce.”
Nevertheless, Fielder’s letter set off a debate within nursing schools over how they could maintain high standards and ensure that all students – even those who will exit early – receive a complete education.
“It was stressful to say the least,” said Caitlin Kraus, a nurse at MedStar Franklin Square Medical Center who graduated from the Towson nursing program in fall 2020. “I remember not learning some of the material that I was supposed to be learning. We had more projects and activities than interactive things. The last semester of the nursing program is geriatrics and because I exited early that meant we were not learning much about the older adult and it was a little concerning.”
Kraus said although it might not be considered changing the curriculum, she still wishes she was taught everything.
Dr. Hayley Mark, the department chairperson for Towson’s College of Health Professions, defends the program and doesn’t feel that it has suffered at all from the early exit strategy.
“I think we are doing all we can to help the nursing shortage, which is critically important right now,” she said. “We moved much of last month’s content into previous months. This does increase the workload for students, but they have the option to exit early or not … We have ensured that we are meeting the course outcomes in the previous months.”
Students who feel they are not learning the entire curriculum due to the early exit are welcome to stay until the end of the semester, Mark said.
And some choose to do so.
Erin Dame, a senior at Towson graduating in May 2022, decided not to accept the early exit offer.
“Because I learned most of the material over Zoom due to the pandemic, I don’t feel prepared yet to go into the field early,” she said. “I’d like to stay on track and get the clinical experience I need in order to be a rounded registered nurse.”
The early exit option was offered to all nursing programs in Maryland. Mark didn’t hesitate to offer her students the opportunity to exit early when she learned of it.
“Governor [Larry] Hogan did request this, and we are a state institution so we definitely wanted to respond to his request,” Mark said. “We hope after students exit early they will take their… licensure exam, afterwards and quickly become nurses to help the shortage close its gap.”
Although Fielder encouraged every campus to implement the early exit for qualified nursing students, some colleges chose not to participate.
“We decided not to be a part of the early exit initiative,” Dr. Sarah Szanton, dean of the School of Nursing at Johns Hopkins University, said. “We decided all of our curriculum is important and should not be rushed because the students are in it for the long haul already.”
Notre Dame of Maryland University followed along with Johns Hopkins’ decision.
Damita McDonald, a spokesperson for Notre Dame, said the university is not participating in the early exit option offered by MHEC but instead has been offering an Accelerated Bachelor of Science in Nursing (ABSN) degree program since 2019 to help fix the nursing shortage.
Across the country, application and enrollment numbers in nursing schools have been trending up steadily since 2018, with the most recent enrollments being just over 250,000 people, according to the American Association of Colleges of Nursing.
Maryland’s nursing school enrollment has remained steady over the past three years, going from 2,351 students in 2018 to 2,524 students in 2020, the association reported. The number of applications for Maryland nursing schools rose from 2,083 in 2019 to 2,247 in 2020, according to the AACN. The number of applications in 2020 was similar to the number in 2018.
Mark didn’t have specific numbers for Towson, but she said the school has seen an increase in nursing applications since COVID-19 began. Likewise, Szanton said Hopkins saw its number of applications increase in 2020, although they have trended down so far this year.
As Blaché begins a nursing position in the emergency room at MedStar Union Memorial Hospital in December, she knows she will be stretched thin due to the shortage, but that doesn’t stop her.
“Knowing that there is a shortage of nurses has made me want to go into the field now more than ever,” Blaché said. “I want to be able to care for patients when they’re in their most vulnerable state.”