What does it take to be a well-trained nurse? The answer used to be two-year associate's or four-year bachelor's degree programs. But as the nursing shortage deepens, a growing number of schools and hospitals are establishing "fast-track programs" that enable college grads with no nursing experience to become registered nurses with only a year or so of specialized training.
In 1991, there were only 40 fast-track curricula; now there are more than 200. Typical is Columbia University's Entry to Practice program. Students earn their bachelor of science in nursing in a year. Those who stay on for an additional two years can earn a master's degree that qualifies them as nurse practitioners, nurse anesthetists, clinical nurse specialists or certified nurse midwives.
Many students are recent grads; others are career switchers. Rudy Guardron, 32, a 2004 grad of Columbia's program, was premed in college and then worked for a pharmaceutical research company. At Columbia, he trained as a nurse practitioner. "I saw that nurses were in high demand and it looked like a really good opportunity," he says. "Also, I didn't want to be in school for that long."
The fast-track trend fills a need, but it's also creating some tension between newcomers and veterans. "Nurses that are still at the bedside view these kids with suspicion," says Linda Pellico, who has taught nursing at Yale University for 18 years. "They wonder, how can they do it quicker?" The answer is they don't. Students entering with a bachelor's have already completed many of the prerequisites of traditional nursing schools. "They hit the ground running," says Hila Richardson, associate dean at New York University, which has a 15-month program. She says the fast-trackers get the same amount of clinical practice and classroom time as traditional nursing students.
No matter how they enter the profession, new nurses must meet state training standards. But these vary, and critics worry that fast-track programs cut too many corners. Offhand comments can provoke resentment. Verlia Brown, coordinating head nurse for adult critical-care units at Kings County Hospital Center in Brooklyn, recalls overhearing a young nurse gossiping about how things would improve when older nurses retire. "Next thing I know," Brown says, "one of her patients began to crash and I rushed in. But I had to say, 'See who's helping you now?' "
Those clashes might diminish if, as expected, more midlife career switchers sign up. "There's nothing like supporting a family through a tough time and sharing their joy when they get through it," says. Columbia's Leanne Currie. For patients, that's all that matters.