Deirdre Thornlow

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Careers in Nursing
Hosted by Deirdre Thornlow
Program Director
American Association of Colleges of Nursing (AACN)
Thursday, July 18, 2002; 1 p.m. EDT

Deirdre K. Thornlow, MN, RN, is a program director for the American Association of Colleges of Nursing (AACN). Her background in health care administration includes recent work at The George Washington University Hospital where she held positions as director of Quality Operations, director of Quality Management and Regulatory Compliance and Performance Improvement manager.

Her experience as an advanced practice nurse included the roles of a cardiovascular clinical nurse specialist and integrated care pathway coordinator. A registered nurse in both the U.S. and the United Kingdom, she received her master’s in nursing at the University of California-Los Angeles and her bachelor’s of science in nursing from Pennsylvania State University.

The transcript follows below.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Deirdre Thornlow: Hi, welcome to our on-line chat.
I’m Deirdre Thornlow MN, RN, a Director with the American Association of Colleges of Nursing. Prior to joining AACN, I was the Director of Quality Operations at the George Washington University Hospital in Washington, DC. My background includes experience as a Clinical Nurse Specialist in both the United States and the United Kingdom.
Now, it’s time to take any questions you may have regarding nursing as a career option, nursing specialties, nursing programs, financing your nursing education and so forth.

Great Falls, Va.: I am just starting an Associates degree program to become an RN. I already have a BS in another field. How imperative is it to have a BSN versus a BS and an RN? I am concerned that it may limit my choices as a Nurse, or that I may get paid less without a BSN. Any insight?

Deirdre Thornlow: Although AD programs will prepare you to become an RN, since you already have a Bachelor's degree in another field, why not consider an accelerated pathway to get your Bachelor's in Nurisng. Currently, there are almost 100 programs nation-wide that offer accelerated baccalaureate nursing programs for individuals with degrees in other disciplines. The programs take approximately 12-18 months to complete. There are also currently about 25 master’s programs, which normally take 36 months to complete. The accelerated nursing programs are attractive to those transitioning from other careers. For more information please contact info@aacn.nche.edu to request a full listing of these exciting programs. Starting with a BSN does afford you career mobility and a higher starting salary.

Arlington, Va. Can you recommend a good place online to find out information regarding scholarships and/or tuition reimbursement for a would be nursing student? thanks, Ron

Deirdre Thornlow: Yes, there are many scholarship opportunities available for those pusuing a degree in nursing. Some good sites for scholarship information include: www.discovernursing.com and www.nsna.org. For a complete listing of financial aid resources contact AACN via e-mail at info@aacn.nche.edu

Somewhere, Md.: I have been seriously considering making the switch from the business world into nursing for many different reasons. I have a business degree (B.S.) from PSU and have been looking at local colleges in MD. What's your opinion on going back to a 4 year college versus as 2 year program at a community college for a RN degree? Any other suggestions would be great!

Thanks so much

Deirdre Thornlow: Since you already have a bachelor's degree in another discipline, there is no need to go back to a two- or four year program to become a nurse. There are accelerated nursing programs that will fit your needs. Currently, there are almost 100 programs nation-wide that offer accelerated baccalaureate nursing programs for individuals with degrees in other disciplines. The programs take approximately 12-18 months to complete. In Maryland, 4 schools offer the programs: Johns Hopkins University, University of Maryland, Salisbury State, and Villa Julie College. For more information please contact info@aacn.nche.edu to request a full listing of these exciting programs.

Wheaton, Md.: Perhaps you can address the fact that many nurses start out at great pay (around $40,000 per year), but that it stays the same (factor in inflation).

My mom WAS a nurse, she has retired, and has informed my children that if they go into nursing she'll break their thumbs. Said the same to me when I went to college.

Deirdre Thornlow: I can personally attest to the fact that this is not true! Nursing affords terrific career mobility. Salaries are reflective of education, speciality and experience. With the nursing shortage, clinical bedside and advanced practice nurses are in great demand and salaries are certainly on the rise.

Washington: Are you familiar with the current demand for clinical specialists versus NPs? Do they both require the same education level? (MSN?)
Any idea what the current/future demand is for specialties?

Deirdre Thornlow: Advanced Practice Nurses are in high demand across all specialities and both require education at the master's level. As for choosing between Nurse Practitioner and Clinical Nurse Specialist, it really depends on your focus. NPs tend to deal more directly with patients and are employed in a wide range of settings. CNSs provide a range of services (education, clinician) in various specialties, generally in more acute care arenas. CNSs tend to deal more with the staff and health care team, but must be expert clinicians, as they are often seen as a resource. For a list of organizations that represent specialty NP and CNS as well as nurse midwives and nurse anesthetists, please contact us at info@aacn.nche.edu

Alexandria, Va.: What are the pre-requisite courses for these accelerated programs? What if you received a BA in liberal arts (history for example) and did need to take very many science courses? Thanks.

Deirdre Thornlow: The programs require a transcript review and pre-requisites in the sciences. The schools are willing to work with the students to offer the pre-requisite classes in an accelerated fashion as well, immediately prior to the beginning of the program. For more information, contact the school that you are interested (among the list of schools offering the accelerated programs).

Alexandria: You mentioned Johns Hopkins Accelerated program. I have checked that out and at a price of $35,000, it seems a bit intimidating financially. The state of MD had grants for nursing students, but I have not seen anything similar for VA. Are you aware of any? Hopkins has the best reputation of most area schools, but, does that really matter in today's job market?

Deirdre Thornlow: I encourage you to inquire with the school to ascertain what financial aid programs they have available for the accelerated program. Some schools have arrangements with employers to provide scholarships in exchange for a work commitment after graduation. You may want to ask about this sort of agreement. As in all fields, a school's reputation may factor into hiring decisions. It is something to consider.

Arlington, Va.: I have seriously considered becoming a nurse - both when I entered college and then last year when I reevaluated my career path. The one thing that I just can't get over is the long shifts and irregular hours. I just don't understand HOW working these kinds of long-hour shifts is good for PATIENTS (or nurses, of course). How did the scheduling practices of hospitals come about? Why aren't there 8 hour shifts in nursing?

Deirdre Thornlow: Nurses work a variety of shifts, ranging from 4 to 12 hours. 12-hour nursing hospital shifts offer continuity in patient care. For the 24 hour period there are only 2 shifts, rather than 3. This scheduling arrangement is also very attractive to some nurses who enjoy working only 3 days per week while still enjoying full-time benefits. We encourage you to look for a position that fits your needs.

Alexandria, Va.: Is there a standardized nursing exam like LSAT's and MCAT's?

Deirdre Thornlow: Yes, the RN licensing exam is the NCLEX-RN which is taken following graduation.

Great Falls, Va.: It is important to note that second-degree seeking students usually already have bills to pay, and college loans building. The AD programs are MUCH cheaper, and sometimes even offer a more well-rounded education than your random 4-year degree college. For example, the program at Northern Virginia Community College is GREAT!

Deirdre Thornlow: The students entering the accelerated nursing programs already have a well-rounded baccalaureate education. The fact that the accelerated programs are only 1 year in length, versus an additional 2 - 3 years of schooling factors into the decision. The BS degree offers the added potential of higher salary and career mobility.

Washington DC: Given the current nursing shortage, are there federal programs that offer funding or on-the-job training to get more people into the career more quickly?

Deirdre Thornlow: Yes there are government programs for loan-repayment, disadvantaged and minority students and for nurses who agree to work in underserved areas. For more details see the DHHS Division of Nursing website. www.hhs.gov/nursing

Alexandria, Va.: I am in my mid-30s, married with toddler, and have thought baout becoming a nurse for many years, but keep putting it off. At this point, how realistic is it for me to switch from my public policy career to nursing? Would I experience any age discrimination once I became a BSN? Would I be out of place even in nursing school?

Thank you!

Deirdre Thornlow: More and more second career seekers are turning to nursing as a viable career option. Most second degree students are older, ranging in age from late 20's to early 40's. In fact we are hearing from faculty that the second-degree learners are motivated, commited and bring a rich diversity to nursing. All are welcome!

Vienna Va.: info-aacn.nche.edu was not recognized as an address when I tried to email to it.

Deirdre Thornlow: our email address is info@aacn.nche.edu

Alexandria, Va.: I am hoping to begin the Accelerated program next Fall. When exactly do you realize what area you want to specialize in? While in school or actually in the workforce?

Deirdre Thornlow: There are many specialty areas within the field of nursing. You will learn more about which area you would like to specialize in as you go through the program. I encourage you to talk with your faculty advisor and others in the field (especially as you do your clinical rotations). If you still find you are unsure, you can begin with medical-surgical nursing and decide from there. A list of nursing specialties can be found on www.discovernursing.com and www.nursesource.org

Washington D.C.:

I was 1 semester away from graduating college a year ago when I decided that I didn't want to become a doctor. Now I want to become a midwife. I am thinking of Georgetown's programs (nursing then midwife). What do you think of them? do you have any suggestions for places for me to do more research about this?

Thanks!

Deirdre Thornlow: The American College of Nurse Midwives has information on Nursing Midwifery programs available in the United States. Their website is www.acnm.org

Alexandria, Va,: I have my masters degree in public health and have been working in the field for about 7 years now - with additional work experience in the health field, in general, for many years before that. I currently coordinate overall health and wellness activities for a national organization, writing health curricula, teaching wellness workshops, writing wellness newsletters, coordinating health fairs etc. I am ready to move away from the "coordinating" aspects of a public health/wellness job and ready to move up a step to being a director/manager. Ideally I would love to manage or direct a wellness center for a hospital/clinic of other health facility. However, in searching the internet and papers, I am not finding many higher level positions available. Any ideas on where to search for such jobs?

Deirdre Thornlow: It certainly sounds like you have many skills that would be highly desirable in a leadership or managerial role. Consider networking in various organizations. Nurse Practitioners often run such clinics and would be a tremendous resource (www.aanp.org). Also, present a business plan, or market yourself directly to the hospitals or organizations where you would like to work.

Laurel Md.: Are there any programs that a foreign trained medical doctor can undergo to allow him transition to the Nursing profession?.

Deirdre Thornlow: Florida International University in Miami, FL has a program to transition physicians from other countries to a career in nursing . This is a great time to make such a transition, especially with the nursing shortage. Another source for information is the Commission on Graduate of Foreign Nursing Schools (www.cgfns.org). Although targeted for nursing, they may be able to assist you.

Alexandria, Va.: What is the average salary and workload for a recent nursing school graduate and for a nurse with 20 years experience.

Deirdre Thornlow: Nursing salaries vary by region, by nursing specialty, by level of education, and by experience. By 2000 figures, the average starting salary for a recent nursing graduate is in the high 30’s to low 40’s. Salaries are certainly on the rise due to demand.

Vienna, Va.: Why is it that we almost never see nurses dressed anymore in the traditional peaked white hat, white uniform, white stockings, and white shoes? Is this another example of political correctness or just simply changes in fashion over the years?

Deirdre Thornlow: Nurses still wear uniforms is just that the fashions have changed with the times! Comfort and sensibility are factors in uniform selection.

Alexandria, Va.: There has been some recent studies on the ill-effects (both personal and patient care) of extensively long hours put in by recent med student grads and internists. Do you feel that these kind of hours are partly b/c of competition rather than management? Can the same be said for nursing?

Deirdre Thornlow: Although the long physician and resident hours' are part of the training program, they have recently been curtailed for a variety of reasons (patient safety, staff safety, etc) Nursing hours generally average 40 hours per week and many organizations are now limiting mandatory overtime.

Fairfax, Va.: Why don't we see more male nurses?.....doctors seem to be well-reprented by both males and females, but it seems rare to see a male nurse. Is there something about this profession that turns men off? In the military, there are both
male and female corpsmen...the military equvalent of civilian nurses and nurse's aides.

Deirdre Thornlow: Nursing has historically been a female-dominated profession, yet this is changing. Men are currently 6% of the workforce, but are 10% of current enrolled students ub baccalaureate programs. Schools are actively recruiting males and other under-represented groups into nursing. There certainly are fields within nursing that generally attract more men, such as trauma and ED nursing, nurse anesthetist, critical care. We'd like to see more men in the field -- in all specialities!

Houston, Texas : I am moving to Forestville, Maryland within the next week, I will be looking for something in Hospital Administration I currently am employed as an Ancillary Outpatient Scheduler at the Methodist Hospital Texas Medical Center. What are my chances for employment in Maryland, and salary ranges, opportunities for advancement.

Deirdre Thornlow: For a list of the hospitals in that area of Maryland, please contact the Maryland Hospital Association or visit their website mdhospitals.org

There is also another organization to assist you to learn about health professions currently in demand in Maryland. Their website is marylandhealthcareers.org

Alexandria, Va.: If I become an RN in Virginia, how easy is it for me to move to another state; what is ininvolved in terms of making me eligible to work in another state? Thanks, Ron

Deirdre Thornlow: Many states offer license reciprocity. Please check with the State Board of Nursing in the state that you plan to relocate.

Harrisburg, Penn.: In Pennsylvania, and elsewhere, there is a shortage of nurses. State governments are responding by providing more funds to nursing schools to increase their enrollments. Do you believe this would be helpful, or would it be more useful to direct such funds to more scholarships or in some other fashion?

Deirdre Thornlow: The funds are dispersed in many ways. Some of the money does go to fund student enrollment and student tuition, yet other funds are directed to faculty development and infrastructure improvement. All are important for ensuring a quality education. AACN is working with local, state and federal legislators to secure more financial assistance for students. If you want a list of sources for student financial aid please visit our website www.aacn.nche.edu

Dan in Alexandria, Va.: The intro to this discussion mentioned a nationwide nursing shortage. Can you elaborate on that any?

Deirdre Thornlow: Yes there is a nation-wide nursing shortage. Although there have been past nursing shortages they have been cyclical in nature. The current shortage is expected to be more severe due to the aging of the population (including the aging of the nursing workforce!) The demand for care is increasing at a time when the number of individuals choosing a career in the health professions is declining. The Department of Labor projects that one million new and replacement nurses will be needed by 2010.

Alexandria, Va.: Hi Deirdre,
I have a teenage cousin that will be going to school in the fall. She will be studying dental hygenist, but she had thought about studying nursing. She lives in North CArolina and she knows if she stays in that area she may not make a lot of money. What do you think? In addition, is it logical to get a Bachelor degree in Nursing or just an Associate degree.
Thanks,
Q

Deirdre Thornlow: Please encourage your cousin to be a nurse. It is a career that offers terrific career mobility and a range of specialties from which to choose. Salaries are based on region, experience and education. We do encourage students to pursue the BSN if possible because, as stated earlier, it affords more career options and higher pay.

Alexandria, Va.: I once met a former nurse who got out of the field because "I got tired of getting bossed around by doctors."

Are doctors rude to nurses? What can be done to stop them?

Deirdre Thornlow: The nursing shortage has served to underscore the important role of the nurse as well as the importance of communication and collaboration among all members of the health care team. Some organizations recognize this through signed agreements that encourage mutual respect by all members of the health care team.

Washington D.C.: Thank you for hosting this chat, as many of the questions for the health careers chat yesterday concerned nursing careers. For those people not currently working in nursing, there seems to be a lot of attention paid to the nursing shortage. While many people in their 30s are considering switching careers, enrolling in 13-month BSN second-degree programs, or pursuing nurse practitioner degrees, there still seems to be a lot of choices in specialization in the RN field. Can you describe some of the pros and cons for those of us who are professionals in other fields that are considering moving into the nursing profession? And, are there more financial advantages to getting a nurse practitioner certification (MSN) over clinical nurse specialist certification? As a current professional, there are also issues related the treatment of nursing staff that concern me personally. As an unsatisfied lawyer, I am still hesitant to enter a profession where you are treated with less respect than other health professionals. (i.e. MDs)

Deirdre Thornlow: Many people are considering nursing as a second career. Nursing is certainly a career in which you can make many transitions, without ever leaving the field of nursing. Nurses can be clinicians, researchers, administrators, educators, health care leaders and policy makers. The opportunities are certainly endless. There is job security and the salaries are also quite good. As for choosing between Nurse Practitioner and Clinical Nurse Specialist, it really depends on your focus. NPs tend to deal more directly with patients and are employed in a wide range of settings. CNSs provide a range of services (education, clinician) in various specialties, generally in more acute care arenas. CNSs tend to deal more with the staff and health care team, but must be expert clinicians, as they are often seen as a resource. For a list of organizations that represent specialty NP and CNS as well as nurse midwives and nurse anesthetists, please contact us at info@aacn.nche.edu

Greenbelt, Maryland: Hi:
I'm very interested in returning to school full-time to obtain my BSN. (This would be my second bachelor's degree.) What kind of financial resources are availble for the non-traditional student with a dependent, a mortagage, and other financial obligations to peruse this educational endeavor full-time? I thought about a second mortagage on my property, but I don't have enough equity to do that. I also checked with my employer about tuition reimbursement so I could attend part-time, but that was a no go because it's not related to my current position in human resourses. Any helpful suggestions would be greatly appreciated. Thank you very much -RN2B.

Deirdre Thornlow: The second-degree programs are acclerated and normally last for 12-18 months. The programs are specifically designed for those with a prior baccalaureate degree. There are also programs that are designed for part-time enrollment, for those unable to commit to full-time study. Either way, the graduates of these programs are in high demand. Since there is an acute nursing shortage, many hospitals are offering scholarships in return for work commitment. Why not inquire at the hospitals in your area? Also be sure to inquire with the school's financial aid administrator.
For a list of sources for student financial aid please visit our website www.aacn.nche.edu

Deirdre Thornlow: Sorry, we are out of time this afternoon. If you still have additional questions or want to know more about nursing careers please visit our website at aacn.nche.edu or e-mail us at rrosseter@aacn.nche.edu.

Thanks and good luck in your nursing career.

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