An RN's decision to return to school to pursue a baccalaureate degree is multifaceted. Most RNs receive no monetary incentive for earning a bachelor of science in nursing (BSN) degree; (1) they return to pursue the degree for other reasons, including personal growth, to improve critical thinking skills, or as a requirement for specialty certification or graduate school entrance. (2) Other key benefits of a baccalaureate education include increased self-direction, improved ethical conduct, enhanced performance, increased responsibility, and professional enhancement. (3)

More than 50% of RNs in the United States have an associate's degree (AD) or diploma as their highest level of educational preparation. According to US Department of Health and Human Services Division of Nursing statistics, nurses with ADs and diplomas make up 34.3% and 22.3% of the RN population, respectively, and 32.7% have BSN degrees. (4) Registered nurses with ADs and diplomas, however, have become one of the fastest growing groups of students enrolled in baccalaureate schools of nursing. (5) In the year 2000, 16% of nurses who initially earned ADs and 24% of nurses who initially earned diplomas were reported to have obtained additional academic nursing education or nursing-related degrees. (6)

LITERATURE REVIEW

According to the literature, RNs often are hesitant to reenter the academic environment, and when they do, they commonly are presented with a plethora of challenges. One group of authors identified several disincentives to RNs considering returning to school, including services, credit transfer, finances, geographic accessibility, and nonavailability of courses in areas of interest. (7) Another author cited difficulty in getting credit for diplomas as a disincentive for RNs returning to school. (8) Registered nurses fear returning to school because they do not feel they can manage both work and school in addition to their personal life. (9) The majority of RNs returning to school are confronted simultaneously with the roles of parent, employee, student, and homemaker. (10) A 1987 comparison of RN students to general studies students found that RNs tended to be older, employed full time, married with children, and commuters to campus. (11) Some RN students are single parents with small children. (12) In spite of these challenges, RNs are returning to school in increasing numbers for a variety of reasons.

After an RN is enrolled in school, he or she may suffer role conflict and strain from the challenge of juggling schedules. (13) One author reported that RNs face time and energy constraints in addition to the problem of scheduling various activities and obligations around their school schedules. (14) Other authors found that money was an important issue and often a deterrent for RNs who want to return to school. (15)

THE SURVEY

To provide helpful advice for RNs wishing to continue their education, an informal survey was conducted among students enrolled in two courses in the Flex-Track RN to BSN Online Program at the University of North Alabama (UNA), Florence. The Flex-Track program is entirely Internet-based, so RNs can complete the professional components of the bachelor's degree online without ever coming to campus. Thirty-six students participated in the survey in December 2001. The average age of participants was 38.8, and they averaged nine years practicing as RNs. The majority of the students were female (86.1%), married (66.7%), parents (69.4%), and working full-time in nursing (88.9%). Most of the students worked in hospitals (83.3%), and the mean annual salary was $43,186.

The students surveyed gave three main reasons for returning to school--personal satisfaction (33.3%), the desire to attend graduate school (30.6%), and the desire for career advancement and to receive promotions (30.6%). They also cited three major obstacles to enrolling in school--difficulty juggling a school schedule with other obligations (66.7%), family concerns (22.2%), and financial concerns (16.7%). These incentives and concerns correspond with those identified in the literature.

This article shares the students' written responses to the survey. Responses are classified under the headings "contemplating," "planning," and "experiencing." These classifications identify the stages the students traversed to reach the current point in their educational process. Most of these students graduated in 2001 and 2002.

CONTEMPLATING

In the first stage, an RN considers returning to school. During this time, he or she will evaluate the pros and cons of this decision. The RN students surveyed discussed six issues that are typical for RNs who contemplate returning to school. These include age, income changes, professional and practice enhancements, time management, nonmonetary benefits, and financing a BSN education.

Age. Students frequently commented that many of their colleagues think they are too old to return to school; however, the UNA students viewed the issue of age as merely an excuse for many. Survey participants ranged in age from 22 to 56, with 33% older than age 40 and 16% older than age 45. The average age was nearly 39.

A 56-year-old home health care nurse who returned to school after 30 years of nursing said, "I do not think you are ever too old to learn. Just think of the experience you can bring to the group of learners. You can share history if nothing else. How wonderful your experience is to the novice." A 53-year-old perioperative clinician who became a nurse at age 43 said,

   I had been out of school for 22 years. When I
   was 39 years old, I went to nursing school. My
   kids were practically grown, and I wanted to
   accomplish this educational goal. I have been
   an RN for I0 years and am now working
   toward my BSN. If I can do it, anyone can.

The prevailing opinion of those surveyed was that learning has no age limit. Students also believed their colleagues use age as an excuse to mask their real reasons for not returning to school, whatever those reasons might be.

Income changes. One of the issues addressed in the survey was the lack of financial rewards for earning a BSN. Many agreed that in lateral positions, there is little difference in the salaries of nurses with ADs, diplomas, and BSNs in the facilities where they are employed. Students said that earning a BSN, however, will make them more marketable and qualify them for promotions that generally carry pay increases. Many of the nurses envision a future in which salary differentials will be greater for a nurse with a BSN compared to a nurse with an AD or a diploma.

The majority of the students surveyed cited personal satisfaction as more important than salary increases. Additionally, they reported that academic learning better equips them to understand health care bureaucracy and policies, navigate the political system, and act as change agents and patient advocates. One 38-years-old student sees education as a professional obligation saying, "Elevating our profession through education should be a goal for all RNs. This will advance the profession, and I feel it will make it a more respected field for future generations to go into." Another student expressed her opinion as follows.

   I want to be able to be prepared to negotiate
   the political system, to remove artificial barriers
   that limit my profession's ability to practice
   in the best interest of the patient.... I think in
   the future the nurse must look at her role in the
   overall scheme of health care, of the range of
   nursing's skill and the scopes of practice, and
   the relationships between nursing care and the
   positive outcomes of patients. We will be called
   on to demonstrate flexibility, accountability,
   and leadership. I think education will help me
   prepare for this challenge.

Commenting on the personal aspect of earning a BSN, a 25-year-old student said,

   Money should never be the motivation for
   returning to school. Even if your facility does
   not pay more for higher education, there will
   be a wider range of job opportunities; however,
   the most important thing is the knowledge
   increase and self-satisfaction that comes from
   continuing education.

Professional and practice enhancements. One disincentive for pursuing a BSN education that was discussed in the survey is the opinion of many nurses that further education will not make a person a better nurse. Several of the participating students mentioned that this school of thought is prevalent among their colleagues. Overwhelmingly, students who participated in the survey believed that their nursing practice improved in ways they never would have realized before enrolling in a BSN program. One student said,

   I have been a nurse for 21 years and also I
   thought [that education does not make a better
   nurse]. Things are newer and more improved;
   it helped me want to make a difference again
   for my patients.