The national dialogue about the nursing shortage has helped to underscore the critical role nurses play in healthcare delivery. The national dialogue about the nursing shortage has helped to underscore the critical role nurses play in healthcare delivery. First noted in 1998, the current shortfall in the number of nurses needed to provide care in the United States (US) is expected to increase to more than 500,000 by the year 2025 according to the latest projections by workforce analysts (Buerhaus, Staiger, & Auerbach, 2008). A growing body of research confirms that registered nurses (RNs) are indeed essential to patient safety; too few nurses have been linked to diminishing the overall quality of care in hospitals and other settings (Agency for Healthcare Research and Quality [AHRQ], 2007). Stakeholders at the federal and state levels have made addressing the nursing shortage a priority and are moving to enact legislation and launch programs both to increase capacity in nursing education programs and to provide funding to prepare the additional faculty needed to teach future generations of nurses.

...nursing has... become an attractive option for career changers looking to transition into the healthcare workforce and add new meaning to their professional pursuits Fortunately, today's nursing shortage cannot be attributed to a lack of interest in nursing careers. Both the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN) have reported steady increases in enrollment in entry-level nursing programs over the past few years, with the latest numbers showing about five percent growth in the number of students enrolled in both 2006 and 2007 (AACN, 2008; NLN, 2008). Applications to nursing programs are up across the board and competition for limited enrollment slots is intensifying. In addition to strong interest among new high school graduates, nursing has also become an attractive option for career changers looking to transition into the healthcare workforce and add new meaning to their professional pursuits.

What is driving this resurgence of interest in nursing careers? The media spotlight on the RN shortage has served to showcase nursing as a lucrative, secure field that offers a variety of practice opportunities beyond traditional roles. With 2.4 million nurses in the workforce in 2006, RNs comprise the largest segment of professionals (28%) working in the healthcare industry and one of the largest segments of the U.S. workforce as a whole (Dohm & Shniper, 2007). Looking forward, government analysts project that more than 587,000 new nursing positions will be created through 2016 making nursing the nation's top profession in terms of projected job growth.

In addition to offering a high level of job security, nurse employers are increasingly offering more attractive levels of compensation in an effort to appeal to new recruits and retain working RNs in the profession. Registered nurses, in fact, are among the highest paid practitioners of any “large occupation” as classified by the U.S. Bureau of Labor Statistics (2007). Nearly 57% of RNs today work in general medical and surgical hospitals where salaries average $60,970 per year. Salaries for new nurses are somewhat lower, but it is not uncommon to hear that new clinicians are offered salaries in the $45,000 to $50,000 range. Nurses with advanced practice preparation, including nurse practitioners and clinical nurse specialists, currently command salaries of $80,000 and upwards (Mee, 2006).

...today's nursing shortage cannot be attributed to a lack of interest in nursing careers...many career seekers see nursing as a dynamic profession that brings many rewards and great potential for advancement.With a career horizon brimming with opportunities, many career seekers see nursing as a dynamic profession that brings many rewards and great potential for career advancement. Beyond the high demand for nurses to provide direct care, nurses are also needed as researchers, healthcare administrators, educators, policy analysts, nurse executives, and independent practitioners. The latest developments from the field promise new nurses virtually unlimited opportunities for progression to advanced degrees in nursing practice, as well as opportunities for teaching. With salaries climbing, opportunities expanding, and the demand for nursing services on the rise, now is an exciting time to consider a career in nursing.

During the past decade new and innovative pathways to prepare nurses for an increasingly complex, uncertain, healthcare environment have emerged. Nursing continues to offer multiple ways for students to enter the profession and has consistently advocated for creative and innovative opportunities for academic progression that meet the needs of a student population that is diverse along numerous dimensions. The focus of this article is on a discussion of the current pathways available to enter the nursing profession and the wide-ranging models available for students to achieve advanced educational preparation within nursing. While it is certainly possible to change goals and directions, early consideration of the desired end point can provide helpful direction in selecting the most efficient and effective path to reaching career goals.

Traditional Entry Points into Nursing

Though the subject of much debate, the nursing profession in the US recognizes three traditional routes to becoming an RN: a diploma program most often administered in hospitals; an associate degree program usually offered at community colleges; and a baccalaureate degree program offered at senior colleges and universities. Graduates of all three programs sit for the National Council Licensing Examination for RNs (NCLEX-RN^©) which measures minimum technical competency for entry-level nursing practice. The National Council of State Boards of Nursing (NCSBN) administers the NCLEX examination and publishes data each year on the number of new nurses by entry point. In 2007, the breakdown of newly minted RNs included 58.4% from associate degree programs, 38.4% with baccalaureate degrees, and 3.1% from diploma programs (NCSBN, 2008).

Diploma Programs

Using an apprenticeship model, hospital-based diploma programs prepare graduates to deliver direct patient care in a variety of settings. Diploma programs may partner with colleges and universities to offer credit courses for co-requisite course work, but, graduates do not receive a nursing degree upon graduation. According to the latest data from the National Sample Survey of Registered Nurses (Health Resources and Services Administration [HRSA], 2007), approximately 25.2% of practicing nurses completed their initial RN education in diploma programs. The number of diploma programs has declined sharply since 1965 when the American Nurses Association called for moving hospital-based RN programs into the college and university system (Donley & Flaherty, 2002).

Associate Degree Programs

Typically offered in community colleges, Associate Degree in Nursing (ADN) programs provide an efficient, economical pathway to becoming a registered nurse. Approximately 42.2% of the RN workforce received their basic education in ADN programs (HRSA, 2007). Graduates are prepared with the clinical competence and technical proficiency needed to practice safely in multiple settings and to fully assume the RN role (Mahaffey, 2002). The number of ADN programs has grown considerably since first introduced in 1958 with about 940 programs now enrolling students nationwide. With more than 600 of these programs offered in the U.S. community-college system, ADN educators are committed to offering quality programs that are “continually evolving to reflect local community needs and current and emerging healthcare delivery systems” (National Organization for Associate Degree Nursing [NOADN], 2007).

Baccalaureate Programs

Offered at four-year colleges and universities, the Bachelor of Science in Nursing (BSN) programs prepare new graduates to practice across all healthcare settings and assume the widest variety of RN roles. BSN programs encompass all of the course work taught in ADN and diploma programs plus a more in-depth treatment of the physical and social sciences, nursing research, public and community health, nursing management, and the humanities. The additional course work enhances the student's professional development, prepares the new nurse for a broader practice, and provides the foundation for progression to advanced practice roles in nursing. With 606 entry-level baccalaureate programs enrolling students nationwide, approximately 31% of nurses in the workforce received their basic education in baccalaureate programs (HRSA, 2007).

Considerations in Selecting a Nursing Entry Route

Choosing the most appropriate entry point depends on a variety of factors including what the future nurse hopes to achieve in his/her career, a student’s opportunities for college entrance, and family and work obligations. Financial considerations are also important. Diploma and associate degree programs typically cost less annually than baccalaureate degree programs. Students choosing to attend schools locally and to live at home based on personal preferences or family obligations may also have lower costs than students who attend schools at a distance or who live on campus. Before making a decision about costs, students are advised to consider all factors including available financial aid at various institutions and the costs of additional education required beyond the various entry points to meet career goals.

At present, nurses entering the profession with a baccalaureate degree are four times more likely to pursue a graduate degree in nursing than other entry-level clinicians (HRSA, 2007). Yet nurses entering the profession today with an ADN or diploma have an increasing number of opportunities to advance their education to the graduate level. In addition to the more traditional path of entering and completing a bachelor’s degree after earning an associate degree in nursing, there are now programs that provide a more direct path to master’s degrees for these students. Currently, there are 153 programs available throughout the US to prepare these RNs in master's degree programs where they can earn a Master’s of Science in Nursing (MSN) degree. RN to MSN programs generally take about three years to complete with specific requirements varying by institution and based on the student's previous course work. The baccalaureate level content not included in diploma and ADN programs is built into the front end of these degree completion programs. Mastery of this upper level, basic, nursing content is necessary for students to move on to graduate study. Upon completion, many programs award both the baccalaureate and master's degrees. Though the majority of these programs are offered in traditional classroom settings, some RN to MSN programs are offered largely online or in a blended classroom/online format.

Finally, those considering which entry point to choose must also pay attention to the issues of accreditation and articulation. Nursing programs accredited by the profession’s two, nationally recognized, accrediting bodies – the Commission on Collegiate Nursing Education and the National League for Nursing Accrediting Commission – have demonstrated that they meet professional standards and are quality programs. Nursing students planning to continue their education beyond their entry point  at some point in their career are strongly encouraged to complete their basic education in an accredited program since credits from unaccredited programs are not generally accepted as transfer credits at four-year institutions.

Entry-level students interested in pursuing a degree-completion program in the future should also inquire about articulation (or transfer) agreements between ADN or diploma programs and four-year institutions. These agreements ensure the smooth transfer of credits between higher education institutions and often specify how many credits can travel from program to program. Hundreds of articulation agreements have been forged by schools nationwide, including some statewide agreements that apply to all public institutions. Students graduating from programs without articulation agreements and those seeking to complete a nursing program in another state may run the risk of having fewer credits transfer between schools. Students are encouraged to contact program administrators to see what articulation agreements exist and determine which courses yield transferable credit.

Emerging Entry Points

Beyond the traditional entry routes to a career as a registered nurse, a number of additional pathways are emerging and proving effective at attracting new audiences into the nursing profession. These alternative routes include entry-level master’s programs; accelerated programs for graduates of non-nursing disciplines; community college-based baccalaureate programs; and RN completion programs for Licensed Practical Nurses and other allied health providers.

Entry-Level Master’s Programs

Interest in entry-level or generic master’s programs is running high among career changers wishing to enter nursing at an advanced level. Designed for individuals with undergraduate degrees in fields other than nursing, these 28-36 month programs build on previous learning experiences and prepare graduates for teaching, research, and specialty nursing roles. According to AACN’s 2007 survey of baccalaureate and graduate nursing programs, 56 entry-level master's programs are enrolling students at nursing schools in the US, and 13 new programs are under development. Enrollments in and graduations from these programs are on the rise. In 2007, 4,303 students were enrolled and 1,032 students graduated from entry-level master’s programs. By comparison, in 2006, there were 3,854 students enrolled and 870 graduates from these programs.

Exciting new options among entry-level master’s degrees are programs that prepare nurses for advanced generalist roles, including the Clinical Nurse Leader (CNL^®). Gaining in prominence, CNLs are lateral integrators of care who put evidence-based practice into action to ensure that patients benefit from the latest innovations in care delivery. Evidence-based nursing practice integrates the best research available with clinical expertise and patient values for optimum care (Institute of Medicine, 2003). The CNL role combines expert clinical practice with microsystems-level advocacy, centralized-care coordination, outcomes management, risk assessment, and quality improvement. AACN is facilitating the efforts of more than 90 education-practice partnerships around the country to integrate this new role into a variety of practice settings. The Department of Veterans Affairs (VA), the nation’s largest employer of RNs, is a strong supporter of the CNL. The VA is among the early adopters of this role and is moving to introduce CNLs into all VA healthcare facilities.

Accelerated Programs for Graduates of Non-Nursing Disciplines

Accelerated baccalaureate programs offer the quickest route to licensure as a registered nurse for adults who have already completed a bachelor's or graduate degree in a non-nursing discipline. These programs generally take between 11 and 18 months to complete, including prerequisites. Accelerated baccalaureate programs accomplish programmatic objectives in a shorter time by building on prior learning. Instruction is intense with courses offered full-time with no breaks between sessions. Students receive the same number of clinical hours as their counterparts in traditional entry-level nursing programs.

Over the past five years, the number of accelerated baccalaureate nursing programs has expanded rapidly, and these programs are now available in 43 states plus the District of Columbia and Puerto Rico. In 2007, there were 205 accelerated baccalaureate programs enrolling students, compared to 90 programs that were available in 2002 (AACN, 2008). In addition, 37 new accelerated baccalaureate programs are in the planning stages. This number of new programs far outpaces all other types of entry-level nursing programs currently being considered at four-year colleges and universities. In terms of enrollment growth, AACN's 2007 annual survey found that 9,938 students were enrolled in accelerated baccalaureate programs, up from 8,493, 7,829 and 6,090 students in 2006, 2005 and 2004, respectively. The number of program graduates has also increased with 5,881 graduates in 2007 as compared to 5,232, 3,769 and 2,422 graduates in 2006, 2005 and 2004, respectively.

Community College-Based Baccalaureate Programs

In response to the calls...to increase the production of baccalaureate-prepared nurses, community colleges across the country are offering BSN programs on-site at these institutions. In response to the calls by the American Organization of Nurse Executives (2005) and other authorities to increase the production of baccalaureate-prepared nurses, community colleges across the country are offering BSN programs on-site at these institutions. Given their commitment to serving local needs, these community colleges are working to provide a cost-effective solution for bringing more baccalaureate nurses into the profession and meeting community demands.

In October 2005, AACN members endorsed a position statement in support of community college-based baccalaureate programs that meet the same standards as traditional baccalaureate programs offered at four-year institutions. The emergence of baccalaureate nursing programs at community colleges underscores the national need to increase the number of accessible and affordable pathways to raise the education level of the nursing workforce. Sixteen states have changed regulations to allow community colleges to offer baccalaureate programs, with four states specifically moving to offer the BSN degree: Florida, Indiana, Nevada and Washington. Community colleges in Florida have made the most progress in offering the BSN through its statewide systems with programs now available at five institutions, including St. Petersburg College and Miami Dade College (Community College Baccalaureate Association, 2008).

RN Completion Programs for Licensed Practical Nurses and Other Allied Health Providers

...LPN to ADN programs were credited with...bringing the highest number of ethnic minority students...into the student population. Community colleges and four-year institutions also offer bridge programs for Licensed Practical Nurses/Licensed Vocational Nurses (LPNs/LVNs), Emergency Medical Technicians (EMTs), and other allied health professionals who wish to transition into the Registered Nurse role. In California, for example, eight community colleges offer LVN to ADN programs which account for 4.2% of the nursing students enrolled in the state’s RN programs (Waneka & Spetz, 2008). Though this percantage is relatively small, the LPN to ADN programs were credited with having the lowest attrition rate (2.9%) among all entry-level programs and were successful at bringing the highest number of ethnic minority students (68.9%) into the student population. These data underscore the importance of developing these pipeline programs even further.

In four-year colleges and universities, the number of LPN to BSN programs reached 155 in 2007 with an additional 12 programs opening over the next few years. Although the majority of these programs are presented using a traditional, in-class format, 18 programs are offered completely online. Schools are working collaboratively to ensure that credits transfer between institutions and students have the support needed to succeed at this new level of academic rigor.

Moving Along the Education Continuum

...too few nurses choose to advance their education to the graduate level, despite...need for nurse practitioners, clinical nurse specialists, nurse anesthetists, nurse midwives, researchers, faculty, administrators, and other roles requiring expert level preparation. Entering the nursing profession is only the first step for professionals wishing to advance in the field and maintain the competency needed in this ever-evolving, practice discipline. The NLN and AACN are both strong supporters of academic progression through formal, degree-granting programs and lifelong-learning experiences to enhance nursing knowledge. Unfortunately, too few nurses choose to advance their education to the graduate level, despite the great need for nurse practitioners, clinical nurse specialists, nurse anesthetists, nurse midwives, researchers, faculty, administrators, and other roles requiring expert level preparation. Nurses looking to move into baccalaureate and/or graduate study may choose from a variety of program options. These options include BSN degree-completion programs for RNs;  direct baccalaureate to doctoral programs leading to either a research-focused, terminal degree (PhD, DNSc, DSN) or a practice-focused, terminal Doctor of Nursing Practice (DNP) degree in nursing; master’s degree programs to progress to the highly complex and specialized-practice roles; and programs providing additional preparation for faculty positions. Many of these options are offered online. These first two options will be discussed in depth below.

RN to BSN Programs

In addition to the growing number of RN to MSN programs, RN to BSN programs provide an efficient bridge for diploma and ADN-prepared nurses who wish to expand and enhance previous knowledge and advance in their careers. In fact, most RNs who advance their formal education beyond their initial preparation choose to complete a baccalaureate nursing program (HRSA, 2007). RN to BSN programs build on initial nursing preparation with course work to enhance professional development, prepare for a broader scope of practice, and provide a better understanding of the cultural, political, economic, and social issues that affect patients and influence care delivery. These programs are growing in importance since many professional practice settings, including Magnet hospitals and academic health centers, now require or prefer the baccalaureate degree for specific nursing roles.

With a growing awareness about the positive outcomes associated with advancing to higher levels of education (Aiken et al., 2003 & 2008; Estabrooks et al., 2005; Ridley, 2008; Tourangeau et al., 2007) and increasing encouragement from employers who provide tuition support for RN to BSN programs, more and more nurses are returning to school to complete a baccalaureate degree. Currently, 50,963 nurses are enrolled in 559 RN to BSN programs offered at schools throughout the US. From 2006 to 2007, enrollments in RN to baccalaureate programs increased by 11.5% or 5,188 students, which makes this the fifth consecutive year of enrollment increases in these degree completion programs (AACN, 2008). As more and more graduates of associate degree and diploma programs enter RN-BSN programs nationally, greater numbers of nurses will be prepared to enter graduate programs in nursing, in order to inform and support evidence-based practice in a wide variety of practice and educational settings.

Baccalaureate to Doctoral Programs

In terms of doctoral preparation, nursing schools nationwide are moving to open more programs leading directly from the baccalaureate degree to doctoral degrees in response to the profession’s dire need for more nurse faculty and researchers. These programs allow graduates of baccalaureate nursing programs to move quickly into graduate study. A great benefit of these programs is that they encourage strong BSN students to continue their education without long gaps between degree completions. In nursing, the average time it takes to complete a doctoral program is 15.9 years from the time a student first enrolls in a master’s program. By comparison, the average completion time for a doctorate in other fields is 8.5 years from the first enrollment in a master’s program (Berlin & Sechrist, 2002).

The “fast-track” nature of a baccalaureate to doctoral program is derived from a sequencing of course work that eliminates the need for students to enroll first in a master’s program and then a doctoral program. These programs take four to five years to complete and provide intense clinical instruction and specialized experiences throughout the course of study. This new level of clinical education builds on the experiences these students have already completed in their BSN programs and becomes progressively more complex as students demonstrate mastery in their graduate studies.

The nation’s first baccalaureate to doctoral program, a BSN to PhD program, was offered in 1995 by the University of Texas Health Science Center–San Antonio. Since then, the number of fast-track doctoral programs has grown steadily from one program in 1995, to eight programs in 1999, to 63 programs in 2007. According to AACN’s latest annual survey (2008), ten new baccalaureate to doctoral programs are under development.

Fast-track doctoral programs are also gaining in popularity with the arrival of Doctor of Nursing Practice programs. Since the passage of AACN’s position statement in October 2004, which called for transitioning specialty nursing programs at the master’s level to the doctoral level by the year 2015, nursing schools nationwide have been moving in this direction at a rapid pace. Today, 65 DNP programs are admitting students at institutions located in 30 states plus the District of Columbia. In addition, 63 new practice doctorates are being developed at both large and mid-sized nursing schools in the US.

DNP curricula build on current master’s programs by providing education in evidence-based practice, quality improvement, and systems thinking among other key areas. The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to a research-focused, doctoral program. DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc and other research-focused nursing doctoral programs.

With the emergence of the Doctor of Nursing Practice degree, more nursing schools are moving to offer a BSN to DNP option. Of the 65 DNP programs now enrolling students, 25 schools (38.4%) admit post-baccalaureate students while the majority only admit graduates of master's-level nursing programs. The number of post-baccalaureate DNP programs is expected to increase dramatically as new programs are opened, and master’s programs are transitioned to the doctoral level.

In addition to hundreds of programs offered in traditional classroom settings, access to baccalaureate nursing and graduate education is further enhanced by the widespread availability of online programs. According to the 2008 edition of Nursing Programs published by Peterson’s, there are currently 163 online baccalaureate degree completion programs offered in the United States as well as 109 master’s programs and 16 doctoral programs in nursing. Most online degree-completion programs will accept graduates from accredited diploma or ADN programs which meet equivalent quality standards set for professional nursing programs.

Conclusion

Nursing as a profession is making great strides in attracting new recruits and increasing the education level of those already in the RN workforce. The latest National Sample Survey of Registered Nurses (2007) found that the greatest changes in education level of nurses between 2000 and 2004 were at the master’s and doctoral degree levels. During this time period, the number of RNs with a graduate degree increase by 37.0%. Further, the National League for Nursing’s latest data report (2008) found that the overall number of American institutions offering nursing programs expanded by 6.4% between 2005 and 2006. During that time frame, graduations from all pre-licensure programs grew by 8.5%, with graduations from baccalaureate programs showing the largest increase of almost 20%. Clearly these are signs that nurses are moving to become more highly educated in response to the evolving needs of the profession.

Moving nurses further along the educational continuum will take a shared commitment among nurse educators and stakeholders that is fueled by innovation and collaboration (Bednash & Lancaster, 2008; NLN, 2005). Together nursing’s academic leaders are working to prepare a strong and well-educated nursing workforce, which is in the best interest of both patients and the healthcare system. Research confirms what nurses have always known: that RNs are the key to patient safety; they play a central role in lowering mortality rates, preventing medical errors, and ensuring quality outcomes. Nurse educators must continue to work together to ensure that nursing remains an attractive career choice, that graduates from all types of nursing education programs are well prepared to enter the workforce, and that these graduates have access to multiple pathways for academic progression, in-order-to meet the challenges of contemporary nursing practice.

Authors

C. Fay Raines, PhD, RN
E-mail: rainesc@uah.edu

C. Fay Raines serves as Dean and Professor of the College of Nursing at the University of Alabama in Huntsville, a position she has held since 1990. Under her leadership, nursing enrollment and the size of the faculty have tripled, and undergraduate and graduate nursing programs have expanded. In addition to her position as Dean, she also served as Associate Provost for Institutional Effectiveness for ten years with responsibility for the University’s assessment programs and for directing the University’s re-accreditation process with the Southern Association of Colleges and Schools.

Dr. Raines was elected and currently serves as President of the American Association of Colleges of Nursing (AACN), the national voice for baccalaureate and graduate nursing education in the nation. Prior to assuming the presidency, she completed two terms as Treasurer of the organization and served on the Board of Directors and on numerous committees and task forces.  In addition to her extensive service with AACN, Dr. Raines has held a number of leadership positions in national and state professional organizations. She serves on the editorial board of the Journal of Professional Education. In Alabama she has served as a leader in nursing, health policy, and higher education groups, including a term as president of the Alabama Association of Colleges of Nursing and member of the State Planning Committee of the Alabama Commission on Higher Education.

Prior to her tenure at the University of Alabama in Huntsville, Dr. Raines served as Associate Dean for Academic Programs and Interim Dean at the University of Virginia School of Nursing. She earned her Bachelor’s and Master’s degrees in Nursing from the University of Virginia and her PhD in Nursing from the University of Maryland in Baltimore. Dr. Raines presents and publishes extensively on healthcare, health policy, and nursing education. Her recent research has focused on the relationship between the pesticide DDT and breast cancer.

M. Elaine Taglaireni EdD, RN
E-mail: etagliareni@ccp.edu

M. Elaine Tagliareni is currently a Professor of Nursing and the Independence Foundation Chair in Community Health Nursing Education at Community College of Philadelphia. She has been an associate degree nursing educator for over 25 years. Dr. Tagliareni received her BSN degree from Georgetown University School of Nursing, a Master’s degree in Mental Health and Community Nursing from the University of California, San Francisco, and her doctoral degree from Teachers College, Columbia University with an emphasis on the role of the nurse educator in community colleges. In 1998, Elaine was awarded the National League for Nursing Mildred Montag Excellence in Leadership Award.

Since 1995, Dr. Tagliareni has been involved with the design and development of a community-based, service-learning project at the Community College of Philadelphia, called the 19130 Zip Code Project and funded by the Independence Foundation, Philadelphia, PA. For the past several years she has organized workshops designed to assist faculty to replicate lessons learned from this project, increase retention, and promote critical thinking based on a foundation of co-learner relationships with students. This approach to teaching and learning was one of the primary reasons that the Nursing Department at Community College of Philadelphia was recently honored as a National League for Nursing Center of Excellence.

Currently Dr. Tagliareni is President of the National League for Nursing (NLN) and is a member of the NLN Board of Governors. From her wide-ranging participation in NLN committees, for example, the Council of Associate Degree Programs and the Nursing Education Advisory Committee, she has played a key role in fostering innovation and in promoting the nurse educator role as an advanced practice role.  As President, Dr. Tagliareni hopes to continue to advocate for excellence in nursing education through pedagogical research and to promote dialogue about successful strategies to prepare a diverse nursing workforce.  

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U.S. Bureau of Labor Statistics, (2007). Occupational employment and wages for 2006. Accessed May 10, 2008 at www.bls.gov/news.release/pdf/ocwage.pdf.