The GBC Nursing Department prepares students to receive an Associate of Applied Science Degree, successfully complete the examination for licensure as a registered nurse, and function as a beginning practitioner of nursing in a variety of settings. In doing so, the program’s philosophy, goals, and outcomes reflect the College’s mission and goals. The nursing faculty strives to assist students in developing critical thinking, problem solving, communication, and analytical and self-directed learning skills.

The AAS in nursing, a 70-credit program, is a combination of general education and nursing courses. This four-semester program is preceded by one year of prerequisite courses. The nursing courses are offered on the Elko campus and open only to the current class of nursing students. Also offered through the Nursing Department are several nursing assistant courses each semester in Elko, Ely and Winnemucca. The Health Sciences Department teams with community service to offer health-related programs such as EMT, First Responder, as well as health professional continuing
education courses.

The nursing curriculum requirements are set by regulatory agencies: the Nevada State Board of Nursing, the National League for Nursing, the Nevada State Licensing Bureau, and the UCCSN Board of Regents. Program length, number of courses, contact hours, and minimum passing rates are set by these agencies. The mastery of program outcomes are measured by national testing for the registered nursing students and state testing for nursing assistants and emergency medical system students. Passing rates are monitored and documented, and are a measure of program effectiveness.

Nursing faculty is responsible for design, integrity, and implementation of the nursing curriculum, which flows from the program’s conceptual framework. The four-semester program moves the course objectives from simple to complex, and includes many problem-solving and critical thinking activities. Each theory course and clinical site are evaluated by students and faculty. Graduates and employers evaluate the outcomes of the nursing program.

Faculty. The Nevada State Board of Nursing and National League for Nursing require all full-time and adjunct nursing faculty to be registered nurses with master’s degrees in nursing. Other health science programs require faculty to be certified and/or licensed and have experience in their teaching area.

FACULTY

*Total years as a nurse. Also includes years as a nursing instructor.

Students. Admission to the Nursing Program follows a rigorous process which relies on a point system that rates individuals in a number of areas. Students are given copies of the admission rating form when they first come for advising. The form is also included as part of the nursing application packet and reviewed a third time when all applicants come to take the Nurse Entrance Test. Points are given for prerequisite and general education courses completed, health-related certifications and work experience, letters of recommendation, scores on a standardized math and reading comprehension exam, and on the applicant’s writing ability. The applicants who have the most points on the admission rating form are admitted as nursing students. Selection is done anonymously and follows the GBC and UCCSN affirmative action guidelines. An average of fourteen students are admitted at one time once a year. The enrollment pattern for the Nursing Department and other health-related courses continues to be steady. The programs maintain full enrollment numbers with high completion and job placement rates. See Exhibit 2.31 for enrollment data on nursing students from 1986 to present, including race, sex, number of applicants, number admitted, and the National Council for Licensing Examination (NCLEX) scores.

Resources. The Health Sciences Department is located in the new health science building. The Nursing Department and Continuing Education Department are in the same office area and share one full-time administrative assistant. The building has two fully equipped nursing labs and six classrooms. The Nursing Department shares the lab space with other faculty for health-related courses. The classroom space is used for other College or community classes.

The health science budget is adequate to cover department needs. Other money is received from one-time allocation money from the legislature and from student lab fees.

Significant Changes
• Facility. The Health Sciences Department moved into a new building in 1996. The move provided more lab, classroom, and office space.
• Distance education. Medical Terminology is open to all students as a WebCT course. In 2001, the mental health nursing course was offered as an online course. In the end of semester evaluation, both students and nursing faculty positively evaluated the course content and the delivery method. It will continue as an online course each fall semester. The nursing students have requested other online courses, and faculty are reviewing the nursing curriculum to determine which class will be next.
• Scheduling changes. Scheduling of the general education courses required for the nursing degree is done at the off-campus sites as well as in Elko. The majority of classes are offered live in addition to the Internet, interactive video, and self-paced. The nursing courses are scheduled in block times in order to reduce the amount of travel time required of nursing students who commute to Elko on a daily basis. If students request, arrangements are made for them to complete their final clinical course in their home communities.
• Increased health science offerings. Other health science courses such as nursing assistant and EMS are offered each semester at the off-campus sites. Student request is most often the determining factor in the number and type of health science classes offered. The Health Sciences Department and Community Service Department work together to increase the variety of courses. Partnering with the Community College of Southern Nevada (CCSN), GBC offers courses toward certifications in Health Information Technology and Phlebotomy. Working with UNLV, GBC provides lab and clinical space, training equipment, and an interactive classroom for distance education classes for their baccalaureate and master’s degrees in nursing. Two Elko area nurses are currently enrolled in the UNLV’s master’s degree program.

Analysis
Faculty recruitment. Although GBC’s Nursing programs have an abundance of qualified student applicants, a major weakness is the difficulty in recruiting qualified faculty. The Nevada State Board of Nursing requires faculty to hold a doctoral or master’s degree in nursing. However, nationally, only one percent of all registered nurses are doctoral-prepared, and five percent hold master’s degrees. The GBC Nursing Department experiences a chronic shortage of nursing faculty. The department is working with other programs in the state to present a plan to the Nevada State Board of Nursing which would allow hiring of nurses who have a bachelor’s degrees in nursing and are enrolled in a master’s program.

Learning outcomes. The measurement of the student outcomes is an on-going process in the nursing program. Formative and summative evaluations are a part of the clinical component of each nursing course. A minimum grade of >C- is required for progression in the nursing program.

Students evaluate each clinical site and experience, each nursing course, and each nursing faculty. The information is used to modify the program as needed. Graduates and employers evaluate the nursing program one year and five years after completing the program. That information is also used to determine program satisfaction and effectiveness. Another method of measuring program outcomes is with the use of National League for Nursing standardized assessment exams. Tests are administered after the completion of each nursing course. Faculty use the results to provide individual student advising, as an assessment tool for the course and for the program.

Student retention. The dropout and/or withdrawal rate for the nursing program is low. This is attributed in part to the selection process used, the individual attention given to each student, and the strong desire and motivation of the nursing students. Placement of the nursing graduates continues to be 100 percent. The recruitment of graduates starts locally and spreads to the national level. Active recruitment begins each spring semester. If a student leaves the program for any reason prior to graduation, a meeting of the program director and student is scheduled. The student’s reason for leaving is discussed. The student is asked to submit the reason(s) in writing. In turn, the program director provides the student with documentation of the reason(s) as well as the student’s status, i.e., returning to the program with or without resubmitting an application. The process is outlined in the Nursing Student Handbook and reviewed with all students on the first day of fall semester.

Assessment. The department has a good deal of documentation of the summative and formative clinical evaluations, the NLN exams given each semester, and the NLN Readiness Test, which is an indicator of how students will perform on their national exam for licensure. The summative and formative evaluations are in individual student folders and the others in binders and are available as supporting documents.

Nursing students’ pass rate on the National Council for Licensing Examination–Registered Nurse are given on the table below:

Placement Information. The department does not need to actively work to place students in jobs. All who want to work, are offered positions immediately. There is 100 percent placement of graduates. Many employers hire the students as soon as they graduate rather than waiting until after they pass their national exam and are licensed. They don’t want to lose good graduates. Many stay in Elko or return to Ely, Winnemucca, or Battle Mountain and work in the hospitals in their hometown.

Nursing shortage. The shortage of nurses has increased the number of qualified applicants for GBC’s Nursing program. In addition, the shortage has prompted the UCCSN Board of Regents to consider doubling the size of the nursing programs in Nevada. Each year, the program has many more qualified applicants than can be accepted. The Great Basin College Nursing Department is experiencing what the majority of programs are experiencing nationally, which is a shortage of nursing faculty. GBC has an ample number of approved clinical sites, adequate lab and classroom space, and enough qualified applicants to double the size of the nursing program. What the College does not have is the required number of nursing faculty.

The GBC Nursing Department has positioned itself to add the upper two years of an RN in order to
provide a BSN degree. This degree would be in addition to the current two-year RN degree. Graduates would be prepared for leadership and management positions within a variety of acute and community-based rural health care settings. These graduates would also be prepared to continue to the master’s degree level and then be educationally qualified to teach nursing. The faculty believes that a BSN will improve retention of nurses in the field.

STRENGTHS
• The large number of students who continue to be interested in health care careers.
• A well-organized and structured program, with policies and practices under continual review and revised according to accreditation requirements of the National League for Nursing and the Nevada State Board of Nursing.
• A department committed to effective student advising and teaching.
• The Health Sciences Department as an integral part of the GBC degree, certificate, and continuing education courses, supportive of other departments on campus.

CHALLENGES
• Recruiting qualified faculty.

RECOMMENDATIONS/ACTION ITEMS
• Prepare for the National league of Nursing re-accreditation scheduled for Fall 2003, with the self-study document to be completed in August 2003 and the site visit in October 2003.
• Continue to seek funding sources or collaborative solutions.
• Continue to plan for the BSN program.