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How one hospital helps staff nurses pay for advanced academic degrees

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Have you made the career-changing decision to go back to school to pursue an advanced
nursing degree? If so, you’re probably excited, determined, a little nervous…and broke! You might be anxious about how you’ll be able to afford tuition, books, and fees. You might even be questioning your judgment, wondering how you can even think about starting another degree program when you have little or no money to pay for it.

In 2006, some of the nurses at Riverside Medical Center in Kankakee, Illinois found themselves in this situation. Fortunately, the chief nursing officer (CNO) was passionate about nursing education and practice, and believed many nurses wouldn’t hesitate to pursue bachelor, master’s, and doctoral degrees and national certifications if only they had the “start-up” funding.

NEF to the rescue

To help solve the funding problem, the CNO and other hospital leaders sought an innovative funding source whose money nurses could access before their first classes began. They decided to write a fund-raising proposal to the hospital’s foundation to raise $500,000 over 3 years, to support nurses wishing to pursue advanced degrees and national certifications. The foundation board accepted the proposal, and leaders created the Nursing Excellence through Education Fund (NEF).

One key element of NEF was to ensure money would be available to nurses for start-up costs, including tuition and fees, before they begin their first course. (In contrast, the hospital’s existing tuition-reimbursement program available through the organization’s human resources department provided funding only after the nurse completed a course.) NEF eligibility was opened to all nurses in the hospital. Eligibility criteria included “good standing” employment status, meaning the applicant couldn’t be in a corrective action process. Also, nurses had to maintain a degree-program grade point average of C or higher, or (as appropriate) take the certification exam within 12 months of receiving NEF money. They weren’t required to maintain employment in any of the hospital’s divisions after receiving NEF money to complete a degree or certification. (In contrast, this was a requirement for the hospital’s tuition-reimbursement program.)

Giving nurses a choice

Next, leaders set about to determine which schools, degree programs, and certifications nurses could pursue through NEF. Should NEF funding be limited to a few designated schools and degree programs? Or should nurses be allowed to choose the school and degree program? Leaders opted for the “menu” approach, giving nurses their choice of school and nursing or non-nursing degree, as long as the school and program were accredited. Nurses could use NEF money for tuition, fees, and textbooks.

Certifications were the next consideration. Should nurses be able to apply for NEF money for both nursing and non-nursing certifications? Leaders decided NEF funds could be used for any certification, as well as preparatory classes and materials, travel to classes and test sites, and testing fees.

NEF selection process

Leaders decided that members of a patient carefocused shared-governance structure, the Professional Development Council (PD Council), would develop structures and processes for NEF application, approval, and selection. PD Council members included direct-care nurses from various patient-care areas and several nursing and non-nursing leaders. The council met
monthly to approve NEF applications. Peer approval was essential to the NEF selection process.

In 2007, the PD Council and Magnet® office staff created NEF policies and procedures, an application form, the application process, and selection criteria beyond initial eligibility requirements. The PD Council also set NEF award amounts. Each nurse could receive up to $2,700 per calendar year ($900 per trimester) for degree programs. Certification awards were $500 for one certification per year per nurse. The council purposefully established funding amounts that wouldn’t cover 100% of degree or certification costs, because council members wanted nurses to assume some responsibility for costs.

Marketing NEF

In 2008, the hospital’s foundation began planning a major donor campaign to raise funds for NEF. A family practice physician in the community became chair of the fundraising committee. The campaign included hospital leader presentations to employees and physicians. A major donor issued a dollar-to-dollar challenge grant to community physicians, who met the challenge in the first 3 years of fundraising and collectively donated more than $100,000 to NEF.

Also in 2008, the foundation and marketing department staffs created a video about NEF and
the importance of continuing education for nurses. Hospital leaders presented the video to the organization and community. Proceeds from the annual foundation-sponsored Pro-Am golf tournament were earmarked for NEF. Donations and pledges totaled $550,000 in 2008. So just 18 months into fundraising efforts, the foundation reached the original NEF fundraising goal.

Program changes over the years

As nurses began to use NEF funds, the PD Council made several changes to conserve money for the future. In 2009, it changed eligibility to include only nurses with a hired full-time equivalent (FTE) of 0.5 or higher. Nurses with a 0.9 FTE or higher (fulltime) could get the maximum degree funding of $900 per trimester. Those with an FTE status of 0.5 to 0.89 (part-time) could receive half that amount, or $450 per trimester, to pursue a degree. Certification eligibility for nurses was changed to $500 per year for full-time nurses and $250 for part-time nurses.

Also in 2009, the PD Council decided to approve only nursing degrees for NEF and to limit funds to one degree per nurse. The council approved only those nursing or non-nursing certifications recognized by the Magnet Recognition Program® and listed on the American Nurses Credentialing Center (ANCC) Magnet Recognition Program website. The council decided to award NEF certification funds only after the nurse submitted proof of successful test completion.

Outcomes

The first NEF awards were made in late 2007. In 2009, a local university announced a 20% tuition discount for all hospital employees who enrolled in degree-completion programs. School leaders also offered on-site cohorts for nurses in the bachelor of science in nursing (BSN) program. The first BSN cohorts included 40 nurses.

Grantwriting was a 2009 NEF fundraising initiative. A nursing faculty shortage prompted the
foundation’s development manager and the Magnet® Coordinator to apply for federal grant
monies to support 21 nurses’ pursuit of master’s and doctoral degrees in nursing education. NEF and the hospital’s tuition-reimbursement programs provided matching funds for the federal grant. The foundation again allocated proceeds from the Pro-Am golf tournament to NEF. In 2009, NEF raised $400,000.

In 2010, proceeds from the Pro-Am tournament again were allocated to NEF. A representative
from the state agency that administered the federal grant offered the hospital additional
funding for more nurses to pursue advanced nursing degrees.

Unexpected windfall

When the formal NEF major donor campaign drew to a close at the end of 2010, several donors decided to endow the NEF contributions, which meant interest from the endowments would become NEF monies in perpetuity. This secured NEF’s future.

In 2011, the hospital again received federal grant money. By the time the grant ended in
June 2011, 38 nurses had received NEF money, tuition reimbursement, and federal grant funding for master’s degrees and two had received NEF and federal grant funding for doctoral degrees. About 30% of nurses in the federal grant supported master’s programs paid no out-of-pocket costs for their degrees; 10 had started teaching in local nursing programs.

Celebrating success

By the end of 2012, NEF had raised $1.35 million, which far exceeded the original goal of $500,000. At the end of each year, hospital leaders host an Annual Nursing Excellence Dinner to honor nurses who’ve achieved national certifications and advanced degrees. Nurses receive a free name badge “upgrade” with their new credentials and are recognized in the hospital newsletter.

In the 6 years since NEF was created, we’ve learned these valuable lessons:

  • Use a shared governance structure for peer selection.
  • Honor donors’ intentions.
  • Focus on retention as one outcome.
  • Maximize funding for each nurse to the greatest extent possible.
  • Use innovative strategies to extend funding life expectancy.
  • Ensure consistency in funding programs for such terms as “good standing.”
  • Encourage nurses to embrace the buddy system when starting a degree program.
  • Involve nurses at all levels of funding initiatives.
  • Make program revisions based on nurses’ feedback and program outcomes.
  • Identify internal funding resources, such as foundations and grant writers.

We attribute the success of NEF to the combined efforts of hospital leaders, the foundation
staff, PD Council, Magnet® office staff, marketing department staff, nursing staff, physicians, and community members.

Selected reference

American Nurses Credentialing Center (ANCC). Application Manual: Magnet Recognition Program®, 2008. Silver Spring, MD: American Nurses Association; 2008.

Vicki Haag is Magnet Coordinator at Riverside Medical Center in Kankakee, Illinois.

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