College of Nursing

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Why We're No. 1 in Nurses

August 21, 2008

They wore crisp white uniforms, prim caps and a pin bearing the motto, Servire, when the first graduates of ECU's new School of Nursing received their diplomas in 1964. The 17 graduates, all women, shared the belief that nurses should be scholars, as well as care givers.

Today, the College of Nursing, East Carolina's oldest professional school, provides the state with more nurses—women and men—than any other four-year institution. Of the roughly 24,000 nurses currently working in North Carolina who hold bachelor's degrees from a North Carolina institution, about one in every nine got their degree from East Carolina. In many counties east of I-95, half or more of the nurses went to ECU, according to figures from the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill.

East Carolina's nursing programs have experienced phenomenal growth in recent years, in enrollment and academics. More than 200 new nurses were expected to graduate this year, making it one of the largest classes ever. And if precedent holds, 96 percent of them will pass the state exam on their first try to become registered nurses (R.N.s), the highest passing rate of the 15 schools in the state that educate nurses, according to the Sheps Center.

The College of Nursing has the state's only nurse midwife concentration, which is part of a robust graduate program, a doctoral degree, a dynamic Center for Nursing Leadership and a sparkling new home on the Health Sciences Campus. But nursing remains true to its original aim of improving health care in the rural east.

While the mission "to serve" still guides the college, much has changed since it opened in 1960 with a dean, five instructors, a handful of students and one office. These days it is a powerhouse, widely respected for the quality and number of its graduates and with a new college designation reflecting a half-century of growth and innovation. U.S. News & World Report lists the College of Nursing ninth in graduate nursing distance education nationally, plus it recently received a new million-dollar endowment, the Richard R. Eakin Distinguished Professorship.

Yet some things haven't changed, says acting dean Sylvia Brown '75 '78. "What we do here at the college has an enormous effect on the community beyond our immediate area," says Brown, who also serves as associate dean for graduate programs. "We take very seriously our commitment to serve. Our school has always been deeply engaged with our community and with the profession at large. We have aimed to be visionary in what we've done, from the start."

In the years ahead, vision will be more important than ever because the college is being asked to produce more nurses, college and university educators and leaders for an ever-more complex health-care environment. And the job of a nurse is getting harder as they care for patients who often are older and sicker, and who require more complicated treatments, than just a few years ago. Expectations are growing for nurse managers, too, who will be expected to have more advanced degrees and professional skills.

Room, at last

In its earliest days, the school occupied just a few offices on campus and later, a university-owned house on Eighth Street. Faculty worked in closets and for a time conducted student conferences in a bathroom.

"It was the only place to have a confidential meeting," remembers Lona Presser Ratcliffe '66, who arrived as a student in 1962 and now serves as clinical associate professor. "One person sat on the toilet and the other person sat on the side of the bathtub. That was what you did if you needed privacy." Conditions improved when nursing moved to the Rivers Building, where it was housed for about 40 years. But space there became cramped and facilities outdated. Plus, Rivers is located on the Main Campus and not on the Health Sciences Campus, where nurses often are assigned to clinicals. In 2006 the university opened the 303,000-square-foot, $60 million Health Sciences Building as nursing's new home, a spacious facility it shares with the College of Allied Health Sciences and the William E. Laupus Library.

This building has eight labs where students learn basics like taking blood pressure, along with advanced skills such as providing intravenous medications. If in the old days nurses used foods such as oranges or hot dogs to practice giving injections, today they can learn in the college's simulation labs with computer-operated mannequins.

A traditional wet lab in the building will allow more bench, or basic sciences, research. The college's new Eakin Professorship will likely be used to attract a researcher, possibly with external funding in place, to get the lab fully operational.

In the building's large lecture halls, students learn about illnesses such as heart disease, diabetes, pulmonary disease and other chronic conditions that plague eastern North Carolina. They learn about wound care, pharmaceuticals and wellness. They learn, too, the importance of considering the big picture when providing care. That's so they can coach new moms, guide family members in caring for elderly relatives, emphasize the importance of treating high blood pressure and safeguard, as much as possible, the health of those who look to them for day-to-day care. They have two years to learn all that.

Despite its rigors, enrollment in nursing programs is at a record high, with 1,021 enrolled this spring. Those numbers include about 100 male students at all levels. In 2007, the College of Nursing awarded Bachelor of Sciences in Nursing degrees to 222 pre-licensure students and 34 R.N.-to B.S.N. students, 83 master's of science in nursing degrees and four doctorate degrees.

Wanted: More nurses

Even as enrollment climbs in the College of Nursing, the pressure is on to grow even faster. State leaders, including the UNC Board of Governors, have asked its schools to produce more nurses for clinical service, education and leadership. One major goal is to double the number of nurse graduates throughout the UNC system by the 2009–10 school year. Programs for registered nurses who wish to receive bachelor's degrees, known as R.N.-to-B.S.N., were asked to increase graduation by 50 percent.

ECU nurses already are making a positive difference. As many as half of all baccalaureate-level nurses working in some eastern North Carolina counties graduated from ECU. Many of these small communities are served by nurse practitioners, who have two or more years of additional educational preparation beyond their four-year degree. They are vital providers in poor, rural counties.

The college is on track to meet its growth goals. During the 2007-08 school year the school admitted more than 275 pre-licensure, or undergraduate-level students, up from about 150 in 2000-01 academic year.

Yet, opening the door to more students cannot mean lowering the bar. Students who apply generally have a B average or higher in some of the university's toughest courses—chemistry, anatomy and physiology, microbiology, nutrition, statistics and ethics. Students apply during their sophomore year and the program begins in the junior year and includes clinical rotations in health-care settings.

During the junior and senior years, students face a rigorous course of study, says Karen Krupa '73 '76, a long-time faculty member and director of undergraduate student services.

"It's our goal to assure students are well-qualified to enter the nursing profession when they graduate," says Krupa. "If you don't want them to take care of your own mother, then we don't believe they should be nurses."

Physical space also sets limits on growth, and even in its new location the college is facing a possible need for more room if its programs are to keep expanding. Compounding an ongoing nursing shortage is another, nationwide shortage of nursing instructors, especially doctorally prepared faculty.

Written by Marion Blackburn
Presented in Summer 2008 East, the magazine of East Carolina University.