Nursing at UHMānoa

Text compiled from the American Nurses Association website at http://nursingworld.org,
the American Association of Colleges of Nursing website at www.aacn.nche.edu/Education.htm,
the UHM School of Nursing website at www.nursing.hawaii.edu,
the Top 100 Health-Care Careers, and the UHM 2005-2006 Catalog

Nursing Degrees
Nursing Programs in Hawaii
Coursework
What makes a strong candidate?
Standardized Tests
Contact Information
Additional Information
Downloadable Brochure

The American Nurses Association's website describes nursing as follows: “The essence of nursing is that nurses combine the art of caring with the science of health care. Nursing places its focus not only on a particular health problem, but on the whole patient and his or her response to treatment. Care of the patient and a firm base of scientific knowledge are indispensable elements.

“Nurses work in many different areas, but the common thread of nursing is the nursing process - the essential core of how a registered nurse delivers care.

This process involves 5 steps:

• assessment: collecting and analyzing physical, psychological and sociocultural data about a patient;
• diagnosis: making a judgment on the cause, condition and path of the illness;
• planning: creating a care plan which sets specific treatment goals;
• implementation: supervising or carrying out the actual treatment plan;
• evaluation: continuous assessment of the plan.

“There is a wide variety of nursing specialty areas; you will certainly be able to find one to fit any interest you have. Examples include: surgery, emergency, pediatric, psychiatric, school, public health, nurse-midwives, and others. Note that some specialty areas require additional experience, study or certification.

“There is a strong demand for nurses today. Career prospects are good, and job possibilities are plentiful. Nurses are needed not only in hospitals, but also in home health agencies, long-term care facilities such as nursing homes, managed care centers, and in community health. Educating patients & their families in preventive care is highly important. Demands for advanced practice nurses are growing in many areas; some APNs are opening their own practices.

“Nurses have never been more important to health care than they are today. They must be well-educated, adaptable, and able to act as patient advocates. Nurses should be prepared for leadership roles in managing resources to promote better health care for their patients, whatever the location or setting.”^[a]

Nursing Degrees

As a career, nursing offers great flexibility, allowing early entry into the workforce, continued professional development, and advancement through retraining and pursuing higher degrees. Consequently, there is no "typical" timeline: students can combine education and work into unique paths that suit their lives.

Students can complete one degree, work, then return to complete a higher level. Over a lifetime’s career span, a student who began as a Nurses’ Aide can eventually complete a Doctorate. And a nurse who, for example, began in family medicine could choose later to switch to surgery, internal medicine, or geriatric nursing. Each degree level allows greater opportunities for new assignments, promotion, administrative/managerial work, and higher salaries.

The most widely available nursing degrees include

• CNA, Certified Nurse Aide or Nursing Assistant (8-12 weeks)
• LPN, Licensed Practical Nurse (1-1 ½ years)
• RN, Registered Nurse (2-5 years)
• APRN, Advanced Practice Registered Nurse (Master level)
• Clincal Nurse Specialist (CNS)
• Nurse-Midwife
• Nurse Practitioner (NP)
• Nurse-Anesthetist
• Ph.D. (Doctorate level)

CNAs, sometimes also called hospital attendants, work under the direct supervision of the nursing staff and assist with the routine daily care of patients, making beds and maintaining patients’ environments; helping patients eat, bathe, dress, and walk; responding to patients’ calls for assistance; and transporting patients.

LPNs, sometimes called licensed vocational nurses (LVNs), work under the supervision of an RN and provide bedside care, such as taking vital signs, feeding and bathing patients, dressing wounds, giving medications, changing intravenous fluids (IVs), preparing patients for medical examinations, and assisting physicians or nurses in those examinations. LPNs also carry out a variety of administrative chores.

RNs are vital members of the health care team. They are responsible for providing direct patient care and for carrying out treatments ordered by physicians. They take medical histories, help perform diagnostic tests and analyze results, administer treatments and medications, assist physicians with medical procedures, educate and provide support for patients and their families, and help with patient follow-up and rehabilitation. RNs also supervise staff. RNs work in all areas of health care – family medicine, internal medicine, pediatrics, obstetrics and gynecology, surgery, geriatrics, and so on. Consequently, there are many different types of nurses as well: private duty nurses, operating room nurses, critical-care nurses, office nurses (who work for physicians, dental surgeons, etc.), school nurses, community health nurses, occupational health nurses, public health nurses, nurse educators, and so on.

Advanced degrees. RNs who have completed Bachelor degrees can earn advanced degrees at the Master or Doctorate level, which bring increased opportunities, responsibilities, and higher salaries. Advanced degrees also allow RNs to work as Nurse Administrators or Nurse Educators. APRNs (Advanced Practice Registered Nurses) are highly trained nurses specializing in one of four areas: CNS, Nurse-Midwife, NP, or Nurse-Anesthetist. Advanced degrees are usually required for college teaching and research.

CNSs complete advanced training in specific areas of expertise: cancer, cardiac, neonatal, mental health, etc. CNCs also train and mentor nursing students.

Nurse-Midwives, or midwives, care for women throughout pregnancy, labor, delivery, and post-delivery. They also provide routine gynecological care and counseling on family planning. Midwives serve only carefully screened women whose pregnancies and unlikely to present complications and work closely with obstetricians and other specialists to provide a wide net of support for their patients. Midwives focus on maintaining the well-being of mother and child and educate patients on nutrition, exercise, breastfeeding, childcare, and family care. Midwives are usually in private practice but are often affiliated with a hospital.

NPs (Nurse Practitioners) handle a wide range of activities, including taking medical histories, conducting physical exams, diagnosing and treating common injuries and illnesses. NPs order and interpret laboratory tests, advise patience, and perform routine procedures such as injections, immunizations, and wound care. The duties of a NP are similar to those of a Physician Assistant, but NPs are more autonomous, working independently or cooperatively with physicians.

Nurse-Anesthetists administer anesthesia to patients under the general supervision of an anesthesiologist, who is a physician. Nurse-anesthetists differ from anesthesiology assistants in that assistants work under the direct supervision of an anesthesiologist whereas nurse-anesthetists work independently. Nurse anesthetists select and administer the appropriate anesthetic and dosage for each procedure and monitor patients under anesthesia. The nurse anesthetist may also assist in the surgical, obstetric, or dental procedure.

Nursing Programs in Hawaii

A wide variety of nursing programs are available in Hawai’i:

Students can become RNs at either the Associate level, by pursuing an Associate Degree in Nursing (ADN) at a 2-year community college, or at the Bachelor level, by pursuing a Bachelor of Science in Nursing (BSN) at a 4-year university. All RN programs require background checks and/or drug testing.

Students may complete an ADN, begin working as a RN, and then return to complete a BSN. Some programs also offer accelerated BSN programs for RNs returning for a Bachelor degree or for students with BS degrees in other fields.

At UHM, there are three options, or pathways:

1. admission to the BSN program after completing a minimum of 34 credits in prerequisites;
2. admission to the BSN program after completing an Associate degree or diploma program in Nursing; or
3. admission to an accelerated 18-month BSN program after completing a Bachelor degree and the nursing prerequisites.

Completing a LPN degree provides good preparation for UHM’s BSN program, and completing Kapi’olani’s ADN program guarantees admission. UHM also gives preference in admission to Hawaii residents and those of Hawaiian/Pacific Islander ethnicity.

All RNs, whether at the Associate or Bachelor level, take the same licensing test, work in the same kinds of jobs, and receive similar salaries. The main differences are that RNs with BS degrees

• are more competitive for hiring and promotion,
• are more flexible in being reassigned,
• are more eligible for administrative positions,
• can change specialties more readily,
• are eligible to work in the military, and
• are eligible to pursue advanced degrees

All LPN, RN, and APRN nurses must be certified and licensed to practice in Hawaii. Certification requires passing a National Council Licensure Examination: NCLEX-LN for Licensed Practical Nurses and NCLEX-RN for Registered Nurses, administered by the National Council of State Boards of Nursing (NCSBN). Nurses can apply for a state license in Hawaii through the Department of Commerce and Consumer Affairs.

Coursework

Prerequisite coursework for nursing programs vary from school to school, so it is important to identify as early as possible which schools you hope to attend. Some nursing schools accept students directly from high school; others accept students at the sophomore or junior level; others accept students only after they have completed a set number of credits or course prerequisites.

The following UHM courses are commonly required for admission to nursing programs:

Additional requirements may include courses in biology, psychology, nutrition, history, or certification in cardiopulmonary resuscitation (CPR).

UHM’s Pre-Health and -Law Advising Center (PAC) offers a suggested academic plan for pre-nursing majors.

What makes a strong candidate?

Admission committees for RN nursing programs are looking for students who have

• completed all the prerequisites,
• a high GPA for the nursing prerequisites,
• a high overall grade point average (GPA),
• performed well on the NET or NLN exam, and
• gained healthcare experience relevant to nursing and sufficient for an understanding of the nursing profession.

Almost all nursing programs require a minimum grade point average (GPA), usually between 2.5 and 3.0. The published national average for a GPA cutoff is 2.8. Some programs, however, are "impacted," which means they receive far more applications than they can accept. Impacted programs usually have a much higher actual cutoff GPA than their published GPA. You might want to contact the Admissions Director for the schools you plan to apply to and ask whether the program is impacted and for the current average GPA for accepted students.

UHM’s School of Nursing accepts students through a competitive application process. Students must receive grades of ‘C’ or higher in all prerequisites, indicated by an asterisk (*) in the list of courses, above. Note that Math 100 and Pharm 203 are not included in the prerequisite GPA.

The School of Nursing recommends students repeat prerequisite courses in which they receive ‘C’ grades, even though credits for repeated courses do not count towards graduation. When students repeat courses in which they received grades of ‘C’ or higher, the grade from the repeated course will not impact their cumulative GPA at UHM, but it will raise their GPA for the nursing prerequisites. Pre-nursing students should talk to an academic advisor before deciding whether to repeat courses. For admission to UHM’s School of Nursing, students may repeat only two prerequisite courses (6 credits).

Standardized Tests

Admissions

Virtually all RN nursing programs require applicants to take a standardized test such as the Nursing Entrance Test (NET) or the National League of Nursing Pre-Admission Examination (NLN, or NLN-PAX), in addition to the SAT or ACT required for admission to the university. International students will also need to submit scores for the Test of English as a Foreign Language (TOEFL) and at some schools, UHM included, may substitute the TOEFL score for their verbal score.

Minimum scores for admission to UHM’s School of Nursing are 50% for the NET, 50% for the NLN, and 510 in both verbal and quantitative for the SAT, and 500 for the TOEFL.

To register for the NET, contact UHM’s School of Nursing. The NET costs $30, takes approximately three hours and assesses verbal and quantitative (i.e., math) reasoning skills.

To register for the NLN, contact Kapi’olani’s Nursing program; students must register at least five weeks in advance. The exam costs $70 and assesses verbal ability, mathematics, and science.

Both the NET and the NLN assess basic skills – skills underlying not one specific field, but all fields of study. These skills are acquired over a long period of time, primarily through liberal arts courses. Preparation consists of doing well in general education courses, becoming familiar with the test, and shortly before taking the exam, a general review of verbal and math skills. Study materials are available in Sinclair Library on the UHM campus.

For more information, a copy of Nursing School Entrance Examinations is available in UHM’s Health and Law Advising Center.

Certification

Upon graduation from an accredited nursing programs, students become eligible to take the National Council Licensure Examination: NCLEX-LN for Licensed Practical Nurses and NCLEX-RN for Registered Nurses, administered by the National Council of State Boards of Nursing (NCSBN).

For more information, visit the NCLEX website at www.ncsbn.org

Contact Information

All students interested in attending UHM’s School of Nursing should first attend an informational session; for information, visit www.nursing.hawaii.edu/students.html

School of Nursing and Dental Hygiene
Department of Nursing
Webster 425
2528 McCarthy Mall
Honolulu, HI 96822

Telephone: (808) 956-8523
Website: www.nursing.hawaii.edu

For advising, contact the Office of Student Services at Webster 201, 956-8939.

Additional Information

UHMānoa’s Pre-Health and -Law Advising Center (PAC) has reference books, academic planning worksheets, and one-on-one advising by peers who can help you prepare for your Nursing program.