Battle breaks out in Mich. on nursing degrees

Kim Kozlowski
The Detroit News

Some Michigan communities could be voting whether to let local two-year colleges offer bachelor’s degrees in nursing.

The issue, under debate again in the Legislature, is among the most controversial in higher education since community colleges have historically offered two-year degrees, while universities offer four-year degrees.

As industry, community and student needs have evolved, community colleges say education should change, too, especially when parts of Michigan lack a four-year university nearby and demand exists for more nurses with bachelor’s degrees.

But universities counter that letting two-year schools offer four-year degrees would duplicate programs and hike costs for local taxpayers, who fund community colleges. They also say more programs aren’t needed.

For nearly a decade, community college leaders have worked to get legislation passed, most recently last June with a bill introduced in the Senate. After universities objected, Sen. Mike Shirkey, the bill’s sponsor, said last week he plans to amend it to require community colleges to ask voters in their district if they can offer a bachelor of science in nursing.

The provision would ease concerns that all of Michigan’s 28 community colleges would start offering BSNs, Shirkey said, and is persuading more of his colleagues to consider making Michigan the nation’s 10th state to let community colleges confer bachelor’s degrees in nursing.

“We have a shortage of nurses with BSNs,” said Shirkey, R-Clark Lake, near Jackson. “Many nurses with a two-year degree are working, raising a family and can’t afford to pick up and go to a four-year university. Community colleges make it more accessible, and affordable.”

But lobbyists for the state’s 15 public universities said they oppose the effort, even if community colleges have to run referendum campaigns.

“Doing so would represent egregious mission creep, a mass duplication of existing programs and enormous inefficiency in the use of taxpayer dollars,” said Daniel Hurley, CEO of the Michigan Association of Universities. “We believe that investing in Michigan’s existing infrastructure and nationally accredited undergraduate nursing programs is the most sensible and cost-effective method to increase the number of Bachelor of Science-prepared nurses.”

Across the nation, states are slowly allowing community colleges to grant bachelor’s degrees, including in nursing. Currently, community colleges in 19 states can confer baccalaureate degrees. Of those, nine states permit the two-year schools to grant BSNs, said Beth Hagan, executive director of the Community College Baccalaureate Association.

The first two years of a nurse’s training cost the most for equipment, clinical placement in hospitals, supervision and more, Hagan said. In the second two years, leading to a bachelor’s degree, courses focus on general education, critical thinking and ethics.

“These are far less costly to deliver,” Hagan said. “Perhaps one of the reasons that a university would be reluctant to lose students who are in their second two years is because of the relatively lower cost to deliver the program.”

Four years have passed since Michigan passed a law allowing community colleges to offer bachelor’s degrees in energy production, concrete technology, maritime technology and culinary arts, where a four-year degree is becoming a job requirement.

So far, eight of the state’s 28 community colleges have begun or are in the process of offering bachelor’s degrees in these fields, according to the Michigan Community College Association.

Nursing was initially included in the 2012 legislation but was dropped shortly before passage.

Now, the junior colleges are trying again to benefit students like Lois Westergard, of Alpena, who went back to college after years working in medicine. Starting at age 42, Westergard earned an associate degree and became a registered nurse.

She then decided to get her BSN, but the community college in Alpena, where she started her education, can’t offer that program.

Since Westergard, now 47, is married and caring for her ailing father, she couldn’t move three hours away to Saginaw Valley State University, the nearest school that offers a BSN. Instead, she enrolled in an online program through the University of Michigan-Flint, but said that is not an ideal arrangement.

“The trend coming our way in nursing is many facilities are going to require a bachelor’s in nursing, so if I want to further my career, I know I will need that degree,” Westergard said.

“In a rural area where I live, there are no universities here, so you are forced with doing an online class if you are going to remain here. To have something more local for people would be very advantageous since many do not prefer an online option.”

The issue is also reverberating nationally: In 2010, a 672-page report on the Future of Nursing said community colleges could help increase the proportion of nurses with bachelor’s degrees to 80 percent by 2020. The report was issued by a division of the National Academies of Sciences, Engineering, and Medicine.

“An increase in the percentage of nurses with a BSN is imperative as the scope of what the public needs from nurses grows, expectations surrounding quality heighten, and the settings where nurses are needed proliferate and become more complex,” the report said. “Community colleges play a key role in attracting students to the nursing education pipeline.”

In Michigan, 47 percent of the 104,351 active registered nurses have a BSN, according to a 2015 survey by the Michigan Center for Nursing.

“The world of health care is increasingly more specialized,” Kathy Young, president and CEO of Borgess Health in Kalamazoo, wrote in a letter to the Senate Commerce Committee. “An associate degree in nursing was traditionally the entry degree to practice as a registered nurse. It has become more the practice to require a baccalaureate degree for most registered nursing positions, especially in hospitals.”

Additionally, the cost to attend community colleges is 75 percent less than for universities: The average annual tuition to attend a public university in Michigan full-time is $11,866, while it’s $3,064 for a community college.

“This is really about trying to meet workforce needs in the future,” said Mike Hansen, president of the Michigan Community College Association. “More and more states are looking at this, and they see it as the next way to help the workforce and give opportunities for students who are either financially or geographically denied these degrees now.”

But Hurley argues that besides duplicating efforts, there is no need for more BSN programs. While there may be a shortage of nurses in certain corners of the state, Hurley said, the longer-term prognosis is for an oversupply.

The supply of registered nurses is expected to outpace demand nationally, including in Michigan, according to a 2014 federal report, “The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025.”

But locally, advocates for community colleges counter that there is anecdotal evidence from hospitals in need of nurses with bachelor’s degrees, and reports of hundreds of nurses crossing the border from Canada to work in Metro Detroit.

Hurley said there are nearly two dozen online programs in Michigan for students to earn a bachelor’s degree where a university is not within driving distance.

“Here we are in Michigan, with the No. 1 forecasted decline in the nation of high school graduates, does it make sense to create 28 more four-year granting institutions for nursing while every public college and university can strive to do better in increasing its graduation rate?” Hurley said.

Hansen countered there aren’t any BSN programs in Alpena, Traverse City, Benton Harbor and other areas in the state. And not every community college would create a bachelor’s degree in nursing.

“If they say these programs aren’t needed,” Hansen said, “why are they so worried about this? It’s a little disingenuous.”