Nursing Bridge Programs

Connecting the Dots to Form Educational and Career Pathways that Work

Posted by Shanna S. RN, BSN on January 29, 2014

Last week I had the pleasure of attending a webinar administered by the Center for Law and Social Policy (CLASP) in conjunction with the National Network of Sector Partners (NNSP) on "Sector Initiatives and Career Pathways". The main point of the webinar was to highlight effective strategies to configure both educational and workforce development systems that help people get good jobs.

As far as I understand it, the idea is to design initiatives that are aimed at creating both a strong workforce, which employers want, and helping low income workers to access educational programs that result in good paying jobs, which is what workers want.

Allow me to give you an example of how this might relate to the world of nursing.

It has been found that in healthcare facilities where a large proportion of Bachelor's prepared Registered Nurses (RNs) are employed, quality outcomes are typically higher than in facilities with fewer Baccalaureate prepared RNs. These BSN staffed facilities demonstrate lower mortality rates, fewer re-admissions, higher patient satisfaction scores, and a possible reduction in medication administration errors as documented in several different studies and literature reviews.

Not surprisingly, healthcare facilities (HCF) that track these measures want them to improve. One way to do that is to strengthen the workforce; in this instance, that could mean developing a nursing workforce that is educated at the Baccalaureate level or beyond.

The question can a healthcare facility create a nursing workforce comprised of BSNs? It doesn't make much sense to fire all the non-BSN nurses and hire new nurses with only Bachelor's degrees. In fact, even a brand new facility would be hard pressed to find enough Bachelor's prepared nurses to staff an entire hospital. The answer must lie then, in a healthcare facility's ability to help its nurses transition from Associate's and Diploma preparation to Baccalaureate preparation, and beyond.

This is a significant undertaking, as it requires creating the supports, systems, and incentives for RNs to return to nursing school to earn Bachelor's degrees.

As many seasoned nurses know, returning to school after practicing for some time can be a daunting, if not downright frightening, proposition. There are also financial issues that come into play, as school often requires working nurses to rearrange their schedules and even cut back on their hours in order to attend classes.

While some nurses may have the means to independently fund their own expanded education, other nurses are likely working full time, caring for their families, paying student loans, and trying to manage finances on a paycheck to paycheck basis. Schedule changes and the possibility for a cut in pay, coupled with school costs, can be a factor preventing RNs from advancing their education.

Image Credit: Darcie Harvey (National Center for Public Policy and Higher Education) and CLASP. Analysis based on data from the Bureau of Labor Statistics, Consumer Price Index, All Urban Consumers. Median family income is from U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplements and the American Community Survey. Maximum Pell Grant from Department of Education, Pell Grant End-of-Year Report (2010-2011). Adapted from figure in Lifting the Fog on Inequitable Financial Aid Policies, Lynch, Engle, and Cruz (2011).

What can employers, educators and communities do, then, when earning a BSN is not a priority, nor even a viable possibility for some working nurses?

This is where sector based initiatives come in, with an aim to facilitate upward mobility for workers while simultaneously making the workforce itself more robust. Sector based initiatives are focused partnerships between employers, workers, educational institutions, not for profits, and other entities aligned to achieve a goal that benefits each party. In theory, they are-if you think back to A & P-successful multi-member symbiotic relationships.

According to NNSP, there are key characteristics to a sector initiative, which include:

  • An intense focus on multiple industry employers within a regional labor market
  • Initiatives are led by a credible workforce intermediary
  • Create pathways for low wage workers within the industry to move up to good jobs and careers
  • Adopt system wide changes that result in "win-win" results for employers, workers, and communities

As I was listening to the webinar, I was trying to piece together some basics about career pathways, sector initiatives, workforce development, and my own position as a proponent of nursing education & resources. I thought of my own experiences in an RN to BSN program.

I was fortunate enough to work somewhere with tuition reimbursement when I decided to return to school, which greatly influenced my decision. I was also able to take advantage of certain distance education courses and a one day a week class schedule as a part of my BSN nursing education. This well designed program allowed me to complete clinical hours near home, while I only had to travel and attend class once a week.

Had it not been for these factors, I don't think I would have been as likely to enter an RN to BSN program when I did. Additionally, these aspects of my RN-BSN bridge program popped into my head as possible sector and career pathway initiatives that were meant to strengthen the nursing workforce by way of making nursing education more accessible to people like me.

While I processed, and as the webinar progressed, I found an even more relevant example of what CLASP and the National Network of Sector Partners are working to create.

One of the organizations highlighted in the webinar as demonstrating success in designing career pathways is the Instituto del Progreso Latino, which has developed a partnership with community and educational entities to assist limited English-proficient individuals in Chicago to enter a pathway that culminates in successful employment as an RN.

The program, "Carreras en Salud", allows students to enter the nursing program at whichever educational level they currently test out at, and progress through incremental steps in the program at their own pace. It begins with the most basic education needed: English as a Second Language (ESL) classes for Healthcare/Pre-CNA careers, and can culminate in licensure as a Registered Nurse.

The program, which I plan to write about in more depth, utilizes bridge programs, like the LPN to RN program, throughout the nursing career pathway to allow for nearly seamless progression through different stages of education and practice.

At we believe that nursing bridge programs are key to strengthening the nursing workforce, and the profession as a whole.

  • They often allow nurses to continue working while attending classes.
  • Bridge programs, like the one I attended, also tend to employ creative scheduling techniques such as offering evening courses, weekend courses and one day a week nursing course options.
  • They tend to have online components built in, allowing for students that live at a distance to complete required coursework on their own time, from their own home.

These are examples of how educational institutions can facilitate nursing career pathways, but there are ways others can collaborate as well. Employers, especially large health systems, are now partnering with schools to offer nationwide clinical sites, where nurses can learn the hands-on aspects of the profession without incurring undue travel expenses.

Employer partners can also strengthen their own nursing workforce by facilitating the advancement of education through tuition reimbursement, clinical ladders that reward educational advancement, and the use of staff from all levels of the nursing workforce, from certificate to PhD prepared.

Outside partners can also help support sector initiatives by offering funding, promotion, marketing and collaboration building efforts. We, at can help connect schools with students, highlighting bridge programs across the country and making information about them available and easy to access.

Businesses, government entities and non profits alike can help potential students, especially those individuals in segments of the population with proven funding needs, connect with the money needed for nursing school.

Utilizing successful strategies, such as bridge programs, to create realistic career and education pathways within the profession of nursing is a worthwhile aim. At, we are happy to collaborate in the dissemination of information about these pathways, and will continue to help students and nurses connect with the resources you need.

Thanks to organizations like CLASP, NNSP and the Instituto del Progreso Latino, that are concerned with improving the health of communities and their residents as well as industries, I think we will see an increase in sector partnerships as they relate to the nursing profession in the coming years. If you'd like to learn more about how others are collaborating to strengthen nursing, please visit the above organizations' websites, or feel free to contact us, and we'll get you pointed in the right direction.

Shanna Shafer RN, BSN is driven by the impact nursing, and nursing education, can have on the health of our patients, families, communities, and nation. She has almost ten years of nursing experience in a variety of settings, and currently serves as the Managing Editor at