College Debt Delays RN Advancement

Nurse Leader Insider, April 20, 2017

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By Jennifer Thew, RN

Students are graduating from college with significant amounts of educational debt—in 2015 the average student borrower had $30,100 in loans upon graduation—and a recently published study finds that nurses are no different.

When Jan Jones-Schenk, DHSc, RN, NE-BC, national director for the college of health professions at Western Governors University, surveyed 1,299 working nurses for the study, 62% of the respondents reported they had prior college debt.

More than 39% of those with debt said their debt ranged from $1 to $24,999 while 23.5% reported debt greater than $25,000. Approximately one-third of the respondents said they had no prior college debt.

"Some had debt as high as $100,000, and 7% reported debt greater than $50,000. That's a lifetime of debt," Jones-Schenk says.

The study also found that educational debt influences nurses' decisions about academic progression.

"The data showed that most of the people who have an education plan are going to go on, and they have debt," she says.

"But if they have more than $10,000 in college debt they're going to delay their educational advancement so they're not going to go on as quickly."

Debt's Influence on Education Decisions

When the National Academy of Medicine (formerly the Institute of Medicine) report, "The Future of Nursing: Leading Change, Advancing Health," was released in 2010, it had very specific recommendations on the educational preparation of RNs.

The report called for 80% of nurses to hold a baccalaureate degree by 2020, and for the number of nurses with doctorate degrees to double during that time as well. It also called upon healthcare organizations to encourage nurses with associate's and diploma degrees to enter baccalaureate nursing programs within 5 years of graduation, and for accredited nursing schools to ensure that at least 10% of all baccalaureate graduates enrolled in master's or doctoral program within 5 years of graduation.

"We all understand the basis of that," Jones-Schenk says. "But I do think that nurse leaders may not understand that while they may offer tuition reimbursement or other incentives for their staff, they may not be aware of the current level of debt those people have already."

While nurses with ADNs may want to obtain BSNs, they may already carry a large amount of educational debt from their associate's degree program.

"Because I do have students in all 50 states, I was seeing programs where students were coming to me with an associate degree and it seemed like their college debt was already pretty high," she says of her inspiration for the study. "Some of the associate degree programs were at $60,000."

The Need for Financial Knowledge

Jones-Schenk says good financial mentoring is one way to help nurses keep their educational debt in check.

"If [students] are eligible for federal financial aid or state financial aid, without good counseling they may take the maximum amount of eligibility. But they may not need all that," she says.

"In our university, we have a specific initiative called 'the responsible borrowing initiative.' We counsel students about how much borrowing they really need and not to over-borrow… so they're going to be able to go on without that debt as a barrier."

Nurses should also look at the overall cost of a program, even if a college or university is offering a discount to their employer.

"'If you're saying, 'Well, I'm going to go to the school that offers the 20% tuition discount vs. one that offers a 5% discount,' that percentage of discount is meaningless. What matters is the ultimate cost to the student," Jones-Schenk says.

"That's where I think a lot of people get hung up. They think they're going to go to a school because they offer a 20% discount, but the ultimate cost to the student is still $30,000 grand to the student vs. $10,000 [with a smaller discount]."

Responsibility for minimizing debt shouldn't be placed entirely on the student. Jones-Schenk says low-interest rate loans and loan forgiveness programs are tools that could help defray educational debt.

"Nurse leaders, people in higher education, the government and other individuals who have an interest in healthcare are all worried about healthcare costs," she says.

"This is part of it as well. I would hope that we would take a serious look at the cost of higher education and its value and contribution to the health of the nation."

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