Bridging the nursing gap for better outcomes

Samantha Girard
Samantha Girard / Marc Studer photo

By Douglas Esser
Samantha Girard, a nurse educator for Kaiser Permanente in Washington, said her Master of Nursing degree from the University of Washington Bothell in 2010 put her in a position to have an impact on the profession at a time nurses are being pushed hard to advance their education.

It’s a trajectory she knows well from her own experience as a nurse, researcher and educator. A Southern California native, Girard entered the profession with an associate degree and worked in emergency medicine.

When her husband’s job moved the family to Washington, she taught at Bellevue College where she was encouraged to apply for the master’s program at UW Bothell. She received a federal grant designed to increase the number of nursing educators.

As someone who went back to school when she had a young child, Girard is keenly aware of what it takes for a nurse to balance life and school.

Higher education for the nursing workforce became a national campaign when a 2010 Institute of Medicine report recommended that 80 percent or more of the registered nurses (RNs) in the United States have a Bachelor of Science in Nursing (BSN) degree by 2020. At the time the number was around 50 percent, and it’s still in the 50s.

“We have a big gap in the nursing profession,” Girard said. “It’s felt among practicing nurses.”

In her two-year program at Bothell, Girard said she received extraordinary support from graduate adviser Linda Bale and mentoring from Nursing Program Director Mary Baroni, now professor emeritus.

“They were not just mentors, they were coaching me the whole time, really shaping my entire view of advanced education,” Girard said. “They helped me understand the importance of that education and the impact it would have on patients.”

Baroni encouraged her to take her next step, a Ph.D. program at Washington State University (WSU), which Girard completed in four years.

“I would have never thought about it until she planted that seed,” Girard said. “She encouraged me in so many ways while I was a student at UW Bothell.”

Research for her master’s and doctorate gave Girard insights into the retention and attrition of RNs in BSN programs. The research for her master’s degree asked nurses what they valued about their BSN degree. Most, not surprisingly, said it would advance their careers and bring a sense of personal accomplishment. About 85 percent who started made it through.

“What we really learned was, we’re on the right track in trying to help nurses by structuring an academic program that would allow them to balance going back to school,” Girard said.

Her doctoral dissertation researched nurses who withdrew from an RN to BSN program. None of the nurses in her study were failing. They made a conscious decision to leave. They had challenges balancing work, school and family life. They reached a tipping point, Girard said.

“It’s a physically demanding job. You work a 12-hour shift, and then you have to get up and go to school.”

Some felt they had been pressured to go back to college to keep their jobs.

“There’s a real undercurrent of threat that nurses feel,” Girard said.

The value of a four-year degree is undeniable for health care and for nurses themselves, said Girard, who trains nurses and other medical staff for Kaiser Permanente statewide.

“With baccalaureate degrees, we have better patient outcomes. We have more nurses involved in research, which is important to our profession. We have nurses who are well prepared to lead in health care delivery, in the political arena, in health care policy,” Girard said.

It’s not enough to be a really good “nurse,” Girard said.

“You have to be able to partner with health care providers, advanced practicing nurses. It’s totally interdisciplinary,” she said. “As a team of people trying to deliver care, they have to work seamlessly with each other.”

Pursuing higher education and national certification is critical, said Girard, who also teaches for WSU and mentors graduate students for several universities.

“Because nurses very much are advocates who stand for patients who can’t stand for themselves,” she said, “it’s really an ethical duty to advocate for patients and to use the best available evidence to provide care.”

Through the Washington Center for Nursing, a nonprofit statewide nursing organization, Washington is a leader in the RN to BSN transition, Girard said.

“UW Bothell is leading this effort. They are leaders in academic progression and streamlining that step from associate to baccalaureate. They are leading the field, with strong leadership on all of the UW campuses,” said Girard, who also has taught at UW Tacoma.

From her own experience, Girard knows UW Bothell guides nursing students to make a difference, not for only one patient at a time but for the overall health care system.

“I think they do a phenomenal job of encouraging students to look at the global picture of health, not just the nation and state but globally,” said Girard. “Those of us who graduate from UW Bothell are making a really big impact.”

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