Three years after gaining authority from the state to offer a bachelor of science in nursing (BSN) degree, the community college system is seeking to expand that program.
Lawmakers will next week tackle a bill that would permit community colleges to offer a BSN to licensed practical nurses (LPNs) who have qualified for their licenses through certificate programs rather than an associate's degree.
Advocates say the proposal will help fill Colorado's critical shortage of nurses by allowing students to obtain the four-year degree faster and at a lower cost.
In 2018, Pikes Peak Community College wanted to offer the BSN degree, part of a collaboration with Memorial Health. That required a change in statute since community colleges generally offer two-year associate degrees, not the four-year degree program.
Pikes Peak, and the rest of the community college system, battled their way to passing the Bridge program, which allowed them to offer the BSN to those who had already earned an associate or two-year degree.
Senate Bill 3 would open up the Bridge program to those who hold a Licensed Practice Nurse (LPN) state certification, which is a one-year certificate program, rather than the two-year associate degree. They would then go through a three-year program to earn the BSN degree.
While a registered nurse can also earn an associate's degree for that license, hospitals increasingly require nurses to obtain the four-year degree.
Some of the four-year institutions with nursing degrees, primarily the University of Colorado, Mesa State and Regis University, initially opposed the 2018 bill, sponsored by then-Rep. Janet Buckner, D-Aurora. They raised concerns over "mission creep" — the attempt by community colleges to offer four-year bachelor degrees. They also questioned whether the community colleges' programs could obtain accreditation.
Then-Gov. John Hickenlooper wasn't a huge fan of allowing community colleges to offer the four-year nursing degree, either, but he allowed the bill to become law without his signature.
Currently, the nursing programs at 10 of the state's 13 community colleges have been accredited. But advocates say a gap still exists and the critical shortage of registered nurses persists — problems exacerbated by the pandemic four years later.
Rep. Kyle Mullica, D-Thornton, an emergency room nurse who is the House sponsor of Senate Bill 3, said he has seen the problems first-hand.
Shortages are across the board, and something of a trickle-down effect is magnified when it comes to emergency rooms, he told Colorado Politics.
He explained it this way: When there aren't enough nurses in the hospital, the ER staff can't send patients up to the floors, and they wind up staying longer in the emergency room waiting to be admitted. In turn, that takes up beds for those coming into the emergency room and leads to delays in their care.
The problem affects both rural and urban emergency rooms, he added.
The problem — including burnout — has gotten worse during the pandemic, he said, adding the heavy workload gets compounded every time a nurse quits, leaving the rest of the staff to handle even more responsibilities.
"It's a brutal cycle," he said.
Buckner, the Senate sponsor of SB3, said the state continues to face a devastating shortage of healthcare providers, including nurses, and SB 3 will allow LPNs to obtain the BSN degree faster and at a lower cost.
Buckner said that students reached out to her after the 2018 bill became law, saying they appreciated that they were able to start their degree at a community college, which was more affordable than some of the other options.
Co-sponsor Senate President Pro tem Kerry Donovan, D-Vail, said the West Slope is experiencing the same shortage issues, and that causes longer wait times for health care.
Community College of Colorado system spokesperson Fiona Lytle said the bill is permissive and doesn't require all the community college to offer the proposed next generation of the Bridge program. She said probably three colleges will start offering the expanded Bridge program, with other community colleges following suit. The expansion is mostly likely going to begin at Community College of Denver, Pikes Peak and Front Range Community College.
Buckner said she has been meeting with those who have concerns and doesn't anticipate the road to the governor's office to be as difficult as it was in 2018.
"When you have a new program, it’s trial and error," she said, adding the trial under the 2018 law has turned out to be important and very positive.
Outside the Capitol, the biggest hurdle is finding clinical training, as well as the staff to supervise the students at those clinical facilities, Lytle said.
For the Community College of Denver, however, Denver Health and Kaiser both have committed to providing clinical spots for the trainees in the program.
Inside the Capitol, the biggest hurdle is concerns raised by some of the same opponents in 2018 over such issues as who will teach the courses in those four-year programs. Opponents also raised this issue in 2018.
The American Association of Colleges of Nursing reported 1,637 faculty vacancies in a 2019 survey of 892 nursing schools with baccalaureate or graduate programs nationwide. More than 80,000 qualified applicants were turned away from nursing schools in 2019 because of the shortage of nursing faculty, the AACN said.
SB 3 is scheduled for a hearing with the Senate Education Committee on Wednesday, Feb. 9.
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