Many Paths To Successful Nursing Careers: An Interview With The Director Of Nursing At San Diego City College

San Diego City College, or "City" is a public community college located in San Diego, California. Founded in 1914, City College offers certificates and associates degrees in several fields of study including Nursing. City College has a semester-based academic calendar and it enrolls more than 10,000 students. The campus consists of more than 35 buildings on 56 acres.

Debbie Berg started working at City College as a clinical instructor in 1982. As a graduate of the University of Michigan, she worked in Medical/Surgical and Oncology nursing in hospitals and in home care until she found her love for teaching. With an MSN from SDSU, she began teaching full time at City College in 1989 and became the Director of Nursing Education in 2006.

Interview Transcript

Jill Randolph: What do you think are the most important things high school students should do to be accepted into your nursing program, and how soon should they start working on their plan?

Debbie Berg: If students want to become nurses, they need to take science classes in high school. We have been trying to encourage high schools in our area to offer advanced placement anatomy, physiology and biology courses. If high school students take AP Biology, then they do not have to take Biology 107 here, which is the prerequisite to anatomy and physiology at our college and for most other colleges as well. Successful completion of AP Biology in high school saves the students time and money once in college.

One of the criteria for admission into the nursing program is the completion of anatomy, physiology and microbiology courses. We also look at the number of times students have had to repeat those three courses in order to receive passing grades. A strong mathematics background is also an advantage, because students are required to pass the Test of Academic Skills (TEAS) in order to be admitted into the nursing program. It's an admissions test, and it includes math, English, science and reading comprehension.

Jill Randolph: Does your school offer certificate programs to help students jumpstart their career quickly?

Related Article: Healthcare Workers Continue To Be In Demand

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The need for skilled healthcare workers is expected to rise in the future. The Wall Street Journalreports that healthcare positions are planned to increase over the long run and the Labor Department predicts that the medical field will add approximately 300,000 jobs a year through 2016.

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Debbie Berg: Yes, we offer an associate of science degree in nursing, which is referred to as an ADN. We also offer a vocational program that prepares people to become licensed-vocational nurses or LVNs.

Our Continuing Education division offers a CNA program, but our Associate Degree Program does not require students to be CNAs in order to be admitted. In fact, ADN students don't receive preferential treatment if they are CNAs. Right now, we have a waitlist, but there is no way for students to get into our program any more quickly than being on the waitlist.

The waiting list situation, at least in San Diego County, will change. Community colleges are moving towards using a multi-criteria system for admission, and it will help us eliminate our waiting list.

The wait to get into our nursing program is currently about two years, and maybe longer for some people. For us, maintaining the list and keeping in touch with everyone year-after-year is becoming cumbersome.

Additionally, students who have been on the waitlist for three years seem to be less prepared for the rigors of nursing education when they are finally admitted. I think the situation will improve regarding shortening prospective students' wait time, but right now the demand for nursing and nursing education is so high that nursing programs have a serious backlog of interested students.

Jill Randolph: To look at it on the plus side, at least the students have their foot in the door so they can take prerequisite courses in the meantime?

Debbie Berg: Yes, they can take all their degree requirements and any other elective classes but they must complete the prerequisites in order to get on the waitlist.

Jill Randolph: If a student takes certificate classes, do those credits apply to an associate's degree?

Debbie Berg: Good question. CNA courses, because they are continuing education, are non-credit. LVN students receive credit for their courses, and they can earn a degree, but not an associate degree in nursing. We also offer an LVN to RN step-up program, where people who already have a license as a vocational nurse can come back and become an RN in a year.

Jill Randolph: Some programs tell students they won't make it in the real world if they can't succeed in the classroom, and the schools purposely try to weed students out. Does your school have a similar approach?

"Becoming involved in agencies or organizations like the Student Nurses' Association, the California Nurses' Association, or the Emergency Room Nurses' group will also help when looking for jobs, because students have had a chance to gain hands-on experience and have been networking with potential employers."

Debbie Berg: Our focus is much more on the positive, though we have a very rigorous program. The attrition rate in most community colleges in the State of California is around 15 to 20 percent, and - at least in California right now - the focus is on student retention. All of the colleges I've spoken with offer student-success programs in order to help people stay in nursing programs.

A lot of times, community college students have other demands in their lives versus high school students who continue right on to universities.

At the community college level, the average age of a student is between 30 and 35. Many community college students have children, are married and have jobs as well; they have a lot of other demands besides their education.

We make concerted efforts to try to help students succeed. These students have the intelligence to succeed, but they have a lot of other demands in their lives; we work with our students to make sure they are aware of the demands of the nursing program.

A rigorous two days of clinical work a week, classroom time, studying and writing papers can be a lot to take on, especially for those trying to raise and support a family at the same time.

We support our students and are trying to train as many nurses as we can. In this country, we have a healthcare crisis and an economic crisis at the same time. It's compounding the healthcare crisis because a lot of nurses who would have already retired or who had been working part-time, are now working full-time because their 401k has become a "201k".

The truth is, when the economy rebounds, the healthcare crisis will be worse than it is now because there are a lot of older nurses who are on the brink of retiring. We are making the effort to introduce as many nursing graduates into the field as possible, but they all have to pass the state licensure exam and prove to us they will be competent healthcare providers, because we are working to produce the best nurses we can.

Jill Randolph: Do you think the shortage of nurses has gotten to the point where a lot of people are coming from other countries to study and eventually work as nurses in America?

Debbie Berg: We have a fair number of foreign students, and we also see a lot of foreign nurses coming to this country. For example, we have a large population of Filipino nurses in San Diego. It's true that the United States recruited foreign nurses because we needed them so badly, and there are a lot of other countries suffering a nursing shortage because of this.

Jill Randolph: What are the biggest trends you are seeing among incoming students?

Debbie Berg: We have a more diverse population enrolling in our nursing program than we have had in the past. There is a higher percentage of Hispanic nurses, and this is an especially good thing in the southern states, including southern California. The type of students also differs from generation to generation; for example, today's college students have a sense of entitlement.

As far as graduation trends go, students recognize the importance of continuing their education a lot more than nursing students did in the past, because there is a big need today for well-prepared nurses. We hear this demand especially from acute care hospitals.

A lot of the facilities are working towards magnet-status, which is a prestigious accreditation for nurses in acute care. Magnet-status facilities look to hire the nurses with a higher level of education or encourage nurses to continue their education once they have been hired.

"People are still finding jobs, but they may not be the positions applicants are really interested in. A lot of students want to work in the ER, ICU or a trauma ward because of what they have seen on popular TV shows, but those types of jobs are few and far between right now."

Jill Randolph: Are you seeing more students returning to school because the job market is very tight right now?

Debbie Berg: Yes, when the economy is bad, people return to school, and we have a large number of students coming into the community-college system, particularly in San Diego. Of course, because of the economic crisis our budgets are being cut and students are having a harder time finding the classes they need or want.

It's a struggle, not only for nursing programs, but also across the board. We want to admit more students, but we are not receiving the budget for increasing our class sizes from the state.

Jill Randolph: What do you think are the three most important things students can do to prepare to find a job in the nursing field?

Debbie Berg: I think the primary step is education. Secondly, if students work in the healthcare field, whether as CNAs or by volunteering their time in a hospital or at a long-term care facility, it is really helpful. Becoming involved in agencies or organizations like the Student Nurses' Association, the California Nurses' Association, or the Emergency Room Nurses' group will also help when looking for jobs, because students have had a chance to gain hands-on experience and have been networking with potential employers.

Jill Randolph: Have you heard of any of your nursing graduates having difficulty finding a job?

Debbie Berg: Yes, but this was not the case last year. Everyone who graduated from our program and wanted a job, found a job easily, and many students had jobs before they graduated. This year however, the job market is more difficult because of the economic crisis; there are just not as many jobs available. People are still finding jobs, but they may not be the positions applicants are really interested in.

A lot of students want to work in the ER, ICU or a trauma ward because of what they have seen on popular TV shows, but those types of jobs are few and far between right now. Therefore, students may have to look at working in long-term care, homecare, at a clinic, or in another healthcare area they had not previously considered. Currently, if there is a nursing job opening in acute care, it requires nursing experience.

Jill Randolph: Do you think this is the case across the country, or is the nursing employment problem more specific to your region?

Debbie Berg: It may not be as dramatic throughout the country as it is in California and Michigan, but I have heard that jobs in general are harder to find because of the economy. A lot of people are being laid off, while others can't retire from their jobs because their retirement plan took a big hit.

Jill Randolph: Do you have any other suggestions to help recent graduates stand out from other nursing applicants?

Debbie Berg: Additional certifications (IV certification, ACLS, PALS, et cetera) are beneficial for those who want to work as specialized nurses and will help them stand out when they apply for jobs.

Jill Randolph: Based on employers you've spoken with, do you feel more positions are being filled today through networking or though traditional methods?

"Most nurses who are employed by hospitals only work 3 12-hour shifts per week. Therefore, hospital nurses can have a work-life balance if they want to, but not necessarily on the days they are working."

Debbie Berg: That's a good question. I think if an employer advertises a job targeted towards new graduates, they will also be looking at referrals or students who have worked for their company in the past. This includes people who have worked as CNAs, LVNs, or as externs, and the employer will consider positive referrals from people who already work for that facility.

I don't think there are very many companies that advertise for new graduates and then only hire referrals. If a company advertises for a new graduate, they will look at all the applications that come in.

Jill Randolph: What advice do you offer students regarding how to have a work-life balance?

Debbie Berg: Most nurses who are employed by hospitals only work 3 12-hour shifts per week. Therefore, hospital nurses can have a work-life balance if they want to, but not necessarily on the days they are working. When people work 12 hours a day, there is really not much time to accomplish anything else that day.

Nursing graduates, however, aren't required to take a job working 12 hours at a time; they can work in a clinic or a private practice where the work is in 8-hour shifts. The best-fitting schedule is up each individual, as to whether 3 12-hour shifts or 5 8-hour shifts are a better fit for their life.

In order to help our students make these kinds of decisions, we offer a Role Transition course, which helps students in their transition out of school and into the working world. We talk about how to keep from burning out, and how to maintain balance in a high-stress environment.

Jill Randolph: Are most new nurses scheduled nights and during other less desirable shifts?

Debbie Berg: It used to be that way and now the market is shifting back in that direction again. Scheduling like this is cyclical and depends on how long someone has worked for a company. Usually, there will be a number of people who have worked as vocational nurses for a hospital for 10 or 15 years, and then they have longevity when they return to school to become RNs. Those people may be able to obtain the job and shift they want, but in this economic climate, a lot less people are landing their dream jobs right out of school.

A year or two ago, people were hired for cushy jobs with normal Monday to Friday hours. For example, when I graduated from college, basically all it took was a warm body and a license to be hired for a job, but today's market fluctuates as the economy does. The dream jobs are not as readily available anymore, so I think it depends on the market at the time of graduation.

Jill Randolph: Do you have any career-related books or websites you recommend to your students?

Debbie Berg: There are quite a few websites we talk about in our Role Transition course to help prepare students for employment. We choose sites with a focus on résumé writing and job search skills.

For example, we have good relationship with a company called, which publishes a job-preparation manual known as the "Blue Book". They have a relationship with quite a few facilities in the San Diego and Orange County areas, and they publish their job openings and job search-related tips on their website. When they receive new job openings, they send me an email, and I send the leads to our graduates.

There are some sites that are better than others for advertising jobs. For students who are coming into nursing schools or thinking about switching to nursing, there are also a couple of really good books published by Elsevier, Davis and Pierson.

Jill Randolph: How has your school changed from years past?

Debbie Berg: Community colleges and universities are both constantly changing and trying to be better and more efficient. That's true of our program too; we are always in the process of rewriting part of our curriculum. We are currently working on a major curriculum rewrite now, which we will hopefully be able to implement by next fall.

We also have new buildings under construction on campus, and the nursing department is part of one building that will be opening in the summer. It will be fantastic, because all of our very expensive human-patient simulators will have their own mock hospital rooms.

A lot of training aspects of the nursing education program are improving based on the fact that simulators are available for student learning, rather than potentially making errors on human patients. The simulators talk, breathe, and have heart, lung and bowel sounds. They offer students a chance to practice for medical situations that may potentially happen during their careers.

San Diego City College works hard to ensure the success of our students, by providing them with the guidance, support, tools, and many paths to successful careers in Nursing and many other fields.

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