A community college's perspective on the RIBN initiative.

The Regionally Increasing Baccalaureate Nurses (RIBN) initiative pairs community colleges and private colleges with universities to help nursing students complete a bachelor of science in nursing (BSN) degree early in their career. In the Eastern North Carolina Collaborative of the RIBN initiative, East Carolina University is partnered with 5 community colleges: Beaufort County Community College, Pitt Community College, Lenoir Community College, Roanoke-Chowan Community College, and Craven Community College. All of the partners in this collaborative have rigorous nursing programs and know how valuable the RIBN program can be to our region. In this sidebar, I will specifically describe Beaufort County Community College’s perspective on the RIBN initiative. Beaufort County Community College serves not just the county of Beaufort but also Hyde, Tyrrell, and Washington counties—essentially, the landmass between the Pamlico and Albemarle sounds. In total, our service area is slightly more than 2,000 square miles [1]. In addition, students from neighboring Martin County who wish to pursue nursing may also attend Beaufort County Community College, because Martin Community College does not offer a nursing program. The North Carolina Department of Commerce currently designates all of these counties as tier 1 counties (a designation given to counties that are most economically distressed); residents of these rural counties face barriers such as limited infrastructure, a higher unemployment rate, limited access to health care, and limited access to higher education [2]. When the leaders of the nursing program at Beaufort County Community College were approached about the RIBN concept, we immediately realized that participation in this initiative would allow our program to become part of an affordable solution for students who wanted to earn a BSN degree. Our program’s nursing graduates overwhelmingly choose to stay in the rural communities in which they live. They are employed by long-term care facilities, small community hospitals, physician offices, and agencies that provide home health care or hospice care. These employers have not had access to an applicant pool of nurses with baccalaureate degrees, but we believed that the RIBN initiative could change that. Thus the RIBN program will have a significant positive impact on rural students who wish to pursue a BSN degree and on health care establishments in the region. The RIBN initiative has also prompted a frank discussion of how we can better prepare students in the traditional associate degree in nursing (ADN) program so that they are better positioned to pursue further education once they graduate from Beaufort County Community College. This conversation led to a paradigm shift in the way we advise students. Historically, we gave our prenursing students a curriculum plan that could be completed in 2 years. If they wanted to continue their education and earn a BSN degree after completing the ADN program, they faced the challenge of having to take college algebra, statistics, microbiology, additional courses in the humanities, and other transfer courses; this meant having to study for an additional year and a half—while working a full-time job—before they could apply to a RN-BSN program. However, we now encourage prenursing students to take the more advanced courses needed to satisfy transfer credit requirements, instead of taking lower-level courses that fulfill only the minimum requirements for the ADN. Currently, approximately 20% of our students take courses that would fulfill BSN requirements, but we hope to increase this percentage. Our lofty goal is that 75% of ADN graduates will need only the university-level nursing courses to obtain their BSN degree. As part of this shift, we are currently in the process of reviewing articulation agreements for the RN-BSN programs; these agreements provide a simplified, guaranteed transfer process. We are also increasing enrollment in transfer courses, providing information to students regarding the RN-BSN admission requirements of nearby universities, and realigning our ranking procedure to give “points” to students who take more advanced courses that provide transfer credits. Over the next few years, we hope to significantly increase the percentage of nursing students at Beaufort County Community College who enroll in the RIBN program. The RIBN program and other initiatives are better preparing our students to function in and lead the health care establishments in our communities. With the changes that are now taking place in national health care policy, we are going to need many new leaders to help our rural communities navigate through the storm.