Textbook Examples STCC Nursing Program Celebrates 40 Years of Evolution, Excellence

Mary Tarbell was among those receiving pins at the graduation ceremonies for the first class of nursing students at Springfield Technical Community College in 1972, and she has many memories from those early days of the program she now directs.

She recalls, for example, that the fledgling nursing program was housed in what amounted to one half of a duplex, known then (and now) as Buildings 5 and 6 on the grounds of the closed Springfield Armory. “We had classes in the bedrooms,” she told HCN, “and labs were in the living room; the faculty ate in what was the kitchen.”

She also remembers that there were some doubts within the medical community about the quality of this college-based program, which was created to help fill the gap when the hospital-based nursing programs that had been existence for decades closed their doors due to the high costs associated with them.

“After I got my first job, someone said to me, ’do you really know what you’re doing?’ I said, ’I think so,’” said Tarbell, who also remembers her first paycheck from that assignment, from Providence Hospital in Holyoke.

“It was for $144, and, if I remember right, 17 cents … I know I have that pay stub somewhere,” she recalled. “That was for a 40-hour week on the second shift. Today, that would represent about three or four hours for some nursing graduates.”

There was quite a bit of this looking back in retrospect going on at a recent get-together to mark the 40th anniversary of that first class of nurses at STCC, said Tarbell, noting that more than 100 people turned out, and all but a few are still active within the profession.

The event was a celebration of just how far the program has come in four decades, she said, as well as the broad impact STCC graduates have had on the large healthcare community in Western Mass.

But the milestone also serves as an appropriate time to examine where nursing education has been, where it is now, and where it’s going, Tarbell noted, adding that, while some things haven’t changed over the years, many things have, especially technology.

And Tarbell used that phrase to refer, collectively, to everything from high-tech simulation labs to students’ ability to put huge textbooks onto their cell phones.

“We can no longer teach the way we were taught,” she explained, referring to educators of her age. “You have to get very innovative; this is a different generation, and it’s a very tech-savvy generation. This class that just came in in September is the first class that’s required to have laptops. We’ve also converted all of our paper-and-pencil tests — we’re in the final phase of shifting all tests to a computer — and we do this to mimic the licensing exam.

“Technology has changed, and you have to embrace the technology, because that’s the only way we’re going to be able to continue to put out safe practitioners.”

For this issue, HCN takes advantage of the 40th-anniversary celebration to examine four decades of change and progress in nursing education, and what lies ahead for the STCC program.

School of Thought

Tarbell said the nursing program had simulation technology in 1972 — well, sort of.

“We had what we call a task trainer,” she explained. “You’d have a model of a leg … and you would use it to teach a student how to put on an elastic stocking or wrap a stump after amputation — something limited to that part of the body.”

Today, students learn from computer-controlled simulators that can talk back to them while displaying a wide range of symptoms and conditions, she continued, adding that this is one of many sea changes that have occurred over the past 40 years. Summing it up, Tarbell said that what’s being taught is virtually the same as when she was attending classes in Building 5, but how it’s being taught is radically different, because of changes in technology and the healthcare industry itself.

Turning the clock back to when Richard Nixon was in the White House, Tarbell said nursing education was undergoing a seismic shift with regard to where and how students were taught.

For decades, area hospitals had their own programs, she said, noting that, by the early ’70s, the last of them had closed due to the high costs of administering the schools. To fill the gap and put more students in the pipeline, college programs were created at STCC, Holyoke Community College, Elms, American International College, and other schools.

The transition process created both challenges and opportunities, she said.

“Those nurses who were going to the hospital-based programs were so exposed to patient care in a different way than an associate-degree nurse was exposed to patient care,” she explained, “because they were actually in the hospitals managing the units and running the units.

“When the associate-degree program came in, we were on limited hours — we were doing 12, maybe 15 hours, and as you advanced, maybe 18 hours a week in clinical, far less than what the diploma schools were doing,” she continued. “But we were getting a sound education based on the fact that we were taking college-level courses along with our nursing curriculum.

“But when we first went out there,” she went on, “no one believed that we could actually function. And that was just one of the obstacles we had to deal with as we went out into practice.”

Today, of course, there are no such doubts about the qualifications of those who graduate from STCC and other area programs, said Tarbell, adding, however, that today’s nursing students face other challenges when they enter the job market, particularly patients who are, overall, sicker than those who would be in a hospital 40 years ago.

And this phenomenon, prompted by a wave in changes in technology, how care is administered, and how it’s paid for, is reflected in how nursing students are prepared for their chosen profession, she told HCN.

“What we see now in the hospital is different than what we saw years ago,” she explained. “Decades ago, if someone had their gallbladder out, a fairly simple surgery, that person would have a large abdominal incision and be in the hospital for a week. Today, you can be in the hospital at 6 in the morning, and many times, you’d be home that evening after having your gallbladder taken out.

“The fast turnover of patients has driven us to deliver care in a more intense fashion,” she continued, “but what you can’t separate from it is the caring and the safety and the knowledge. One of the key things we look at in all of our students is safety; if we find anyone who is unable to maintain safety, we counsel that student and we try to help them and facilitate how they can be a safe practitioner.”

There are other challenges awaiting today’s nursing graduates, said Tarbell, including a tighter job market than many industry and workforce experts were predicting even a few years ago. Graduates are still finding jobs, she continued, but sometimes not in the desired acute-care setting.

One of reasons for this is that many of the Baby Boom-aged nurses who were expected to retire over the past few years — including some from that first class at STCC — are finding that they can’t retire yet for financial reasons, or are not yet ready to leave the profession. But perhaps more importantly, she said, many employers, especially those in acute-care settings, are demanding more than an associate’s degree from their nursing applicants.

“We’re graduating nurses, just as the other schools are, but the vacancy rate is just not what it used to be,” said Tarbell. “You used to be guaranteed that, when an associate-degree nurse or a bachelor-degree nurse graduated, they would have a job in an acute-care facility — and not that many years ago, it was even before they graduated; they had their jobs in January, February, or March.

“Now, many places are not interviewing or even accepting applications until after that nurse has his or her license in hand,” she continued. “At the same time, when they [associate-degree recipients] graduate, they’re not guaranteed a job in acute care. It’s few and far between when it comes to associate-degree students being hired into acute care right away.”

Instead, they’re finding jobs in community nursing (as school nurses, for example), long-term-care facilities, and other settings, such as home care, she told HCN, adding that there is still 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} placement within six months of graduation.

To help its graduates get the jobs they desire — and to address the demand for higher-degreed nursing graduates — STCC started collaborating with UMass Amherst and Baystate Health on a program that would enable the college’s two-year graduates to then earn a bachelor’s in a year plus the intervening summer.

“They can do it three years instead of four,” she said, adding that this program, in addition to similar initiatives involving other four-year schools, is designed to improve the likelihood that those leaving STCC with an associate’s degree can get the bachelor’s degree needed to open more doors, and in less time.

Class Acts

As she talked with HCN, Tarbell paused for a minute and went to a bookcase to collect a textbook from her days as a student at STCC.

As she thumbed through Cooper’s Nutrition in Health And Disease, she marveled at the simplicity of the diagrams — and also the price tag on the inside cover: $9.75.

“That’s another thing that has changed, obviously,” she said with a laugh, noting that today’s textbooks, like the one recently sent to her one publisher in hopes that it might become part of the curriculum, cost perhaps 20 times what they did four decades ago.

Those inflationary changes aside, as well as the myriad advances in technology, the basic mission of the STCC hasn’t changed and won’t, said Tarbell. Now, as then, the goal has been to properly prepare students for the industry they have chosen.