by Kelly Heyboar

Saint Peter’s University Hospital nurse Linda Stolfi calls it the letter that shook up her life and the future of many of her co-workers. Last year, the New Brunswick hospital sent the staff a brief letter stating a new policy for the institution: All registered nurses — even those who have been treating patients for decades — need to earn a bachelor of science degree in nursing within the next decade. That meant about half of the hospital’s registered nurses, most of whom have two-year associate’s degrees, would have to go back to college to earn the four-year degree if they want to keep their jobs.

"We went, ‘Why? Oh God, please don’t make us do this ... I’m a good nurse,’" said Stolfi, 49, describing her and other nurses’ initial reaction to the news.

Similar scenes are taking place at hospitals and medical institutions across the nation thanks to new recommendations from the Institute of Medicine, an influential non-profit group that advises the government and industry on health issues. The group is pushing for 80 percent of all nurses to hold bachelor’s degrees by 2020 in an effort to improve patient care nationwide.

The recommendations have been a money-maker for colleges and universities. As more hospitals voluntarily adopt the new rules, colleges are scrambling to set up accelerated programs to help working registered nurses quickly upgrade their diplomas and two-year nursing degrees to bachelor of science, or BSN, degrees.

In New Jersey, more than a dozen colleges and universities are offering special programs — called RN to BSN — to help nurses go back to school to get their four-year degrees. Some schools, including Rutgers University, Seton Hall University and Caldwell College, are offering online programs, so nurses can take classes at home or after work.

Other colleges are sending professors into hospitals so nurses can squeeze in traditional college classes between shifts. The College of New Jersey recently began offering on-site nursing classes at Saint Peter’s University Hospital, 26 miles north of its Ewing campus.

About 36 nurses at the Catholic hospital are registered for the College of New Jersey classes, while others are taking courses online through other colleges, hospital officials said.

Saint Peter’s is picking up most of the cost of the BSN classes because the hospital believes better-educated nurses are worth the investment if it means patients get better care, said Cheryl Saffer, the hospital’s coordinator of clinical education and nursing research.

In 2010, the Institute of Medicine shook up the nursing field when it called for 80 percent of all nurses to hold bachelor’s degrees by 2020. The experts pointed to studies that show patients get better care in hospitals where the majority of nurses have higher-level academic degrees.

"As BSN rates go up, patient outcomes improve," Saffer said.

The College of New Jersey is charging Saint Peter’s University Hospital the discounted tuition rate of $1,248 per student for each four-credit class, a campus spokesman said. That is $220 less than part-time students pay for similar classes on the college’s Ewing campus.

At a recent Nursing 210: Public Policy class held at the hospital, nurses filed into the classroom, some still in their scrubs after completing long shifts. They took notes as a group of classmates gave a PowerPoint presentation on a research project.

After the initial shock of being told they needed to go back to college, many of the nurses said they were finding the coursework interesting.

"It’s a long day," said Stolfi, who has worked at the hospital for 13 years. "But we’re used to long days."

Most of the nurses said they expect to spend the next three years or more taking one or two classes a semester to complete their bachelor’s degrees. The courses include pharmacology, nutrition, research and professional development.

Many of the nurses in the class said they were unsure taking the classes will make them better caregivers at the bedside. Most of the bachelor’s degree courses focus more on research and theory than practical day-to-day nursing techniques.

Sunita Shah, a nurse in the neonatal intensive care unit, said she was adamant she did not want to go back to college after earning her associate’s degree in nursing at Middlesex County College. But she has enjoyed taking classes with her co-workers, even if it means learning new computer programs to nervously give class presentations.

"It’s not difficult. But it’s getting out of my comfort zone," said Shah, of Old Bridge.

Nurse Irina Groza said she was thinking about winding down her career when she learned Saint Peter’s wanted nurses to earn a bachelor’s degree. She decided to begin taking classes to give herself the option of continuing to work as a nurse as long as she needs too.

"I’m 59 years old. I’m really thinking more about retirement," said Groza, a geriatric nurse from Spotswood. "But they really make it easy for us. I only have to drive here — and do my homework."