Success Tips & Considerations for Online Nursing Students
Featuring advice from nursing student Melissa Mullins
Nursing school…online? Yes, it’s real! Depending on your program, you can complete much of your nursing degree from the comfort of your own home. In very specific situations—such as for currently employed RNs who can rely on their employment to fulfill clinical hours—you may even be able to earn your degree with no additional in-person hours.
Traditionally, all or much of a nursing degree had to be in person, especially clinical hours. For instance, California requires that 75 percent or more of a nursing student’s clinical hours be performed in a setting that provides direct patient care. However, Sharon Goldfarb, dean of health sciences for the College of Marin, says that’s an outdated idea, written before modern distance learning methods were available. Further, Maryann Alexander, chief officer of nursing regulation for the National Council of State Boards of Nursing, contends that nursing students can do up to half of their clinical work online without any negative outcomes.
Norms and regulations may continue to change to reflect the increasing acceptance of nursing education delivered online. Is a nursing program online the right fit for you? If you are in a program with a significant online component, how can you best succeed? This guide is here to help answer these questions.
What Does Online Learning Look Like?
In many ways, online education looks the same as in-person learning with a few key changes. In fact, Julia Brunicardi, Michigan State nursing student, said, “…I honestly feel like it wasn’t that hard to transition from in class to online” when her in-person courses were suddenly canceled due to COVID-19.
With nursing online coursework, you still regularly interact with your professors and peers, engage in rigorous coursework, and receive a degree identical to those given to campus-based students. A few differences do exist, however, and they’re worth noting as you decide whether this path best serves your needs.
Online Learning Expectations for any Degree Program
No matter what degree you’re earning online, there are a few things you can expect:
Learning management systems
Whether your college uses Blackboard, Canvas, or another learning management system, this is the tool that hosts your online classes, allows you to turn in assignments, and makes it easier to communicate with everyone in your program.
Synchronous vs. asynchronous classes
It’s important to decide whether you want to learn in real-time or watch pre-recorded lectures. Students with more flexible schedules often choose the first option (synchronous), while those with more personal and/or professional responsibilities opt for the latter (asynchronous).
Hands-on and group work
Online degrees include the same type of group projects and solo assignments as traditional degrees, but they’re organized and completed online. You will meet virtually with your group partners to divvy up responsibilities, review progress, and bring together necessary materials and/or presentations.
While much of the communication you have with your professor will likely take place over email, many also provide virtual office hours where they can be reached for phone or video calls.
What to Expect in Online Nursing Programs
However, in online nursing programs, you may find some unique expectations you might not find in other online degree and certification paths.
On-Campus and On-Site Work for Online Nursing Students
As a nursing student, you’ll likely be expected to do work outside of your online environment.
On-campus work will probably be for practical skills training. While there are many things you can practice via simulations (more on that below), some things are best done with in-person supervision and training. This could include hands-on experience in CPR, injections and IV placement, and physically moving classmates posing as patients from wheelchairs, among other possibilities.
Nurses, particularly those at entry levels, will likely also need to complete work at a hospital, long-term care facility, or other healthcare institution. These requirements are often set by the state and should grant you on-the-ground experience working with patients and their families.
Many nursing programs are now offering simulated practice for nursing students. These options are often offered at all degree levels and allow you to practice skills you’d usually need to experience in person. While they aren’t available for all necessary tasks, many tasks and skills can be practiced this way.
It’s worth noting even on-campus programs sometimes have requirements like virtual simulations. This can be so students can do additional practice as homework or become more comfortable with telehealth visits.
Simulations have additional benefits—where working directly with patients can be stressful and result in feeling judged for your abilities, these stressors are taken out of the equation in a virtual setting. Karis Casseus, clinical assistant professor of nursing at Georgia State University, adds that simulations allow time to reflect after completing the work.
Simulated labs take several forms:
In this type of simulation, nursing instructors communicate with students via video while the students instruct them on what to do on medical-grade mannequins. These mannequins are equipped to provide feedback on the skills implemented once the procedures are over, and the instructors provide feedback and assistance along the way.
There are two basic types of video simulations: diagnostic/treatment and patient communication.
For the first, nursing students are shown a virtual patient, along with their vitals and any relevant documentation (X-rays, patient history, etc.). They assess and treat these issues in real-time, and the simulations monitor their psychomotor and clinical skills, along with other relevant abilities.
For the second, they practice speaking with their patients. Simulations are often timed so your professors can see how long it took to complete a treatment or how much time you spent with a patient discussing concerns. You can investigate a few simulations from this list compiled by the National League for Nursing—and possibly even access them even if your school isn’t using these ones so you can get additional practice.
Some programs may opt to use full-blown virtual reality (VR) Though the training is similar to simulations, things like your hand movements are more easily monitored.
For these, you put on a pair of VR goggles and gloves and practice treatments you’d normally do inside a classroom. One type of VR program, created at Robert Morris University, turned urinary catheter insertion into a game. And it proved effective—those who practiced catheter insertion this way passed this step of their training at the same rate as those who practiced on mannequins.
When studying this program, it was also discovered “students who trained with VR spent more time practicing, could complete more procedures in a 60-minute period and gave higher marks to the immersive experience.”
Succeeding in Online School When You Don’t Have Reliable Internet Access
Many people would love to learn online, but don’t have easy access. Many companies offer reduced-price services—check on internet providers in your area to see your options. One fairly widespread option is Internet Essentials, which provides affordable web access—just $9.95 per month—to those who qualify for programs like SNAP or Medicaid. They can also help you acquire a computer at a reduced price.
If you’re in a real bind, places like your local library or coffee shop may have WiFi available. Many libraries leave their internet on 24/7 so people can sit outside and use it.
Types of Nursing Programs You Can Complete Online
Nearly all types of nursing programs can be completed entirely or partially online, though clinical hours may still need to be completed in a local in-person facility. Here are some details about the different types of certification or degree programs within the nursing field.
Online CNA Programs
Certified nursing assistant (CNA) programs are highly hands-on, as CNAs do a lot of the “grunt work” like moving patients to and from wheelchairs or helping them with daily living activities. So, it may be harder to find one that allows you to complete most of your training via the web. However, these programs are occasionally offered in a hybrid format—that is, you take more “theoretical” classes online and do the hands-on work at a medical facility or in a classroom.
These programs are typically short, taking as few as two to six weeks. As of 2019, nursing assistants earned a median salary of $30,720 per year.
Licensed Practical Nurse (LPN) – Certificate or Diploma
Like with CNAs, it’s not possible to complete your LPN programs entirely online due to the hands-on nature of the work. That said, hybrid programs are available, with your theoretical work done virtually. If your program requires core classes in science, math, etc., these can also often be taken online.
These usually take one year to complete and can be found online via community colleges and technical schools. Upon graduating, plan to sit for the NCLEX-PN examination to receive licensure in your state. According to the Bureau of Labor Statistics (BLS), LPNs earned annual median salaries of $47,480 in 2019.
Registered Nurse (RN) – Associate Degree, Bachelor’s Degree, or Diploma
If you aspire to work as a registered nurse, the most common educational paths are to pursue either an associate (ADN) or a bachelor’s (BSN) degree. Associate and bachelor’s degrees require core classes, which can often be taken online. It is possible to find some RN degree programs that are entirely online except for your state-required fieldwork. When studying to become an RN, you can generally expect more simulation than is available to CNAs and LPNs.
Full-time study takes around two years for an associate and four years for a bachelor’s degree. RNs overall (regardless of educational path) earned median annual salaries of $75,330 in 2020.
As an increasingly uncommon alternative, some hospitals and healthcare facilities offer RN diploma programs, which take two to three years to complete. RN diplomas focus heavily on clinical hours while preparing students for entry-level nursing careers.
As a registered nurse diploma student, you’ll provide direct patient care and take online or in-person classes that cover general nursing topics such as basic pharmacology, human biology, elements of patient care, medication administration, and more. Once you have your diploma, you can take the NCLEX-RN exam and apply for your RN license. RNs with a diploma typically make less than degreed RNs, with an average yearly salary of $65,620. In addition, your coursework might not transfer to a degree program if you decide to continue your education down the road.
It’s worth noting the medical world is putting increasing pressure on RNs to have bachelor’s degrees, so if you’re going for your associate, keep in mind you may need to study for your bachelor’s degree while working.
Online education can help RNs going for higher degrees, as online degree programs are often geared toward working professionals. Some schools offer online RN to Bachelor of Science in Nursing (BSN) completion programs, and you can even find some with accelerated RN-BSN-master’s (MSN) programs.
Master’s-Level Nursing (APRN, Management)
Advanced practice registered nurses (APRNs) can hold titles such as nurse practitioner, nurse anesthetist, or nurse-midwife, among others. Nurse managers can lead teams of nurses or move to the business side of the field. The amount of time you must spend doing hands-on work will vary based on your career path. If you want to focus on the business end of nursing (administration, informatics, etc.), you may be able to find a program entirely online. If you hope to work (or expand your knowledge) in a new area of patient care, like anesthetics or midwifery, you may find yourself doing more simulation or on-site training.
Whether pursuing a master’s or doctorate, the amount of time required to graduate depends on previous education. If you possess an associate degree and want to earn a doctorate, plan to spend at least five years enrolled. If you already have a BSN and want an MSN, this can usually be done in 18 to 24 months. In 2019, APRNs earned median salaries of $115,800, and medical and health service managers made $100,980.
Professor of Nursing – Doctorate in Nursing
Like APRNs, the amount of online vs. on-site work you can expect to do will vary based on your pathway. If you want to work in academia or leadership, you may find these programs entirely online. If your goal is to work in nursing practice, you may find yourself doing more simulations or on-site work.
These programs can take between three and five years, depending on the degree you currently hold. The BLS found the median salary for nursing instructors was $71,260 in 2019.
Is Online Learning Right for Me?
Before committing yourself to distance learning, you should consider whether it best fits with what you need at this time. Some points to consider include:
Online learning can be great if you’re trying to fit school into personal and professional responsibilities. Jenn Barber, who graduated from Utica College’s online ABSN program, said, “The online course structure gave me the flexibility I needed to have a home life while I was going to school. It allowed me to study on my terms.” On the flipside, though, some find it easier to balance school and life when they have the structure and schedule of in-person learning.
Completing in-person vs. remote work
You might be the type of student known for your focus and determination, regardless of the format. Or, you may need the push that comes from working on campus. Consider which path fits best with your style.
Comfort with virtual work
Are you okay with practicing in virtual patients, or would you be more comfortable working with real people? The only right answer is your
To succeed in online learning, you must keep yourself organized and manage your time well.
Interacting with others
While you will engage with fellow students in live sessions, consider whether you need to be physically present with others to feel at your best academically.
While tuition typically costs the same regardless of whether you study online or on-campus, some schools allow distance learners to pay the same tuition rate regardless of whether they live in the state or further afield. Additionally, you won’t have to pay to travel to campus as often, and you may not have to pay on-campus fees.
Using various learning management systems, telecommunication tools, and other required software requires an up-to-date computer and video capabilities.
Tips for Success in Online Programs
If you want to succeed in online learning, you need to have a plan in place. These tips are here to help you excel in your program.
Before You Begin Your Online Classes
Ensure Your Housemates are Supportive
Deciding to pursue an online nursing degree requires a big commitment from both you and your housemates. Whether they consist of roommates, a partner, or your family, these people’s lives will change due to your own life changing.
This could mean getting to spend less time with you, more responsibilities for them to take on, or giving up a portion of the living space so you can have a private area for attending classes and studying. It’s best to sit down with those you live with before starting a degree program to explain your schedule and set expectations on both sides. Make sure they understand many of your classes will involve timed simulations—one of the things factored in is how long you spend with each virtual patient and the speed at which you provide treatment. Clear communication throughout your program can help ease misunderstandings and tension.
Find Ways to Keep Your Kids Occupied
If you have children, trying to keep them busy while you’re working on projects and assignments can seem like a challenge. Things can be doubly hard for nursing students, as some virtual simulations show medical issues or nude bodies, which you may not want your children to see. And those VR headsets? Those could probably be pretty tempting!
If your kids are older, they may be able to entertain themselves and understand why they can’t bother you or mess with your equipment. For elementary students, it might be helpful to compare your work to things like their timed tests at school and allow them privileges like screen time they may not get at other times. If you have a VR headset, explain to them it only works for medical things—not kids’ games—and you could even say they only work during your class time (whether or not that’s true). For the smallest ones, finding a sitter or leaning on older housemates may be your best bet—if this isn’t an option, set up a safe place for them to play while you work, and be sure your professor knows about this hurdle.
Letting your larger community know about your plans means your kids may be able to spend more time at their friends’ houses, join community sports teams, or take advantage of later pick-up times at school. Start researching your options and talking to others well in advance to see what’s feasible and try to have a couple options in case one falls through.
Set Up a Dedicated Workspace
You need a dedicated workspace for completing your online nursing classes. Even if you cannot cordon off a whole room, setting up a desk only you use can help you stay focused. Make sure your computer doesn’t face out toward others, as you may work with images others find unnerving or have private information on your screen.
Creating a dedicated workspace can also help you set boundaries between school and your personal life and provide an area where you can keep all your textbooks and school supplies out of the way of others.
Make sure your workspace is a spot you like being in—but try to keep it out of your bedroom. If you can see your schoolwork from bed, you may find yourself wrestling with the idea you “should be studying” when you, in fact, should be sleeping. A tired brain isn’t a fully functional brain.
If there isn’t a great place in your home and you have the time to go elsewhere, library study rooms are built for this type of work. You can often reserve a room online and work in a relatively distraction-free environment. Coffee shops and similar also often have WiFi, but you should be aware of what will be on your screen if you opt to study in one of these locations and try to have your computer facing a wall, so others don’t see what you’re doing. (Also, using VR technology might look a bit silly there!)
Anticipate and Plan for Technology Issues
Despite your best-laid plans, technology snafus will inevitably happen while you’re studying online. It’s important to consider all the ways your tech could malfunction.
One of the best plans is to ensure you have contact info for your teachers and classmates. Even if you can’t get logged into the learning management system or have trouble connecting to your telecommunication software, you can still send an email or text from your phone to let everyone know what’s happening.
Anything you can download, do so. That way, you can access it offline. Additionally, try to finish assignments early so you don’t have to worry about missing a deadline if your internet goes down. Don’t forget many coffee shops and public libraries have free WiFi, so you can trek over to one of those to submit things if you need to—often even from your vehicle if they’re closed or if you just don’t feel like going in.
Utilize Your Advisor
Your advisor is one of the best resources you’ll have in school. They likely understand the balance you must strike with school, work, and family obligations. Communicate with them early and often; keep them aware of any struggles you face, and they may be able to help you before things get overwhelming.
During Your Online Nursing Program
Create a Schedule
Following this step is one of the most important things you can do to set yourself up for success before the semester begins. Once you receive the syllabi for your courses, go through and write down important due dates or add them to your digital calendar. You can also add in your available work schedule to get a sense of days that might be busier than others or when you might need more help with childcare.
While some students may work best with a more planned, hourly breakdown, others may feel better simply seeing everything on one page and mentally breaking down their days. Figure out which plan works best for your organization style and stick with it.
A particularly important thing to put in your schedule is anything that will be timed—exams, simulations—or things that require you to put on a VR headset. You want to make sure you have the time and space available to complete these assignments.
Build Relationships with Your Professors
In most cases, your instructors worked as professional nurses before switching to academia. Utilizing their experience, connections, and wisdom can support you in myriad ways. They can help you anticipate what to expect during clinicals, connect you with important networking contacts, and provide support when you’re struggling.
Building these relationships should start on day one. You could start off with a friendly email introducing yourself and telling the teachers how excited you are for the classes. If you know you have challenges with technology or at home—for instance, if you have young children or care for an elderly relative—you can bring this up then. But, be sure to not have it be the focus of the email, as you don’t want them to get the idea that you’re not dedicated. Focus on solutions rather than problems.
It’s important to remember your professors aren’t only there to teach you. Part of their job is to make sure you receive the support needed outside when they’re teaching. You aren’t bothering them by asking questions or for support.
Robert Blackwelder, an online master’s in nursing student at the University of South Carolina, found online professors incredibly helpful and supportive. “Although I am not physically in front of my professors, I can honestly say my learning has not been affected,” he said. “If anything, it has been enhanced. All of my professors have been willing to go the extra mile to ensure I’m receiving a quality education.”
Get to Know Your Classmates
One of the benefits of online nursing study is that your classmates may live all around the country. Some may work in areas facing challenges your own may not—for instance, if your local facilities are suburban, you may learn a thing or two from someone who works with rural patients. These relationships provide unique perspectives and may help you build contacts in case you move to a new state.
Additionally, everyone has strengths and areas for improvement. If you discover one of your classmates really understands how the heart works and you’re still struggling, for instance, they may prove to be a valuable resource. If you’re excellent at patient communication, you can offer your assistance to others.
Build in Breaks
When you study on campus, breaks are naturally built-in as you walk campus between classes, stop to eat lunch, and chat with friends. When studying online—especially if you take asynchronous classes—breaks don’t necessarily happen naturally; you have to add them in yourself.
It may seem tempting to watch five lectures in a row and try to get all your assignments turned in on your one day off, but this can encourage burnout. Building in breaks, even if they’re only 10 to 15 minutes long, gives you time to stretch, get another cup of coffee, chat with housemates, and replenish your brain before jumping in again.
What have been some of the challenges and successes of transitioning nursing education to online formats?
Starting in March 2020 (end of our second semester), we went completely online, so all of the clinicals got cancelled. This left us with having to figure out how to make up those hours with virtual simulations. Luckily there are a lot of programs that are made for this; however, it cost the school to set these up for us, [and] it also doesn’t compare to caring for patients in real life clinicals. So we lost that in-person contact that I believe is essential in nursing.
Trying to learn online had its setbacks as well: the distractions and wifi issues are real! Thankfully, I don’t have many distractions at my apartment; however, just the guys mowing the lawns was distracting and hard to focus on the material.
I felt like my school was able to transition and handle the changes fairly effectively, and the communication between the instructors and students helped aid the changes.
What are some of the benefits and drawbacks to taking online nursing courses?
I honestly feel like having nursing classes online are not effective enough to produce well-rounded nurses. A huge part of nursing is not only knowing the extensive amount of information, but [also] how to talk to our patients in an empathetic and caring manner. Unless the student has worked in a hospital and cared for patients in real life, there is no way to get comfortable performing tasks online. There is a level of comfort that a nursing student has to reach to be able to touch, assess, and talk to patients, as it is different than just holding a conversation with a stranger.
The benefits that could come from online nursing classes could be a time issue with someone that has a full-time day job, or a family to take care of.
What are some things potential online nursing students need to consider before choosing this instructional method?
As mentioned above, if someone is hoping to do a [fully] online nursing class, I would highly suggest to get a job, or volunteer in a hospital or nursing home in order to gain that person-to-person contact.
What have been some of the most fascinating technologies you’ve seen used to allow students to learn remotely? What have been their benefits?
Some of the simulations that were the most realistic, in my opinion, is called Vsim. It is realistic in how you, as the nurse, cares for the virtual patient and makes decisions, the patient reflects those choices fairly accurately. The scoring of this site is helpful in aiding you to what you can do differently and why.
What advice would you have for nursing students who are taking their courses online?
My best advice would be to set aside an ample amount of study time, volunteer, or work in a position where you will be caring for a patient, talking with a patient, or can be exposed to equipment, procedures, time management in the healthcare setting.
While you should focus and strive to excel in nursing school, make sure to do self-care, have an escape, take some time to do something that is not nursing-related!