Skip Navigation LinksHome > January 2011 - Volume 111 - Issue 1 > Under Fire: Nursing Degrees from For-Profit Institutions
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000393050.33074.3c
AJN Reports

Under Fire: Nursing Degrees from For-Profit Institutions

Lyttle, Bethany

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Some schools dominating the online market may not deliver on their promises.

Nursing degrees—including online degrees—from proprietary (or for-profit) colleges and universities may be convenient. But a degree from some of these schools can be the end—not the beginning—of a promising career. An unprecedented flow of accusations by whistle-blowing recruiters along with testimony from former faculty members and students has coincided with hundreds of lawsuits directed at these schools, raising questions about the quality of the education offered, the validity of the degrees bestowed, and the ethics of associated costs.

Figure. Aja Holmes s...
Figure. Aja Holmes s...
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Transferring credits from these schools or getting hired after graduation may be impossible. And paying back student loans (typically in amounts that far exceed any earning potential) can result in extreme debt or in garnisheed wages and ruined credit ratings for those who default.

Nancy Spector, director of regulatory innovations at the National Council of State Boards of Nursing (NCSBN), said that press releases about for-profit nursing degrees are being monitored carefully and that information about the council's findings are being communicated to individual state boards of nursing. She notes that not every for-profit school is risky but recommends that prospective students be diligent and cautious. "As nursing becomes more complex, the goal should be the highest-quality degree possible."

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Prospective students sometimes confuse a for-profit school with a private college or university, assuming that a degree from a for-profit school possesses a level of prestige and reputation that simply isn't there. In fact, a for-profit school is a business, often owned by a multibillion-dollar parent company that may be publicly traded. Ironically, these company profits are often boosted by federal student loan dollars from students who can't afford the tuitions. Some of the schools derive the bulk of their revenue from federal student aid, according to Daniel Golden, writing in the March 4, 2010, issue of Bloomberg Businessweek ( For instance, according to Golden, Ashford University, formerly the regionally accredited Franciscan University of the Prairies until it was bought by Bridgepoint Education in 2005, received 86% of its revenue from student aid in 2009; University of the Rockies, formerly the Colorado School of Professional Psychology, received 85% of its revenue from student aid that year. Figures from the U.S. Department of Education show that degrees from such schools don't offer a boost in income for graduates.

This isn't to say that every for-profit college or university is inherently a problem. But according to Barmak Nassirian, associate executive director of the American Association of Collegiate Registrars and Admissions Officers (a nonprofit voluntary, professional association of more than 10,000 higher-education admissions and registration professionals who represent more than 2,600 institutions and agencies in the United States), the for-profit sector is overwhelmingly biased in the direction of privileging profits over ethical, high-quality education—and does so at the expense of low-income, minority students who might not have a chance to get a degree otherwise. In an interview Nassirian did as part of the PBS Frontline episode "College, Inc.," (, he said, "As a business model, as a scheme, it would be vacuous and completely nonsensical to set up a whole edifice whose purpose was to victimize low-income people to take their money. . . . Now, refine that business model. Render them eligible for tens of thousands of dollars of federal financing, and now chase after them. . . . Pull them in with promises that really tug at the heartstrings; they push all the right buttons about the American dream: 'You've been marginalized. Here's your chance to better yourself.'"

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Most of the answer to that question can be found in the millions of dollars spent on ubiquitous advertising campaigns and Web sites. These ads funnel prospective students to one-on-one recruitment personnel who can make saying no seem almost impossible. In fact, many recent settlements, lawsuits, and allegations are tied to misleading information and top-down, company-enforced pressure tactics by recruiters to enroll students at any cost.

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Prospective nursing students must first understand the nature of nursing licensure. There have been dozens of cases in which students have paid tuition to for-profit schools that haven't gained approval or accreditation in their state and, as a result, can't take the National Council Licensure Examination (NCLEX). The NCSBN strongly recommends that prospective nursing students be clear about which schools qualify. In addition, prospective students should take the time to do the following:

* Find out whether the program is nationally accredited by either the National League for Nursing Accrediting Commission ( or the Commission on Collegiate Nursing Education (; click on "CCNE Accreditation"). Keep in mind that accreditation in nursing isn't mandatory for schools and that approval from a state board of nursing means only that the program has met a minimum standard.

* Find out whether faculty members possess, at the least, a master's degree in nursing.

* Learn about the quality, eligibility, and number of supervised clinical experiences provided by the program.

* Select a program that includes some clinical experiences with the program's faculty members, not only unit nurses.

* Call hospitals and potential employers before you enroll, and ask how the college or university is viewed and whether they hire graduates from those programs.

* If you hope to pursue graduate school at a nonprofit school, contact graduate programs that interest you and ask whether they accept credits or degrees earned at the for-profit school you are considering.

* For-profit schools have names that differ from those of their parent companies. For instance, the University of Phoenix is owned by Apollo Group, Inc.; the Chamberlain College of Nursing is owned by DeVry, Inc.; and Kaplan University is owned by the Washington Post Company. Find out the name of the parent company, and then type it into the Securities and Exchange Commission's database ( Publicly traded companies are required to disclose lawsuits and government investigations. Search the database by typing in the company's name and "10-K," the name of the annual report form.

* It may seem obvious, but if you decide to attend one of these schools, read every document before you sign it and, ideally, have someone with legal knowledge review it first.

Don't take a recruiter's word for it. Always do the research to find out whether the information you've been given is misleading. These steps can appear daunting, but by spending time now, you can save money later and guarantee advancement in a career worthy of your ambition.—Bethany Lyttle

For an in-depth look at for-profit higher education—including the experiences of several nurses who claim they were promised hands-on training and job placement but received neither—see the PBS Frontline episode "College, Inc.,"; also see "In Hard Times, Lured into Trade School and Debt" in the New York Times,

© 2011 Lippincott Williams & Wilkins, Inc.


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