The USA is facing a chronic nursing shortage with a projected RN shortage of 800,000 by the year 2020 (Discover Nursing, 2006). Any person currently studying and working in the medical field will have an opinion on the nursing shortage and how they have felt its rippling effects. Ultimately, the current fluctuating nurse to patient ratio is the biggest indicator of the lack of nurses. [Invisible Nurse; Photo Credit: Illustration by David Stroud, 2004]
The shortage is driven by the lack of nursing instructors.
As mentioned in the UCLA 2007 Nursing Shortage blog, one of the key factors affecting the nursing shortage is the lack of adequate state and federal funding for nursing education. This lack of funding has led to financial problems in nursing schools, which overall affects funding for classroom space, nurse faculty salary, and educational programs. Similar to a never ending cycle, the lack of nursing schools leads to a smaller output of nurses. The smaller number of actively working staff nurses results in a smaller number of nurses who return to school to receive higher degrees and eventually become nursing instructors. Nursing schools need to have ample and essential resources in order to graduate not only the highest number of nursing students, but also competent and fully-prepared registered nurses who would help fill in the gaps of the nursing shortage. However, providing enough enrollment space and sufficient faculty service in most nursing schools is becoming more problematic today (Bliss, DeYoung, & Tracy, 2002). “Nursing schools had to turn away over 41,000 qualified applicants in 2005 because there wasn’t enough faculty to teach” (Ward, 2006). For instance, in 2002, surveys of New York State nursing programs reveal that one out of every ten programs turned away qualified nursing applicants because of faculty shortage (USNY State Education Department, 2008). [Crisis in White; Photo Credit: Herb Watson, 2003]
As we experience a combined crisis of more nurses retiring and more baby boomers seeking geriatric care, the nursing shortage will put much more strain on the healthcare system in a few years (Bonnel, 2003; Ward, 2006). Three key points contributing to the shortage of faculty are economic, social, and educational factors. (For more information on the overall nursing shortage, including contributing factors and possible alleviating strategies, please visit AACN). The greater difficulty and longer process of pursuing higher degrees, such as an MSN or PhD, compared to receiving a bachelor's or associate's degree could affect the student's decision to return to school. This could become challenging, if not discouraging, for some nursing students. In addition to not wanting to put out the money to return to school, staff nurses find themselves in more favorable positions than nurse educators. (To find how to make the transition from a bedside nurse to a nurse educator, please visit AMSN). For instance, staff nurses often have more desirable hours and find more flexibility in their schedule without the worry of inconsistency in their jobs. On the other hand, nursing educators can never assume that they will have a job waiting for them because the lack of adequate funding for nursing education leads to the ambiguity in the number of nursing programs that are opening and closing. For example, the UCLA School of Nursing had offered an undergraduate program since 1949, but the program was dropped in the mid-1990s due to budget cuts. After a decade-long hiatus, the undergraduate nursing program at UCLA reopened in 2006 (Dudley, 2005).
Socially, nurse educators need to be able to serve as the link between students and nurses. Nurse educators are faced with the demanding task of trying to gain respect from their doctor and nurse colleagues, while at the same time providing top notch education for their students. [Projected Open RN Positions; Credit: Peter Buerhaus, 2000][Support Nursing Scholarships; Photo Credit: University of the State of New York, 2008]
Furthermore, to be well qualified for this academic position, educators need to have both teaching experience and clinical expertise, as well as educational preparation (Beres, 2006). However, finding the time to do this poses another challenge. One possible solution includes the offering of an educator education program online that would assist instructors in adopting role changes in a timely manner (Phillips, 2006). With the technological advancements of today, online nursing classes are easier to access for potential nursing students delivering up to date education (Neuman, 2006). Another approach to this problem is the Nurse Educator Certificate for advanced practice clinicians. This new web based educator certificate program provides flexibility for students preparing to meet the rapidly changing healthcare needs of our population (Bonnel, 2003).
Not only are nursing programs becoming more advanced technologically, but nursing schools are also experiencing an expansion of accelerated programs in order to catch up with the growing demand for graduate nurses (American Association of Colleges of Nursing [AACN], 2005). By offering master’s entry-level degrees, nursing schools are hoping not only to graduate more nurses at a faster rate, but also to attract qualified undergraduate degree holders who are contemplating a career change (AACN, 2005) (If you are interested in returning to school please visit UCLA School Of Nursing website). Future nursing students can be made aware of these solutions and possibly change their academic goals in hopes of engaging in higher practice, possibly in education.
Fortunately, in the past few years, both government and private organizations have shown efforts to address the economic demand in nursing schools. One of the main public policies related to nursing is the Nurse Reinvestment Act (Andrews, 2004). This legislation was signed by President Bush in 2002 in order to allocate funds for programs that focus on basic and advanced nursing education, nursing workforce diversity, nursing practice and retention, loan repayment, scholarships, and grants (Beu, 2004). The act also called for private organizations to help fulfill the need for more public awareness campaigns (Beu, 2004). Thus, in 2007, AACN and Johnson & Johnson teamed up and launched a new national scholarship program designed to increase the number of nurse faculty from ethnic and minority backgrounds (AACN, 2007). (For information on an upcoming conference regarding nursing legislation please visit NCSBN).
In an economically driven marketplace, deciding what gets priority in funding can be difficult. Since the nursing shortage has serious implications for the healthcare standards, some may argue that solutions for the shortage problem (i.e. nursing education) should be given priority in funding. However, with limited resources available, others would also recognize that giving financial priority to some means denying to others. Indeed, formulating and passing initiatives is complex. The nursing shortage is seen in hospitals, schools, jails, clinics, and everywhere else nurses are found, including the academic setting. While hospitals are experiencing problems over nurse-to-patient ratios, nursing schools are currently experiencing a shortage in faculty (Bliss, DeYoung, & Tracy, 2002). In what seems like a never ending cycle of the nursing shortage, an increase in nursing faculty could play a huge role to slow the cycle down. However, it is only one of the many voids still needing to be filled.
["...we're understaffed" ; Credit: Reality RN, 2007]
For Further Reading...
Nursing Against the Odds: How Health Care Costs Cutting, Media Stereotypes and Medical Hubris Undermine Nurses and Patient Care by Suzanne Gordon
For More Information Please Visit...
American Association of Colleges of Nursing (2005). Accelerated Programs: The Fast-Track to Careers in Nursing. Retrieved November 21, 2007, from http://www.aacn.nche.edu/publications/issues/aug02.htm
American Association of Colleges of Nursing (2007). Johnson & Johnson Campaign for Nursing’s Future Joins with the American Association of Colleges of Nursing to Offer A New Minority Nurse Faculty Scholars Program. Journal of Professional Nursing, 23 (5), 249-250.
Andrews, D. (2004). The Nurse Reinvestment Act: The Impact of Governmental and Nongovernmental Administrative Tools. Journal of Professional Nursing, 24 (4), 260-269.
Beres, J. (2006). Staff development to university faculty: Reflections of a nurse educator. Nurse's Forum, 3, (41), 141-145.
Beu, B. (2004). The Nursing Shortage and the Nurse Reinvestment Act. AORN Journal, 79 (5), 1061-1063.
Bliss, J., DeYoung, S., & Tracy, J. (2002). The Nursing Faculty Shortage: Is There Hope? Journal of Professional Nursing, 18 (6), 313-319.
Bonnel, W., and C. Starling. (2003). Nurse educator shortage, new program approach. Kans Nurse, (78), 1-2.
Discover Nursing (2006). Job Opportunities. Retrieved March 2, 2008 from http://www.discovernursing.com/job-opportunities
Dudley, Melinda. (2005). Nursing opens to undergraduates. Daily Bruin. Retrieved February 28, 2008 from http://www.dailybruin.ucla.edu/news/2005/nov/22/nursing-opens-to-undergraduate/
Neuman, L. H. (2006). Creating new future in nursing education. Nursing Educator Perspectives, (1), 5-12.
Phillips, J. M. (2006). Preparing preceptors through online education. Nurses Staff Development, 3, (22), 150-156.
University of the State of New York, State Education Department. (2008). Nursing faculty shortage program. NYSED. Retrieved January 25, 2008 from http://www.oms.nysed.gov/
Ward, Jerry L. (2006). Over 41,000 qualified nursing school applicants rejected in 2005. Retrieved January 25, 2008 from http://garloward.com/2006/10/