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Benign Neglect and the Nursing Shortage – Brian Klepper

I sit on the Dean’s Advisory Councils of the Colleges of Health at two public universities in Florida. Both Colleges are led by extremely capable PhD nurses, and have a variety of programs that train students to be health professionals, including nurses.

A few months ago, I was startled when one of the Deans mentioned that
her Nursing program had 500 qualified applicants for 132 student slots.
In other words, at a time when the market wants her to gear up, she
turns away 3 qualified applicants for each one she accepts. As it turns
out, it’s a national problem. In 2006, Colleges of Nursing turned away 43,000 qualified applicants.

It’s not news that health care institutions face a critical nursing shortage. An April 2006 AHA report estimated that American hospitals currently need 118,000 RNs to fill vacancies. That number is expected to triple by 2020, to 340,000 vacancies.

What is less clear to most of us is exactly why the shortage exists. Most of the facts in this piece were drawn from an excellent presentation by Geraldine Polly Bednash, PhD RN. Dr. Bednash is the Executive Director of the American Association of Colleges of Nursing (AACN). AACN’s site has a wealth of data on the problem, and the distinguished members of that association draw a VERY compelling picture of benign neglect of the training process by the sector it serves.

Almost three-quarters of Nursing schools surveyed said the main reason that they can’t train enough new nurses is a lack of qualified faculty. When I first heard this, it seemed counter-intuitive. There must be thousands of very seasoned and appropriately trained nurses who would be glad to go into the classroom.

Not so. A July 2005 survey of Colleges of Nursing around the country found that 2/3 of all respondents said they had nursing faculty vacancies and needed to hire additional faculty. Of course they want nurses with PhDs, if possible, but with a range of specializations and the ability to both teach and do research. Even so, between 1992 and 2000, the percentage of Nursing faculty positions occupied by PhDs dropped 19%, from two-thirds to less than half.

Data from 2001 showed it took a PhD nurse almost 21 years on average after receiving her undergraduate degree to get her terminal degree. The average age of full time Nursing faculty in 2001 was 51, and its almost certainly older now. As many a 300 PhD Nursing faculty are expected to retire in the next decade, exacerbating the problem.

There are many reasons why Nursing faculty are difficult to come by, but one is overwhelmingly dominant. Nurses qualified to be faculty have to take significant pay cuts for the privilege of taking a teaching position. Nursing schools are unable to pay Nursing faculty candidates what they would make working as nurses in clinical positions in the marketplace. Academic institutions are on tight budgets, especially during times of economic instability, and so cannot compete with the marketplace. Meanwhile, to a large degree, the organizations that employ nurses – typically very affluent entities in the scheme of things – stand by and assume that it is not their responsibility.

Comparison of Nursing Salaries: Instructional and Non-Academic Positions

Nursing_salaries2004_2

American Association of Colleges of Nursing, White Paper of Faculty Shortages

On average, each Nursing faculty position produces about 10 new nurses per year, a pretty impressive production figure. As jobs go, nurses are well paid, and with so many other American jobs on the decline, one would think that nursing would look like a great future to many students.

What is needed is for hospitals and other health care organizations to collaborate with universities to subsidize nursing faculty salaries so the bottleneck is eliminated, and so we can prepare for the deluge of need coming down the pike. A failure to do this would be irresponsible. The leadership on this issue must come from the tops of health care organizations within each community around the country.

This one is easily solvable. There is no excuse for not having enough nurses, who are among our best, most capable and most caring professionals.

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Red Cross CNA TrainingBiancaReese HowardAnnieMM'LIssa Edwards Recent comment authors
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Red Cross CNA Training
Guest

Nursing shortage is big issue US also suffering from it. Even I read one article that described that due to shortage death rate is increasing. Just join nursing training at http://cnaonlinetrainingclass.com/ and save people.

Bianca
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Bianca

Admittedly, nursing shortage problem is really profound in U.S. It is estimated that by 2020 nursing vacancy will be 800,000. I believe without government intervention, this problems will be even worse. But I know Johnson & Johnson, the US largest pharmaceutical company, has launched a national awareness campaign Johnson & Johnson Campaign for Nursing’s Future to alleviate this problem through multifocal endeavors in retaining and recruiting nurses from diverse backgrounds. Since its initiation in 2002, Johnson & Johnson unwavering efforts in improving nurses’ image and welfare systems have made great headways in this issue. Particularly, Johnson & Johnson believed that… Read more »

Reese Howard
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Reese Howard

I am immensely proud of M’Lissa Edwards, who happens to be my daughter, and also one of the most intelligent people I ever met, making a difference in this world

AnnieM
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AnnieM

I am a midlife Master’s degreed nurse who went into debt for both BS and MS level education, taught for awhile and now am back to a staff nurse position for $20K per year more pay. Why? Because I have education loans! All it would take for me to teach fulltime would be a federally funded education loan repayment program for nursing faculty, regardless of ethnicity, background, etc. Just pay my loans in exchange for me to teach, and I’ll do it for the rest of my career. Simple, eh? Oh no, maybe not, since they’d rather I pay for… Read more »

M'LIssa Edwards
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M'LIssa Edwards

If the problem is really a shortage of faculty, then what is being done to recruit faculty? There are plenty of experienced nurse clinicians out there who might enjoy having regular hours and slightly less pay if there were real trade-offs. What might the perks be in the absence of better pay? Market intelligently to these experienced clinicians and you might see a flood of applicants. An ad in a paper might not spark the interest of a nurse who has the brains and experience to teach but more active recruitment methods might make the difference. Some people just don’t… Read more »

Bignurse
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Bignurse

As a nurse of over 20 years with an MSN, I believe that the degree-inflation argument holds water. Nursing needs to re-organize its educational process — the initial training should be at the LPN level, then the graduate should be required to work in nursing for a year. Then, if the LPN qualifies on the entry exams after one year, they would be fully-subsidized to go to school for an Associate Degree RN. After that, if the nurse wants an advanced degree, they would take a combined BSN/MSN program with partial subsidy and part-time work if they choose. This educational… Read more »

lin
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lin

The biggest deciding factor for many nurses in leaving their jobs and nursing practice is the lack of a supportive atmosphere within the nursing culture. This will have to change before we see the tide turn. Retention of nursing personnel is the crux of the problem. Bringing out of practice nurses back into the workforce doesn’t address the main issue of why these nurses left their jobs in the first place. I’m an NP, and always wanted to be an NP. I am happy in this role, but I was very unhappy as a staff nurse. I am also a… Read more »

Shelley
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To “Joe Blow” and other readers of this blog: You don’t get your groceries for free; why do you expect nurses and doctors to work for free? How to Fix the United States Health Care System We Must Do It Ourselves “Problems cannot be solved at the same level of awareness that created them.” –Albert Einstein Identify the Components: Ones That Work and Ones That Don’t The first step to solving any seemingly daunting problems is to break it down into component parts, identify what works about the existing status; and what doesn’t. It’s crucial to learn from the past.… Read more »

jane doe
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jane doe

It seems it is a self image issue. Are we trying affirm our identity and worth from a career??? Nurses are not the head of the health care team, and neither are physicians. PATIENTS ARE!!! When we stop fighting among the ranks and stop the finger pointing and the “I’m more important than you, because I have more education” attitude, we will get somewhere. Let’s get over ourselves and get to work!!!

Male nurse
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Male nurse

I’m not sure what joeblow’s problem is with nurses? We are highly trained professionals who are responsible for patient safety and care, not simply asswipers as you put it. The next time you are in the hospital, we will simply grab someone off the street and tell them that all you have to do is wipe his ass and shovel some food in his mouth. I’m sure that will assist in your overall wellness. Being a nurse involves a huge gamet of patient care from assisting in activities of daily living to DOUBLE CHECKING MEDS as doctors are simply human… Read more »

Elaine
Guest

As a nurse, I appreciate all the comments. The nursing profession needs educators, but the universities are not producing enough to educate the nurses we will need in the future. Online nursing degree programs may be helpful.

Nicole
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Nicole

I am a Nurse Recruiter with a current degree in University Studies, and I was/is one of the many nursing school applicants who was accepted into a 2yr nursing program but I would have had a 2yr waiting list before I would have actually started. I have since decided to work on a Bachelors of Business Administration in Management. I will graduate next May ’08 and at that I point I hope that I will be able to get into a program rather quickly this time around considering my A&P’s will be set to expire in the next year sometime.… Read more »

Peter
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Peter

“First of all, nurses are EDUCATED not trained. According to Miss Nightingale dogs and horses are trained–nurses are educated.” Ms. Meyers, I would rather have a nurse looking after me who is educated rather than trained. Depending on the teacher the student can turn out as either, no matter the degree. I wish we had more educated doctors then trained ones as well. Training suggests blind reaction to events or information and education hopefully allows a better more reasoned evalualtion (sometimes outside the books)of a situation to get to the truth. But the (educated?)BSN students hired on my wife’s NIC… Read more »

Kate RN
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Kate RN

Two things to input: 1) I believe there is a factual error in the original article, if my memory serves me, at last count there were well over 3,000 (not 300) nursing faculty planning to retire in the next 5-10 years, and 2) to Joe Blow, whatever you think nurses do (apparently you don’t think we think), I would hope you would respect the science. Research data clearly demonstrates that there are better clinical outcomes (including fewer patient deaths) when there is a higher percentage of BSN nurses providing the care (see the work of Linda Aiken)

joe blow
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joe blow

“We are shame-faced that pharmacy and much of PT has gone to doctoral preparation and we continue fighting to keep the two year degree as entry to practice. I suppose nurses aren’t bright enough for us to implement the baccalaureate as entry level. I find it very odd that pharmacy and PT (one wonders who is next) can enter at the professional level and nursing just can’t. Poor dears. ” Yes, the solution to the nursing shortage is to make PhD an entry level degree required for all nurses. That will really solve the shortage. You gotta be kidding me.… Read more »