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
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.