With the graying of America and a projected increase in life expectancy (the number of people age 65 and older is expected to double between 2000 and 2030), the impending spike in covered lives beginning in 2014 when the new healthcare reform law is in full swing has universities bracing for a surge in interest among those seeking healthcare degrees to help care for them.1
"There was a lot of attention being paid to the [presidential] election," in November, said Al Rundio, PhD, DNP, RN, APRN, NEA-BC, DPNAP, clinical professor, department chair, and assistant dean for advanced practice nursing in the division of graduate nursing at Drexel University in Philadelphia. "With the president being re-elected, the focus now is on the effects of the Affordable Care Act and the increase in insured people under the plan."
Drexel has responded to increased student enrollment by establishing creative programs to meet student needs. A portfolio of traditional and online formats are designed to embrace the expected wave of students looking to enter healthcare - particularly nursing.
In fact, Drexel doubled its nursing student enrollment in 2012, Rundio said.
Across the nation, university programs are facing a similar uptick in student demand while experiencing a shortage of appropriately qualified faculty. While Drexel doesn't currently have a critical need for faculty, other programs aren't as fortunate.
According to the American Association of Colleges of Nursing (AACN), U.S. nursing schools turned away 75,587 qualified applicants from baccalaureate and graduate nursing programs in 2011, due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints. Almost two-thirds of the nursing schools cited faculty shortages for not accepting all qualified applicants into their baccalaureate programs.2
In addition to the spike in nursing student enrollments, a constellation of current demographic trends are adding to the critical need for nurse faculty. Here are the primary ones:
Higher education: Attaining the required higher degree can be a substantial barrier for practicing nurses. Today's nursing programs seek to fill educator positions with postgraduate nurses; even adjunct positions typically ask for a minimum of a master's degree in addition to recent clinical experience.
Of the 1,181 faculty vacancies identified in a just-released AACN report, the majority of vacancies (88.3%) were faculty positions requiring or preferring a doctoral degree.3 The top reason cited by schools having difficulty finding faculty were a limited pool of doctorally-prepared faculty.
"One of the struggles is [nurses] have been slow to return to school for our graduate education," said Jane Kirschling, PhD, RN, FAAN, nursing dean at the University of Maryland and AACN president. "For those who have been in the field for many years and who have family commitments, pursuing an advanced degree can be a daunting prospect."
Salaries: A 2010 AACN survey showed an average annual nurse practitioner salary of $81,060, compared to a nurse educator average annual salary of $69,489.3 With many workers delaying retirement and one-income households having to make-do with less, many may be reluctant to leave a more lucrative clinical career for one in academia, Kirschling said.
"In the healthcare delivery system, clinical compensation has gone up" but faculty salaries have not, Kirschling noted. "Nursing continues to be a growth industry, and clinical salaries have historically outpaced those in the academic fields," she said.
Faculty retirement: A wave of nurse faculty retirements are predicted over the next six years, according to an article in the March-April 2002 issue of Nursing Outlook.4 The average age of nurse faculty at retirement is 62.5, and between 220 and 280 master's-prepared nurse faculty will become eligible for retirement through 2018, according to the article.
What's Being Done
With faculty shortages reaching critical levels around the country, the focus has shifted toward coping strategies. From the grassroots charitable levels to wide-scale federally-sponsored programs, there are a number of efforts designed to counteract the nurse educator shortage. Many target the investment in time and money asked of practicing nurses returning to school.
In October 2012, the Jonas Center for Nursing Excellence, a philanthropic organization offering grants and programs to nursing students, expanded its Jonas Nurse Leaders Scholar Program nationally and now funds 198 doctoral nursing students in 87 schools across U.S. "We've been very fortunate to enjoy the support of the Jonas Family," Kirschling said. AACN is working with the Jonas Center to facilitate the program's expansion to all 50 states.
On the federal level, AACN advocates for program funding to support nursing students interested in future faculty service. In August 2012, Barry University in Miami Shores, Fla., was awarded $1.1 million from the Health Resources and Services Administration. A nurse accepted into the Nurse Faculty Loan Program can expect 85% tuition forgiveness provided they begin teaching as a full-time faculty member at any college or university. They have up to a year to obtain a teaching position and must teach for four years after graduation to qualify.
"The key to addressing the nursing shortage in the state of Florida is the production of nursing faculty," said Claudette Spalding, PhD, ARNP, associate dean, College of Health Sciences, and Division of Nursing chair at Barry University. "This loan program makes the difference in the recruitment and production of nurses who will become the faculty needed by all of Florida's nursing programs."
One recent recipient of the loan forgiveness program is Lisa Easterby, DNP, RN, CNE, dean, Our Lady of Lourdes School of Nursing, Camden, N.J. While going back to school in her 60s was daunting, Easterby credits the loan forgiveness program for facilitating the decision to remain in academia for the remainder of her career.
Innovative programs and partnerships between universities and practice environments also are addressing the need for advanced degrees. Drexel University Online offers an online master's program in nursing education and faculty specifically to prepare nurses to be educators. In addition to exploring theories specific to adult learning and curriculum design, students complete two practicum experiences in teaching.
Our Lady of Lourdes School of Nursing announced in November 2012 an educational partnership with Immaculata University in Immaculata, Pa., and Camden County College whereby RN diploma students have the option to earn a BSN or MSN. Students entering the RN-to-BSN program are afforded a tuition discount at Immaculata as a result of the partnership. An MSN program is expected to be available by summer 2013.
Our Lady of Lourdes currently has a pool of 11 full-time nurse faculty largely constant for years, Easterby said. While the school sometimes has open teaching spots, Easterby said enrollment is not limited by a lack of faculty at her school. "I'm very proud of our long-standing faculty members and credit them for our top-notch graduates," she said.
'Bitten by the Teaching Bug'
While the deficit of qualified nurse educators is dire in many parts of the county, Rundio is encouraged by a surge of interest in academia as a career among new nursing students. And that could be the crux of the solution, according to Kirschling - people entering nursing with an inherent desire to teach. Reaching out to them will mean conveying the message that while it's a nontraditional nursing path, a career in academia can be as rewarding as one spent at the bedside.
"It's really a uniqueness of our discipline," Kirschling said. "We continually need to get students 'bitten by the teaching bug.' I've spent my career in academia. It's a rich calling. You're investing in the next generation of nursing professionals. To me that's very exciting."
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Jonathan Bassett is on staff at ADVANCE. Contact: JBassett@advanceweb.com