Currently the nation is experiencing
a persistent nursing shortage of several
years duration. As documented in NACNEP's
first report, health care service providers
throughout the country report substantial
numbers of vacant RN positions and difficulties
in recruiting. Stories and feature articles
about the nursing shortage persist in
today's newspapers, radio and television
news broadcasts. In August 2002, the Joint
Commission on Accreditation of Healthcare
Organizations (JCAHO) issued a report
citing the deleterious effect of the lack
of adequate nursing personnel on patient
care in hospitals. JCAHO indicates that,
based on an analysis of data reported
to the Commission as of March 2002, low
nurse staffing levels have contributed
to 24 percent of unanticipated events
in hospitals that resulted in death, injury
or permanent loss of function. The immediate
shortfall in registered nurse resources,
however, can only be affected by putting
into place approaches to assure that the
maximum number possible of those who are
already educated and licensed as RNs are
working in that capacity.
Strategies for the
Current Nursing Shortage
The March 2000 National Sample Survey
of Registered Nurses (NSSRN) showed that
a very substantial proportion of the currently
licensed RNs, 81.7 percent, were actively
engaged in the extensive array of nursing
positions available in the health care
arena. However, nearly 500,000 RNs were
not working in nursing, 18.3 percent of
the 2.7 million with licenses to practice
in 2000. Of these, 28 percent were employed
in non-nursing positions (See Chart 1).
Dr. Julie Sochalski from the University
of Pennsylvania and a Senior Scholar at
the Division of Nursing provided NACNEP
with some interesting insight into the
currently licensed RNs who were not working
as nurses (See Appendix
B).
Chart 1. Nursing Employment Status
of Registered Nurse Population, March
2000
Total = 2,696,540
 [D]
Source: USDHHS, HRSA, BHPr, Division
of Nursing, The Registered Nurse Population,
March 2000, Findings from the National
Sample Survey of Registered Nurses.
Those RNs employed in occupations other
than nursing tended to be older, on the
average, than those employed in nursing
positions. They were more likely to have
higher family incomes than those working
in nursing positions. They were more likely
to be in part-time positions than were
the RNs employed in nursing. The average
length of time since these nurses had
worked in a nursing position was 8 years.
Nearly one-half of the RNs who were working
in other occupations cited better hours
as the reason they are not in a nursing
position. About half of these pointed
to better pay and more rewarding work
in their non-nursing position. Dr. Sochalski
stated that changes in the workplace,
including more flexible hours, better
salaries, and an environment where work
is valued and rewarding may recruit some
of these RNs back to nursing as well as
salvage some who are considering leaving
because of dissatisfactions with these
areas.
The vast majority of the RNs who were
not employed in nursing, over 70 percent
of the 500,000, were not working. As a
group, they were considerably older than
RNs who were employed in nursing. More
than one-quarter of these RNs, about 92,000,
were over 65 years old, with 89 percent
having left nursing more than 10 years
earlier. Around 132,000 of these older
inactive RNs were between the ages of
51 and 65 years old, characterized by
Dr. Sochalski as "pre-retirement." Among
this latter group were nearly 11,000 nurses
with a master's or doctorate degree. Dr.
Sochalski points out that this group of
nurses may be a possible resource in helping
to alleviate the nurse faculty segment
of the present nursing shortage while
steps are taken to educate the future
faculty members.
Younger inactive RNs, those 50 years
of age or less, were more than twice as
likely to have very young children at
home than the RNs of similar age who were
working in nursing positions. Only 14
percent of those who were not employed
were actively seeking nursing employment.
About half were looking for part-time
work. Dr. Sochalski concluded that enhancements
such as provision for childcare and flexible
hours may also entice some of the younger
inactive RNs back into the nursing workplace
or shorten the time they are away if they
have temporarily withdrawn from nursing.
The NSSRN did not ask those who were not
working the reason why they were not.
Such data could assist in determining
what changes might be needed to encourage
the younger inactive RNs to return.
While recruitment of RNs for vacant
nursing positions is important it is equally
essential to retain the RNs already on
staff. Hospitals employ an estimated 1.3
million RNs, a substantially greater number
than in any other segment of the health
care delivery system. Thus RN vacancies
in hospitals represent the need for significant
numbers of additional RNs. According to
the latest data from the American Hospital
Association, hospitals have an estimated
126,000 vacant RN positions. A number
of hospitals have instituted bonus programs
for new RNs or those already on staff
if they recommend a new recruit. In her
report to NACNEP, Dr. Theresa L. Carroll
from the University of Texas Health Science
Center Houston School of Nursing focused
on best practices for retention of RNs
in the nation's hospitals (See
Appendix C). Dr. Carroll highlighted
many of the factors related to retention
that Dr. Sochalski had stressed in relation
to recruiting RNs back into nursing. Retention
is a complex issue requiring attention
to both organizational and individual
factors. Factors related to retaining
a qualified and experienced RN staff include
both economic and noneconomic issues.
The issue of wages is of particular
concern. The NSSRN showed that the average
annual salary of an RN employed in nursing
on a full-time basis was $46,782. Taking
into account inflation, between 1980 and
1992, the average real annual salary of
RNs increased by nearly $6,000. However,
between 1992 and 2000, the average real
annual salary increased by only a little
over $200 (See Chart 2). As the RN workforce
ages, health care and retirement benefits
have become as important as wages. In
a recent study conducted by the American
Organization of Nurse Executives and the
publication Nurse Week (2002),
79 percent of RNs stated that improved
wages and benefits would help a great
deal to solve the nursing shortage. Among
those RNs who were planning to leave their
positions over the next three-year period,
58 percent said that improved compensation
would very likely influence a decision
to remain.
 [D]
Source: USDHHS, HRSA, BHPr, Division
of Nursing, The Registered Nurse Population,
March 2000, Findings from the National
Sample Survey of Registered Nurses, September
2001.
But, as Dr. Carroll points out, dealing
with the issue of wages and benefits alone
will not stabilize the RN workforce. Among
the many noneconomic factors contributing
to retention, two of the most important
are staffing and scheduling and the presence
of a professional practice environment.
Hospital nursing is a 24 hours a day/
7 days a week commitment that requires
RNs to work undesirable weekend, evening,
and night schedules. In some instances
the availability of such work schedules
may be an advantage in arranging a schedule
that would fit with individual responsibilities.
However, with a largely female workforce
committed to child bearing, child rearing
and care giving, these work commitments
compete with family responsibilities and
quality of life.
Quality of work life is also affected
by the professional practice environment.
The professional practice environment
is characterized by a well-educated nursing
leadership and participatory decision
making in matters related to patient care
and practice, and a climate where continuous
improvement is the norm. The environment
also involves respectful collegial relationships
with physicians, administrators and other
members of the interdisciplinary team.
Immediate strategies for improving the
professional practice environment require
actions that address multidisciplinary
interactions leading to respect, collegiality
and evidence-based, patient-focused outcomes.
Over the longer term, strategies should
emphasize service-education partnerships
that include educators and practitioners
from all disciplines such as those NACNEP
is fostering in its interdisciplinary
activities.
Dr. Carroll indicated that the body
of published evidence about retention
strategies is still limited and consists
primarily of descriptions of plans implemented
within individual hospitals. Retention
is a complex issue that requires attention
to both organizational level and individual
level factors. In order to impact the
professional practice environment, new
models of care delivery need to be developed
and evaluated. There needs to be a sustained
and concerted effort to develop, test
and report successful retention models
to provide the evidence upon which to
base future decisions.
Looking to the Future
The current shortfall in the numbers
of RNs available to provide health care
services to the population is a precursor
to anticipated future shortages of even
greater magnitude. The nursing population
is aging. With the average age of employed
RNs at 43.3 years and 46 percent at least
45 years old, it is expected that considerable
numbers of them will be retiring in the
not too distant future. In recent years
nursing schools have experienced declining
enrollments. Although the latest data
from the American Association of Colleges
of Nursing (AACN) showed an increase in
baccalaureate program enrollments, they
still were at a comparatively lower level
than they were in 1995, when enrollments
started to decline. Furthermore, it is
not anticipated that there will be substantial
increases in overall nursing school enrollments
under current conditions. At the same
time, the aging United States population
and the technological and therapeutic
advances in health care foretell increasing
needs for health care providers. A recent
analysis by HRSA of the comparison between
the supply and demand for RNs estimated
that the shortfall in 2000 was 6 percent,
or 110,000 full-time equivalent (FTE)
RNs. HRSA projected that, if current trends
persist, the shortfall would reach 12
percent by 2010, for a demand of 275,000
more FTE RNs than would be available in
the supply. Without major efforts that
address the issue, the shortfall is projected
to grow to 29 percent by 2020 (See Chart
3). Now is the time to act!
Chart 3. Projected Supply Of and Demand
For Full-Time Equivalent RNs, 2000-2020
 [D]
Source: USDHHS, HRSA, BHPr, National
Center for Health Workforce Analysis,
Projected Supply, Demand, and Shortages
of Registered Nurses: 2000-2020, July
2002.
The distribution of RNs within the country
is of concern along with the overall national
requirements. A wide disparity exists
in the nurse supply among the States as
can be seen when data showing the RN per
100,000 population are examined (See Chart
4). Differences among States can be due
to many factors. Employment of nurses
is dependent upon the availability and
type of facilities or organized service
settings in which they practice. As an
example, large central cities are more
likely to have the larger teaching and
research hospitals with high staffing
needs that serve a much broader population
group than their immediate surroundings.
Smaller, more rural areas, with wide distances
to travel to cover a caseload, require
different staffing models in public health
agencies than large, metropolitan area
agencies. Staffing models are dependent
on many organizational variables and vary
from facility to facility and area to
area. Thus, differences in nurse-population
ratios reflect differences in and among
facilities and service settings that might
be specific to a particular geographic
area in contrast to another. To the extent
that the disparity shown might mirror
a greater lack of availability of RNs
in some States than others, the comparative
data may be of some help in pointing to
areas of significant regional shortages.
However, HRSA in its data for 2000 estimated
that the demand for RNs was greater than
the supply in 30 States. Included among
these States were many with both relatively
high nurse-population ratios and substantial
shortfalls such as a number in the New
England region of the country. For the
most part, the State-by-State projections
predicted greater shortages for the future.
By 2020, 44 States were estimated to have
a greater demand for RNs than the available
supply.
Chart 4. Registered Nurses Per 100,000
Population in Each State, March 2000
Source: USDHHS, HRSA, BHPr, Division
of Nursing, The Registered Nurse Population,
March 2000, Findings from The National
Sample Survey of Registered Nurses,
September 2001.
Nurse Faculty Shortages
Any substantive increase in the number
of working RNs for the future must, of
necessity, come from significantly increasing
the number of individuals who are being
prepared to become RNs. To do so requires
expanding educational resources. A number
of issues affect the ability to expand
these resources, such as, the availability
of sufficient funds and appropriate clinical
practice sites. However, the availability
of sufficient nursing faculty, an essential
component of effective educational resources,
is particularly troublesome. The alleviation
of the overall nursing shortage is dependent
to a large measure on the ability to greatly
expand the nurse faculty, the segment
of the nursing resources devoted to creating
these resources. Well-qualified faculty
members are the foundation of a well-qualified
nurse workforce. They are not only responsible
for providing the nursing students with
a sound theoretical foundation for their
practice but are responsible for the clinical
aspects of the students' education as
they learn how to care for all types of
patients, including the acutely ill. Thus,
nurse faculty members not only have to
be well-prepared individuals to start
but also have to keep up-to-date on the
rapidly changing dynamics of health care.
Even under the present constrained nursing
school enrollments, studies show that
nursing education administrators throughout
the country are concerned about vacant
faculty positions and difficulties in
recruiting. These same studies also point
to even more dire circumstances for the
future.
- The Southern Regional Educational
Board (SREB) in reporting on a survey
made in its 16 member States says, "…the
survey reveals a bleak picture about
the supply of nurse educators and projections
for the future." It further states,
"This projected shortage of nurse educators
threatens the region's capacity to ensure
the health of its residents." The survey
findings showed that there were 432
unfilled positions for nurse educators
and that 971 educators were without
the minimal academic credential for
national accreditation for the program.
Separate studies carried out by some
of the States within the region reinforced
the concerns expressed by the SREB.
- The North Carolina Center for Nursing
in reporting the results of a telephone
survey in November 2001 indicated that
"…nurse educators, as a group,
are rapidly moving toward retirement
age and nursing programs are already
finding it difficult to fill faculty
vacancies." The survey results showed
a 10 percent faculty vacancy with almost
20 percent of the contacted programs
reporting at least one vacancy. In answer
to a question of whether the nursing
program could increase enrollments by
15 percent in the next year without
hiring additional faculty, 90 percent
of the programs indicated that they
could not.
- The South Carolina Colleagues in Caring
group states "Enrollments in SC nursing
education programs are limited because
of a faculty shortage. There are 30
faculty vacancies today and more than
70 positions will be vacated due to
retirement in the next 5 years. Only
6% of the workforce hold Master's degrees
in Nursing that is a requirement to
teach in accredited nursing programs."
- The Texas Nurses Association quoting
from a study made by the Center for
Health Economics and Policy at the University
of Texas Health Science Center at San
Antonio in 2000 indicates, "…The
Texas nursing education system is operating
close to capacity and faces several
impediments to producing more graduates.
One of the biggest barriers is an unprecedented
faculty shortage due to aging, inadequate
salaries and a consequent scarcity of
applicants. …"
Similar statements appear in documents
from States in other areas of the country.
- The California Strategic Planning
Committee for Nursing estimated a need
for 333.5 full-time equivalent faculty
over the next two years based on a survey
of associate degree and baccalaureate
and higher degree nursing education
program administrators made in the Spring
of 2001. More than half of the anticipated
vacancies reported by baccalaureate
and higher degree program administrators
were for doctorally prepared faculty,
a group that the respondents indicated
as particularly difficult to recruit.
- The Northwest Health Foundation of
Oregon reporting on responses received
to their survey of nursing education
programs in the State indicated that
program directors cited an inadequate
supply of educationally qualified nurses
in their area as the reason for difficulty
in hiring faculty. Half the directors
also cited poor salaries. The program
directors projected substantial faculty
requirements in the future due to the
aging of the faculty.
- A fact sheet from the South Dakota
Colleagues in Caring project indicates
"All schools of nursing report difficulty
in attracting and retaining qualified
faculty. …More than half the nursing
faculty will be eligible to retire in
the next 10 years…"
- A fact sheet from the Minnesota Colleagues
in Caring group states that one of the
factors limiting the opportunity to
increase enrollments was the difficulty
in recruiting faculty. It further states,
"Increased numbers of master's and doctoral
students are needed to fill undergraduate
and graduate nursing faculty positions.
Faculty salary incentives and workload
adjustments are needed to compete with
clinical and other roles available to
RNs qualified to teach nursing."
- Testimony presented to the New Jersey
Senate Health Committee in February
2001 by the New Jersey Colleagues in
Caring group pointed to the aging of
the nurse faculty leading to large numbers
being eligible for retirement as limiting
"the number of seats available for New
Jersey nursing students in all types
of nursing programs."
This sampling of comments from various
States around the country demonstrates
a number of the critical issues underlying
faculty shortages. From a national perspective,
Dr. Theresa M. Valiga, in her presentation
to NACNEP on behalf of the National League
for Nursing (NLN), stated that, based
on "informal feedback" received by the
NLN and its accreditation commission,
"a vast majority of schools have at least
one full-time position they are unable
to fill with a qualified candidate. Many
schools also report that they have placed
a limit on student admissions, increased
class sizes, or delayed students' progression
in their programs as ways to deal with
the vacancies" (See Appendix
D).
The American Association of Colleges
of Nursing (AACN) in its 2000-2001 survey
of baccalaureate and higher degree educational
programs indicated that respondent baccalaureate
programs preparing individuals to become
RNs could not accept 3,847 qualified applications.
Over a third, 38.8 percent of the responding
administrators from these educational
programs gave insufficient number of faculty
as a reason for not being able to accept
all their qualified applicants. Dr.Geraldine
Bednash, the Executive Director of AACN,
in her presentation to NACNEP, pointed
out that in a postcard survey of their
member baccalaureate and higher degree
programs, it was found that the preponderance
of baccalaureate and higher degree program
vacancies are for individuals with doctoral
preparation. The study showed that 64
percent of the faculty vacancies called
for earned doctorates. Another 30 percent
were for master's degree preparation but
with a doctorate preferred (See
Appendix E).
Today's concerns about the availability
of an adequate nurse faculty workforce
are readily born out through an examination
of the characteristics of the current
teaching faculty. Based on data from the
NSSRN, there were an estimated 36,025
RNs whose primary employment setting was
involved in preparing students to become
RNs or providing advanced education for
those already RNs in March 2000. Of these,
27,715 were engaged primarily in teaching
in that they were instructors, assistant
or associate professors, professors, or
spent at least 50 percent of their time
in a usual workweek in teaching students.
More than two-thirds, 67.9 percent, were
teaching students in baccalaureate or
higher degree programs. Twenty-nine percent
were teaching in associate degree programs
and a little over 3 percent taught in
diploma programs. These faculty members
spend a considerable amount of their time
during a usual workweek in teaching. Associate
degree faculty averaged 83 percent of
their time teaching students and baccalaureate
and higher degree faculty, 74 percent.
Teaching faculty in nursing educational
programs were more likely than those in
higher education in other disciplines
to be employed on a full-time basis. Seventy-five
percent of the nursing education program
faculty were full-time compared to 65.5
percent of all instructional faculty in
4-year schools and only about 38 percent
of all instructional personnel in 2-year
public schools.
The average age of the teaching faculty
in RN educational programs was 49.8 years
(See Chart 5). Baccalaureate and higher
degree faculty were older, on the average,
than associate degree program faculty,
50.2 years compared to 48.9 years. With
more than three-quarters of the faculty
at least 45 years old, it is obvious why
there is widespread concern about substantial
numbers of faculty retiring within the
not too distant future. The average age
of nurse faculty is not drastically different
than that of all higher education faculty
and other disciplines, as well, are faced
with the problem of an aging faculty.
However, faculty members in other disciplines
may more likely be both younger and older
than those in nursing. For example, only
about 23 percent of the teaching faculty
in baccalaureate and higher degree nursing
programs were less than 45 years compared
to about 35 percent of the instructional
personnel in all program areas of 4-year
schools. On the other hand, about 8 percent
of the instructional personnel in the
4-year schools were 65 years old or over
whereas, in the nursing educational programs,
less than 3 percent were in that age category.
Chart 5. Age Distribution of RN Faculty
in RN Nursing Education Programs, March
2000
 [D]
Source: USDHHS, HRSA, BHPr, Division
of Nursing, National Sample Survey of
Registered Nurses, March 2000
The qualifications to teach in an RN
educational program require a master's
degree or a doctorate. Almost 83 percent
of the teaching faculty in RN nursing
educational programs had at least a master's
degree. Twenty-two percent of them had
doctorates. Those with doctorates were
for the most part found in baccalaureate
and higher degree programs. The lack of
relatively young faculty members can,
in part, be attributed to the length-of-time
involved in an RN becoming qualified to
teach. The average age at which the nurse
faculty members received their master's
degree was 34.5 years. The average number
of years between the time they received
the master's degree and when they graduated
from their associate degree, diploma or
baccalaureate basic nursing education
was 10.8 years.
RNs with doctorates are rarely found
among the younger segments of the nurse
population. Only about 17,300 of the 2.7
million RNs in 2000 had doctorate degrees.
The average age at which these RNs achieved
that degree was 44.2 years. More than
2 out of every 10 were at least 50 years
old before earning their doctorates. RNs
take far longer than those in other disciplines
to achieve their doctorates after graduating
from their entrance level educational
program. The average time between the
doctoral degree and graduation from the
baccalaureate, associate degree or diploma
basic nursing educational program for
RNs was 20.9 years. In contrast, the National
Science Foundation estimates that, for
all academic disciplines in total, the
average time between the baccalaureate
and doctorate degree is 12.7 years.
The age level at which RNs achieve doctorates
coupled with the very limited numbers
of graduates with doctorate degrees each
year adds to the many concerns about the
ability to satisfy the faculty requirements
necessary to expand the RN workforce.
Dr. Bednash in her report to NACNEP indicated
that the number of graduates each year
from doctoral nursing educational programs
has remained fairly stable despite the
substantial increase in the number of
programs. In the 1999-2000 academic year,
the 77 doctoral programs graduated 444
students. Furthermore, as both Dr. Valiga
and Dr. Bednash indicated, a substantial
proportion of the students in doctoral
programs are teaching in nursing educational
programs while they are attending school.
Thus, only a very limited number of new
teachers can be anticipated from the graduates
of these programs.
Moreover, while on an overall basis,
the number of nurses with doctorates has
increased significantly over the years;
the scope of positions available for such
nurses has also increased dramatically.
For example, in March 1988, about 80 percent
of the RNs with doctorate degrees were
working in a position within a nursing
education program. By March 2000, although
the number of RNs working in nursing education
programs that had doctorates had increased
82 percent, the percentage of all doctorally
prepared RNs who were in nursing education
programs had decreased to 61 percent.
This critical issue has particular relevance
to baccalaureate and higher degree nursing
educational programs where preparation
at the doctoral level is required for
teaching or, if not required, certainly
preferred.
Another issue is whether nursing education
programs can compete with other demands
for RNs with master's degree preparation.
According to the NSSRN the primary focus
of the master's degree preparation for
56 percent of the teaching faculty in
2000 was clinical practice or public health.
The AACN reports that in the 1999-2000
academic year the major area of study
for the vast majority of graduates from
master's degree programs was clinical
practice. The number of RNs whose highest
degree is a master's degree has more than
doubled in the 12-year period from 1988
to 2000. However, here, too, the demands
for nurses with such degrees have increased
dramatically. Master's degree prepared
RNs are widely sought for specialized
nursing positions as nurse practitioners,
clinical nurse specialists, nurse anesthetists,
and nurse midwives. Master's degree preparation
is preferred or required for supervisory
and management positions in nursing as
well. Nursing positions at these levels
have much higher salaries than are afforded
teaching positions in nursing educational
programs as demonstrated by data from
the March 2000 NSSRN (See Chart 6). The
average salary of a teaching faculty member
employed on a full-time basis was $48,410.
Full-time faculty in baccalaureate and
higher degree programs averaged $48,845
and those in associate degree programs
averaged $47,211. Although these data
represent the average for the year regardless
of whether the salary was on an academic
9 or 10-month or calendar 12-month year
basis, when compared to the considerably
higher average salary of $61,262 for all
RNs with master's degree preparation who
are employed on a full-time basis, it
is clear that other positions provide
far better compensation than teaching
does.
 [D]
Source: USDHHS, HRSA, BHPr, Division
of Nursing, National Sample Survey of
Registered Nurses, March 2000
As was the case for the total RN workforce,
once faculty members are recruited it
is equally important to retain them. A
3-member Task Force of NACNEP, consisting
of Dr. Karen L. Miller, chairperson, and
Drs. Eula Aiken and Linda Norman, provided
NACNEP with a review of best practices
for retention of nurse faculty members
(See Appendix F).
Both economic and noneconomic factors
were outlined. Compensation initially
and over time should be based on established
guidelines and a system for annual review
and enhancements. Opportunities should
be created for bonuses, administrative
rewards or incentives for special or meritorious
performance, and special awards, including
monetary rewards as possible, for teaching,
clinical practice and/or research accomplishments.
Programs should be implemented to support
further education for faculty. Work environments
should encourage scholarship, mutual support
among faculty, students and administration,
interdisciplinary interaction in teaching
and research, and attention to individual
professional needs of faculty. Faculty
need to be made aware of the institutional
resources available to them. Opportunities
should be developed and supported for
faculty to maintain clinical expertise
and for professional development. Private
funds should be solicited for endowed
chairs or other special faculty positions,
for specialized awards, and in support
of faculty retention plans.
In addition to the question of whether
there is a sufficient number of faculty
to expand the number of individuals entering
nursing, is the important consideration
of where will the students come from.
One major future resource for expanding
the pool of nursing students is the rapidly
increasing minority segment of the population.
NACNEP, in developing an agenda designed
to increase the racial/ethnic diversity
of nursing, pointed out that "The availability
of a critical mass of minority faculty
in health professions schools has come
to be recognized as a major factor in
the recruitment and retention of minority
students." In 2000, teaching faculty in
RN educational programs were predominantly
white (nonHispanic). About 9 out of every
10 faculty members were white. About 4
percent were black (nonHispanic) and only
2 percent were Hispanic. About 1 percent
each were from Asian (non-Hispanic) or
multi-racial backgrounds. Those from American
Indian or Alaskan Native or Native Hawaiian
or other Pacific Island racial backgrounds
each constituted less than 1 percent of
the teaching RN faculty members. Thus,
attention also needs to be directed toward
the diversity of the teaching faculty
in order to attract students from the
broad base of the potential available
population.
Another source for both the entry level
nursing students and advanced students
necessary to increase the pool of RNs
for leadership and highly complex care
positions could be individuals located
in communities remote from educational
facilities. On-line courses could facilitate
the education of these students through
enabling them to achieve some of their
educational experiences in their own community
setting. The findings from the Division
of Nursing's Rural RN to BSN Using Distance
Learning initiative that involved 6 institutions
through cooperative agreements are helpful
to the examination of the impact on faculty
requirements. Dr. Carole Gassert, a staff
member of the Division of Nursing, in
reporting to NACNEP on these projects,
indicated that on-line learning takes
more faculty time. Preparations for class
need to take place well in advance and
take longer than for other types of classes.
Faculty need to be available to students
on an extended basis electronically. Initially
faculty need to develop skills for teaching
in a different way thus taking time away
from other teaching assignments.
However, in addition to potentially
adding to the student body, on-line learning
courses/programs can help with faculty
requirements in that courses could be
taught collaboratively to share resources
between or among schools of nursing. On-line
learning could allow for flexibility in
the use of time thus allowing faculty
to budget their time more efficiently.
As both faculty and students become more
skilled in using on-line learning more
effectively, the acceptable student to
faculty ratio may increase. Thus, on-line
learning in the future might lead to both
enhancing the potential student body and
easing some faculty requirements (See
Appendix G).
On an overall basis the number of RNs
required for teaching new entrants into
nursing and for preparing those who are
already RNs for positions requiring higher
levels of knowledge and skills do represent
a relatively small portion of the overall
RN workforce, no more than about 2 percent.
However, these positions are critical
to the ability of nursing to fulfill its
responsibilities to provide effective
qualified health care to the nation's
population. Serious shortfalls in this
segment of the RN workforce can only exacerbate
critical shortages in the total RN workforce.
Without assurances of an adequate faculty
body to provide the educational preparation
necessary to become an RN the many worthwhile
programs being instituted to attract individuals
into the profession cannot fulfill their
missions. Therefore, NACNEP believes that
measures designed to alleviate the nurse
faculty shortage are critical first steps
to alleviating the future RN workforce
shortage. It is necessary to take immediate
action to increase the availability of
nurse faculty members in order to enable
the nursing education system to significantly
increase current student enrollments.
The measures needed are multifaceted.
These include those measures that will
maintain the current faculty workforce
and attract new faculty members from among
those RNs who already have graduate-level
preparation and are currently employed
in other nursing endeavors and from those
who are currently "inactive." It is equally
important, in looking to the future, to
take measures that will ensure the availability
of a cadre of RNs capable of sustaining
and increasing the numbers of faculty
members necessary to prepare future student
bodies so that projected pending nursing
shortages can be avoided.
|
