Not Fiction: The Nursing Shortage Results From the Nursing FACULTY Shortage

We recently heard Dr. Beverly Malone of the National League for Nursing talk about the direct correlation between the shortage of nurses at the bedside, the qualified applicants being turned away from most nursing schools around the country and the shortage of nurse faculty. In baccalaureate nursing degree programs, such as the one we offer at UNC-Chapel Hill, our faculty are educated at the doctoral degree level, qualifying them as nurse educators who also are knowledgeable about nursing research. Leadership, scholarship, providing excellent direct patient care at the bedside, creating innovative approaches to managing patient care and health outcomes are linked to the quality — educational background and experience — of a nursing school’s faculty.

Yet, we have a huge gap that continues to widen. There are not enough doctoral students who will become the faculty to teach our current and future nurses. Why? One reason is support. At a public university like Chapel Hill, we are only able to provide support to doctoral students IF we have T-32 government training grants tied to our research projects that offer stipends to students. But, this support for nursing is decreasing nationally, and our only other option to be competitive with other universities vying for the same doctoral candidates, is to offer private scholarship support. To date, there is ONE privately funded doctoral scholarship in our School. It takes $26,000 per year to support one doctoral student. A $100,000 investment in an endowed scholarship fund will guarantee that support and the continuity of faculty to teach students to become nurses. We raise this issue because public institutions of our caliber must be responsive to public needs, yet without these key resources, it will be impossible to meet these needs.

Our Doctoral Education Committee told me yesterday that they are concerned that the public does not understand why it is necessary and important to educate doctorally-prepared nurses. What do you think?

Here, I am attaching a Wall Street Journal article about the economy, the nursing shortage and how critical it is for us to have qualified nurses giving us care. Imagine the risks, then think about the link between the nursing shortage and the faculty shortage and what you might possibly do to help.

“Nurse faculty key to the nursing shortage,” says NLN CEO Beverly Malone, PhD, RN, FAAN

“Nurse educators are essential to the future of health care,” said Beverly Malone, PhD, RN, FAAN, chief executive officer of the National League for Nursing (NLN), who spoke at UNC-Chapel Hill last week. “Nurses bring hope to hopeless situations. We are powerful to help patients live day-to-day with the resources they have available,” she said. Malone was the invited 2008 Ethnic Minority Visiting Scholar and gave a public lecture in honor of the retirement of Bonnie Angel, EdD, RN, who taught in the School of Nursing for more than 20 years. Nurse educators are the backbone of nursing, Malone observed. They teach, do community work, maintain clinical practices, contribute to publications, and are involved in professional organizations. Yet, Malone comments, nurse educators have been invisible. “We don’t do enough to acknowledge the contributions our faculty members are making to graduating the nurses who are there to care for patients.” And, she added, we don’t do enough to encourage the nurse scholars who are responsible for stimulating and motivating others. “What are we doing to stimulate and motivate them?” she asked.

All nurses need to progress, noted Malone.

Her role is to help people advance in the system, help them get advancing degrees. Only 21 percent of BSN graduates go back to get the next degree. A mere 17 percent of associate degree nurses go back to get the next degree. This is not an individual choice, said Malone, it is symptomatic of the system where we don’t encourage people to continue their education at an earlier point in time in their careers. “We need to get everyone into the house,” said Malone. “All levels of nursing need to be encouraged to pursue education. It is in the best interests of our profession and for our patients.” Malone said that 67 percent of nurses come out of associate degree programs.

She also noted that we need ‘daring ingenuity’ to succeed.

Change is not transformation, Malone commented. Nurses must let go of old ideas, embrace men into nursing, not just tolerate them, not be afraid to disagree, engage in dialog about migration, racial and ethnic disparities, and how to better address the health issues of Indians, African Americans and Hispanics. We must celebrate our diversity and all that we have accomplished, address the micro inequities, and highlight the accomplishments of our nurse faculty. When only 7 percent of nursing faculty members who are minorities, we must pay attention to educating students from diverse ethnic and racial backgrounds and encouraging them to become our faculty. Only then will be address the disparities.

“I hope other schools will emulate UNC-Chapel Hill’s nursing school commitment to preparing doctoral students who are minorities. There is a great group of talent students here,” Malone said.

Of the 42,000 full and part time nurse faculty in the United States, only one-third are doctorally-prepared and one-third are master’s prepared. The nursing shortage will not be solved without nurse faculty, who earn 39 percent less than a nurse anesthetist, less than nurse administrators and midwives, and 76 percent of other academic colleagues.

“If you really want to address the nurse shortage, then faculty salaries need to rise,” Malone emphasized.

Malone, who lived in the United Kingdom for six years, is concerned about recruiting nurses from countries like sub-Saharan African, creating a drain of health care professionals in countries that are vulnerable and cannot afford to lose their nursing staff. The UK developed an ethical code of conduct that outlines where it could recruit from under her leadership there. The United States does not have an ethical code of recruitment, she said, adding, “This is a global issue because there are not enough nurses.”

The average age of nursing school faculty is over age 55 and there are few in the pipeline to replace them. Schools are turning away students because there are not enough faculty members to teach them and not enough clinical placements. This will be reflected in the future quality of our health care system.

Malone honors retirement of Bonnie Angel, EdD, RN

Bonnie was an incredible mentor, said Malone. “We don’t think of ourselves necessarily as mentors,” she said. “We think of ourselves as nurturers. This is important because we tell our students ‘you don’t have to do it the hard way.’” Malone says Bonnie Angel helped students see the door, not the wall, which is exactly the role of the mentor. Under mentors like Angel, students learn they can climb the ladder, create a power base, networks and connections without the scars and bruises many associate with learning nursing.

“Nothing is as important to the future of our health care than how we mentor our students,” said Malone. “We don’t want to be junior doctors. We want to be maxi nurses.”

Angel inspired many, created new academic programs, was an innovator and was a leader in the use of distance technology to teach. She made learning fun, was supportive, dedicated and held high standards. She exemplified the nurse educator and an audience of about 100 people attended the lecture to honor her service to the University and the School of Nursing.


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