Perhaps nothing causes more administrative anxiety for deans at nursing schools than the nation’s nursing shortage. It not only poses a real threat to the country’s health care delivery system, but also to higher ed institutions that need nursing faculty.
Many are feeling the pinch. Positions remain unfilled, some for years. So nursing schools are rethinking and redesigning their traditional recruiting and retention strategies. Their solutions are quite varied, ranging from creating e-jobs and dual appointments to sharing existing faculty.
According to the Special Survey on Vacant Faculty Positions, published in October 2012 by the American Association of Colleges of Nursing (AACN), 662 nursing schools with baccalaureate and/or graduate programs identified 1,181 faculty vacancies. Another AACN report—titled “2011-2012 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing”—reveals even more problems. 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.”
Consider the University of Indianapolis, a private institution that employs 39 nursing faculty. The assistant dean for graduate programs position has been vacant for almost four years, explains Anne Thomas, dean of the School of Nursing. “We’re relooking at why we’re having such a difficult time,” she says, adding that many schools struggle with similar issues. One consideration is to convert hard-to-fill positions into “e-jobs,” where faculty can perform part of the job on campus and the rest at home, which could be anywhere in the country.
Another is to split staff time with local health care facilities. Back in June, the school began sharing a hospital nurse who also acts as the school’s coordinator for its master’s level specialization track. While she is employed by the hospital, the school pays the hospital her university salary.
Since nurses can earn significantly more in clinical versus academic positions, she says dual appointments are very helpful in supplementing academic salaries. “It’s very difficult for academic salaries to compete with clinical salaries, no matter how big or good [your school is]. If I’m getting offered $120,000 a year to work 40 hours a week, and you’re going to pay me $70,000 as a new assistant professor working 60 to 70 hours a week on a tenure track, I think I know where I’m going to jump.”
To make matters worse, the bulk of nursing programs require faculty with either a doctoral degree or those with a master’s degree who are pursuing a doctoral degree. However, nurses with such credentials are growing scarce.
Some schools try to grow their own. Linfield College (Ore.), provides masters-level nurses looking to further their education with tuition assistance, reduced workload options, and work release time. An associate dean is assigned to mentor these students.
“Over the last two to three years, it seems that we’ve been having a constant search for faculty,” says Pam Wheeler, interim dean of nursing. “The problem will get worse by virtue of the retirement of current faculty.” In her state, 1,800 qualified applicants were turned away because schools didn’t have enough faculty or classroom space. The four-year college, which employs 30 nursing faculty, had two current vacancies as of early December 2012, and knew of two others that would occur in January, due to a retirement and resignation.
Making more federal funds available for graduate studies would help grow the applicant pool, but Wheeler says more needs to be done—such as introducing teaching opportunities to nurses early in their careers. Since many don’t start their doctoral program until mid-career, faculty career length is limited.
With more than 7,500 nursing students, The University of Texas at Arlington went online for its solution. The school offers web-based programs so it can accommodate large numbers of students without expanding the size of its faculty, explains College of Nursing Dean Elizabeth Poster.
The courses are divided into five- to 10-week modules. Between 50 and 100 nurses at the school—who either have a Ph.D. or master’s degree—also act as coaches, encouraging students to complete their assignments.
“I don’t believe we can continue to build space for more and more students, that we have to do more online teaching,” Poster says, adding that the school has three vacant faculty positions. So far, both traditional and online programs are producing similar results. More than 90 percent of students graduate and nearly 95 percent pass their licensure exam.
One barrier that has yet to be broken involves relocation. “Relocation is more difficult for those faculty members who already have received tenure from another institution and have a well-established program of research,” Poster says, adding that the local salaries earned by faculty nurses tend to be $20,000 less than those employed in clinical practice. “People we hired in the past have primarily been faculty in the early part of their career.” Several faculty nurses are currently pursuing a doctoral degree offered by the university.
With 110 full-time and 136 part-time nursing faculty, one of Poster’s biggest concerns is tenured faculty nearing retirement. “That’s why our strategy is to hire people now to fill our open lines for tenure track and tenure positions so that we can have the strength in research that we might not otherwise have,” she explains. The school will soon target faculty in the fields of geriatrics, translations research, and possibly genomics and innovations in the use of simulations.
Sharing the Wealth
Although widespread, the nursing shortage isn’t impacting every school.
“We’re in a very unique marketplace,” says Patrick Coonan, dean of the nursing school at Adelphi University (N.Y.). “We have three major Ph.D. programs that put out more [graduates] than other places throughout the country.”
With 40 Ph.D.s on its nursing staff, he says the school has two vacant faculty positions. Coonan realizes that once faculty members are tenured, they rarely accept positions at other schools.
So recruiters at his school began reaching out to nurses from its own Ph.D. program, established four years ago. Likewise, they also recruit master’s-prepared nurses and work around their schedule so they can complete further studies, but preferably at other schools to avoid conflicts of interest.
Roughly half of the school’s faculty is under the age of 50. With a relatively young staff, Coonan anticipates that his staffing needs will be minimal during the next three to five years. But that may not be the case in a related profession—health care informatics—where he is seeing a big shortage of individuals skilled at system integration, mining data, and applying that data to identify current or future trends.
Meanwhile, he suggests nursing schools partner with other colleges or universities that offer doctoral programs. Officials could send high-level or potential Ph.D. candidates to these programs, providing tuition assistance and/or a leave of absence. In exchange, they would teach at the helping institution after graduation. “It would be a planned growth, instead of just leaving it to arbitrary means,” Coonan says.
Or connect with local resources. Bouve College of Health Sciences at Northeastern University in Boston is among six local nursing schools that participate in the Northeast Region VA Nursing Alliance (NERVANA), developed by two nearby hospitals. It hopes to increase recruitment and retention of nurses and clinical faculty and encourage practicing nurses to advance their education.
“I’ve created collaborative programs my whole career that were shared between two to three universities,” says Carole Kenner, nursing school dean at Bouve. “The key is collaboration these days and being innovative on how you work together. We cannot afford to be in competition.”
The school currently has vacancies in one clinical and two tenure track positions. As part of a universitywide marketing campaign implemented five years ago, the nursing school began promoting its own benefits last year. Its messaging focused on how the school is beefing up its research, has added four tenure track positions, is surrounded by premier hospitals and big name schools, and that because of its in-house structure, faculty can easily work across disciplines.
Regardless of geography, Kenner says nursing schools can actively promote their strengths. As for collaborating with other schools or health care facilities, she adds, “That’s where the added-value comes in.”