Nursing Students Overwhelm Schools

[NRSKarenRN, BSN, RN]

By THE ASSOCIATED PRESS

Filed at 7:28 p.m. ET

http://www.nytimes.com/aponline/national/AP-Teaching-Nurses.html

YAKIMA, Wash. (AP) -- Hospitals across the country are desperate for nurses like Tracey Rasmussen, a 34-year-old mom with a warm, down-to-earth bedside manner and a 3.9 grade point average.

There's a nationwide shortage of nurses, as anyone who's spent time in a hospital lately knows. And by 2020 that shortage is expected to grow to more than 800,000 nurses nationwide, according to projections by the U.S. Department of Health and Human Services.

But the problem isn't finding people who want to be nurses, it's getting them into nursing schools.

Rasmussen was rejected twice from nursing school -- one of thousands of qualified people turned away from the profession each year because nursing colleges lack space, faculty and funding.

``It was so frustrating,'' said Rasmussen, who was finally accepted into Washington State University's Yakima nursing program. She has a job waiting for her in a hospital maternity ward when she graduates in May.

U.S. nursing schools turned away nearly 6,000 qualified applicants last year, according to a survey by the American Association of Colleges of Nursing.

``Some of them will reapply. Some of them go to other schools, community colleges and private schools. A significant pool will be lost to nursing,'' said Washington State University College of Nursing Dean Dorothy Detlor, whose program rejects two-thirds of its qualified applicants each year. ``It's a serious problem across the country.''

A new federal law, the Nursing Reinvestment Act, expands scholarships for student nurses, offers grants for nursing schools and includes loan forgiveness programs for nurses who earn advanced degrees and become teachers.

Nursing educators applaud the law, but are waiting to see if Congress puts money behind it. The House Appropriations Committee will determine funding next year.

A generation ago, women had few options in the workplace beyond nurse, teacher or secretary. As opportunities expanded, however, the allure of nursing faded, and nursing schools sometimes struggled to recruit students.

Times have changed. Today, even in a struggling economy, college graduates get multiple job offers with starting salaries of up to $60,000 in some areas.

``We've gotten the message out there that nursing is an exciting career,'' said Kathleen Ann Long, Dean of the College of Nursing at the University of Florida and president of the American Association of Colleges of Nursing. ``That's the good news.''

The bad news is there's not enough faculty to teach them.

Nurses are in such high demand that they invariably must take a pay cut to teach. A 2001 survey found that nurses with master's degrees earn an average of $24,000 more in practice than they do teaching.

``The universities are just not able to compete,'' said Johnie Mozingo, associate dean of Academic Affairs at the University of Tennessee College of Nursing, which rejected half its nursing applicants this year.

Cramming more students into classes isn't an option. Most states mandate student-to-teacher ratios of 12-to-1 or less.

And the national average age of nursing faculty is 51. When the current generation retires, their replacements will be hard to find.

``Without those faculty we cannot prepare the nurses of the future,'' Long said.

Nursing schools need more money to expand their programs, but most rely heavily on state budgets -- and states are facing their worst budget crises in a decade.

In many areas, hospitals are stepping in to expand nursing programs.

In Ohio, Cleveland State University will start a fast-track nursing degree program this spring, backed financially by the Cleveland Clinic Health System. North Carolina Baptist Hospital is giving Winston-Salem State University $750,000 to hire more nursing faculty members. And in Alaska, five hospitals and health care agencies have promised the University of Alaska $1.8 million to double the number of nursing graduates.

Nursing experts agree there's no one magic solution.

``We are pressed to the wall, and it's going to take maybe one crisis to push us over the edge,'' said University of Connecticut School of Nursing Dean Laura Dzurec. ``It's a huge need and unfortunately it's an invisible need. There isn't anything more essential than this.''

[emily_mom]

Our school just double their program and is also starting to offer it in another city. That town has a university, but no nursing program. While our school is now doubled in attendance, the addition won't be complete until 2005. We are stretched as it is...

Kristy

[EmeraldNYL, BSN, RN]

We have a waiting list at my school-- it is an accelerated BSN for 2nd degree students. I see a lot more 2nd degree programs popping up around my area, but where are they gonna find the faculty to teach all these wannabe nurses? Again, it's not a shortage of nurses, it's a shortage of nurses willing to work in nursing!!

[VickyRN, MSN, DNP, RN]

I am a relatively new ADN faculty member--just started teaching in August. Our community college nursing school is very highly reputed. There are many, many more students trying to get into our ADN program than we have spaces. At the beginning of last semester, we were toying with the idea of expanding our ADN program by 50%. However, we just weren't able to do so. We don't have the faculty (THREE of our faculty members are brand-new like me) nor the space to accomodate any new students and keep the quality in our program. Sad but true. Training new nurses is very labor-intensive if it is done correctly. I am working on my Master's now and also took a sizeable pay cut from hospital nursing.

[renerian, BSN, RN]

That is alot of students to turn away isn't it?

renerian

[2banurse]

Originally posted by VickyRN

I am a relatively new ADN faculty member--just started teaching in August. Our community college nursing school is very highly reputed. There are many, many more students trying to get into our ADN program than we have spaces. At the beginning of last semester, we were toying with the idea of expanding our ADN program by 50%. However, we just weren't able to do so. We don't have the faculty (THREE of our faculty members are brand-new like me) nor the space to accomodate any new students and keep the quality in our program. Sad but true. Training new nurses is very labor-intensive if it is done correctly. I am working on my Master's now and also took a sizeable pay cut from hospital nursing.

Hi VickyRN,

I was just curious because teaching is something that I would like to do in the future...how much floor experience would you recommend before applying for a faculty position? Also, as you study for your Master's, are you studying for any particular specialty?

Thanks,

Kris

[sjoe]

First: If it works anything like it did during the previous major "nursing shortage," nursing schools will come up to speed about the time that a "nursing surplus" begins, and will have to cut back their programs as they did before.

Secondly: If there is such a shortage of nurse instructors for schools wishing to expand, and such a student demand for this instruction, then why aren't the schools raising tuitition and fees in order to pay higher salaries to their instructors so they can recruit more of them? Have they not heard of supply and demand? And, there is NO reason at all for instructors to be required to be masters- or doctoral-prepared to teach many of these nursing courses, IMHO.

Third: What about the current problem of lack of clinical placements? This seems to be rarely discussed. It doesn't matter how large schools become and how many nurses they can recruit if schools are unable to arrange suitable clinical placements. Again, what is the problem in this area? What is being done to deal with it (except for saying that since the schools have not yet grown enough and have not yet accepted larger numbers of students, this particular problem has not yet become acute)?

Fourth: This "nursing education" situation seems to be a good argument for vastly expanding diploma nursing programs.

Do we always have to wait for crises before taking obvious planning steps? Do we have to repeat all these problems every couple of decades without learning anything from them? It is not as though the situation were a surprise, unforseeable, or just sprang up one day "out of the blue." Businesses run this way tend to fail, why should the nursing education industry be any different? It is just one more example of a stunningly dysfunctional healthcare system that needs to be radically changed throughout.

[Youda]

sjoe, once again, you have written an insightful, no-nonsense post. Like most jobs in nursing, there is a shortage of people willing to work, not a shortage of nurses, educators, etc. Please don't ever change your sig line.

[VickyRN, MSN, DNP, RN]

2banurse wrote:

Hi VickyRN,

I was just curious because teaching is something that I would like to do in the future...how much floor experience would you recommend before applying for a faculty position? Also, as you study for your Master's, are you studying for any particular specialty?

Thanks,

Kris

I graduated from an ADN program in '96, just 6-1/2 short years ago. Now I have gone full circle, back to where I began, teaching at the same community college from which I graduated. Over the course of these past years, I had a "garden-variety" of nursing experiences, everything from L & D, med-surg, long-term ventilator patients, to working in a cardiac ICU! All of this came in very handy, since we instructors need to lecture on so many different areas---a jack of all trades and master of all! While I was working more than full time during those years, I also managed to get my BSN. Teaching is very hard work, but I am learning and growing with it. I am enjoying a surprising amount of respect and autonomy that I did not have while doing hospital nursing (BTW, am still working PT in a hospital--but just once in awhile--to stay in touch with "the real world.") Teaching impressionable students also carries great influence and responsibility--I feel that I am able to "give back" and contribute my part in improving nursing as a profession. In addition to teaching, I am starting a Masters in Nursing--Nurse Educator online degree program from the University of Southern Indiana.

Kris, in answer to your question, I would recommend at least 5 years of clinical experience before teaching in the classroom. Sjoe, good point about clinical sites. Our small school has had great difficulty in locating good sites--the big university "next door" gets first dibs on all the sites. This is also a big factor in being able to educate nursing students. (Besides the lack of faculty and no space to expand.)

[tonchitoRN]

my adn program flunked 50% of the class after the first semester. that is 50% less funding for the rest of the year. perhaps if they spent more time being supportive and heping those to pass then they will have the funds to run the program properly. btw some flunked for small things i.e. a student did not know what npo meant. now if this happened in the hospital she could have asked a collegue what it meant. time to rethink this "weeding out" process that is used to the delight of some instructors.

[sjoe]

"this "weeding out" process that is used to the delight of some instructors."

Well, after all, it DOES lighten their workload.

Now if their salaries were based on:

1) the number of students they were successful in teaching the skills and information in their particular courses, which after all, is their job, AND

2) the number of students they had who scored well on the NCLEX

THEN we could expect some things to change for the better.

But of course any suggestion of responsibility and accountability and actual performance is out of the question for nursing schools, except as these factors apply to students.

[azgirl]

Here the waiting lists are outrageous and you must have all pre reqs and co reqs completed with the proper GPA before even applying. By the time someones number comes up years have passed and many have gone on to other things.