A quiet driver of the nurse shortage, explained

In 2006, well before the COVID-19 pandemic, the World Health Organization warned healthcare that a severe nursing faculty shortage was on the horizon worldwide. 

Industry leaders have cautioned about nursing shortages since the 1990s, but the deficit’s direct correlation to a shortage of nurse educators often receives insufficient attention. A deeper dive into the nursing shortage shows a lack of nursing school faculty is compounding the problem, with fewer applicants being admitted due to fewer qualified teachers.

U.S. nursing schools turned away 65,766 qualified applications from baccalaureate and graduate nursing programs in 2023 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints, according to AACN. In addition, according to Becker's Clinical Leadership, 10,000 applicants were turned away from graduate programs, further limiting the number of educators who need advanced degrees to teach. 

There is a national nurse faculty vacancy rate of 7.8%, and most of the vacancies (79.8%) were faculty positions requiring or preferring a doctoral degree, according to the latest survey from AACN.

Why is this happening?

In a nutshell, the average age of nursing faculty is between 48.6 and 62.5 years old, and one-third of nursing faculty who teach are expected to retire by 2025. Add in the stress of COVID-19 and the lack of clinical opportunities during that time, and a crisis is intensifying. 

In surveys conducted by nurse organizations, nurse faculty cite these three things as reasons not to teach:

  1. Salary gap. Educators in the field are required to have advanced degrees yet typically take pay cuts of as much as $40,000 when leaving clinical practice to teach full-time.
  2. Burnout left over from the pandemic. One academic study showed the highest contributing factor to burnout for nurse educators is high workload levels and lack of work-life balance. 
  3. Requirement for doctoral degrees. Experienced nurses may be reluctant to invest additional years and resources into advanced education while simultaneously accepting lower compensation.

Compounding the problem is it is proving difficult to find new faculty to replace the large number of Baby Boomers retiring. Programs are struggling to offer competitive salaries compared to clinical jobs, find faculty with the right specialty mix, and master's and doctoral programs in nursing have insufficient output to meet staffing needs.

What are the solutions?

Nurse organizations are working hard to find creative solutions for the nurse and nurse educator shortages. Federal and state lawmakers also are working on the answers before the situation gets dire. 

According to a study in The New England Journal of Medicine, federal policies could help the situation. The study's authors suggest that policymakers could increase pay and incentives to recruit nurse educators, fund grants for hospitals and nursing schools to share expert nurses as clinician-educators and raise salaries for educators in regions hard hit by the shortage.

Nursing schools and hospitals are creating academic-practice partnerships to help solve the nursing and nursing faculty shortage. As suggested by leaders of two leading nursing associations, AONL and AACN, the solution may be to increase these academic-practice partnerships to support faculty and the nursing workforce. This can involve joint appointments and teaching opportunities to nurses working at the bedside. Many studies have been published about the effectiveness of these partnerships; the results are mixed

Other grassroots suggestions to address nursing education challenges include:

  • Loan forgiveness programs for those who become nurse educators
  • Partnerships between hospitals and schools to provide competitive compensation packages
  • Shared faculty positions between clinical and academic settings
  • Remote, part-time and/or adjunct teaching opportunities for experienced nurses
  • Accelerated pathways to become nursing instructors and more clear career pathways from clinical practice to teaching
  • Simplification of the accreditation process for nurse educators by updating accreditation requirements and emphasizing practical teaching abilities

On September 1, 2021, the American Nurses Association wrote to the Secretary of the Department of Health and Human Services to call for a "robust and immediate action to address the unsustainable nurse staffing shortage facing our country. In order to achieve a resolution of this dire situation, the alarming shortage of nurse educators must also be addressed."

In August of 2023 a $100 million grant program to grow the nursing workforce was announced and includes nursing school faculty. In its announcement, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, said the goal was to address the increasing demand for registered nurses, nurse practitioners, certified nurse midwives, and nurse faculty.

As part of that overall grant, $26.5 million was granted through the Nurse Faculty Loan Program for award recipient schools to provide low-interest loans and loan cancellation to incentivize careers as nursing school faculty. 

What is the prognosis for the nursing shortage?

The outlook is concerning, with multiple studies painting a stark picture. There is a projected shortage of 78,610 full-time equivalent RNs in 2025 and 63,720 FTE RNs in 2030, according to a 2022 estimate released by HRSA. McKinsey has projected the nursing shortage to reach critical levels by 2025, with the faculty shortage acting as a major bottleneck in addressing the crisis. Without sufficient educators, nursing schools cannot train enough new nurses to meet growing healthcare demands.

 

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