You probably remember the story of the Dutch boy who put his finger in the dike to stop a leak. He is pronounced a hero, but despite the cold he is left standing at the dike as other boys are recruited to help him save Holland. Eventually town officials decide this strategy isn't working and set out to dig another hole to divert the North Sea.
The story is, I believe, an apt analogy for the way we have looked at the nursing faculty shortage. We continue to put a lot of fingers in the dike.
Like the Dutch officials in the story who recruited more boys, we continue to spend money to fix our problem. Although many of these efforts have improved local situations, none has fixed the underlying problem of the faculty shortage. Consider the following:
Dedicated education units are areas in health care organizations designated for the education of RNs. A skilled faculty member, placed in the institution on a full-time basis, educates staff and students and fosters a culture that supports all learning. Mentoring programs focus on decreasing the isolation and unfamiliarity many clinicians experience when they begin the faculty role.
For a while, joint appointments between academia and practice were all the rage. Individuals divide their time between teaching and directing practice. Some flourish in the role and relish the opportunity, but others feel overwhelmed by the competing demands on their time.
The use of part-time and adjunct faculty to conduct clinical supervision is the new normal. But ensuring a quality education is complicated by the fact that these employees are not always a regular part of faculty discussions. At the University of Texas at Arlington, we hold weekly meetings using conferencing software to bring the team together for such discussions.
Pedagogy improvements have been spreading like wild fire across the academy as new generations of students have different expectations of faculty. Flipped classrooms, clickers, and the use of blended methods - online and onsite - have expanded the faculty repertoire. Simulation is now a distinct specialty within nursing education - and a welcome one. Evidence from the sentinel NCSBN study about replacing clinical experiences with simulation, under a tight set of conditions, addressed a main issue for faculty - finding enough and appropriate clinical placements.
Unfolding case studies, requiring a few props and students as actors, have also become popular. The unfolding case studies from the NLN for the care of elderly people and veterans give detailed instructions for faculty and provide doable exercises in integrating information and critical thinking within a group setting. Schools of nursing that did not invest heavily in manikins can take advantage of vSim for Nursing, virtual simulations, loaded on to local computers, that serve some of the same critical thinking integration functions.
Quality of faculty work life is important, and thoughtful workflow analysis has brought significant change. Consider, for example, the use of professional advisers and admission staff, all trained on the complexities of nursing education requirements. Student success counselors work with students early and often to improve study habits, testing skills, and other fundamental processes of the student world. Dedicated tutors, often peers who did well in a given course, support faculty courses.
Online programs have changed many aspects of nursing education, as faculty become accustomed to using the latest technologies to advance the education mission. Partnering with design experts has led to a new look for both online and in-class instruction.
Still, I worry. Faculty shortages are real and particularly potent in areas where it is prohibitive to expand the faculty with adjuncts or part-time faculty. Student advising and guiding the at-risk or struggling student often continue to be faculty responsibilities. And let's acknowledge that the appeal of the faculty role may not exist for new master's graduates. Greater emphasis on evidence-based practice and patient outcomes makes the demand high for advanced practice nurses, especially those who gain the leadership skills common among DNP graduates.
Nursing education must realize that, to fix the dike, we cannot act alone. The long-term solution requires forming and strengthening partnerships, rebuilding the dike with new strengths learned as we plug the hole: lessons like how instructional designers can add variety and fun to a classroom, and how recruiters, professional advisers, and media people can become wonderful additions to the team.
Nursing education must realize that, to fix the dike, we cannot act alone. The long-term solution requires forming and strengthening partnerships.
Nursing education has worked so hard to avoid the physician-dominant classroom that we often forget that other health disciplines can offer their expertise. Take California, for example, where pharmacists are required to teach pharmacy to advanced practice nursing students and exercise physiologists and athletic trainers contribute knowledge of movement science to undergraduate courses.
It is time to think beyond the boundaries of academia and health care systems to build new partnerships. We must realize that education is a mission-driven business and find advisers and experts who can bring new paradigms to our efforts. We know how to keep the focus on patients and students. Let's learn new approaches to help our mission thrive.