For the last 3 years, undergraduate nursing school enrollment has seen steady increases. According to a recent survey by the American Association of Colleges of Nursing (AACN) (2003), there were 126,954 students enrolled in baccalaureate nursing programs in fall 2003. This was nearly an 11,000 increase from fall 2002. Associate-degree programs have also seen increasing enrollments.FIGURE
It would appear that the prayers of nurses throughout America have finally been answered. Increasing awareness regarding the challenges, benefits, and rewards of a career in nursing have been seen in both print and television media. The concern regarding the nursing shortage has been the topic of talk shows and news programs. There is no question that the campaign by Johnson & Johnson (Campaign for Nursing's Future) to help bring awareness to the profession of nurses has had a great impact for recruiting new students.
So what could possibly be the bad news when we have been hoping for this resurgence in nursing school enrollments? AACN also found that more than 11,000 qualified students wishing to enter a baccalaureate nursing program were turned away. The reasons for not being able to admit all qualified students were faculty shortage and lack of clinical sites and classroom space. So, finally, we have interested students and we cannot manage the new workload. Similarly, according the Southern Regional Education Board Council on Collegiate Education for Nursing (2004), 52% of associate-degree programs also turned away qualified candidates.
Enrollment in master's and doctoral programs in nursing have also increased. This may sound like the solution to the faculty shortage is already being addressed, but the answer is most likely not. Many nurses with advanced degrees are not choosing academic positions but rather advanced clinical nursing practice opportunities, because these careers are more lucrative. In a 2003 survey conducted by ADVANCE for Nurse Practitioners (Tumolo, 2003), the average salary for a nurse practitioner in a private practice was $94,313. This is greater than $33,000 more than the average master'sprepared nurse faculty member earns per year.
Reports of the current faculty vacancy rate have been reported as high as 12% (Williams, 2002). In summer 2003, AACN reported an 8.6% faculty vacancy rate, with the majority of vacancies for doctorally prepared faculty. As is the situation across the profession, retirement will be increasing these numbers with the possibility of 200-300 faculty members retiring from faculty positions annually for the next 8 years. (Berlin & Sechrist, 2002).
Is it possible to increase nursing faculty by allowing those faculty members to participate in clinical practice opportunities? This might be an attractive opportunity for those qualified individuals looking for a career modification. Being able to increase income via the practice opportunities that now exist for advanced practice nurses and combining that with a faculty position allowing them to become a highly valuable faculty member would appear to be a partial resolution to the problem. Blending faculty positions and clinical practice is not a new concept. Christman (1979) made popular the Practitioner-Teacher Model at Rush Presbyterian-St. Luke's Medical Center, Chicago, IL. This combined role should be assessed for its broader implementation, which may provide that "best-of-both-worlds" opportunity for our next generation of nursing faculty.
Nurses for a Healthier Tomorrow (NHT), a coalition of 43 nursing and healthcare organizations, has developed an advertising campaign "Nursing education...pass it on." NAON is proud to be part of this coalition. You will see ads speaking to the rewards of being a nursing educator (see page 6A). They are well done and inspirational. For additional information, you may go to http://www.nursesource.org.
Nurses, by being vocal and joining with others to inform the public and legislators about the nursing shortage, have made inroads into this huge healthcare problem. It is now time for each of us to support our colleagues who may choose to return to school and take on the challenges of being nursing faculty by not only supporting colleagues but also considering this challenge ourselves. Shouldn't we all do some soul searching to determine how we can support our educational programs? Step up to the plate to serve as clinical preceptors for students. One thing that many faculty note is that staff nurses, our greatest resource in our clinical units, are not always invested in assisting to teach our students. Also, ask your hospital administrators to consider allowing student access for clinical experiences. If the nursing staff takes up the challenge, then hospitals could seek out affiliations with nursing schools. Administrators won't do this on their own. They need the nursing staff to be the catalyst. Being open to new faculty practice designs that may mold future career opportunities is important.
We know that we will need to manage increasing patient volumes in the future. This is not something we can say will not be our problem because "we will be out of here." The faculty shortage and nursing shortage will affect the care that is available to us in the future. This is an effort we all should embrace.
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