The National League for Nursing (NLN) Education Summit held this past September was a remarkable experience, with more than 1,000 attendees, nearly 80 exhibitors, and programming that brought the best and the brightest to Washington, DC. During the Summit, we also celebrated another NLN milestone - 130 years of promoting the core values of caring, integrity, diversity and inclusion, and excellence to build a strong and diverse nursing workforce to advance the health of our nation and the global community! The entire time was a wonderful celebration.
Throughout the many outstanding sessions at the Summit, it was evident that educators are committed to designing innovative teaching-learning strategies that support preparation of new graduates for the rapidly evolving health care landscape. As we are aware, medical knowledge is expanding exponentially; by 2020, it was projected to double every 73 days (Densen, 2011). This rapid change and the expansion of knowledge require us to reimagine nursing education and commit to a new vision that prepares our graduates for the uncertainty and continued transformation anticipated in the future.
To ensure that we prepare residency-ready graduates, we must be at the forefront of these advancements, continuously updating our knowledge and skills and seeking ways to effectively transfer our knowledge to our students. Professional development is one way to broaden our perspectives. Another is to invest in creative partnerships with colleagues, to better align our programs with the needs of the health care industry, and to provide experiences that support our students in developing the competencies crucial to the delivery of quality nursing care. We must also reexamine the why, what, and how of our teaching-learning methods.
Simon Sinek, the British-born American author and inspirational speaker, asserts that the why is more important than the what or how when it comes to driving human behavior and decision-making. The "why" is how we explain our purpose and the reasons we behave as we do. I believe that we must step back a moment to remember our purpose as educators. If we believe our purpose is to prepare graduates who are excited to be part of a respected profession that touches the lives of patients and their families while maintaining an exquisite relationship with them, a dynamic profession that transforms ordinary persons into knowledgeable and skilled heroes, and a compassionate profession that makes a difference in the lives of those we touch, then our "why" is grounded in ensuring that the work we do is well positioned to achieve this purpose. The intentional integration of classroom and clinical teaching, focusing on deeper learning and reducing content, using situated questioning to help guide students toward a sense of salience and growth of clinical reasoning skills, must be the foundation of our work (Benner et al., 2010). Furthermore, we must not be complacent, preparing our students simply for the clinical challenges before them. Rather, we must develop and support strategies that foster and strengthen their capacity for resilience so that our graduates are able to successfully transition to practice and manage the stress associated with the work they do.
Reality shock, now identified as transition shock, or what is identified as feelings of anxiety, instability, and insufficiency experienced in the roles, responsibilities, relationships, knowledge, and expectations when moving to a new environment, should not be a tolerable manifestation in new graduates (Labrague & Delos Santos, 2020). Transition shock is costly in many ways. Almost 18 percent of newly licensed registered nurses leave the profession within the first year (Kovner et al., 2014). Silvestre et al. (2017) found that new graduate nurses leave their first positions to try new specialties within one year at a rate of 15.5 percent to 26.8 percent. The cost of this turnover is significant, ranging from $10,000 to $88,000 per new graduate, depending upon location and clinical specialty (Alshawush et al., 2020). Although the exodus of new nurses from the workforce early in their careers is frequently attributed to poor work environments, studies indicate that empowering students early in their professional formation can help moderate transitional stress (Lanahan et al., 2022).
As educators, we must find ways to mitigate transition shock through strategies that build resiliency and experiences that prepare students to understand the realities and joys of professional practice. Resiliency training can positively impact retention as resilient nurses are better able to manage their responses to stress and adversity, contributing to positive patient outcomes. Educating faculty on resilience will support the development of instructional approaches that improve mental health and may promote the effective transition of students into practice (Stubin, 2023). Equipping future nurses with coping strategies can strengthen their capacity for moral courage.
As we enthusiastically look for ways to improve educational outcomes, we are unfortunately confronted with a serious shortage of educators. We are a scarce, valuable resource. Disparities in compensation and the challenge of identifying qualified candidates prepared to teach add complexity to this shortage, hindering our ability to meet the growing needs of our health care systems and our communities. Furthermore, these challenges place a significant burden upon those already serving in this capacity. The shortage of faculty also limits our ability to teach effectively. Collectively, we must advocate for educational programs that distinctly prepare nurses for the faculty role and support regulatory and accreditation bodies that recognize the wide-ranging knowledge and skills required of this work. It is vital that we both attract and retain talented and diverse educators, providing them with the support, resources, education, and compensation necessary to thrive.
As with nurses in health care systems, the mental health and well-being of nurse educators cannot be ignored. However, Owens (2017) found that the work-related stress that nurse educators experience is frequently ignored, as the educator role has not typically been viewed as a high-stress or high-trauma profession. The demands of the profession, the shortage of educators, the declining access to clinical experiences, the secondary stress associated with trauma experienced by students - all coupled with the moral distress of the responsibility of educating future nurses - have an impact on educator health and well-being. It is crucial that we learn to model self-care and seek support when needed and that nursing programs create supportive communities that foster resilience and mental well-being. By taking care of ourselves, we can better care for our students and contribute to their success.
Last, but definitely not least important, we must acknowledge that the profession continues to struggle with issues of diversity and inclusivity. Collectively, we must confront the disparities in representation within nursing education and work toward creating a more diverse and inclusive learning environment. It is critical that we foster cultures that value and support individuals from all backgrounds, ensuring that our educational programs reflect the diversity of the communities we serve. Curricula must cultivate not only a focus on caring but promote a social justice framework incorporating the significance of injustices such as discrimination, oppression, structural factors that influence care delivery, and issues of access. By doing so, we can strengthen the nursing workforce and deliver culturally competent care. We must remember the importance of our role in influencing policy and policy drivers that support diverse measures to strengthen the impact of the work that we do. Let us find ways to collaborate, innovate, and advocate for change. Let us strive for excellence in our educational programs, ensuring that we foster the development of nurses who are well prepared to meet the challenges of the ever-evolving health care landscape. Let us inspire and empower the next generation of nurses to be change agents, leaders, and advocates for the profession. Let us embrace our role in teaching them to be adaptable and resilient critical thinkers, and lifelong learners who never cease to grow and evolve.
For 130 years, the NLN has led the nation in engaging the best of the best in nursing education to guide you in addressing these challenges in each of your programs, in every community, and across the nation. The core values of the NLN - caring, integrity, diversity and inclusion, and excellence - are a guiding light to the work a nurse educator does. For nursing education to reimagine its possibilities and boldly move forward, we must chart our future using the lessons we learned through the pandemic and in the newest strategies that we have developed. The challenges we face as nurse educators are significant, but they are not insurmountable. By acknowledging the obstacles before us and committing to work together to address them, we have the power to shape a brighter future for nursing education and, ultimately, the profession. Unwavering dedication, resilience, and commitment to the advancement of nursing education are required to make this vision a reality. Through your efforts, we can overcome each of the challenges we face and build a stronger and more vibrant nursing workforce. Let us embrace these challenges as opportunities for growth and transformation, for it is in the face of adversity that we truly shine. It is our day; it is our time!
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