When nurse leaders in Texas sought to address a shortage of nursing professors, they presented a stark reality to their Legislature. A 2007 study published by the Texas Center for Nursing Workforce Studies revealed that nurses in academia earned $52,000 per year on average, compared to $72,000 for nurses in practice.
By narrowing the $20,000 wage gap, state nursing advocates believed they could increase the number of faculty positions and in turn increase their R.N. supply to meet an expected demand that could leave the state short of more than 70,000 nurses by 2020. The Texas legislature—for a variety of reasons—ultimately rejected the group's request for $32 million for faculty salaries. Nevertheless, Texas' effort is emblematic of what a number of states are doing to attract more nurses to teaching so schools will have the faculty to build their pipelines and avert a nursing shortage. This includes increasing faculty salaries, providing stipends, and expanding nine-month academic contracts to 12 months.
The growing shortage of qualified nurse faculty severely curtails the ability of nursing schools to expand. That is a key message contained in a new white paper "Blowing Open the Bottleneck: Designing New Approaches to Increase Nurse Education Capacity." The white paper was released June 26-27, 2008, at a Nurse Education Capacity Summit convened by AARP, the Robert Wood Johnson Foundation, and the U.S. Department of Labor, to identify and develop approaches to improving nurse education capacity, with the ultimate goal of reversing the persistent nursing shortage that could hurt patient care.
Although many factors are driving the nurse faculty shortage, including aging and retiring faculty, low wages are a major contributor, according to the report. What states can do to address the gap in salaries between faculty and practicing nurses was one of the major topics covered at the June 2008 summit in Crystal City, Va., where nurse leaders, consumer advocates, state policy and government representatives, business leaders, hospital and health care experts, and representatives from the Department of Labor and other federal health and workforce agencies, gathered to share strategies for addressing nurse faculty shortages and dismantling barriers to increasing capacity.
With state budgets tightening, nursing leaders are increasingly embracing strategic partnerships with the private sector as a way to align and leverage resources. "We are getting the message that to increase faculty, don't look to the state," says Aileen Kishi, Ph.D., R.N., project director for the Texas Center for Nursing Workforce Studies at the Texas Department of State Health Services. "The states are basically saying—you need to find funds from other sources," she says.
Nursing leaders in Florida have gotten the same message. "They don't feel like it's the role of the legislature to address some of these shortages," says Martha DeCastro, R.N., M.S., C.I.C., Vice President of Nursing at the Florida Hospital Association. In order to address an increasing demand for qualified nurses due to the aging of the baby boom population, DeCastro and other nurse leaders in the state have been working to obtain state funding for developing and retaining nurse education faculty. In July, nurses will seek legislative support once again for the Nursing Education Faculty Enhancement Program. This legislation would have the state support monetary incentives and recognition awards for promoting the recruitment and retention of nurse education faculty in the state. Additionally, the state would provide an additional $5,000 for nurse faculty with masters degrees and $10,000 for nurse faculty with Ph.D.s.
With prospects for that legislation dimming due to the state's economy, nurse leaders in Florida are focusing on ways to expand private partnerships. One promising model is having hospitals fund nurse faculty positions. In Florida, Baptist Health South Florida and Barry University in Miami have partnered to expand capacity. The "Barry On-Site Nursing Dimension Program" enables eligible applicants to obtain baccalaureate degrees in nursing through coursework offered by the university on-site at its Baptist Hospital facility. The school has been able to expand its nursing programs by 40 slots because of Baptist's support, which provides adjunct faculty space and tuition assistance for staff. This partnership is helping to expand the capacity of nurse education in the state and DeCastro thinks it could be a viable model for the state and the nation. The support and leadership of Baptist's CEO has been instrumental in making this model work. "His vision has been critical," says DeCastro. "He has been willing to prioritize resources for this purpose because he realizes that optimal nursing care is essential to having a successful hospital organization." DeCastro thinks other critical components to success have been the flexibility of the nurse education program to adapt new models and take advantage of opportunities to collaborate and do things differently.
Cathleen Shultz, the Arkansas-based president-elect of the National League for Nursing, agrees that having outside champions such as business leaders or employers is key to making the case for investing in nurse education capacity. "We're losing nurses to other states and that has an impact on our state economy," she says. Many of the summit participants agree that having adequate nurse capacity generates income for educational institutions, local areas, and regional areas. "If we can make the economic development argument, this gets business' attention," says Shultz.
Aileen Kishi of the Texas Center for Nursing Workforce Studies, says the June Nurse Education Capacity Summit marks an important milestone for nursing because the participants came from non-traditional circles. "A lot of the discussion in the past has been held within the nursing and educational circles so it is good that we are widening it further to other stakeholders who need to play a role in addressing the problem and developing solutions."