Problem: Like many other states, New Jersey faces a looming shortage of registered and advanced practice nurses that threatens to undermine patient care. One key way to curb the shortage is to train enough new nurses to meet a projected surge in demand. But a shortage of another kind—one of nurse faculty—is making that difficult.
Background: One evening some three decades ago, Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., turned on the national news and happened to see an interview with renowned nurse leader Claire Fagin, Ph.D., R.N., F.A.A.N. During the interview, Fagin called on young nurses to advance their education—and Bakewell-Sachs, then a young neonatal nurse in Virginia, heeded the call.
She left her job and earned master’s and doctoral degrees in nursing from the University of Pennsylvania. Now dean of the nursing school at The College of New Jersey, Bakewell-Sachs is spreading the same message she heard all those years ago.
“We just don’t have enough nurses with master’s and doctoral degrees,” she says.
A new report on the future of the nursing profession, released this month by the Institute of Medicine and supported by the Robert Wood Johnson Foundation (RWJF), buttresses this statement. Nurse education—as well as nurses’ roles and responsibilities—should change significantly to meet the increased demand for care that will be created by health reform and to advance improvements in America’s increasingly complex health system, the report says.
Providing nurses with at least a bachelor’s degree will help give them the tools they need to care for patients who are living longer, and sicker—and with multiple chronic health conditions to manage. Nurses with advanced education can then specialize to provide primary care, as well as care for a patient population that is aging.
The demand for better educated nurses is expected to grow as reform expands access to primary care and as the Baby Boom generation ages.
Nurse faculty are desperately needed to educate that next generation of nurses.
But nursing schools in New Jersey and elsewhere are having a difficult time finding enough nurses with advanced degrees to fill faculty vacancies. Those nurses who do have advanced degrees are also highly sought for clinical positions where salaries tend to be higher. Nurse faculty, meanwhile, are aging along with the rest of the population and are expected to begin retiring en masse in coming years.
As a result, nursing schools nationally are turning away thousands of qualified applicants—precisely the opposite of what needs to happen to curb the looming shortage of highly trained nurses.
“We simply do not have the workforce to meet the practice, education and research needs of the discipline, and the health and health care of people in New Jersey and around the country is going to suffer as a result,” Bakewell-Sachs says. “If we can help to address the nurse faculty shortage by producing new nurse faculty, then we certainly hope we can contribute to capacity development in nursing education.”
Solution: Developing the nurse education workforce is what Bakewell-Sachs focused on as a Robert Wood Johnson Foundation Executive Nurse Fellow (2007-2010). It is a leadership development program designed to prepare a select cadre of registered nurses in senior executive positions for influential roles in shaping the U.S. health care system of the future.
As part of her fellowship, Bakewell-Sachs became program director of the New Jersey Nursing Initiative (NJNI), a five-year $22 million project of RWJF and the New Jersey Chamber of Commerce Foundation that is working to transform nursing education in the state and ensure that it has the diverse nurse faculty it needs.
To reach that goal, the initiative is convening strategic working groups that are developing innovative strategies to expand and diversify New Jersey’s nurse faculty and providing support to future nurse educators, nursing programs and nurse education collaboratives in the state.
Currently, NJNI is supporting master’s degree and doctoral students with financial aid that covers tuition, fees, books, a laptop computer and an annual stipend of $50,000. The goal is to produce 46 new nurse faculty in New Jersey.
These New Jersey Nursing Scholars are in programs offering an integrated curriculum that includes nurse educator competencies along with their clinical master’s or research Ph.D. program, which prepares them for careers in nursing education. That kind of preparation, often absent from existing nursing school curricula, will help nurses choose a career as faculty. Scholars who complete these competencies will be eligible to sit for the certified nurse educator exam given by the National League for Nursing.
NJNI is also working to gather data about salary disparities between practice and academia and across academic disciplines, to find ways to give clinical scholarship more academic recognition, and to create new positions for nurses who want to have clinical and education roles. These efforts, Bakewell-Sachs hopes, will help attract more practicing nurses into academia.
The initiative is working on a policy front as well. Last year, it helped enact a faculty loan-forgiveness program for nurse educators in the state and helped secure a grant to create a health workforce advisory council.
More good news came this year when the Horizon Foundation for New Jersey won a grant from Partners Investing in Nursing’s Future, a partnership of the Northwest Health Foundation and RWJF. The Horizon Foundation will assist first-year graduate nurses to succeed in their pursuit of master’s degrees in nursing—a goal supported by the New Jersey Nursing Initiative.
RWJF Perspective: The Robert Wood Johnson Foundation supports the New Jersey Nursing Initiative because it will help ensure that the state has the well prepared, diverse nurse faculty it needs to educate nurses to meet the demand for health and health care in the 21st century. The goal is for NJNI to serve as a model for other states facing shortages of nurse educators and practicing nurses so that there will be enough nurses for all Americans who need them—now and in the future.