In the graying world of academic nursing, Taura Barr stands out like a child prodigy in a university-level biochemistry class.
Just 31 years old, Barr, PhD, RN, holds a tenure-track position as an assistant professor of nursing at West Virginia University, where she is researching the implications of genomic variability, immunity, and cardiovascular disease on individual recovery from ischemic stroke.
The vast majority of Barr’s professional contemporaries, however, have chosen to work in other settings, like hospitals and long-term care facilities, but not colleges and universities. Fewer than 4 percent of nurses younger than 40 work in academic settings, according to a recent survey by the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers (NFSNWC). And early-career nursing professors are rare birds; only 14 percent of nurses who hold full-time faculty positions are younger than 40—further evidence that young nurses “are not choosing to work as full-time faculty,” the survey found.
That’s certainly the case at the West Virginia University School of Nursing, said Barr, a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2012-2014). “I’m definitely the youngest, and I have consistently been the youngest anywhere I go.”
Young nurses like Barr, however, are badly needed in academia, nursing workforce experts say. The nurse faculty workforce is aging and on the brink of a mass retirement, according to the survey, which was published in July in the Journal of Nursing Regulation. Nearly three-quarters of full-time nurse faculty (72 percent) are 50 and older, and a stunning14 percent are at least 65—and already working past the traditional age of retirement.
The insufficient number of young nurse faculty threatens to exacerbate the looming nurse shortage, according to Patricia Moulton, PhD, co-author of the survey and chair of the NFSNWC’s research committee. “Ten years from now, when all of these faculty retire, there aren’t going to be a lot of younger nurse faculty in the pipeline to replace them,” she said.
And that fact begs the question: Who will prepare the next generation of nurses?
The nation’s nursing schools are already turning away tens of thousands of qualified nursing applicants every year, in part because of insufficient numbers of nurse faculty. And demand for nurses is projected to grow as the nation’s population ages and as millions more people enter the health care system under the Affordable Care Act.
Higher Salaries in Clinical Practice
Young nurses are drawn to practice in large part because salaries tend to be higher in clinical settings than they are in academia, Moulton said. Faculty positions also require graduate degrees, and stepping out of the paid workforce for extended periods to get those degrees can be difficult, especially for those who are also managing child care and other responsibilities. For most people, master’s and doctoral programs each take a few years to complete, and most currently enrolled students are taking classes on a part-time basis, which extends the time it takes to complete the programs, according to the American Association of Colleges of Nursing.
“There’s no incentive to go back to school and pay for more education, only to get less money in the end,” Moulton said.
Moreover, the culture of the nursing profession encourages nurses to gain clinical experience before advancing their education, said Jane Kirschling, PhD, RN, FAAN, dean of the school of nursing at the University of Maryland, president of the American Association of Colleges of Nursing, and a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program alumna (2000-2003). As a result, many nurses—even those who aspire to become educators—work in clinical settings before pursuing their graduate degrees. Nurses, in fact, wait longer to get their PhDs than other professionals; the average age at which nurses get their PhDs in the United States is 46—13 years older than PhD earners in other fields.
To be sure, postponing advanced education has its advantages. Lisa Heelan, MSN, FNP-BC, ANP-BC, a scholar supported by the New Jersey Nursing Initiative, is glad she worked in a variety of settings before starting a doctoral program in her early 50s. “I have a lot to contribute to nursing because I have a very solid foundation in practice,” Heelan said, adding that her clinical experience has informed her work as an educator and as a scientist. And while the age of 65 may be a little more than a decade away, Heelan has no intention of retiring any time soon, saying: “I come from a family where the women choose to work full-time until they’re about 88.”
Nevertheless, the price of postponing graduate education can be high, if not for individual nurse educators then for the health care system at large. Nurses who become faculty later in life have fewer years to train the next generation of nurses, conduct badly needed research, and become leaders in academia and in health and health care.
Barr, however, has at least four decades to flower as an academic nurse leader. She originally intended to postpone her graduate education, but a mentor urged her not to, and she has never looked back. “The position I have right now is really flexible,” said Barr, a mother. “And I can do the kind of research I want to do, and when I want to do it. Not a lot of people can say that.”
The nursing profession and its allies need to do more to attract younger nurses like Barr to academia, Kirschling says: “We need to highlight the rewards of academic life” and “think creatively” about ways to speed up the production of nurse faculty.
Sue Hassmiller, PhD, RN, FAAN, RWJF’s senior adviser for nursing, agreed, and pointed to strategies such as emphasizing the non-monetary benefits of university life like academic freedom, interesting national and international practice and consultation opportunities, flexible, family friendly schedules, and the opportunity to improve lives through teaching and research.
She also wants to find ways to boost pay for nurse faculty and highlight opportunities for them to earn supplemental income through publishing, joint appointments, speaking, consulting, and entrepreneurship. Innovations in nursing and nurse education, such as online courses, joint appointments, and dedicated education units—where practicing nurses also serve as adjunct faculty—can expand opportunities for nurses to earn graduate degrees and work as educators, she said.
Young nurse faculty can also benefit from institutional support, and RWJF is paving the way for more nurses to become faculty through several of its programs. The RWJF Nurse Faculty Scholars program, for example, provides outstanding junior nurse faculty with three-year career development awards of up to $350,000. The program aims to strengthen the academic productivity and overall excellence of nursing schools by providing mentorship, leadership training, and salary and research support to young faculty.
The New Jersey Nursing Initiative, supported by RWJF and the New Jersey Chamber of Commerce Foundation, provides graduate nursing students in New Jersey with scholarships, living stipends, and laptop computers as well as financial incentives to reward those who choose to teach at a school of nursing in New Jersey for up to three years after graduation.
And in its first two years, RWJF’s new Future of Nursing Scholars program will provide scholarships, stipends, mentoring, leadership development, and dedicated post-doctoral research support to a number of nurses studying for their PhDs. The first cohort of scholars will commence their studies in 2014. The program will target nurses early in their careers so they have more time to reach their full potential as academic nurse leaders.
“We all know that nurses don’t get their PhDs until later in life,” Hassmiller said. “But you cannot manage a profession that way. We’ve got to get people into PhD programs more quickly, and we’ve got to get them out more quickly. The future of our nursing workforce depends on this.”
Learn about a powerful campaign from Johnson & Johnson urging nurses to consider careers in the classroom.