The nursing shortage & nursing education
Almost every nurse I know, no matter their specialty, has given at least minimal thought to the nursing shortage, even if it is something as simple as wondering who will replace them when they retire, or more important, who will care for them or their family when the time comes. Nurses are stretched thin and stressed to the max, and many are leaving the bedside to pursue specialties considered more compatible with their definition of work-life balance.
In my years as a nurse educator and nursing school administrator, I often said when speaking to potential students or their families that nursing schools had the unwritten but often spoken end-program objective of “not graduating people who we thought would kill us.” Using these words with a lay audience brought home the awesome and intense role of nurses within the healthcare and patient care arenas.
That statement seems flippant or insincere on the surface, but it is one of the most true-to-life goals a program can reach. The reality of this sentiment means that nursing school is hard. It must be hard. And it is serious business—not to be taken lightly, no matter what words are used to describe it.
A few weeks ago, the Texas Nurses Association invited me to be interviewed for an article published by a local community newspaper. The topic was the nursing shortage, and how those regional hospitals and nursing schools managed the shortage during the COVID-19 situation.
I was described as a former dean and as the President of Texas Nurses Association District 9, which covers 11 counties in the Houston-Galveston area, including that region. The story in the community paper was published in other areas of town, and interviews relative to the other regions were included in the additional stories.
I said that, “There’s the part of nursing where people are tired; they’re burned out; and they’re having a hard time staying in it. But there’s another part where people are looking at nursing and go, ‘I really want to be a part of that.’”
I stand by this; nursing is hard work, but it’s also exceptionally rewarding.
I explained that while 12-hour hospital shifts might sound great on the surface because one might be working fewer days, there’s more to it than that. “(If) you’re so tired that you’re sleeping through all your days off, then that’s not very helpful.”
COVID has only added to the typical shift-work exhaustion.
Finally, I described the critical role of compensation in nursing — not necessarily for hospital nurses, but those who want to teach them.
“We absolutely need more faculty, which means that the schools have to pay the faculty something that they consider desirable enough to leave the hospital.”
I understand this dynamic more than most, as someone who was tasked with recruiting and hiring people to teach nursing school. For some, summers off and more traditional office hours are a huge benefit, but it’s still hard to outweigh a better salary.
In this interview, I was speaking for myself, based on my previous experience, and not for TNA, though I think they would largely agree. I enjoyed the interview very much, and I was really surprised at how passionate I became as I answered the questions. Clearly, this is a problem I have spent years thinking about and trying to solve.
I was quoted three times in the article, but I had a lot more to say about this than was able to be printed. Here are some other things that I said. Most of the other interviewees said the same things.
Nursing education formats really need to change. The dependence on the acute care inpatient clinical environment is difficult for many schools and students to manage, and it is not consistent with the direction of nursing and patient care.
Related to the impact of COVID-19 on nursing education:
Could decrease enrollment in nursing schools; could decrease ability to teach currently enrolled students because of a decrease in clinical spots; nurses could leave full-time positions to make more as a travel nurse; nurses could leave because of safety concerns and demanding schedules.
RN-BSN and MSN/doctoral students had to withdraw from classes because of work demands, so that did not help to increase the numbers of available nursing faculty.
Nursing school and nursing in general must change to meet the health care demands and must change for safety of providers and patients. Things cannot stay the same way and expect patients to survive.
Nursing education needs to move to the community and out of the acute care settings for safety and efficiency. Schools cannot afford to maintain the status quo with education methods, and the current methods do not match anticipated course of nursing.