When it comes to shortages in nursing, the conversation typically involves practitioners. In academic circles, however, you're just as likely to hear about another pressing concern: Many nursing professors are nearing retirement, and there aren't enough candidates ready to take their place.
One in five nurse educators plans to retire within three to five years, according to the National League for Nursing, a membership group that includes nursing faculty.
Or, take this snapshot: In Iowa, upwards of 40 percent of all nursing faculty are likely to end their careers within the next 5 to 10 years, according to Rita Frantz, dean of the University of Iowa's College of Nursing. In that program, the average age of the faculty is about 55. "That's typical," Frantz said. "Many nurses work for years before getting their master's degree, and then are doing their doctoral work into their 40s."
That's why Iowa's program is shifting its emphasis away from undergraduates and toward students who can soon enter the teaching ranks -- a move that Frantz said is addressing the faculty shortage problem.
The school is increasing its capacity to train students who are seeking a master's level degree in nursing, and at the same time cutting in half (from 150 to 75) the number of bachelor's of science in nursing candidates admitted per year. Instead of making the primary focus undergraduates who are likely to leave the state after graduation, Frantz argues, why not concentrate on students who are more apt to stay?
"In order to increase faculty and licensed clinicians who will work here, this reconfiguration of our program will better meet the needs of the state," she said.
Persuading students to choose teaching can be a tough sell. Nursing faculty are generally paid less than their counterparts in hospital or clinical settings who have the same level of education. Many full-time faculty take on extra administrative or teaching positions to boost their salaries.
Because nursing schools adhere to strict student-to-faculty ratios (often 10:1 or 12:1), a shortage of teachers could make it impossible to educate more nursing students.
"Faculty shortage is the biggest problem we have,” Geraldine “Polly” Bednash, executive director of the American Association of Colleges of Nursing, said earlier this year. “Most of the focus is on producing people at the bottom of the pipeline, but we aren’t looking out for the future.”
Iowa's nursing school is the only one in the state that prepares nurse educators at the doctoral level. The new plan, approved by the institution's Board of Regents, includes adding a doctor of nursing practice degree, which prepares nurses to take advanced hospital leadership and faculty positions. Frantz emphasized that this track isn't meant for research -- the program has separate space for Ph.D candidates.
The school is continuing to develop a program that enables students who have already earned a bachelor's degree in a non-nursing field to earn a master's degree and pursue a nursing career. For the past several years, Iowa has piloted the so-called "second degree" program, which is being reconfigured as an entry-into-practice master of nursing science program that gives students who have met prerequisites a higher degree after 18 months.
Frantz said graduates of the program will be prepared to be nurse educators in undergraduate programs, or to work in community colleges. And because many will be older students who have started other careers, the hope is that they are more likely to stay in state to teach.
"The level of preparation needed for leadership that's required in nursing these days mandates that nurses be prepared at the master's level," she said.
Iowa will also increase enrollment in its RN-to-BSN program that educates registered nurses throughout the state through online courses. The program is increasing its online teaching capabilities and targeting potential students who likely aren't right out of college.
Since the school's changes were just announced, Frantz said she has yet to hear significant feedback. She defends the decision to cut back on undergraduate slots, asserting that training more master's students who can sit for a licensure exam will not decrease the number of students the school is preparing to become licensed clinicians.
Both Beverly Malone, chief executive officer of the National League for Nursing, and Robert Rosseter, associate executive director with the American Association of Colleges of Nursing, said decreasing bachelor's-level numbers to make way for a greater graduate-level focus isn't a trend.
Enrollment in baccalaureate nursing programs, after dipping below 80,000 nationwide in the late 1990s, has steadily increased since -- rising to 133,578 in 2006. Still, more than 42,000 "qualified" nursing students were turned away from these and graduate programs due to a lack of faculty, clinical placement sites and classroom space, Rosseter said.
Iowa's decision "may be the school's best option when it comes to addressing the nursing shortage and making the best use of limited resources. The cutting of baccalaureate nursing slots ... is all about the resources an institution receives, not whether they value the baccalaureate degree."