Yet as the number of Americans who need medical attention rises, the number of available nurses seems to diminish. Nationwide, there were 116,000 registered nurse vacancies in 2006 according to a survey of the AHA (American Hospital Association). In the Kansas City metro, there was a 9.0% RN vacancy rate, according to the Missouri Hospital Association Annual Workforce Survey (MHA) released in 2006. Kansas City’s situation may be better than our neighbors to the west. The central Missouri region, including Jefferson City and Columbia, had a slightly higher RN vacancy rate of 9.8%. Still, Kansas City’s RN vacancy rate was more than twice that of St. Louis’s, which was 4.5%. These numbers require special attention, especially when compared to Missouri’s 7.5% vacancy rate, or the estimated national vacancy rate of 8.1% reported by the AHA for 2006.

The nursing shortage is not a new problem. Many working RNs can remember the shortage of nurses in the 1980s that resurfaced in the 90s. The current shortage, however, is more enduring. And while the past shortages tended to be cyclical in nature, the current shortage goes deeper and affects the educational system.

“The nursing shortages of the 80s, and 90s were sheer number shortages that didn’t impact the level of education,” explains Lora Lacey-Haun, R.N., Ph.D., dean of the University of Missouri – Kansas City School of Nursing. “The current shortage is not part of the cyclic thing.” As Lacey-Haun explains, the nation’s aging population places more demands on the health care system. More concerning, a large percentage of the nursing workforce is projected to retire in the next five to ten years. A scarcity of nurses may compromise the level of patient care and increase turnover, which for patients means abbreviated hospital stays, less individual attention, an increase in errors and decrease in favorable outcomes.

Nursing schools struggle to keep up with the demand, but the dearth of graduates is not due to lack of interest. Many young people are drawn to the pay, flexibility, and job security of nursing. “Unfortunately we do have interest but not the capacity to enroll,” explains Nancy DeBasio, PhD, RN, Dean of Research College of Nursing. In 2006, U.S. nursing schools had to turn away 42,866 qualified applicants, according to the AACN (American Association of Colleges and Nursing). A primary reason nursing schools cannot upsize is declining numbers of faculty, the RNs who possess the requisite master’s degrees or Ph.D.s to teach. According to a 2007 survey by the AACN, there was a nearly 9% faculty vacancy rate at polled nursing schools. Many of the vacant positions were intended for faculty with a doctoral degree. DeBasio draws attention to the less than 1% of the 2.9 million RNs in America who have received their Ph.D. Nursing schools face the formidable task of not only producing more nurse educators in an economy of dwindling nurses, but also of training the nurses to go on and become teachers. “Even though we feel that there are a great number of benefits on the education side from a flexibility standpoint, from a professional development standpoint, or having the ability to have an impact on the future generation of nurses, that hasn’t been quite enough,” says DeBasio.

Why would RNs shy away from the predictable hours and relative calmness of a teaching position? A primary reason is salary. The AACN reported an average salary of $64,011 for a faculty member with a master’s degree, compared to $72,480 for a comparably trained nurse practitioner as reported by The Nurse Practitioner. As mentioned, many nurses are anticipating retirement, and the average age of the RN has risen from 45.2 in 2000 to 46.8 in 2004, according to the National Sample Survey of Registered Nurses (NSSRN). “The issue of the shortage of faculty is the primary concern that we have,” says DeBasio. “Over the next five to ten years we are going to see that cadre of full time faculty retiring and we don’t have people in the pipeline to fill that gap.”

Still, educators remain optimistic. An obvious solution is more funding from the government for both hospitals and nursing schools. The budget affects the school’s ability not only to hire faculty, but also to provide scholarships, build facilities and update technology. “New funding would help us to expand so that we could admit more qualified students,” explains Lacey-Haun. “Programs like ours [at UMKC] would be able to focus on bringing in more students and educating more people who could be nurse faculty.” Another solution is fostering partnerships of schools and hospitals, sometimes between cities. These allow nurses employed at hospitals to teach parttime or students to train in hospitals.

One promising local initiative is the Clinical Faculty Academy, a two-day event held every August and January that began in 2005 and has been used as a national model. The program is intended to educate participants about roles in clinical instruction, and features the presentations of area program faculty, deans and directors examining topics from legal issues in clinical student learning to creating a positive learning environment. The intended audience is hospital clinical staff who provide clinical supervision to nursing schools, as well as new faculty who may become part of this shared group.

“The effort began as a result of a shortage of nurses at the bedside,” explains DeBasio. “We pulled together individuals from the community to look at how to address the shortage.” UMKC also takes part in the Clinical Faculty Academy, as well as a host of local and regional partnerships. Lacey-Haun is enthusiastic about the collaborative spirit of Kansas City and our region in general. “Kansas City is unique in how the schools of nursing work together and collaborate and support each other,” she says. “Right now we need to admit as many students as we can. If we have faculty that can be helping another school in a semester, we do that.”

The good news is that the medical community has succeeded in spreading the word about nursing. Most young people are aware of the benefits of a career in nursing and understand that nurses are esteemed community members with a reputation for hard work and compassion. The nursing schools are working to accommodate the interest. “We have to think in different ways, whether it’s the use of simulation to provide or enhance clinical experiences, or utilizing faculty in a different way,” comments DeBasio. “My hope would be to look at creative, innovative strategies.”

«February 2008 Edition