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Illinois Explores New Option to Reduce RN Shortage

Monday August 25, 2008
<b>According to the American Association of Colleges of Nursing, in 2007 the average age of a professor was 59 and an associate professor 52.</b>
According to the American Association of Colleges of Nursing, in 2007 the average age of a professor was 59 and an associate professor 52.
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It has been almost 10 years since Brenda Recchia Jeffers, RN, PhD, joined the faculty at Mennonite College of Nursing at Illinois State University in Normal, and she has watched several nursing shortage factors escalate to disconcerting levels.

A professor and the director of graduate programs and research, Jeffers not only has observed a shrinking pool of candidates apply for open professor positions — typically about four applicants per vacancy — but she has also observed existing nursing faculty, herself included, edge closer to retirement.

"We are all kind of aging here and there's not a lot of people to replace us," Jeffers says.

If the already minimal number of nursing professors continues to dwindle, fewer students will be accepted into nursing school, therefore exacerbating a shortage the U.S. Department of Health expects to reach 1 million by 2020.

It's a scenario Jeffers heard repeatedly as a participant in the first Nursing Education Capacity Summit in June in Arlington, Va. Sponsored by the Association for the Advancement of Retired Persons (AARP), the Robert Wood Johnson Foundation (RWJF), and the U.S. Department of Labor (DOL), the event brought together nursing professors, advocacy groups, foundations, hospital administrators, and other stakeholders from 18 states to share strategies and develop ideas to curb the troubling trends blamed for nursing faculty and consequential nursing shortages.

"The public is becoming aware of the nursing shortage but has no clue that it's from the nursing faculty shortage," says Susan Reinhard, RN, PhD, FAAN, senior vice president of the AARP Public Policy Institute and chief strategist for the Center to Champion Nursing in America. "We know the bottleneck is the shortage of nursing faculty. That's why we're making nursing education capacity the first big solution we're working toward."

Simply allowing more nursing school students into classrooms will not solve the problem, especially considering most post-secondary professors will be retiring within the next decade. According to the American Association of Colleges of Nursing, in 2007 the average age of a professor was 59 and an associate professor 52.

Essential to the solution is redesigning nursing education, forming partnerships with alternate agencies and aligning resources, and changing public policy and regulation. Throughout the two-day event, various permutations of these objectives in place across the nation were highlighted to provide insight into developing a feasible, far-reaching plan.

"Illinois is a very diverse state in its people and geography, and one of our themes going in was we are a state with many voices," says Mary Anne Kelly, vice president and chief human resources officer for the Metropolitan Chicago Healthcare Council (MCHC). "We recognize the plan we develop can't be one size fits all, but we can learn from each other. The summit really brought us together as a team. I think we all left with new ideas and an affirmation that we are working toward a common goal. I think we're all looking forward to keeping in contact, keeping each other informed of the progress we are making, and sharing our successes."

Those conversations are critical to retooling the faculty education system, a topic that underscored the summit.

"Making [professorship] a viable career track is key to the success of this movement," Kelly says. "What we talked about at the conference is sometimes it's not just a matter of tuition. What are the other barriers to going on in education and completing it? Is it keeping yourself whole in terms of benefits when you may need to work part time to finish a degree? Is it family support? Child care?"

Kelly adds the entire industry needs to examine faculty salaries to determine if those of clinicians and professors are more disparate than other professions.

"Certainly salaries on the practice side are higher than faculty, so we need to look at the disparity and try to do something about that. And we need to do a better job of making the nursing community aware of the great opportunities in education and the benefits of serving as faculty."

Although the summit underlined what needs to be done, it also legitimized solutions under way in Illinois.

"Talking with other states really validated what we're doing," says Michelle Bromberg, RN, APN, BSN, BC, chair of the Illinois Center for Nursing and nursing coordinator for the Illinois Department of Financial and Professional Regulation. "We are really on target with making a major effort in impacting the nursing shortage here in Illinois. The national discussion totally mirrored what we're doing."

At the conference, Bromberg and Team Illinois shared with other participants the progress made to date throughout the state.

Foremost among the state's initiatives were the creation of a governmental subcabinet that focuses 14 member agencies on eradicating the shortage; the completion of an exhaustive workforce study in 2007 that tracked nurses and identified shortage areas; and the establishment of several pilot programs.

"We're doing two partnering for resource alignment pilot programs — with MCHC in the northeastern part of the state and Southern Illinois Connect in the southern region — to come up with strategic planning," Bromberg says.

Education redesign has been approached through the piloting of the Clinical Rotation Scheduler Program (CRSP) in the northeastern and southern regions. Designed to connect nursing schools and healthcare facilities by placing available student clinicians in facilities with corresponding clinical needs, CRSP would standardize clinical placement contracts between colleges and work sites.

The time saved by schools and facilities, which traditionally search autonomously for matches, is just one program benefit, Bromberg says.

"If you have the contract agreement, you will have the clinical placement honored and it will open up placements people never before thought about," Bromberg adds. "Other states have said other agencies get involved because as we try to work on the shortage, we have to open up clinics to other venues."

Further, students working in clinical placements at facilities that need them are more likely to feel valued, which results in smoother transitions and higher retention.

At the summit, programs such as CRSP, which have opened the nursing shortage bottleneck, were more than discussed, they were dissected.

"It's not enough to know what was done. We need to know what was done first. Who were the partners? What was the resistance? How did they overcome it? And what exactly were these dollars used for?" Reinhard says. "States have been achieving some successes here, but never as a nation have we looked at what's going on at a state level and diffused that innovation."

Those involved in the movement agree it's the participation of local, state, and national stakeholders from across the nursing profession that will allay the negative forces creating the shortage bottleneck.

"The solutions have to be global because if we work in isolation we're not going to accomplish what we need," says Dale Beatty, RN, BSN, MSN, CNO, of Northwest Community Hospital in Arlington Heights, Ill. "I think we have a good handle on the problem, but solutions won't come from just hospitals, academia or the state. It's through partnerships and collaboration that we come up with solutions, and now we've got some big guns, like AARP and the Robert Wood Foundation, working in concert with professional nurses to address the problem."

Robin Huiras is a freelance writer. To comment, e-mail editorIL@nursingspectrum.com.