I am frequently asked questions relating to the number of students admitted into the College of Nursing. The most frequent questions are: have we decreased the number of students admitted into the nursing program; are our students able to get jobs; and is there a nursing shortage. The conversations generally focus on the awareness that many healthcare facilities across the country are hiring very few new graduates, as they do not have any practice experience outside of educational clinical experiences. All of these are good questions.
It is true that in the past couple of years, new graduates from all nursing programs have experienced a delay in obtaining employment upon graduation. Seventy-four percent of our graduates are employed within 4-6 months after graduation. This rate is much higher than the reported national rate for university graduates. Multiple factors influence the decline in job opportunities for new nursing graduates. The most significant contributor is the declining economy that resulted in nurses delaying retirement. The reaction of health care agencies to the changing economy have led to hiring freezes and hiring nurses with two or more years of experiences into the limited vacancies. Changes in health care delivery and funding are changing the arenas of practice from hospitals to other settings such as clinics, home health, and community settings. Also, the clinical area of nursing practice is moving from generalized practice to specialized practice (e.g. emergency room, intensive care, psychiatric settings).
The College of Nursing has not decreased the number of students enrolled in nursing. Reality is that due to an improving economy, more than half of the current nursing workforce is poised to retire en masse between now and 2022.
The term Tsunami: RN Retirement is being used when describing this mass exodus from the practice and educational setting. In 2013 the U.S. Department of Labor, Bureau of Labor Statistics updated its nursing employment projections for 2012-2022. It is now predicted that employment of nurses is projected to grow 19 percent, which is higher than the projected employment growth of 11% in all occupations. The magnitude of the looming nurse shortage is problematic. A demand for healthcare services will increase due to the aging population resulting in an increased population who are living with chronic health problems such as diabetes, hypertension, arthritis, and cardiovascular disease. There is also a high demand for nurse practitioners, and for faculty and Deans in programs of nursing.
The College of Nursing will continue to offer nursing programs that are responsive to nursing workforce needs, needs of our community of interest, and changing trends in healthcare delivery. We will continue to graduate entry-level nurses, family nurse practitioners, psychiatric nurse practitioners, nurse anesthetists, researchers, faculty, and administrators.
Last month, students received baccalaureate, masters, and doctoral degrees from the College of Nursing. As I watched our students walk across the stage to receive their diplomas, I noticed their excitement and confidence as they transitioned to a new phase in their life. Students were confident because they have the knowledge, competencies, professional values, and role development needed to be successful in their chosen practice of nursing. Excited because they are assuming roles as entry-level nurses, nurse practitioners, nursing faculty, or nurse administrators. I wonder if they realized that in addition to their chosen professional role, they would also be emerging leaders.
The healthcare delivery system is constantly and continuously changing. Along with it, the field of nursing also evolves in such a way that it enables questioning of existing practices, the development of new knowledge and the improvement of delivery of health care services. The opportunity for leadership will exist and Southern Miss students are capable of providing leadership in change. Three of our current DNP students, Arlen Cooper, Sharon Catledge, and Courtney Bennett are examples of emerging leaders. Arlen is a Jonas Scholar and has participated in national health policy activities, Sharon is serving as the President of the Mississippi State Board of Nursing, and Courtney is featured on the American Association of Colleges of Nursing link as an emerging leader (http://www.aacn.nche.edu/students/gnsa/gnsa-bulletin/2014/may).
Last month, the American Association of College of Nursing (AACN) released data that showed that graduates with a baccalaureate or master’s degree in nursing are more likely to have job offers at the time of graduation or within 4 to 6 months following graduation (Journal of Professional Nursing, 2014). That is encouraging news amidst concerns about new college graduates finding employment in today’s job market.
This is not only encouraging news for the graduates of our program but for the current and future population who access healthcare. For the past decade a significant body of research has demonstrated that nurses with a baccalaureate-level preparation are linked to better patient outcomes. Based upon these studies, the faculty at Southern Miss has designed the curriculum to prepare graduates who have strong clinical decision making skills and are prepared to practice from a culture of patient safety. The use of simulation and case studies in the classroom enhance the acquisition of the knowledge and competencies needed for successful nursing practice.
In a recent conversation with an administrator at one of our health care agencies, I was inspired to hear the success of our recent graduates who are working together in a patient care unit and making a difference in the quality of care in that agency. Just one example of our baccalaureate nurses making a difference in the State of Mississippi.
I have been reading with interest in past Chronicles of Higher Education articles pertaining to changes that are occurring in institutions of higher education, such as changes in student financial aid, decreased instructional budgets, perceptions of value of a college degree, student’s non-linear progress through the degree plan, and a plethora of technology being used in educational instruction. Authors have labeled these changes as disruptive innovation.
Disruptive innovation in nursing education is not new as the College of Nursing and nursing programs throughout the nation have been continually updating curricula and changing pedagogy to address changes in the standards of nursing practice that require the need for graduates to be better skilled in clinical decision-making. The introduction of clinical simulation is a great example of innovation in teaching.
But the pace of change has accelerated in the last few years as a result of several significant reports and events. In January 2010, the Carnegie Foundation for the Advancement of Teaching released a report calling for a “radical transformation” in nursing education. In March of that same year, President Obama signed into law unprecedented reforms to the U.S. health care system. In October of 2010, the Institute of Medicine (IOM) released a groundbreaking report about the future of nursing that discusses innovation in nursing education. In November 2010, the Robert Wood Johnson Foundation in collaboration with the Institute of Medicine launched an initiative to advance comprehensive change in the nation’s health care system and in nursing practice and education.
As the College of Nursing contemplates our response to innovative disruption, we can reflect on the words of T.S. Eliot, “For last year’s words belong to last year’s language and next year’s words await another voice. And to make an end is to make a beginning”.
The Robert Wood Johnson Foundation for Nursing recently released a featured article on the national need for younger nursing faculty (September 9, 2013). The article called attention to the mass retirement of nursing faculty that will occur in the next 10 years and the lack of young nurses moving into faculty positions. In fact only 14% of the current faculty in the nation are under the age of 40. This data suggests that urgent and thoughtful actions must be implemented to ensure that sufficient faculty are employed to educate the next generation of nurses.
An appropriate question would be why aren’t young nurses choosing nursing education as a career choice. Multiple reasons exist such as, nurses practicing in health care agencies receive higher pay than faculty, the amount of time that it takes to graduate from doctoral programs of nursing is longer then required in other fields, the rising cost of education, and the expectation that nurses should gain clinical practice experience before beginning to teach nursing.
It is important to the future nursing workforce that strategies are developed that will attract younger nurses into academic teaching. The Robert Wood Johnson Foundation has championed this initiative by marketing media interviews with faculty describing the benefits of teaching nursing and by providing stipends and other financial support for nurses pursuing faculty positions. Yet, existing nursing programs in preparing the next generation of nursing faculty must do more.
This semester Southern Miss nursing implemented a BSN to PhD program to facilitate the seamless transition of recent graduates to the terminal degree. This pathway to the PhD degree will decrease the amount of time to graduation and will also provide students with funding as graduate assistants. It will also provide opportunity for mentoring these students in the faculty role. In addition, we are providing opportunities for our current BSN students to develop the skills needed for future employment as a faculty through a focus on undergraduate research, opportunities for undergraduate students to publish with faculty, and to attend professional conferences where faculty are in attendance.