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Fast-track fixes sought

October 4, 2006 -- Today USA Today ran a generally good article by G. Jeffrey MacDonald about the faculty shortage at U.S. nursing schools. The piece is "Nursing schools short on teachers: With care in demand, fast-track fixes sought." Relying on expert comment from several nurses, the article explains some basic aspects of the faculty shortage, including its role in the overall nursing shortage. It also describes some measures being pursued to address the lack of faculty, though it paints too rosy a picture of the likely effects of those measures. The piece also could have provided more context to show why the shortages exist. On the whole, though, the piece gives readers a basic sense of the problem, and we thank those responsible.

The piece provides some of the basic information about the nursing shortage. U.S. nursing schools are turning away more reportedly qualified applicants each year, including 41,000 in 2005, according to data from the American Association of Colleges of Nursing (AACN). Lack of faculty is the main reason: the piece reports that 7.9% of teaching positions are now unfilled. Meanwhile, the Department of Health & Human Services predicts that the 10% overall nurse vacancy rate today will grow to 36% (more than 1 million jobs) by 2020. University of Wisconsin-Milwaukee nursing dean Sally Lundeen notes that the overall shortage means that the lack of faculty--and the fact that existing faculty are "gray and contemplating retirement in droves over the next few years"--is a national crisis.

The piece spends most of its time on measures to increase nursing faculty. It says many nursing schools are creating and streamlining nursing doctoral programs, including setting up "fast-track" programs to reduce by "at least a year" the current 4 1/2 years between earning a bachelor's degree and a doctorate. This piece, like others we have seen, does not question whether there might be any downsides to severely streamlining nursing education; we doubt that would be the case if we were discussing physician education.

The piece also says other institutions are "stepping up to sweeten the pot" for nursing faculty. It cites $500,000 in federal defense funding to encourage military nurses to become faculty, and the private sector allocation of comparable amounts to fund faculty positions in Alabama and the Philadelphia area. The piece does not explain how these commendable but isolated and relatively limited efforts could make a dent in a system that is short thousands of faculty and hundreds of thousands of nurses overall. The piece does note that Congress has acted to expand opportunities for foreign nurses, though the AACN's Robert Rosseter rightly observes that some have ethical issues with this approach because of shortages in other nations. But the piece makes no mention of the kind of large-scale systemic change, including the allocation of significant additional resources, that would be needed to actually address the problem.

To its credit, the piece does quote Stephen Fera of Independence Blue Cross on the inadequacy of efforts to get potential faculty quick graduate degrees: "Many of these (faculty track) nurses are working, incurring debt, going to school at night, and at the end of all of their studies, they're going to choose a profession that actually pays them less than they're earning today?" This is a reference to the pay disparity that many feel is a key immediate factor in the faculty shortage. According to Antoinette Hays, director of nursing at Regis College in Massachusetts, the most highly trained clinical nurses can make more than $100,000 per year, compared to $60,000 or $70,000 in academia.

Of course, people in some other fields do take pay cuts to teach--why is nursing different? Is the pay gap too large? Is nursing academia less attractive than other academic pursuits for some other reason? The mainstream press' failure to pursue such issues suggests that a nursing job is a nursing job, and at the end of the day, nurses will basically go with whatever pays the most.

In any case, the piece notes that some nurses with masters degrees do teach part-time while earning their doctorates. The piece cites the University of Maryland's Matthew D'Angelo, who left a "$125,000-a-year job" for a lower paying teaching post in large part so he could earn his doctorate at the school at no cost. Another faculty member and doctoral student at Maryland, Brigit Vangraafeiland, values the good benefits and a flexible schedule she gets there. These descriptions end the piece on a hopeful note.

On the whole, this piece gives readers a good deal of important information about the U.S. faculty shortage, though it may leave many with the mistaken impression that the shortage is now well in hand.

See the article by G. Jeffrey MacDonald from the October 4, 2006 edition of USA Today.