Midway through the pandemic, nurses began to recognize an unsettling future for our profession. War-torn and tired, working in a beleaguered healthcare system, we witnessed the cracks emerging in each other and within the very organizations we worked. Nurses were burning out, and our healthcare model was breaking.
We watched as the first wave of nurses opted to retire early or leave the profession to maintain their sanity.
During this time, I remember asking other nurses what should be done to help with the impending nurse shortage. I wondered if our profession and educational system should get creative to find new ways to train nurses faster to help fill the widening staffing gaps.
I cited how during WWII, the army prepared nursing students quickly to fill the sudden demand that had exceeded the supply. Could we use a similar method to replace our current waning reserve of nurses?
Although we were not at war, the present circumstances necessitated drastic changes. Some of my peers agreed that our profession needed to step up with solutions to recruit and educate new nurses differently than our typical four-year programs. Others scoffed at this idea, stating that anything other than our traditional BSN training would water down our nursing pool.
Fast-forward two years to 2023. Our struggling healthcare system and severe nursing shortage have finally caught the attention of the media and the public at large.
Long ER waits are the norm due to insufficient staffing, and hospitalized patients have learned that call bells may go unattended for extended periods. Empty nurse roles are common in all areas of medicine.
We can no longer sit back, wringing our hands, pondering the issue.
Action is needed now. Fortunately, some forward-thinking and innovative nursing schools, hospitals, and states have initiated fixes to bolster our dwindling troops. Here's how some institutions are thinking outside the box to place new nurses on the floor as efficiently as possible.
1. Addressing the nurse educator obstacle
One of the biggest barriers to churning out more new nurses is the lack of nurse educators. It's well-known that we need more faculty to teach nursing students. In fact, "2,166 full-time faculty vacancies were identified in a (recent) survey of 909 nursing schools," according to the American Association of Colleges of Nursing (AACN).
One main reason for this problem is that university compensation is not closely competitive with nursing wages elsewhere. Although nurse educators for BSN programs possess a minimum of a master's degree, their pay does not reflect their value. Universities simply can't compete with nursing jobs that offer higher compensation in clinical settings.
With a dire need for educators, nursing schools and universities are challenged to offer the recommended additional nursing programs and classes. This problem unfortunately results in limited admission slots.
However, finding avenues to solve the nurse educator gap is one idea that is still worth pursuing long term. Offering scholarships and grants to entice prospective nurse educators (such as the Jonas Nurse Scholars Program) is one remedy that numerous states and universities have instituted.
The problem of historically low pay for nurse educators remains a drawback and needs to be addressed by our educational system. Thus, more immediate solutions are required to usher new nurses into the fold quickly.
2. Trying new approaches
Hospitals have become quite creative in resolving their staffing shortages. To fill nursing gaps temporarily or permanently, healthcare facilities have turned to unique avenues such as:
- Hiring international nurses
- Increased pay to recruit and retain nurses
- Sign-on and retention bonuses
- Employing travel nurses
- Flexible scheduling for increased nurse satisfaction
- Work-from-home nursing opportunities
- Student loan repayment
- Reimbursement of moving expenses for new nurses
Some hospitals partner with local universities to help train nurses in accelerated Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN) programs. These partnerships have facilitated increased on-the-job training so that new nurses are competent upon graduation despite the abbreviated training period. Hospitals implementing partnerships will likely gain new nurses through this joint venture due to student familiarity with the hospital and a steady stream of potential recruits.
3. Increasing technical college programs
For the past few decades, practical nurses, once the backbone of nursing, have encountered limited job offerings with nursing home environments as their only option. Most hospitals eventually adopted the all-BSN staff model, pushing out less educated nurses. LPN and ADN nursing programs dried up due to the push for nurses to achieve higher education in the field.
Post-pandemic nursing shortages have necessitated the need to revive the 3-tiered nursing education hierarchy of LPN, ADN nurse, and BSN grads. Healthcare employers are now welcoming ADN nurses and LPNs to staff all facilities. We are seeing a reemergence of 2 year and practical nursing programs as a result.
Nurse educators typically do not need a master's degree to teach this level of nursing students. Therefore, the pool of nursing faculty is more abundant in these programs compared to a BSN option.
This abbreviated training process can obviously produce new nurses faster than BSN-prepared students, making this a viable solution.
4. Leveraging state and city solutions
Most states and many cities have now stepped up to the challenge of assisting with the nursing shortage.
Due to numerous state and private monetary incentives, there has never been a better time to become a nurse where compensation is concerned. Scholarships, grants, and loan repayment programs have become the norm. For example, New York offers free nursing tuition to entice local applicants into the profession.
And South Carolina has allocated one million dollars to fund practical state nursing schools to produce trained nurses to expedite a solution to their own nursing shortage.
Oregon has instituted a unique staffing remedy called a nursing internship license that allows nursing students to treat patients under the supervision of a registered nurse. Here senior nursing students can help ease staff overload while gaining valuable on-the-job experience -- a win-win solution.
5. Tapping into universities
Nursing schools and universities are also doing their part to help ease the nursing shortage. Although nursing programs turn away many applicants due to a scarcity of educators, these institutions are still trying new avenues to attract and train more incoming nurses. Creative solutions include practices such as:
- Increased online classes and programs
- Rolling admissions
- Increased scholarships and grants
- More ADN programs
- Abbreviated nursing programs
- Partnering with local hospitals for use of their space and medical personnel for training purposes
- Flexible scheduling, classes, and clinicals
- Increased simulation training, reducing the need for live instruction
6. Improving working conditions
One of the most obvious solutions to the nursing shortage is to value the nurses that are currently working tirelessly in our healthcare system. By creating tolerable, lower stress work environments and appreciating those in the field, we can help to stem the exodus of nurses from the profession. Nurse retention strategies such as the following can go a long way in keeping nurses happy and on the job.
- Provide flexible work scheduling
- Eliminate mandatory overtime
- Offer wellness programs such as emotional support services, exercise breaks, and planned relaxation (without guilt)
- Encourage nurse input and autonomy
- Support mandated staff-to-patient ratios
- Offer incentives for excellence
Of course, competitive pay and bonuses are welcome, but we all know that nurse job satisfaction is much more than a fat paycheck.
To be fully happy as a nurse, we need to feel heard and appreciated and have time for relaxation and life outside of our jobs. The benefits of a satisfactory work-life balance are more important than ever for nurses. Until health care addresses these points, our nursing pool will likely continue to suffer.
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