AMSN Commentary on a Severe Nursing Shortage

No Room at the Inn: Applicants Being Turned Away at Nursing Schools

by Linda H. Yoder, PhD, MBA, RN, AOCN, FAAN

A severe nursing shortage, lack of faculty, and aging baby boomer population are all colliding. The industry is crying out for a long-term solution. 

The hot-button topic of the nursing shortage took center stage on April 30 when CNN published an article by Parija Kavilanz, “Nursing Schools Are Rejecting Thousands of Applicants – In the Middle of a Nursing Shortage.”

Sadly, the CNN article is true: Nursing schools are turning away thousands of qualified applicants (56,000 in 2017), and schools are struggling to hire more qualified teachers. The reasons given also are true: Finding enough clinical track and tenure track faculty is challenging and faculty shortages will get even worse.

Faculty pay is one of the issues that keep nurses from taking full-time faculty positions. Also, State Boards of Nursing have rules about how many students can be under the supervision of a faculty member in the clinical setting.

Even with the creation of new schools of nursing, the challenge then becomes obtaining clinical sites that will accept the students. Unfortunately, I hear students talking about how they are treated badly by some nurses on the units where they go for their clinical rotations. I realize we are busy, but those students can become your colleagues after graduation; we should be welcoming them and helping them.

Most nursing schools engage in simulation to some degree but eventually students must learn how to manage real patients, which can be anxiety provoking! Senior nurses are indeed retiring and the retirements of the baby boomer nurses in clinical and faculty jobs will further stress the system.

Implications for the Med-Surg Specialty
What does all of this mean for med-surg nursing? We have to be visible to students to explain the challenges and wonderful experiences of being a med-surg nurse. We also need to be talking to middle school and high school students about nursing as a career.

In some locations, new graduates no longer are expected to be a med-surg nurse before going to the ICU, the operating room, the emergency department, etc. So, we are challenged to make med-surg nursing appealing to these graduates.

Also, before letting a senior med-surg nurse retire, we need to ask if there is a position in nursing education or another part of the organization where they can facilitate the growth and development of the staff, which improves patient care. These nurses have knowledge and experience that can be used in schools of nursing as well.

Dangling Carrots: Not the Long-Term Answer
In another recent article published by CNN and written by the same reporter, “Hospitals Offer Big Bonuses, Free Housing and Tuition to Recruit Nurses,” Seun Ross, director of nursing practice and work environment at the American Nurses Association (ANA) said rich bonuses and creative perks are not the long-term solution to the nursing shortage. A better approach, Ross said in the article, is to invest in improving the work environment for nurses and offering better pay, career development, and solutions to protect them from burnout.

I adamantly agree with Ross: Big bonuses are not the answer in the long-run. We should be spending money on improving the practice environment to recruit and retain excellent nurses. Of course, creating a healthy practice environment does cost money because often it requires better staffing, ongoing education for the staff, and frontline and senior leadership support. However, it will pay off in a way that short-term band-aids will not.

Let’s invest thoughtfully and wisely across the industry so we retain nurses and make nursing attractive to future nurses.

Deans of Schools of Nursing should make the case for expanding their faculty and increasing salaries to facilitate opening more seats. In some cases, extra classroom and simulation space may be needed as well.

In the end, we have to make the profession, and med-surg nursing in particular, appealing if we are to keep our units staffed and patient care safe.

Linda H. Yoder, PhD, MBA, RN, AOCN, FAAN, is President, Academy of Medical-Surgical Nurses, and Associate Professor, Luci Baines Johnson Fellow in Nursing, University of Texas at Austin School of Nursing, Austin, TX.