I know that nursing students will email me to say they cannot return to class because of financial hardships related to COVID-19. These students will not enter or, at best, will delay entering the shockingly understaffed nursing workforce at a time when we have all become aware of our need for direct patient care nurses.
The nursing shortage has existed for a long time. The issue has not been resolved because of its complexity. What we are now seeing with the unique strategies to address the nurse workforce shortage related to the COVID-19 pandemic (asking retired nurses to return and utilizing nursing students to meet the demand) are clear examples of why addressing the existing nursing shortage must be prioritized as a healthcare emergency. SB 3636 provides a holistic approach to the nursing shortage by addressing the interconnection of the need for nurse-driven staffing decisions, financial support that ensures nursing students complete nursing school, and incentives that encourage nurses to take faculty roles so that students have access to nursing education.
COVID-19 has put strains on just about every facet of our lives…but most worrisome is the extra stress placed on our fragile healthcare system. I work as the Associate Director of the Master’s Entry to Nursing Practice Program at DePaul University. Building a solid nursing knowledge foundation requires a substantial time commitment, which makes it difficult for students to work while in school. Understandably, students constantly ask me about scholarships, and the truth is that the university has few resources to offer them, particularly at the master’s entry level. Having more financial assistance available through nursing scholarships would both provide opportunities for more people to consider nursing and support current students in finishing nursing programs.
A lack of scholarships is only one of the challenges facing the nursing field. According to the American Association of Colleges of Nursing (AACN), in 2018 alone, nursing schools turned away 75,029 qualified applicants because of reasons that include nurse faculty shortages. We cannot attract enough faculty to educate future nurses. Every time I interview a potential adjunct faculty and tell them the starting rate, I worry they will say, “No.” That is a common barrier that most nursing programs encounter since nurses can earn much more in clinical practice. A tax credit could incentivize nurses to become and stay educators.
Nurse educators have a responsibility to graduate nurses who require the skills and knowledge to save lives. Beyond the classroom, they facilitate student clinical rotations, build relationships with hospital partners and nurse preceptors who help students complete clinical rotations. From what I have observed in my administrative role, offering tax incentives to attract and retain more faculty and adjuncts could mean more consistency in the way courses are taught and consistency in clinical placements. It means enhanced student learning.
The clinical aspect of nursing education requires collaboration outside of the university that often proves to be challenging. Nursing programs depend on hospital nurses to help teach students critical processes and skills that connect classroom learning to practice. When the number of patients they must care for or poor work environments overwhelm nurses in hospitals, they do not have the time or tools to be able to best educate students. I have, at times, struggled to find clinical sites with a staffing capacity large enough to open their doors to students. I do not want to further inundate nurses; however, nursing students need hands-on clinical learning experiences that direct-patient care nurses help provide. Building nurse-driven staffing committees that advocate for fair schedules that allow for work with nursing students will help address the limited clinical placements that contribute to the nursing shortage.
Acceptable workloads can only happen if nurses are at the table for staffing conversations. I hear from nurses who don’t feel listened to. Many feel overworked, and overlooked by not having a voice in decision making. Nurses, who are at the front lines, can provide new and useful ideas to influence health outcomes, improve patient satisfaction, and decrease nurse burnout. As a nursing professor, I would like to know that, once students graduate, they will all practice in an environment where they can self-advocate and create change. If nurses feel empowered in the clinical setting, we will retain more nurses providing excellent care.
My responsibility as a nurse educator and administrator is to prepare the next generation of nursing students to provide the highest-quality safe patient care. However, it is worrisome to think that, once they leave our academic doors, they may work in an unsafe environment because of poor staffing or limited resources. In the current COVID-19 crisis, we are witnessing nurses risking their own health and working under incredible stress that may further contribute to more nurses exiting direct-patient care and, also, impede new nurses from joining the workforce. We must take action now by passing SB3636 to address this healthcare emergency by protecting nurses through safe staffing and incentives to open the pipeline for more nurses and nurse faculty.
Elizabeth Aquino, PhD, RN
Associate Director of the Master’s Entry to Nursing Practice Program