The Nursing Numbers Game

The Nursing Numbers Game

By Patricia M. Davidson

The nursing shortage in America didn’t happen overnight. And it wasn’t caused by any one simple factor and will not disappear with a single intervention. Still, with the need so great and our collective frustration growing, people are asking legitimate questions. For instance, CNN published a report this week that nursing schools are turning away applicants at such a time of need. The reasons offered by our fellow schools of nursing are familiar: limited resources, difficulty recruiting faculty (which limits class sizes), and a lack of space for student practice in clinical settings, which has the same effect. Supply and demand means nurses can make more in practice than as instructors, so they work in medical settings rather than teach, and the cycle repeats itself. What to do?

First, we can expand and continue to improve our online education to promote access. This is an area we’ve focused intently on at Johns Hopkins, introducing online modules into every level of learning. This is important in addressing the maldistribution of nursing resources. But to create quality programs is highly resource-intensive and increases the complexity and cost of running nursing programs. For-profit providers are big players in this space—as they can achieve scale and have deeper pockets than most nursing schools.

We can—and do—build nurses who can perform multiple roles on a health care team. These are leaders who make caregivers around them better and make systems smarter, increasing quality and efficiency of care and easing some of the burden on the entire health team. This is the idea behind our MSN (Entry into Nursing) Program, which finds the best minds from any walk of life and turns these students into the best nurses—leaders, care providers, and creative thinkers.

Our doctoral program has expanded tremendously to increase a pipeline of nursing faculty—a key component to solving the nursing shortage.

As nursing schools, it is our responsibility to help solve the nursing shortage. There is much work to do, and educational institutions nationwide need to seek to expand and improve training opportunities that are high-quality, flexible, and inclusive. We also need to reach out to nursing alumni nationwide to build stronger relationships with health systems and community centers to provide increased opportunities for student clinical placements.

Foundations such as the Hillman, Jonas, and Robert Wood Johnson Foundations have also been important in investing in and promoting nursing, but foundations with a core interest in nursing are few and far between compared to our medical colleagues.

As reported by CNN, it is heartbreaking that so many want to be nurses and that nursing schools must turn people away. It remains among the most gratifying and trusted of professions. What the nation doesn’t need, though, is a flood of nurses who are less than fully prepared to care for an aging population with ever more complex needs. What is abundantly clear is that nurses need higher levels of education than ever before. Financial aid, holistic admissions are important in creating schools that live the mission of diversity and inclusion.

Unfortunately, the answer isn’t as simple as just making room for more baccalaureate nursing students. As we said, the nursing shortage didn’t happen overnight. And it’s not going to be fixed overnight by a single solution. It will take an integrated and strategic approach to rebuild a professional pipeline at all levels and we need workforce models that are contemporaneous and meet the needs of current health care priorities. The nursing shortage is so much more than a numbers game and playing Russian Roulette with the bedrock of our health care system is just folly.


trish_blog-shotPatricia M. Davidson, PhD, MEd, RN, is dean of the Johns Hopkins School of Nursing and a fellow of the Australian College of Nursing, the American Heart Association, the Preventive Cardiovascular Nurses Association, and the American Academy of Nursing. She is counsel general of the International Council on Women’s Health Issues and actively involved in the international activities of Sigma Theta Tau International. Follow her on Twitter (@nursingdean).

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