The nursing shortage did not start or end with the COVID-19 pandemic, and it is not a lack of interest that is the primary cause of why not enough new nurses are being educated to replace those who have left the profession. So said Susan Gatto, a professor and director of the school of nursing at the University of Central Arkansas in Conway.
“The whole reason for the nurse shortage is because of the nurse educator shortage,” she said. “Nurse educator salaries are so much lower than on the clinical side. Nurses with master’s degrees can get a whole lot better pay on the clinical side than they can get as a nurse educator, so I do have trouble recruiting students into the Master of Science in nursing nurse educator program and recruiting faculty to teach in all of the UCA nursing programs. It is a nationwide issue with not enough nursing teachers.”
One nurse practitioner who took a job with the UCA School of Nursing in August 2022 took a pay cut of $40,000 per year, Gatto said. She added that the nurse practitioner took the job to have more time with her family, including summers off with her children.
“That worked out well for her family, but it is hard to take a $40,000 per year pay cut,” Gatto said. “For most people, why spend more money to get a master’s degree to make less money? Some newly graduated nurses with a Bachelor of Science in Nursing are making more money than nurse educators with a master’s degree and 10 years teaching experience.”
Gatto said it is particularly difficult to recruit men into nurse education, which has contributed to the UCA School of Nursing having a faculty that is 100 percent female. Most of the teachers are married and have another income in their household. The majority are mothers or grandmothers helping with families.
In 2022, Gatto had four nurse educator openings. She offered 14 people the jobs before four accepted.
Despite these challenges, nursing education can also be very rewarding, she said.
“It is very intellectually stimulating,” Gatto said. “Most people also do it because they feel like they are giving back to the profession. Instead of taking care of one patient at a time, they are educating a student who treats hundreds of patients over their career. I’ve been teaching 35 years, so that equates to a lot of patients through all the students I have educated. My faculty are so dedicated. They care about the students. They want them to meet their goals. They work hard to make them employable and meet all the competencies to pass the licensing exam.”
Gatto said there has been a nursing shortage since the 1980s. There has always been a gap in salaries, worsened by COVID-19, yet she is not sure whether it is primarily an overall nursing shortage or a question of nursing deserts. Those include rural areas that do not pay as well or attract as many applicants, and they also include acute care hospital settings where nurses work often grueling 12-hour shifts.
“Some nurses are choosing different things, rather than shift work in hospitals,” Gatto said. “I think that is why acute care settings are seeing more of a shortage.”
Students who want to become a nurse can receive their BSN degree at UCA. They do their freshman and sophomore years as pre-licensure BSN students taking prerequisite courses and then go through a competitive admission process for admittance into the BSN major for the final two years.
“Right now, we have more applicants than we can admit,” Gatto said. “In addition to not having more instructors, another reason we can’t admit them all is because of clinical placements. Students have to do clinical experiences all through the program to meet expected competencies. That is one of the biggest barriers to admitting more students.”
She also has trouble getting a full cohort for UCA’s post-master’s Doctor of Nursing Practice degree, which has a focus on leadership development and process improvement for nursing administrators. UCA offers online information sessions to attract students and has a dedicated education counselor, Julie Ingram, whose job is to recruit and advise students in the UCA nursing graduate programs.
“We have been doing more with our graduate program recruiting than ever,” Gatto said. “Julie has been going to different conferences, including in neighboring states, to recruit more students.”
UCA also offers a BSN to Doctor of Nursing Practice program with an emphasis as a family nurse practitioner.
Recruitment and retention of nurses continues to be one of the biggest challenges for health care organizations across the nation, said Meredith Green, chief nursing officer at Washington Regional Medical Center in Fayetteville.
“There will always be a need for nurses to provide care at the bedside, and that is not unique to Washington Regional,” Green said. “That is why it’s important that hospitals collaborate with community nursing programs to find ways to grow the pipeline of skilled nurses. Washington Regional has built strong partnerships with area nursing programs to help better meet the needs of our community.”
Some hospitals, particularly in rural areas of the state, still need to hire travel nurses to fill staffing gaps. Travel nurse salaries are much higher and can be burdensome to hospitals that are already financially stressed. Green said Washington Regional’s recruitment efforts are currently meeting staffing needs adequately.
“We are actively engaged with our community and area nursing programs to recruit and retain nurses,” Green said. “Washington Regional’s vision is to be the best place for patients to receive care while providing our nurses with an environment that is the best place for them to give care. For those looking to enter the nursing profession, Washington Regional can help them achieve their professional goals with the nurse tuition loan program. For approved applicants, the program pays for nursing school with the goal of offering them a job at Washington Regional after graduation.”
Green said newly graduated nurses can gain additional skills and knowledge during their first year through Washington Regional’s nurse residency program. The program helps nurses transition to professional practice and become confident care providers through a variety of sessions designed to strengthen their assessment, critical thinking, communication, teamwork and technical skills in a safe learning environment.
Nursing can be a profoundly rewarding career, she said.
“Nurses have the power to impact lives, and I believe they are some of the bravest and most needed people in our society,” Green said. “Washington Regional helps nurses create a fulfilling career and meet their personal and professional goals. We encourage our nurses to get involved in professional organizations and support them as they develop new skills to advance their careers. Whether it’s a nurse with decades of experience or a new graduate just beginning their career, we value the work our nurses do.”
Feature image: From left to right, Susan Gatto and Meredith Green.
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