In the third grade, Kacie M. Spencer resolved to become a nurse. She read about Florence Nightingale, bandaged her little brothers’ scrapes, and started thinking about the courses she would take.
Years later, Ms. Spencer earned an associate degree in nursing at McLennan Community College, in Waco, Tex., and took a job at a nearby hospital. She worked there for six years, but then chose a different professional path. After earning a master’s degree, she returned to McLennan last fall to become a full-time faculty member in nursing. “Teaching was always in the back of my mind,” says Ms. Spencer, 28. “I just reached a point in my life where I thought it would be a good idea.”
Community colleges everywhere are searching for Ms. Spencers — experienced nurses with advanced degrees who are willing to leave their jobs and return to the classroom, usually for significantly less pay. People who fit that description have long been difficult to find, but the need for them is growing.
The dearth of instructors has contributed significantly to the nation’s nursing bottleneck: Most institutions that train nurses have many more qualified applicants than they can enroll. The problem has become dire in regions with an increasing shortage of health-care workers.
Nationally, an aging population and a wave of retiring nurses will cause a “surging demand” for new nurses over the next decade, according to a recent report by the U.S. Health Resources and Services Administration. The agency projects that the supply of full-time registered nurses will fall 36 percent (about a million nurses) short of the number required by 2020, unless health-care-training programs expand substantially.
Much of the responsibility will fall to community colleges. About 60 percent of the nation’s registered nurses come through associate-degree programs, according to the American Association of Community Colleges. In recent years, many two-year institutions have increased the size of their nursing programs while seeking ways around the shortages of both nurses and faculty members.
Take Lewis and Clark Community College, in Illinois. A few years ago, the college received a federal grant to operate a nurse-managed center that provides health care to local residents and gives nursing students the opportunities to complete their clinical-service requirements. “Finding clinical sites for students had been an issue, so we built our own,” says Donna Meyer, dean of allied health and director of nursing at Lewis and Clark.
Last summer the center received another federal grant that allowed it to purchase and operate a mobile clinic that would offer dental, general health, and mental-health screenings to some 90,000 residents in the rural communities near the college. Local fuel companies donated all the gas for the vehicle, which gets about six miles per gallon. Since December, the clinic-on-wheels has hit the road about three times a week. “Once we did 500 flu shots in six hours,” Ms. Meyer says.
Some job-training experts say more community colleges must pursue creative solutions. “Many places are trying to address this on their own and are not looking to partnerships,” says Julian L. Alssid, executive director of the Workforce Strategy Center, a New York City nonprofit group. “No single community college alone is going to solve this issue without active involvement with employers, four-year schools, and economic-development officials.”
An ailing economy has emphasized the need for collaboration, as it has driven more students to pursue careers in nursing, a field that guarantees long-term employment. Many community colleges face budget cuts, and educating nurses is among the most expensive things those institutions do. “We lose money on every nurse we train,” says Dennis F. Michaelis, McLennan’s president.
Over all, the college’s nursing program loses about $550,000 annually. A major reason: Like many states, Texas requires that nursing programs have one faculty member for every 10 students, a ratio designed to ensure the safety of patients who receive treatment from nursing students in clinical settings.
The requirement also limits how fast McLennan’s nursing program can grow. Each year about 120 students graduate from the program, a number Mr. Michaelis has pledged to eventually double. (The program’s waiting list usually goes about 250 deep.)
The goal hinges on the imminent completion of a new science building on the campus, part of a $75-million project financed by local bonds. The plan also depends on the hiring of new faculty members. McLennan officials plan to add about 10 students each year to the nursing program, which means the college would add just one instructor at a time.
As the program grows, Mr. Michaelis expects to seek help from local hospitals, whose financial support helped the college create an evening nursing program. This time the president would ask them not for money but for volunteers — nurses with master’s degrees who might like to teach on the side. “Loaning them to us on a part-time basis, to teach a class or so, it would be a great thing,” he says. “But we know they’re limited in terms of how much help they can give us.”
Partnerships like the one Mr. Michaelis envisions have become commonplace elsewhere. Recently, the Community College of Baltimore County, in Maryland, made a deal with a nearby hospital that allowed the nursing program to expand its enrollment. The community college reserved 10 spots for hospital employees who had completed their nursing prerequisites and qualified for admission. In return, the hospital provided the college with instructors for both the theory and clinical components of Baltimore County’s nursing curriculum.
A total of 20 hospital staffers, including IV therapists and clinical nurse specialists, served as part-time teachers in the program, which was offered on evenings and weekends. Most of the clinical instruction occurred at the hospital, which eased the challenge of finding sites for nursing students. The partnership, which will continue in the fall, allowed Baltimore County to graduate 24 more students this spring than it otherwise could have enrolled.
In recent years, Baltimore County’s nursing program has typically had two or more open faculty positions at any given time. Each job usually take between six and 18 months to fill, according to Carol Eustis, dean of the college’s School of Health Professions. As of early March, the college had four openings. “The salaries we are able to provide are not competitive,” she says.
Some of the college’s nursing graduates get jobs that pay $50,000 a year, she notes, about what faculty members with four or five years of experience make. Nurses who go on to earn master’s degrees can earn tens of thousands of dollars more than they could teaching at two-year colleges.
Yet partnerships like Baltimore County’s may have a crucial benefit for higher education: bringing more nurses into the teaching fold. The college recently hired two of the nurses who taught in the program as adjuncts.
Giving nurses an opportunity to work with students part time can hook them on teaching, says Deborah Berg. An associate dean and director of nursing education at San Diego City College, she started teaching there part time in 1982 and became a full-time faculty member seven years later. She has taught nearly every course the program offers.
“If you want to effect change in the profession,” she says, “this is the way to do it.”
It’s a pitch she has made to nurses from local hospitals. San Diego City College has 10 full-time faculty members for its 160 nursing students and usually must rely on at least three adjuncts to help carry the teaching load.
Next year the college will open a new career-technology center that will include additional space for the nursing program. That would allow the college to start admitting nursing students twice a year, doubling the number of slots. It would help the program cut into its waiting list of about 700 applicants.
Expanding is one thing, but paying for it is another. The new facility will include 16 offices for nursing faculty members. Given the budget shortfalls in California, however, Ms. Berg is not sure the college can fill those additional offices any time soon. And so she might turn to more adjuncts, who can make $60 to $70 an hour, working 12 to 15 hours per week.
Sometimes those adjuncts become full-time faculty members because they seek a new challenge or want to work a different schedule. “There are some positive things that tend to appeal to people, especially how fresh it makes your outlook on nursing,” Ms. Berg says, “plus weekends off and summers off.”
The transition from nurse to teacher does not always work, however. Ms. Berg has hired a few faculty members who stayed only one year. “They just couldn’t swing it financially,” she says.
Money is not the only hesitation nurses may have about teaching. Ms. Spencer, who left her hospital job to return to McLennan Community College, says associate-degree programs are so intense that some nurses are reluctant to pursue a master’s degree.
And working with students is different than working with patients. During her first semester as a faculty member, Ms. Spencer says, she was often apprehensive. This semester, though, her confidence grew. “I’m watching these students,” she says, “and their light bulbs are coming on.”
http://chronicle.com Section: Diversity in Academe Volume 55, Issue 29, Page B9
