Introduction and Background
The nursing profession is critical to the advancement of positive health outcomes. Nurses play a crucial role in the health sector; they provide direct care in hospitals. Across the globe, the need for nurses has been on the increase. This is against the backdrop of nursing faculty shortages at various nursing institutions, which limits the capacity of the students. The result has been increased shortage of nurses in the different health facilities across the globe. In the United States of America, it is projected that the shortage of registered nurses (RNs) will keep on intensifying due to various reasons (Rosseter, 2012).
The nursing faculty shortage in the United States directly affects the overall shortage of nurses in the country. The administrators of higher education are faced with the issue of not being able to register all the qualified students to the various nursing courses due to a low number of qualified nursing faculty members. According to American Association of Colleges of Nursing (AACN), (2014) nursing schools rejected 68,938 applicants who were qualified from graduate nursing schools and baccalaureate. AACN (2014) identified the factors leading to the turn way as “insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints” (p. 3). The worsening faculty shortages in the nursing schools and health centers are a major setback to the health infrastructure. As a result, there is the need to explore the factors that have exacerbated the situation and the probable strategies to address the faculty shortage and remedy the national nurse shortage.
Significance of the Study
A study by AACN (2014) to investigate the situation of the nursing faculty shortage indicated that there was increasing vacancy rate in the profession. According to Penn, Wilson and Rosseter (2008) there are different factors that contribute to the shortage of the nursing faculty. Some of the factors include the age, few nurses who are willing to receive masters and doctorate degrees, the workload in the faculty and the alternative career choices. Therefore, the study will be critical in establishing the contemporary factors that contribute to the faculty shortage. In addition, the research provides the authorities and the government with information that can form the basis for policy formulation in order to address the issue. Furthermore, it will add to the existing knowledge. Thus, the study will contribute to understanding the reasons for the shortages of the nursing faculties and explain the need for adequate nursing faculties that have an integral role in providing high-quality care delivery.
Statement of the problem
Many studies have been undertaken to find out the reasons for the nurse faculty shortage. As noted by AACN (2014) the nurse faculty shortage is directly related to the shortage of nurses. The shortages in the nursing faculty have led to increase in the demand for nurses at the time when there is rise in the number of RNs planning to retire. In addition, the shortage of nursing faculty has been restricting the qualified students to be admitted to the universities and colleges. According to Auerbach, Buerhaus, and Staiger (2014), currently, there are large numbers of baby boomer registered nurses who have delayed their retirement. When the generation retires, the nurse workforce will suffer a significant deficit. Auerbach et al. (2014) noted that “the demand for nurses and the faculty who educate them is a serious impediment to improving the nation’s healthcare needs” (p. 179). As a result, the shortage of faculty may have an enormous influence on the preparation of the nurses to fill the gap left by the retiring nurses and the high labor turnover. The consequence will be a negative impact on the healthcare industry and delivery of care.
Research Question and Objectives
Nurses play an integral role in supporting the health system in the United States. According to Maas, Conn, Buckwalter, Herr, and Tripp (2009) the failure to understand the perceptions and behaviors that lead to nurse faculty leads to strategies that do not address the issue of faculty members and hence qualified applicants will keep on being turned away due to the inadequate teaching staff. In order to have an in-depth understanding of the situation, the study will be guided by the following research question.
- What is the primary reason for the occurrence of the shortages of nursing institutions, which are related to the limitation of the impartation of knowledge and skills of students?
- To integrate the findings of the qualitative study to determine the primary reasons for the nursing faculty shortages and the impact they have on the health care system.
- To determine the essentiality and the integral role of the nursing facilities in contributing quality health care delivery.
Methodology and Data Analysis
The research based on stepwise multi-method process consisting of qualitative research methods and comparisons. The study entailed a systematic review of literature in order to understand the issue of nurse faculty shortage. The data collection entailed an in-depth search to identify the non-reviewed literature by scanning of the various qualitative articles in electronic databases. The electronic databases used are Science direct, CINAHL, HealthSTAR, PubMed, and Medline with the focus on nursing faculty. The main reason for using the articles is because they contain peer reviewed articles. In addition, the databases provide comprehensive studies that have been carried in the area of health care. In addition, the systematic review is supplemented by expert and students opinion. The data included articles that explore expert opinion of the nursing faculty and perceptions of the nursing faculty members about the issue. The study started with a systematic review of the abstracts from the databases in order to identify the relevant qualitative reviews and exclude gray literature. The analysis of the data entailed constant comparison analysis.
Data Analysis Justification
The constant comparative analysis provides the researcher with a comprehensive understanding of a piece of data and compares it to different or similar data in order to have different perspectives on the phenomena being studied. The approach is inductive because it allows the researcher to examine critically the data and draw meaning. The constant comparative entails systematic collection of data, analysis by application of theoretical sampling in order to achieve data that can be further subjected to other statistical testing.
The search of the articles was limited to the referenced electronic databases. The articles selected for the study met the following criteria for inclusion. First, the articles focused on nurse shortage and nurse faculty shortage. Second, the selected studies must have been conducted using qualitative approaches. Third, the studies included should have focused on the perspectives and experiences of the key stakeholders (administrators and tutors). The key words used for the search in the electronic databases included nurse shortage and nurse faculty shortage. Even though the study focused on nurse faculty shortage in the US, there were no restrictions in relation to the articles from other countries. In addition, the study was limited to the period between 2005 and 2015. The research question also guided the inclusion, thus, studies that did not answer study question were excluded. Based on the inclusion criteria, eight articles were admitted into the constant comparative analysis. The table below is a summary of the findings.
|Qualitative article||Author(s) and Year of Publication||Findings|
|Registered Nurses Are Delaying Retirement, A Shift That Has Contributed To Recent Growth In The Nurse Workforce||Auerbach, D. I., Buerhaus, P. I. & Staiger, D. O |
|There are large numbers of baby boomer registered nurses who have delayed their retirement. When the generation retires, the nurse workforce will suffer a significant deficit.|
|Ensuring the availability of the nursing workforce through philanthropy: a case study.||Bolton LB, Swanson J, Zamora E |
|The number of patients seeking health care has been on the increase while the nurses have been on the decrease. Hence, the work burnout and dissatisfaction in the profession.|
|The American epidemic: The US nursing shortage and turnover problem.||Cox, P., Willis, K., & Coustasse |
|Majority of nurses are aged over 50 and there few young nurses entering the profession. The contributing factors relate to situation in the nursing schools, age, and salary.|
|Addressing the nurse shortage to improve the quality of patient care||Hassmiller, S., & Cozine, M |
|Aging of the current faculty members and shortage of nurses with doctoral qualifications prepared to fill the gaps contribute to the nursing faculty shortage|
|A continuing challenge: The shortage of educationally prepared nursing faculty.||Hinshaw, A. |
|The nursing faculty shortage has made it difficult to achieve the required number of the RNs.|
|Building bridges in academic nursing and health care practice settings.||Levin, R. F., Vetter, M. J., Chaya, J., Feldman, H., & Marren, J. |
|Workload and stressful work environment contributes to dissatisfaction in the nursing profession|
|Transitioning from nursing practice to a teaching role.||Penn, B. K., Wilson, L. D., & Rosseter, R. |
|Age, and few nurses who are willing to receive masters and doctorate degrees results in few nurses transitioning from clinical to academic profession|
|A systematic review of strategies to address the clinical nursing faculty shortage||Tran, K., & Dobalian, A. |
|Nurses with clinical background are not prepared for the faculty roles, hence, the low number transitioning to the nursing faculties.|
Discussion and Implication
The Reasons for the Lack of Nursing Faculty
Nurses play a critical role in advancing the health of the nation. According to Hinshaw (2010), the shortage of the nursing professionals has become a crisis across the globe. As such, countries such as the US have been devising measures to ensure that the number of registered nurses (RNs) is increased. The nursing faculty shortage has made it difficult to achieve the required number of the RNs. It is worth noting that the RNs account for the highest number of the health professionals in the US. Similarly, they play a critical role in influencing the health care system. The shortage of the nursing faculty has had a ripple effect on the entire health system. The shortage has affected not only the medical institutions or private doctors’ offices but also schools and universities where the lack or even absence of nurses threatens the health and sometimes even the lives of pupils and students.
One of the key reasons is the fact that nursing schools in the US have been struggling to expand their capacity to meet the required training needs. The other cause is the aging Baby Boomers (Rosseter, 2012). The number of nurses joining the profession from the nursing institutions is lower than those leaving the profession. According to Hassmiller and Cozine (2006), various reasons contribute to the shortage of nursing faculty. The study established that one of the reasons is the aging of the current faculty members. Despite the aging, there is a shortage of nurses with doctoral qualifications prepared to fill the gaps. Tran and Dobalian (2013) noted that most of the faculty members come from the clinical background and hence are not prepared for the faculty roles. Thus, the few transitioning to academics experience burnout and hence high attrition, which worsens the situation.
Rosseter (2012) noted the number of nurses joining the profession from the nursing institutions is lower than those leaving. Thus, the number transitioning from the clinical practice to academics is limited as both clinical and academics are facing shortages. A study conducted by Levin, Vetter, Chaya, Feldman and Marren (2007) pointed to increased stressors and workload. Furthermore, Hassmiller and Cozine (2006) pointed to the economic issues such as low salaries hence the nurses are potentially opting for other careers due to lack of competitive salaries and job dissatisfactions.
The Implication of Nursing Faculty Shortage in the Health Care Delivery
The nurse faculty shortage has negatively affected the health care delivery. It has led to the shortage of nurses in the nursing units and increased workload for the few nurses. A study conducted by Cox, Willis and Coustasse (2014), established that majority of the current nurses are aged over 50. The study established that several issues relate to the aging workforce. For example, increased work stressors due to chronic pain, and tiredness. There has also been a change of the patient-nurse ratio. According to Bolton, Swanson and Zamora (2014), the number of patients seeking health care has been on the increase while the nurses have been on the decrease. The result is work burnout, which has been blamed for the high nurse turnover. The work environment has become a major stressor. According to Cox et al. (2014), nurse turnover has been a recurring issue for health care organizations. The problem is caused by both economic and non-economic factors. The non-economic factors relate to the management of the nurses in terms of retaining the appropriate number, overburdening the nurses, poor work environments and lack of incentives to attracts quality nurse. The combinations of these factors lead to compromised health care delivery across the nation.
Nurses play an integral role in the health care system. The shortage of nursing faculty limits the progress of qualified students who intend to become nurses. The nursing shortage in the US has also affected the health care delivery. The study established that there are myriad of factors that contribute to the nursing faculty shortage. The qualitative study established that there are economic, personal and administrative factors that lead to the shortage. For instance, the number of nurses transitioning from clinical practice to academic has been very low due to the salary issues and work dissatisfaction caused by the work stressors and nurse burnout. Therefore, the findings provide a useful qualitative basis from which strategies can be drawn to address the nursing faculty nursing and the overall nurse shortage.
American Association of Colleges of Nursing. (2014). The impact of education on nursing practice: Fact sheet. Web.
Auerbach, D. I., Buerhaus, P. I. & Staiger, D. O. (2014). Registered nurses are delaying retirement, a shift that has contributed to recent growth in the nurse workforce. Health Affairs, 33(8), 1474-1480.
Bolton, L. B., Swanson, J., & Zamora, E. (2014). Ensuring the availability of the nursing workforce through philanthropy: A case study. Nursing Administration Quarterly, 38(4), 327-331.
Cox, P., Willis, K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Insights to a Changing World Journal, 14(2), 1-4.
Hassmiller, S., & Cozine, M. (2006). Addressing the nurse shortage to improve the quality of patient care. Health Affairs, 25(1), 268-274.
Hinshaw, A. (2010). A continuing challenge: The shortage of educationally prepared nursing faculty. Journal of Issues in Nursing, 6(1), 1-14.
Levin, R. F., Vetter, M. J., Chaya, J., Feldman, H., & Marren, J. (2007). Building bridges in academic nursing and health care practice settings. Journal of Professional Nursing, 23(6), 362-368.
Maas, M. L., Conn, V., Buckwalter, K. C., Herr, K., & Tripp, T. (2009). Increasing nursing faculty research: The Iowa gerontological nursing research and regional research consortium strategies. Journal of Nursing Scholarship, 41(4), 411-419.
Penn, B. K., Wilson, L. D., & Rosseter, R. (2008). Transitioning from nursing practice to a teaching role. Journal of Issues in Nursing, 13(3), 1-19.
Rosseter, R. (2012). Nursing shortage fact sheet. Web.
Tran, K., & Dobalian, A. (2013). A systematic review of strategies to address the clinical nursing faculty shortage. Journal of Nursing Education, 52(5), 245-351.