The Future of Nursing – Anticipated Shortage On Hold

The expected nursing shortage in the U.S. is well-documented. November 2007 projections from the U.S. Bureau of Labor Statistics show more than 1 million new and replacement nurses will be needed by 2016. In Michigan, the predicted nursing shortage remains on the books, but it has been delayed by the economy.

“Our retention of nursing staff has been excellent since the recession started,” explains Amy Palmer, nurse recruiter at Borgess Hospital and Medical Center in Kalamazoo. “We are fortunate today. Nurses who are eligible to retire aren’t retiring as expected. Nurses that were once part-time have opted in for full time schedules. On the other hand, we are hiring fewer recently graduated nurses, which could be a problem when the economy is better and boomer-age nurses take retirement.”

As a response to the labor shortage, as well as the need to increase the number of qualified teaching faculty for nursing schools, several schools now offer a degree in the Doctor of Nursing Practice (DNP).

Madonna University, located in Livonia, first offered courses for this terminal professional degree in May 2009.

With the American Association of Colleges of Nursing targeting 2015 as the date for bumping up the required level of preparation for advanced nursing practice from a master’s degree to the DNP, Teresa Thompson, Ph.D., dean of Madonna’s College of Nursing and Health, says more graduate nurses will be involved in easing a predicted shortage.

“Close to one third of those graduating will become part of a nursing school faculty which addresses the predicted national shortage,” says Thompson.

The DNP at Madonna, a clinical doctorate degree designed to develop health care leaders to improve the quality of care, reduce costs, and increase access to health care, may also help nurses meet the changes and challenges that are coming with new developments in health care policy.

Nicole Stein, who holds a master’s in nursing and is enrolled in Madonna’s doctoral program, agrees.

Teresa Thompson, dean of Madonna University’s College of Nursing.

“Currently there are more nurses seeking employment in Michigan than are being hired,” says Stein. “Unfortunately, they are having difficulty obtaining positions because of the economic crisis. I think it’s important to encourage nurses to further their education. Most hospitals offer some form of tuition reimbursement and schedule flexibility to help hospital nurses continue their education. I see part of my responsibility as a DNP student is to encourage and mentor other nurses and be a role model as someone who can work, have a family, and continue my education.”

Doctoral programs in nursing are aimed at preparing students for careers in health administration, education, clinical research and advanced clinical practice. An important outcome of the creation of the DNP degree is to help address the nationwide shortage of nursing school faculty.

“Nursing education is evolving,” says Linda Scott, associate dean for graduate programs at Grand Valley State University’s Kirkhof College of Nursing, based in Grand Rapids.

“As the complexity of health care increases, nurses need to be better educated for better patient outcomes,” continues Scott, who this fall will be inducted into the American Academy of Nursing for her research on staff nurse work hours and the impact of work schedules on patient safety. “Eight of the 20 students in our DNP program this year already have master degrees. Some of the program graduates may well become teaching faculty, others will choose nursing administration and other advanced nursing, but all will provide higher quality nursing.”

Erika Duncan, director of talent acquisition for Spectrum Health Hospitals, also located in Grand Rapids, says future staffing remains a challenge, even if the immediate need is not pressing.

“Our turnover rate for nurses is low so we’ve been able to replace the RNs we needed and most of the specialty nurses,” notes Duncan. “The nursing schools are meeting our needs for qualified nurses. Even so we are planning ahead. For instance, we expect to open a new Children’s Hospital in 18 months and plans are in place for staffing. As consumer expectations rise for better health care, we’re making sure we meet those demands.”

Oakland University, based in Rochester, was first to offer the DNP program in Michigan in 2006.

“We started the program to address the predicted nursing shortage by offering accelerated programs at the highest level for clinical practice,” says Frances Jackson, Ph.D., director of the school’s Nursing Practice Degree program. “We believe the program is important for training more nurse educators to fill the nursing shortage and to improve patient care.”

The Oakland DNP program can be completed in two years of full-time study building on master’s level content and providing doctoral-level courses in research methods.

“This program supports graduates in leadership roles in the health care system and gives them more abilities to initiate change in clinical settings and to do clinical teaching,” says Jackson. “We expect our graduates to pursue careers as clinical leaders in the health care system, policymakers in government and entrepreneurs in the health care industry.”

Oakland University offers its DNP coursework to nurses with master’s degrees in nine other states through its Elluminate video conferencing service.

“Our model is rather unique in that the online students never come to our campus until graduation,” explains Jackson. “Everyone does gather locally every few months, but the live lectures take place at the hotel where the students stay for a few days, usually on weekends.”

At Beaumont Hospitals, based in Oakland County, Mich., nursing shortages may not be front and center, but officials there remain cautious as they look ahead to an economic rebound and the inevitable retirement of older nurses.

Linda Scott is the associate dean for graduate programs at Kirkhof College of Nursing, Grand Valley State University.

“We have a lot of nurses that are aging baby boomers which makes our future nursing assignments more vulnerable for a shortage,” says Linda Kruso, Beaumont’s director of workforce planning. “Right now our vacancy rate is just 1 percent and we are taking this window of time and working on a strategic plan so there will be nurses in our pipeline. We are collaborating with various nursing schools and hire what we consider the best from each graduating class.”

With a nursing staff of about 5,400, one Beaumont strategy is retention, notably through flexible scheduling and even student loans in exchange for working with the hospital upon graduation.

Not all nursing professionals agree with the idea that advanced nursing training will ease the projected shortage.

One is Linda Bez, a nurse who teaches at Dearborn’s Henry Ford Community College and who takes nursing students through clinical rotations at Garden City Hospital.

“I don’t see how getting nurses back into the classroom is going to help the predicted shortage because graduates will receive more income as administrators or in private practice than as teachers,” says Bez, who has taught nurses for close to 30 years. “I am concerned about whether this advanced program benefits the schools of nursing more than it does the nurse and patient welfare.”

Only time and the economy will show for certain how advanced education will affect the nursing profession now and in the future.