ECU@SOSU nursing students Karen Holiday, Dana Danderson, Sabrina Durant and Brandie Gray participate in a clinical day at the Choctaw Nation Health Care Center in Talihina, Oklahoma.
Providing baccalaureate nursing education in a culturally diverse rural setting affords unique opportunities and challenges for faculty, administration and students–especially when that education is delivered via interactive television. This article will describe how East Central University (ECU) and Southeast Oklahoma State University (SOSU) joined resources to offer a distance learning extension of ECU’s baccalaureate nursing program at SOSU.
For more than 30 years, ECU has been the only baccalaureate nursing program serving southeastern Oklahoma and north Texas. Both ECU and SOSU are situated in southeast Oklahoma, which is home to the Chickasaw and Choctaw Nations’ tribal headquarters. ECU’s service area consists of 22 counties, 20 of which are federally designated as medically underserved. Approximately 35% of the university’s nursing majors self-identify as American Indian and a high percentage of nursing majors are first-generation college attendees. There is a higher percentage of American Indian students enrolled in nursing compared to the average percentage of American Indian students enrolled on both the ECU and SOSU campuses in other academic majors.
In the mid 1990s the Oklahoma State Regents for Higher Education urged academic institutions to work collaboratively to preclude program duplication. The presidents of both ECU and SOSU enthusiastically supported this concept and directed their respective vice presidents of Academic Affairs to proceed with establishing the ECU baccalaureate nursing program at SOSU. The goal of our joint project has been to provide a quality baccalaureate nursing educational experience to students enrolled on both campuses. Another major goal has been to enhance cultural experiences for our nursing students, with an emphasis on American Indian culture.
First of Its Kind
This project was unique in that there were no similar collaborative programs in Oklahoma at the time. Prior to this, a number of academic institutions in the state had delivered courses and programs electronically to other institutions. However, the difference between our project and other existing collaborative programs is that ECU placed a program coordinator from its faculty, Dr. Deborah Flowers, on-site at the SOSU campus. Other unique aspects of the collaboration were signing an articulation agreement with SOSU to accept its general education and science support courses in ECU’s program, agreeing to financial aid arrangements and having ECU award the degree.
Establishing the nursing program extension was technically challenging, because the ECU courses needed to be reformatted for live electronic delivery over the State Regents’ One-Net system of two-way interactive digital television (ITV) and enhanced with WebCT. Since the nursing faculty had no previous experience in distance education, ECU administration supported their efforts to attend conferences in order to learn these skills. In addition, laboratory space and equipment and clinical experiences had to be planned.
To fund the project, the Oklahoma State Regents for Higher Education provided ECU with a continuing special appropriation of $250,000 (now reduced by budget cuts to about $225,000) and provided SOSU with a one-time $100,000 allocation to build and equip an ITV classroom and office space. Additional funding was achieved through a U.S. Department of Health and Human Services, Health Resources and Services Administration grant funded through the Division of Nursing’s Basic Nursing Education and Practice program (BNEP). The grant, Extending Baccalaureate Nursing Education to Rural Oklahoma, was funded in 2000 for approximately $800,000 over three years. A second grant, Nursing Education with Enhanced Retention Activities (NEW ERA), is now in progress.
Community support to establish and retain the cooperative program has been outstanding. Local health care employers seek our nursing graduates and have actively supported our program. Clinical facilities and the Chickasaw and Choctaw Nations have funded professorial chairs to assist with faculty salaries. Two clinical facilities assist with part-time clinical faculty salaries. In addition, the Chickasaw Nation donates two textbooks to each entering sophomore student: R.E. Spector’s Cultural Diversity in Health & Illness (Sixth Edition) and Twiname & Boyd’s Student Nurse Handbook: Difficult Concepts Made Easy (Second Edition).
Setting the Stage
Once the full-time on-site program coordinator was designated, we needed to create a name for the distance education nursing program that would be acceptable to both schools. This required some political sensitivity, because for many years a rivalry had existed between the two institutions. After a certain amount of discussion, the name chosen for the program was ECU @ Southeastern Department of Nursing (ECU@SOSU).
The next step was the development of the distance education site. Specific activities we needed to accomplish included:
1. Developing a liaison between ECU and SOSU and establishing relations with key persons and departments at SOSU.
2. Designating space for the new department, staffing it, and equipping it.
3. Developing policies and procedures relating to requirements for general education, nursing prerequisites, course substitutions, transference of financial aid, student registration and enrollment, and student transfers between campuses, as well as adapting existing ECU Department of Nursing policies and procedures for ECU @ Southeastern nursing students.
4. Developing and implementing a media plan for recruitment of a qualified student applicant pool.
5. Establishing clinical sites in the surrounding area and hiring clinical instructors.
6. Ensuring equal access to quality nursing education for students at both schools, including access to campus resources, student support services, student nursing organizations and faculty advisement.
The ECU @ Southeastern Department of Nursing was placed under the auspices of the SOSU Department of Biology, a division of the SOSU School of Arts and Sciences, with the chain of command beginning with the chair of the Biology Department. We held meetings with the various department personnel with whom the ECU@SOSU program coordinator would be working. Qualified Department of Nursing office personnel were hired and the department’s computer, basic skills and physical assessment laboratories were fully equipped to replicate ECU’s laboratories. The SOSU Telecommunications Department oversaw the installation of two state-of-the-art ITV classrooms.
To ensure adequate numbers of qualified prospective students from which to select a nursing class, the ECU @ Southeastern Department of Nursing advertised to the SOSU catchment area, using a recruitment/media plan developed with input from an American Indian consultant and the ECU public relations director. The program coordinator, Dr. Flowers, met with nursing administrators to select qualified clinical sites; contracts were signed as per ECU protocols. Locating qualified clinical faculty in this rural setting was a challenge, but having available ECU graduates in the area has been an asset.
An articulation agreement between ECU and SOSU was developed, delineating the specific responsibilities each university would assume in the education of the ECU@SOSU students. Both university presidents signed the agreement.
All of these activities took place over approximately 18 months while the distant site became operational. The first cohort of students to graduate from the ECU @ Southeastern Department of Nursing did so in 2002.
Focusing on Retention
While our first HRSA grant project focused on initiating a baccalaureate nursing program at SOSU, the current project is focused on student retention and successful graduation. Because of concern that the new nursing department’s retention rate was not as high as anticipated, we developed the second project with the goal of increasing retention in order to increase the workforce of culturally competent professional nurses who would be able to serve the area’s diverse communities. Nursing faculty and students in the ECU@SOSU program are involved in a variety of retention activities. Some activities are didactic, others emphasize student orientation and advisement.
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From the beginning, students are introduced to retention activities as part of their program acceptance packet. In an effort to communicate college expectations to students and their families, the department holds a “Back to SchoolNight” for students and their significant others. The event is conducted in the first few weeks of the sophomore-level course and is transmitted via ITV with some nursing faculty at each site. The department chair welcomes students and guests, explains the program and underscores the students’ study time expectations. Each faculty member is introduced and the respective department sites are open for tours. This event also provides an opportunity to introduce and explain specific retention activities, particularly the Individual Observational Experience and the department’s friendly “invasive advisement.”
Invasive advisement is a proactive advising approach that the department has adopted. Following each unit exam, the project retention coordinator communicates with each student via the course Web site. Students are sent notes, which vary in content based on their test grades. Students in academic jeopardy are asked to make an appointment with the course coordinator or faculty to discuss issues that may be impacting their performance. The students are asked to identify work hours, study techniques and any other factors that may be affecting their academic success. Then faculty members assist the students in planning interventions, including referrals to university services, such as counseling for test anxiety, support services for study and test-taking skills, and tutoring arranged by ECU’s Native American counselor. The faculty document each advising session.
Individual Observational Experiences (IOEx) are offered to each sophomore-level student enrolled in the first clinical course. Students participate in a four-hour clinical observational experience in their choice of clinical settings. Four local clinical agencies generously pair staff nurses with students, most of whom have never worked in a hospital setting. The goal is to offer a realistic look at nursing from a “real” nurse’s perspective. The project director coordinates IOExs in concert with the Human Resources or nursing office staff at the participating health care facilities.
In addition, faculty have designed in-class activities, called Teaching-Learning Cultural sessions (TLCs), which promote student retention. TLCs are concentrated, lively 10- to 15-minute weekly sessions that cover a multitude of topics, such as health promotion, stress reduction and how to form an effective study group. For example, students may be asked to complete a schedule of their week, evaluate quality study time and determine realistic study goals. The schedules become the basis for TLC class discussion about time management. TLCs can also incorporate cultural or pathophysiologic topics relevant to the class lecture material.
Plus, clinical cultural sessions are held monthly during post-conference in most major clinical junior- and senior-level courses. Students from both the ECU and SOSU campuses attend these sessions to discuss cultural aspects of nursing care. Clinical faculty develop the sessions and facilitate discussion, which is held via ITV. For example: Students assess their assigned patient’s traditional health beliefs or home health practices, then share this information with their student colleagues. As part of the discussion, students also share their own family’s traditions. Additional clinical topics include beliefs related to the dying process, diabetic care and cultural or ethnic assessment findings. The textbooks by Spector and Twiname & Boyd serve as a springboard for both TLCs and clinical cultural sessions.
A culminating senior-level cultural experience occurs in the Community Health course. Students plan, implement and evaluate health career fairs and health assessments at local elementary and secondary schools that have a high percentage of American Indian students.
Bridging Boundaries
Developing and implementing this technologically complex collaborative project was often challenging, but the results we have achieved together have been more than worth it. Our first grant project’s goal of bringing baccalaureate nursing to rural southeastern Oklahoma has been successfully met: We have a vibrant extended nursing department which is flourishing in the distance education environment.
NCLEX-RN® pass rates are consistent across the two campuses and exceed the national average. This fall semester, the senior class will be the largest we have ever had, with 60 students. This represents a two-year average increase of over 10 students. The junior class has retained 71 of the original 74 students. Preparation of a new ITV classroom is in progress to accommodate the larger ECU campus site class size. We continue to maintain a higher enrollment of Native American students in the nursing program than the overall average percentage on both the ECU and SOSU campuses.
We have bridged many boundaries to build the ECU @ Southeastern Department of Nursing, not the least of which was the longstanding rivalry between the two educational institutions. Initially the two campuses had separate student nurse organizations, but now the two organizations are merging. Most clinical agencies in the area have been eager to accommodate ECU@SOSU nursing students and faculty.
By extending ECU’s program to a sister university with an equally diverse student population, we have increased the accessibility of a baccalaureate nursing program that is well established and fully accredited. We continue to maintain a philosophy of providing quality nursing education to all students regardless of which campus site they attend. Faculty physically travel to ECU@SOSU to originate at least 25% of didactic class sessions. The instructors’ sensitivity to promoting distant students’ class participation has been integral in achieving inclusiveness.
Classroom and clinical activities are designed to enhance student interaction across both campuses and to increase cultural sensitivity. Every junior-level student has at least one clinical day at the Chickasaw Nation’s Carl Albert Indian Health Facility. ECU campus senior students travel to the ECU@SOSU campus for selected class activities. The program’s clinical cultural sessions and TLCs receive positive evaluations from the students.
An important benefit of this project is that we are helping to alleviate minority health care disparities in our area by reaching out to surrounding diverse communities to recruit our nursing students. We also conduct clinical activities in predominantly Native American secondary schools. In one of these schools, our senior Community Health students have conducted physical assessments and health career fairs for six years; the high school students look forward to the nursing students’ activities. Altogether, approximately 200 grade school and high school students per year participate in activities planned by our nursing students. At least one of these pre-college students has indicated that she plans to enroll in our nursing program when she graduates.
Most of the nurses we prepare at ECU and at ECU @ Southeastern remain in the area after graduation. Thus, our project has increased the numbers of culturally diverse professional nurses in the rural Oklahoma health care workforce. As more baccalaureate-prepared American Indian students continue to graduate from our program and embark on nursing careers, they will be able to provide enhanced culturally sensitive care to underserved populations who urgently need it.
Authors’ Note
The authors gratefully acknowledge the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing for its financial support of this project. We also wish to express our gratitude to the administrations at ECU and SOSU, and to the ECU Department of Nursing’s faculty, staff and students.
Harvey “Skip” Davis, RN, PhD, switched from full-time student to full-time nursing educator this year after completing his doctorate last summer. Then, he says, his education began in earnest.
“The transition has been daunting at times,” the San Francisco State University assistant professor admits. “The amount of actual work required between teaching, serving on committees and my research has been the biggest surprise. Teaching a class is actually the easiest thing I do.”
In addition, Davis is the only person of color on the nursing faculty and one of only two men.
That situation is all too common at many of the nation’s nursing schools, but it’s slowly beginning to change. Today, more and more academic institutions are aggressively seeking out racial, ethnic and gender minority nursing faculty, just as they’re trying equally hard to diversify their student populations.
For minority nurses who are just starting out as faculty members, getting on the right career path in academia requires navigational skills that Magellan would have envied. Should you choose a tenure- or non-tenure-track position? Would you be happier at a historically minority-serving institution? Will your college support your research efforts?
Completing a graduate degree is, of course, the first step toward getting on the faculty career track. After that, many different doors are open to you. Entering the right one is critical, not only for your professional advancement but also for your personal fulfillment. Just be sure to keep your expectations realistic.
Alone in a Crowd
Because nurses of color and male nurses are still extremely underrepresented in the ranks of nursing school faculty, many minority junior faculty starting out their careers at majority schools are likely to find themselves in a position similar to Davis’. While you would think that the enlightened, intellectual halls of academe would be free from prejudice and discrimination, the unfortunate reality is that this isn’t always the case. Davis knew this and he set out to find a university that would welcome him not only as a nurse educator but also as an African-American man. His first priority, however, was to become part of a high-quality educational institution, and SFSU’s reputation among area health care providers for graduating well-prepared nurses was the initial attraction. He looked at several schools, though, to make sure his gender wouldn’t hamper his career progress.
“Male faculty members need to ask questions to make sure you avoid [schools that aren’t welcoming to men],” he explains. “I’m pretty straight to the point. I ask if there’s a feminist philosophy. Do that and listen to the various responses you receive from members of a search committee. You’ll be able to figure out quickly if men are welcome.”
While it’s advice heard often, nursing education leaders recommend that minority faculty members who are victims of bias speak up and work within the institutional framework to address the issue. Begin with your supervisor or, if that’s not feasible, with the equal opportunity officer of the division or the college.
Minority professors looking for a completely prejudice-free campus, though, are unlikely to find it. “Sometimes you may feel that no matter how much you do, it’s never going to be enough to achieve the status of your non-minority colleagues. Just do the best you can do, give it 100% and then let it go,” advises Barbara Broome, RN, PhD, CNS, assistant dean and chair of community/mental health nursing at the University of South Alabama College of Nursing in Mobile. She is also president of the Association of Black Nursing Faculty.
The faculty lounge is not the only place on campus where minority professors may encounter insensitivity based on race or gender. Roxanne Struthers, RN, PhD, has the luxury of being one of three American Indian nursing faculty members at the University of Minnesota at Minneapolis. Still, she often faces an entirely Caucasian classroom.
“The student body is often very monocultural and that’s hard sometimes for faculty,” she says. “It’s important to know how to teach about [other cultures] and how to be proactive to help students understand. They’re not going to get it from their classmates.”
Struthers, an assistant professor in nursing and an adjunct professor in the university’s American Indian Studies department, encourages other minority faculty to take advantage of their captive audience and view it as an opportunity to educate majority students about minority cultures. One way to do that, she adds, is simply by making yourself available and listening to questions with a nonjudgmental attitude. “Encourage questions even though they may not be politically correct or may even seem uncomfortable or out of the ordinary.”
Struthers also refuses to let student attitudes influence her own. “One of the things I notice about students,” she says, “is that because I am a member of a minority group and they are not, they have a tendency to act as if I’m invisible. They go on and on talking about everything under the sun as though I’m not even there. It’s as though they think I’m not on their level. I just delve into class when that happens. I don’t say anything and I don’t let myself get frustrated.”
Historically Minority Schools: A Haven for Minority Faculty?
Teaching in a Historically Black College or University (HBCU), a Hispanic-Serving Institution (HSI) or a Tribal College or University (TCU) may seem like the perfect alternative for professors of color who want to avoid the potential for prejudice they might find at a majority school. But while choosing this option may increase your comfort level on campus, it doesn’t completely banish the specter of discrimination. Majority nurses are often unaware of the rich academic and social traditions of historically minority institutions and may incorrectly perceive those schools–and their faculty–as second-rate.
“There’s a misconception that because a school is historically black, there’s always an open admission policy or that students come here because they can’t make it in a majority institution,” says Alma Dixon, RN, EdD, MPH, dean of nursing at Bethune-Cookman College, a historically black college in Daytona Beach, Florida. “That’s simply not true.”
Most students, she argues, are drawn to HBCUs because of their academic excellence, the nurturing environment and the strong traditions. In fact, many students choose to attend them because of the positive experiences their parents had as students at historically black colleges.
“Certain sororities and fraternities are well-recognized within the black community and are only present on black campuses,” Dixon emphasizes. “People come here to share in that experience and tradition. That’s why I want my son to go to a historically black college.”
Teaching at a traditionally minority nursing school offers many rewards, but also presents its own unique challenges. Because these institutions are typically smaller schools, one of the biggest challenges, says Dixon, is staying financially sound. While no one becomes a nursing professor to get rich, faculty members and administrators at financially strapped universities often must stretch to make sure the budget can cover the entire semester.
“At a historically black college, you’re always mindful of money, “ Dixon explains. “You are always aware of what things cost. My colleagues at several state institutions are facing this now for the first time. You have to carefully weigh which conferences you’re going to attend. Traveling needs to be very cost effective, so that may mean two faculty members sharing a room or driving instead of flying.”
An indirect benefit of tight budget constraints is a constant focus on student retention. Dixon says that’s common to all private institutions, not just historically minority schools.
“In private institutions, you are always aware of how tuition translates into revenue,” she adds. “There’s a greater focus on retaining students and that creates a challenge in and of itself: keeping students while still maintaining your commitment to academic excellence.”
Getting the Right Fit
Teaching at a university that’s not a good fit for your interests and your style can be far more uncomfortable than wearing shoes that are a size too small. Dixon believes the most important thing to do when shopping around for a teaching position is to first do a thorough self-analysis.
“You have to know what you’re looking for and what your interests are,” she says. “Then, if you’re comparing different faculty positions, you need to know what the mission of the school is and how that plays out. Research may be stressed at one college, service at another.”
Most schools value a combination of teaching, research and service, but not necessarily in that order. You need to look at how your working hours will be allotted to determine which of those three will be most important.
“At our school, teaching is more important than service and research,” Dixon continues. “Here, you’re expected to have so many teaching hours and so many office hours. If you have a research project that’s going to take up three days every week, it would never work at this school because of the teaching and nurturing demands.”
Antonia Villarruel, RN, PhD, FAAN, associate professor and director of the Center for Health Promotion at the University of Michigan School of Nursing in Ann Arbor, says it’s important to make sure you know all the details about the school’s faculty evaluation system before walking into the classroom.
“I am fortunate to be at a place where being a director is not just an added responsibility. It’s considered part of my workload,” she comments. “That’s an indication of the school’s commitment to my research.”
Indeed, one of the reasons why Villarruel, a past president of the National Association of Hispanic Nurses, accepted the position at the University of Michigan is because the school allows her to grow in her specialty areas, which are preventing HIV infection in Latino youth and health promotion. “If a university tells you they value research and then gives you a very heavy teaching load, it’s going to be tough for you if you want to do research,” she says.
Dixon also advises beginning faculty to watch out for red flags that may signal hidden problems at the school. One example would be a low passing rate on the NCLEX-RNâ exam.
“This is a hard thing for us to talk about,” she says, “but you need to find out what the student success rate is. If the school is struggling with constant program reports to the board of nursing, that’s going to be an intense cloud hanging over the institution. I would want to know about problems like that before I signed on. At least going in I would know where the focus is. I would expect a lot of my energy to be consumed in making sure students pass that exam.”
Tenure: The Brass Ring?
Davis has just completed his first year in a track that will eventually lead him to tenure, that magical milestone sought and treasured by most faculty members.
“It’s a big rite of passage,” says Villarruel. “Every faculty member has a ‘tenure story’ to tell. The destination is the same but the journey is different. Everyone has encountered different roadblocks and figured out different paths.” She encourages minority faculty to share their stories as a way of learning from each other.
Most tenure tracks are seven years long. To reach tenure, professors are usually required to show excellence in the areas of teaching, scholarship and service to the university.
Teaching excellence can be measured in several different ways, the most common being the dreaded student evaluations. Some schools also evaluate faculty on the basis of student performance on standardized tests and use peer evaluations.
Scholarship means a track record in research and it is usually measured in two ways. First, faculty members are encouraged to bring grant money for research projects into the university. Second, they’re expected to publish their research results.
“Some people say that the research project isn’t finished until the articles are published,” says Villarruel. “You can have a wonderful project but if the world doesn’t know about it, it’s a moot exercise.”
Service can be measured in many ways and can mean different things at different institutions. “At some schools, it can be service to a professional organization,” Villarruel explains. “At others, it has to be service at the university. So it’s very important to know how you will be evaluated.”
While tenure is still highly valued, it has lost some of its glitter in recent years. Today, tenured professors no longer have reason to relax and stop worrying about having to prove themselves.
“In the past, tenure did bring a certain sense of job security and a certain amount of prestige,” says Villarruel. “Now, universities do post-tenure reviews and evaluations. You still have to do research and publish and continuing performing at the expected level.”
If the pressures associated with becoming tenured seem too stressful for you, or if you’d rather skip the research and service aspects of faculty positions, Broome suggests you consider a non-tenure track.
“Be aware of all the different roles and options that are available to you in academia,” she counsels. “Going into a non-tenured track allows you to focus only on teaching and clinicals.”
Broome does, however, caution new instructors to realize what they are giving up by not pursuing a tenure track. Non-tenure teaching tracks offer very limited, if any, research or publishing opportunities. Teaching loads will be very heavy, reducing time available to participate in other aspects of university life. Non-tenured faculty may also be paid less and be the last to be considered for professional development opportunities.
Aiming Higher
While many nurse educators thrive on daily classroom interaction with students, for others the classroom is just the beginning. A career in academia can offer minority nursing faculty many opportunities to advance into administrative and leadership roles, including department chair, dean, curriculum developer and education policy-maker.
“I love teaching, but I wanted to do more,” says Broome. While she has only been an assistant dean for a little over a year, she’s very pleased to have moved up to a position that allows her to have some influence on the future of nursing education.
“It’s good to be involved in helping to make changes that will benefit students,” she continues. “I also have the opportunity to be supportive of faculty and I am in a position to be an advocate for them.”
Broome advises junior faculty hoping to climb the academic career ladder to do so in small steps. One the most important breaks in her career came when she relocated to the University of South Alabama to assume a chair position.
Both Broome and Dixon credit previous clinical managerial positions with helping them develop the leadership skills needed to succeed in academia’s higher levels.
“Having a leadership position in a hospital gave me a clear view of the practicing environment of nursing, and I’ve never lost sight of it,” Dixon explains. “You do need a strong clinical experience [even in an academic setting].”
She also advises nursing faculty members to leave the security of the nursing department and venture out into other areas of the campus. For example, she says, get involved with university-wide faculty senates, seek out committee assignments that match your interests, and network with non-nursing faculty.
However, just as administrative experience and leadership skills can help you rise to a new role, making a few critical mistakes will block your path. One of the biggest “don’ts,” says Broome, is burning your bridges behind you.
“Nursing is a very small world,” she cautions, “especially when that world is narrowed down to minority faculty members. There are still so few of us that you will practically get to meet most of them during your career. Never forget where you came from. It’s been said that you meet the same people on the way down that you passed on the way up, and I think that’s true.”
Getting Along
In the business world, the process of fitting in with your employer’s company philosophy, goals and style is known as “navigating the corporate culture.” Similarly, every academic institution has its own personality and it’s the wise faculty member that learns its rules early. Perhaps even more important is learning how you function inside those rules, which are often unwritten.
Playing politics, though, can derail your career and your enjoyment of training future nurses.
“Don’t get caught up in things that may not pertain to you or in things you cannot control,” says Villarruel. “As a faculty member, you have enough on your mind.”
Broome advises junior faculty members to find other instructors with whom they can build networks of support. Alliances, after all, aren’t just limited to reality TV shows.
“Faculty circles do have cliques,” she says. “There are certain people you will be able to work well with regardless of color and you should seek those people out and form alliances to further your work.”
Still, if you are a racial or gender minority faculty member teaching at a majority school, it’s empowering to be able to network with colleagues who look like you. But since this is not always possible, all of the educators interviewed for this article stress the importance of becoming involved in minority nursing associations.
Davis encourages young faculty members not to overlook the opportunity to learn from nurses who are different from you. He says he’s grown and benefited from the support of many female nurses. “The reality is that this is a woman-dominated field,” he adds. “You will find many willing mentors who are women and have different things to offer. Just listen and take what you think will work for you.”
Last summer, I was approached on campus by an African-American nursing student who said to me: “I have been waiting to meet you. I didn’t know your name or what you looked like. But I was looking for someone [on the faculty] who looks like me. And if I didn’t find you, the university administration would have to answer to why.”
This incident dramatically illustrates the frustration many minority students feel concerning the shortage of minority faculty in the nation’s schools of nursing. While minority student enrollment in college and university nursing programs continues to increase, this growth has not been matched by minority faculty hiring.
Students and teachers alike recognize the importance of providing role models for both minority and majority students in an academic environment of diverse cultures and ethnicities. In particular, the lack of professional role models for students of color within an increasingly diverse U.S. population threatens to result in educational deficits for our minority youth—deficits that could damage America’s future prosperity and our ability to compete in the educational arena with other industrial countries around the world.
Several factors have been identified as contributors to the minority teacher shortage. One of the most troubling and significant of these is a general decline of interest in the teaching profession, partly as a result of non-competitive faculty salaries and slower rates of academic promotion. Furthermore, because the median age of full-time nursing faculty in 1998-99 was 50 years, early retirement programs are taking their toll on the faculty supply.1, 2
Clearly, greater efforts to recruit and retain minority nursing faculty are urgently needed.3 However, a solution to the crippling shortage of minority faculty is unlikely to be achieved without some major adjustments in thinking and methodology on the parts of both nursing school faculty search committees and nurses of color who hope to pursue teaching careers.
The Four Cs
Based on my own experience as a black faculty member teaching at a predominantly white institution, I believe the keys to success in recruiting and retaining minority nursing faculty can be summed up by “the four Cs”—commitment, concern, collaboration and creativity.
Nursing schools must demonstrate commitment and concern about tackling the shortage of minority faculty by providing leadership and sufficient revenues to launch a successful recruitment campaign. Current minority faculty can also provide this commitment from a personal standpoint. A few years ago, when I was the only black faculty member at my institution, I resolved that instead of just complaining about the situation or being passive, I would actively commit myself to improving minority faculty recruitment efforts: I volunteered to chair the university’s faculty search subcommittee.
The third C, collaboration, means there must be active involvement, networking and joint efforts between all concerned parties—not just the search committee but also faculty members, administrators and student representation.
Creativity is perhaps the most overlooked factor in the entire process. Successfully recruiting minority nursing faculty requires both a clearly defined, targeted plan for search efforts and the use of innovative strategies to locate and advertise for minority candidates. This means using not just the traditional sources, such as the Chronicle of Higher Education and AACN journals, but specifically targeting places where minority faculty are likely to be looking for positions—such as local minority media, minority professional organizations and minority colleges.
Creativity also plays a key role in the retention of minority faculty once they are hired. Minority faculty should be offered more opportunities to serve as chairs of committees instead of just committee members. They should also be incorporated into decision-making processes affecting all facets of college life. This can be achieved through a thorough orientation process that promotes collegiality, support and commitment.
Finally, schools of nursing must provide mentoring and growth opportunities for minority faculty members. This can be done by empowering them to assume leadership roles within the institution, by providing opportunities for research and publications through research support programs within the nursing department, by providing clinical or field placements at ethnically diverse institutions and by encouraging seminars that foster cultural sensitivity.3
Bringing the Right Tools to the Table
The other crucial lesson I learned from becoming personally involved in the minority faculty search process was that many of the candidates who apply for faculty positions —and especially the minority candidates—are simply not prepared for careers in academia. This is largely because many would-be nurse educators possess substantial experience as clinical nurse specialists or clinical educators but lack the specific criteria that nursing schools typically use to determine qualified faculty.
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Nurses of color who hope to successfully make the transition from the clinical setting to academia must be acutely aware of how faculty search committees will be evaluating their background—and must be fully prepared to meet these criteria. Here is what you will need to bring to the table:
• Education in the area in which you want to teach. Search committees look for education in the form of a terminal degree (PhD, EdD, DNSc, MSN, etc.). The more closely your degree is related to nursing and the specialty area required for the position, the more highly you will be evaluated. If you want to be a professor of nursing, do your doctorate in nursing. If you want to teach a certain nursing specialty, make sure your master’s degree is in that specialty.
• Teaching experience. Don’t expect to land a job as a university professor unless you have some type of experience teaching college-level students. I often recommend starting out as an adjunct, or even teaching in a diploma or associate degree nursing program, to get your feet wet in this crucial area.
• Solid clinical experience. Faculty search committees look for extensive, full-time clinical experience—rather than part-time or short-term experience—that is concentrated in the candidate’s nursing specialty.
• Published scholarship and research. Many minority faculty candidates are especially lacking in this type of experience. Look for opportunities to build a track record by writing and publishing articles in peer-reviewed nursing journals, presenting poster or podium sessions in peer-reviewed forums and conducting independent research.
• Professional and community involvement. This component is critically important. It is not enough to simply belong to your state nursing association or a professional group such as the National Black Nurses Association. Faculty search committees evaluate candidates on the number of professional organizations they belong to, as well as the leadership positions they have held in those organizations. Similarly, active involvement in community service is seen as another key indicator that the candidate is a well-rounded, committed individual.
References
1. American Association of Colleges for Teacher Education, 1989. 2. American Council on Education, 1997. 3. Washington, L. Joyce (1999). “Expanding Opportunities in Graduate Education for Minority Nurses,” Journal of the National Black Nurses Association, 10(1), 68-80.
The nursing profession is and has been experiencing what is often described as an unendurable shortage of clinical nurses. Organizations are having difficulty recruiting new nurses and retaining current staff.1 The U.S. Bureau of Labor Statistics predicts the demand for registered nurses to grow from two million to 3.2 million between 2008 and 2018, a 60% increase. Ideally, a sufficient number of new graduates will fill the demand; however, according to Benjamin Isgur, Assistant Director of Price Waterhouse Cooper’s Health and Research Institute, the projections aren’t great. Of the 320,000 who applied to nursing school in 2008, only 78,000 graduated and 23% are currently working as nurses.2 After graduation, about 30,000 nurses stay in the field, but 50% leave their first job after two years. Compounding this staffing problem is the increasing age of the nursing population and their anticipated retirement.
Problem identification
Without a sufficient number of nurses, patient care and safety may become compromised, while nurses themselves may be overwhelmed, distressed, and dissatisfied. High patient-to-nurse ratios have been shown to lead to frustration and job burnout, which is linked to higher turnover. 3 An inadequately staffed nursing force has been found to play a negative role in patient outcomes. In contrast, studies have demonstrated that hospitals with low nurse turnover “have the lowest rates of risk-adjusted mortality and severity-adjusted length of stay.”3 In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a met-analysis that found “the shortage of registered nurses, in combination with an increased workload, poses a potential threat to the quality of care…Increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stays.”4
Nurses of all specialties and institutional roles, and those in administrative and leadership positions in particular, must examine the contributing factors of the current nursing shortage to familiarize themselves with the situation and determine what should be implemented to influence strategies for improvement. The objectives of this evaluation are to express the severity and implications of the nursing shortage, determine current contributing factors, and examine possible solutions, i.e., successful recruitment and retention strategies.
Reviewing the facts
Through review of literature it is easy to see that the nursing shortage is not confined to the United States but is a widespread issue. Canadian nurses, for example, are challenged by the same workforce dilemmas and report being overworked, stressed, and generally ill.5 All over the world, nurses are an integral part of the health care system and make up a significantly large portion of the health care provider population. In the United States, the largest group of nurses is expected to retire by the year 2020, pushing health care facilities’ resources beyond their limits.6 Blakeley and Ribeiro suggest that reasons contributing to a nurse’s early retirement include desire to decrease their workload, freedom and flexibility of schedules, and that senior nurses do not feel valued by their companies.7
Just over a decade ago, in 2000, the estimated pool of registered nurses in the United States was 1.89 million, while the demand was two million—a deficit of only 110,000, or 6%. Yet the gap continues to widen. In 2008, there were approximately 2.6 million working RNs, but it is predicted that by 2020 the shortage will be approximately 808,400 nurses, or 29%.8 The already fragile health care infrastructure is at risk of becoming completely handicapped by ineffective recruitment and retention, lack of nurse educators, and a growing elderly population requiring care.
In addition to the problems faced by seasoned nurses, job dissatisfaction, disappointment, and disillusionment with the nursing practice contribute to new nurses quitting. 9 With regard to disillusionment, it is simply not enough to view nursing exclusively in terms of personal commitment; it requires a “wide-range knowledge of illness, medication and appropriate treatment, comprehensive managerial skills, and emotional strength and sensibility.”10 It is important to portray an accurate and positive employment brand in any discipline, but this is particularly true for the profession of nursing.11 If individuals are expected to become dedicated and productive members of the nursing work force, job satisfaction must play a key role. Developing a retention committee to address high-ranking issues such as improving job satisfaction, approval, and expectations by providing some rewards and recognitions may be an example of positive employee branding.
Next in the series of considerations is a correlation between job satisfaction and autonomy. When nurses perceive they have little or no control within the work setting, they become frustrated and unhappy, and the desire to leave increases.1 Like any employee, nurses want to feel valued, to be recognized for their work, and enjoy the other professional benefits, such as flexible schedules. The top three areas considered by nurses in their decision to stay at their current job, according to Palumbo, McIntosh, Rambur, and Naud, are recognition and respect, a voice in discussion and decisions, and performance evaluation. Compensation ranks fourth, while the recruitment of older nurses falls last on a list of 10.
Dissatisfaction with one’s profession can also be detrimental to one’s personal health. In nursing, this is a notable dilemma. Nurses are consistently found to be among the most overworked, stressed, and sick workers, with more than 8% of the workforce absent each week due to illness.5 It is not so surprising, then, that nurses who report being unhappy in their work environment are also less motivated to perform their duties, experience more absenteeism, and tend to leave their jobs in favor of better career opportunities.
Fortunately, researchers are looking into potential solutions for the nursing shortage as they examine its causes. Their findings offer hope for maintaining and improving a healthy work environment that facilitates safe, quality health care and promotes a desirable professional avenue.
One recent job satisfaction study attempted to determine what entices and retains nurses and other human services employees. Respondents reported valuing, among other things, entrepreneurial opportunities and jobs that facilitate work-life balance. These findings suggest that focusing on an environment that nurtures advancement and autonomy may attract new younger nurses, while shorter shifts, job sharing, and work schedule flexibility would help retain veteran nurses.12 Other studies found comparable results.
Palumbo, McIntosh, Rambur, and Naud sought to examine what both nurses and their health care employers valued in the workplace. They found nurses appreciated recognition and respect. Employers’ focus seemed to center around employee health and safety, while recognition and respect ranked lower.
According to Coshow, Davis, and Wolosin, who examined decrements in registered nurse satisfaction mid-career, organizations may benefit from channeling their efforts on retaining nurses by investing in areas that result in higher job satisfaction, such as staffing, fulfillment, benefits, and pay.3 This is vitally important given their application of the Social Exchange Theory. The theory suggests that when “the benefits of maintaining an existing employment relationship are outweighed by its costs, employees will tend to seek out a more rewarding situation.” High turnover is expensive as well, with replacement costing 1.2 to 1.3 times the annual RN salary.13 As previously noted, job satisfaction is related to turnover intent, and a perceived stressful work situation, job tension, and emotional exhaustion increase its likelihood.14
Thus far two main strategies have been used to address the discrepancy between the supply and demand in nursing: first, increased nursing program enrollment, and second, the importation of nurses from other countries. However, the latter treads on controversial grounds, given the dire situations other countries’ nursing pools also share. Thus far, the strategy to increase nursing student enrollment enough to improve the shortage has failed. According to the American Association of Colleges of Nursing, U.S. nursing schools would have to increase the number of graduates by 90% to fill the gap.4
As researchers examine what motivates nurses to remain in their current work environments, they have determined the following: perceived autonomy, workload, recognition, scheduling, managements’ leadership skills, home duties, and peer relationships in the workplace all impact a nurse’s decision to stay. Concentrating on factors that affect nurse job satisfaction and promote retention can only be positive.15 Perceived autonomy, workload, recognition, and related issues deserve focused attention, as they have been found by numerous studies to be important to nurses’ job satisfaction.
Often hindering progress, however, is the gap that exists between what is being done by health care administration and what the clinical staff perceives is being done. What is highest on the clinical staff’s list and what is on the administration’s still seem to vary, despite research efforts. Most corporations’ goals are recruitment and retention, and their approach is to empower their staff to facilitate this within the organization.
A generational divide?
To facilitate improvements in nurse staffing, now and in the future, health care organizations must focus on recruitment, maintenance, and retention. A recommendation derived from a research study by Nogueras suggests policies also need to be developed to increase the recruitment and retention of young adults into the nursing profession.16 The nursing profession should be recognized as a profession that possesses high levels of pertinent scientific and technical knowledge as well as a personable aspect.10 This may appeal to younger people, or perhaps a more diverse applicant pool as well. Finally, it is imperative for nurse leaders to create and sustain an environment where employees are connected to their organization, with a focus on retention as well as recruitment. Other suggestions include examination of the hiring processes, maintaining public relations initiatives, and ensuring employee contributions as part of the recruitment of new nursing staff.11
Nurses report higher job satisfaction if they perceive they are part of a team and feel a sense of belonging, though age is another variable in retention and job satisfaction.3 Senior nurses were less satisfied across all dimensions measured. Researchers suggest organizations focus on aspects that yield higher satisfaction in older nurses such as pay, staffing, and benefits. Multiple studies focus on the retention of veteran nurses, who evidence supports prefer shorter shifts, part-time hours, and assessment of less acute patient populations.7 Younger employees were found to prefer more vacations and flexible scheduling, especially during summer holidays. Klug’s study concluded both older and younger nurses could benefit from programs and policies that support improvements in retention.17 Nurses at any age who perceive their work is appropriately recognized and rewarded tend to show more job satisfaction.7
Predicting the future
Truly, health care is facing losing a huge cohort of nurses in a small time frame very soon. Research has shown that a significant number of nurses intend to leave their current position for a new job or retire early, and in nursing schools, many of those enrolled abandon their studies. Yet, proactive maneuvers could curb the tide, such as designing work environments desirable to older nurses, developing more stringent screening tools for nursing school applicants and more supportive educational programs, and identifying ways to make becoming a nurse educator more desirable. Portraying the nurse educator as a more attractive career choice may lead to increased student enrollment and program development as well.
The retirement of the baby boomer nurses will be difficult to absorb; however, if changes are made based on evidence that supports the retention of older nurses, there is a possibility to ease that burden. But, of course, the profession will need to account for their absence eventually. Health care organizations need to focus on areas such as reward and recognition, which in turn yield high job satisfaction for, and retention of, nurses. Ideally this investment will lead to a positive employment brand that not only entices new applicants, but also affirms the commitment made by nurses of all ages.
References
1. Zurmehly, J. (2008). “The Relationship of Educational Preparation, Autonomy, and Critical Thinking to Nursing Job Satisfaction.” Journal of Continuing Education in Nursing, 39(10), 453–460.
2. Isgur, B. (Panelist). (2008, July/ August). Conference of Statebased Nursing Workforce Centers Explores Retention Issues and Solutions. Sixth National Conference of Workforce Leaders. “Effective Retention Throughout the Career Continuum.” Retrieved from www.NursingWorld.org.
3. Coshow, S., Davis, P., and Wolosin, R. (2009). “The ‘Big Dip’: Decrements in RN Satisfaction at Mid-Career.” Nursing Economic$. 27(1), 15–18.
4. American Association of Colleges of Nursing. (2009, September, 28). “Nursing Shortage Fact Sheet” (9-09.DOC). USA: AACN.
5. Cummings, G., Olson, K., Hayduk, L., Bakker, D., Fitch, M., Green, E., Butler, L., and Conlon, M. (2008). “The Relationship Between Nursing Leadership and Nurses’ Job Satisfaction in Canadian Oncology Work Environments.” Journal of Nursing Management, 16(5), 508–518.
6. Palumbo, M., McIntosh, B., Rambur, B., and Naud, S. (2009). “Retaining an Aging Nurse Workforce: Perceptions of Human Resource Practices.” Nursing Economic$, 27(4), 221–232.
7. Blakeley, J., and Ribeiro, V. (2008). “Early Retirement Among Registered Nurses: Contributing Factors.” Journal of Nursing Management, 16(1), 29–37.
8. Lavoie-Tremblay, M., O’brien-Pallas, L., Gélinas, C., Desforges, N., and Marchionni, C. (2008). “Addressing the Turnover Issue Among New Nurses from a Generational Viewpoint.” Journal of Nursing Management, 16(6), 724–733.
9. Gindel, C., and Hagerstrom, G. (2009). “Nurses Nurturing Nurses: Outcomes and Lessons Learned.” MEDSURG Nursing, 18(3), 183.
10. Sturgeon, D. (2008). “Skills for Caring: Valuing Knowledge of Applied Science in Nursing.” British Journal of Nursing(BJN), 17(5), 322–325.
11. Mitchell, S. (2008). “Your Employment Brand: Is it Working for or Against You?” Nursing Economic$, 26(2), 128–129.
12. Haley-Lock, A. (2008). “Happy Doing Good? How Workers’ Career Orientations and Job Satisfaction Relate in Grassroots Human Services.” Journal of Community Practice, 16(2), 143–163.
13. Kovner, Brewer, Greene, and Fairchild. (2009). “Changing Work Needs of New RNs: Literature Review.” The Online Journal of Issues in Nursing, 15(1).
14. O’Brien-Pallas, L., Duffield, C., and Hayes, L. (2006). “Do We Really Understand How to Retain Nurses?” Journal of Nursing Management, 14, 262–270.
15. Davis, B., Ward, C., Woodall, M., Shultz, S., and Davis, H. (2007). Comparison of Job Satisfaction Between Experienced Medical-Surgical Nurses and Experienced Critical Care Nurses.” MEDSURG Nursing, 16(5), 311–316.
16. Nogueras, D. (2006). “Occupational Commitment, Education, and Experience as a Predictor of Intent to Leave the Nursing Profession.” Nursing Economic$, 24(2), 86–93.
17. Klug, S. (2009). “Recruit, Respect, and Retain: The Impact of Baby Boomer Nurses on Hospital Workforce Strategy—A Case Study.” Creative Nursing, 15(2), 70–74.
An urgent shortage of nursing faculty isn’t just something to worry about in the future. It’s here now.
According to the American Association of Colleges of Nursing (AACN), U.S. nursing schools turned away more than 32,000 qualified students in 2004. Most of those schools cited a lack of faculty as the reason these students could not be admitted. Add in a wave of nursing faculty retirements that’s expected to sweep the nation over the next 10 years and the implications for the future of nursing become very serious indeed.
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In light of these alarming statistics, a growing number of nursing graduate programs across the country are offering education-focused master’s degrees–ranging from Master’s in Nursing Education to MSN degrees with a nursing education certificate or option–designed to move nurses from clinical practice into teaching positions quickly. Of course, these types of programs are not exactly new. But what’s newsworthy about them these days is that many schools have recently begun to offer them for the first time as a direct response to the faculty shortage.
Traditionally, nurse educators have taken a long, sometimes daunting path to the faculty ranks. It involved hours in the classroom, both as a student and as a teaching or graduate assistant. A master’s degree was just the beginning: Potential educators were expected to eventually complete a PhD or EdD, terminal degrees conferred after more time in the classroom, extensive research and public service.
Most nursing programs today still require or prefer doctorally prepared faculty, especially for teaching at the baccalaureate level and above. But with the current hemorrhaging of the nursing faculty supply, there’s no denying that a fast-track approach to producing more nurse educators is becoming more and more of a necessity.
From Nurse to Teacher
Heather Griffin, an African American nurse who was born in Jamaica, is one of those students who will soon be making the transition from clinical nurse to nursing educator. She will graduate in May from William Paterson University in Wayne, N.J., with an MSN degree with a concentration in nursing education. And she’s already fielding offers to become a faculty member.
Griffin returned to school for her master’s after working as a nurse for 15 years. One reason was purely physical. She says she felt it wouldn’t be too many more years before the eight-to-12-hour shifts she regularly worked would take their toll on her back and legs. But her biggest motivation had more to do with her heart and head.
“I always liked teaching and working with nursing students,” she explains, “and this opportunity presented itself. I remember how scared I was when I was a new nurse. I want to support new nurses.”
Choosing a master’s program with a focus on nursing education allowed Griffin to concentrate on her new passion–teaching. While she hasn’t ruled out getting a PhD, it isn’t in her immediate plans.
“The next step in my educational advancement was to pursue a master’s degree,” she emphasizes. “It took me a long time to decide to return to school. Part of the focus in a PhD program is research and, at the time that I decided [to go to graduate school], that did not appeal to me.”
Diversifying the Faculty
As the nursing profession gears up to aggressively recruit and train a new generation of nursing educators to replenish the dwindling supply, it hopes to pull from candidates too often overlooked in the past–minorities and men. Both populations have long been severely underrepresented at the faculty level.
“Our programs need to reflect the demographics of society,” says Kem Louie, PhD, RN, FAAN, director of the graduate nursing program at William Paterson University and past president of the Asian American/Pacific Islander Nurses Association. “Ethnic and [racial] minority populations are increasing and it’s important that [minority] nursing students see role models in those that teach and those that practice.”
Many of the current crop of master’s-level nursing educator programs are specifically reaching out to nurses from diverse backgrounds. For example, the College of New Rochelle (CNR) School of Nursing in New Rochelle, N.Y., which launched its new Nurse Educator Master’s Program last fall, has a large population of African American and Hispanic students.
The mission to attract more nurses from underrepresented populations to teaching careers must begin at the undergraduate level, believes Mary Alice Higgins Donius, EdD, RN, who will become the new dean of the CNR School of Nursing in July. She is currently an associate professor in the School of Nursing at Sound Shore Medical Center.
“We have to identify those students who might be interested in nursing education and reach out to them,” Donius says. “[Nurse educators] need to talk to students about why we like [teaching] and how they can plan a career in nursing education.”
The emergence of online distance-learning courses has helped make graduate school more accessible for many types of students, including more minorities, men and people living in rural communities. Clarkson College, based in Omaha, Neb., is a pioneer in providing online education for health care providers. The college offers an MSN program with an option in nursing education, as well as a post-master’s certificate in nursing education.
“The school is totally online and we have students located all over the country,” notes Marla Erbin-Roesemann, PhD, RN, associate professor and director of the college’s graduate program. Students in the nursing education master’s program visit the campus physically only once or twice during the program. They perform required clinical rotations and preceptor teaching in the communities where they live.
The college makes sure support services are available to help students who need assistance with projects and problems. “Students do get support through their professors and often look to community members for support as well,” Erbin-Roesemann explains. “If they need additional help, it’s handled online. We have counselors on campus. We also have a director of diversity who can talk to students.”
Nurse Educators for Tomorrow
One of the newest master’s degree programs created in response to the nursing faculty shortage is being offered at the University of Wisconsin-Madison School of Nursing. Funded by a grant from the federal Health Resources and Services Administration (HRSA), this online program likewise hopes to increase the number of nurse educators from underrepresented populations–nurses of color, men and rural nurses.
The program, known as Nurse Educators for Tomorrow (NET), has an unusual two-pronged focus. It trains nurses to become clinical nurse specialists or nurse practitioners with added post-graduate courses that prepare them to be educators as well. Students must complete the standard 36 hours required by most master’s programs, plus nine additional hours in nursing education, including courses covering online teaching and curriculum development.
“Graduates are prepared to function in either setting–as practitioners and/or educators–so it’s a win-win situation,” says Nadine Nehls, PhD, RN, professor and associate dean for academic programs at the nursing school. On the clinical side, students may specialize in either pediatric or medical-surgical care.
The program’s recruiting efforts are assisted by a community liaison, says Gale Barber, MA, assistant dean for graduate studies. This person does community outreach and is actually housed at a rural site in order to put her closer to prospective students.
How has NET succeeded in its first year? Nehls reports that the program has attracted a large percentage of students from rural areas, but so far no minority or male students. The school is closely examining its recruiting plans with an eye toward developing strategies that will more effectively reach these targeted populations.
“This year, we’re going to do more targeted recruitment,” explains Pam Scheibel, MSN, RN, a clinical professor in the program. “We’re looking at alumni lists and trying to make individualized, tailored outreach to these students.”
Even though the program is taught online, one of the major obstacles to attracting more culturally diverse students seems to be simple geography. Madison just doesn’t have a large minority population, says Barber.
Adds Scheibel, “Several [minority] students who have come here and had good experiences during the recruitment process eventually decided to go to school in another area where there’s more [diversity]. Some also choose schools that are able to offer larger scholarships.”
This year, the school’s recruiting efforts will accentuate the program’s online format, helping students realize that the location of the campus is really not that relevant. “Students can stay in their own communities and do their clinical and teaching experience there,” Barber emphasizes.
Master’s vs. Doctorate
Pursuing a career as a master’s-prepared–rather than doctorally prepared–nursing educator is not for everybody. Nurses who are considering making the move to academia need to be aware of the advantages and disadvantages of both options and must evaluate them closely against their particular career goals.
For example, Heather Griffin knows that without a terminal degree, one of the biggest benefits offered by a university–tenure–will not be available for her. The tenure system, exclusive to the academic world, means that a faculty member can’t be fired or downsized except under the most extreme conditions.
“Tenure gives you a sense of permanency and shows that you have paid your dues. You really can’t be asked to leave,” Louie explains.
The lack of a terminal degree will also limit the career advancement options available to a nurse educator. “Having only a master’s degree is going to limit where and how far you go,” says Donius. “A master’s degree in nursing education is a very valuable credential in preparing people for [certain] roles in teaching and nursing. In higher education, though, a master’s degree does have a more limited scope. Nurse educators with master’s degrees are used at the associate degree level and in clinical, off-site settings. If you really want a career in [academic] nursing education, a doctorate will be required.”
But that doesn’t mean you can’t have a very rewarding faculty career without that terminal degree–especially if, like Griffin, what you really want to focus on is teaching.
“According to the Board of Nursing, nurses with a master’s degree can teach in academic programs, which gives a more focused concentration in the role of educator,” Louie points out. “The doctoral degree generally provides a research focus or more specialization in the practice of nursing. Many universities have clinical or non-tenured faculty positions which may or may not have a time limit and can be renewed without a doctoral degree.”
It is very important for newly minted nurse educators to make sure their goals match those of the educational institution they join, Louie advises. “Nursing faculty need to conform to university expectations.” Ultimately, she adds, “I believe nurses who want a career of teaching other nurses will eventually continue toward their doctoral degrees.”
The Money Factor
Salary considerations are another factor nurses contemplating a move to teaching must weigh against their career aspirations as well as their personal goals. Many experts believe faculty pay may well be one of the biggest reasons for the shortage in the number of professors. A recent study by ADVANCE for Nurse Practitioners revealed that the typical salary for an NP working in an emergency room was around $80,000. That’s $20,000 more than the average nursing professor earns.
“A lot of our students [in the nursing education concentration] do not go into education [when they complete the program],” says Erbin-Roesemann. “They go back to nursing because of the money. Educators earn less than staff nurses.”
And educators with only a master’s degree will earn less than their doctorally prepared counterparts. Louie cites a 2002 report by AACN that showed the median salary for all nurses with doctoral degrees to be around $75,000. Those with master’s degrees earned about $15,000 less.
However, she points out, “[Faculty] pay can vary greatly across the country and depending on the type of nursing program, whether it’s a private or public college, and the regional location.”
Getting In
You’ve weighed all the pros and cons and you’ve decided that a master’s degree program with an emphasis on nursing education is the right option for you. What are your chances of actually getting in?
While methods of delivery have changed, entrance requirements have not. Like most other master’s programs, nursing education programs require a minimum 3.0 GPA, professional and academic references, an essay explaining why you want to enter the program, plus the dreaded GRE®, formally known as the Graduate Record Examination®. The GRE is an assessment test that measures skills in mathematics, comprehension, analytical reasoning and other areas.
“Each [of these entrance requirements] is only one part of an application,” says Nehls. “[In the admissions process,] we look at the whole application.” She adds that the once-common philosophy that years and years of experience were needed to be a good teacher has faded somewhat.
None of the schools interviewed for this article require any previous teaching experience, although many students currently enrolled in their nurse educator programs had worked as preceptors or mentors in clinical settings. At Clarkson College, students may enter the program without any work experience, but are expected to get some quickly.
“Most of our students do have a couple of years experience,” Erbin-Roesemann clarifies. “Students can come right into the master’s program without any work experience but they do need at least one year of experience before starting their option courses. They can get that experience while taking core courses.”
Helping Minority Students Succeed
As the number of underrepresented minority students in graduate school increases, nursing program administrators are taking steps to make sure those students succeed. “ We don’t like to talk about students needing help in graduate school, but sometimes it happens,” says Louie. “Many students, particularly if English is not their native language, may need help with writing. Some students have problems with statistics.”
The graduate program at William Paterson University provides a nursing support coordinator who serves as the “go to” person when students have academic problems or trouble with an assignment. “The coordinator is not a professor, so the student is not intimidated,” Louie explains. “The coordinator can work with the professor to see exactly what is expected. The coordinator’s role is to find someone on campus who can help. We do refer students to other resources in any department at the university.”
Funding Future Faculty
For many nurses, lack of financial resources can be an obstacle that keeps them from returning to school to pursue master’s degrees. That’s why many of the current efforts to address the nursing faculty shortage are offering special scholarships, loans and other types of financial assistance for students who make the commitment to become nursing educators.
Heather Griffin, an African American nurse who is currently completing an MSN degree with a concentration in nursing education at William Paterson University in Wayne, N.J., was able to take advantage of the federally funded Nurse Faculty Loan Program (NFLP). William Paterson is one of a limited number of universities to receive these funds through the Health Resources and Services Administration (HRSA). Griffin will be able to cancel 85% of the loan she received by completing the degree and working for five years in an approved educational role.
“I was fortunate enough to go back to school full-time and that made me eligible for the loan,” she says. “It is helping me pay for part of my education. [Going back to school] is difficult when you have other financial responsibilities.”
While this loan program is currently available at only two nursing schools, most colleges and universities do have private resources that fund scholarships and assistantship programs for graduate students. Ask about this when choosing a school. Some funds are awarded based on need, some based on merit and some based on potential. In some parts of the country, financial assistance designed specifically for future nursing educators is available at the state level. The Mississippi Board of Trustees of State Institutions of Higher Learning, as part of its Nursing Education Loan Scholarship (NELS) Program, offers a Nursing Teacher Stipend Program for MSN and PhD students who agree to teach at an accredited nursing school in Mississippi upon graduation. Candidates must be Mississippi residents attending a school in that state.
In Pennsylvania, nurses who are interested in going back to school to teach nursing can receive financial assistance from the Nurse Scholars Program, a partnership between Independence Blue Cross and the Pennsylvania Higher Education Assistance Agency. The program will underwrite scholarship funding for qualified students attending an accredited nursing graduate program in five southeastern Pennsylvania counties. It also gives future nurse educators the opportunity to receive grants and scholarships toward their graduate degree directly from the qualified nursing schools they attend.
One national scholarship program created to increase the supply of doctorally prepared nursing educators is the Monster Healthcare-American Association of Colleges of Nursing (AACN) Nursing Faculty Scholarship. Launched in August 2005, this program provides $25,000 scholarships, plus part-time clinical employment and health benefits, to students enrolled full-time in a baccalaureate-to-doctoral degree or Doctor of Nursing Practice program who intend to pursue faculty careers. Upon graduation, recipients must serve in a teaching capacity at a nursing school for a minimum of one year for each year of scholarship support received.
