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Education: Nursing Crisis
Area schools plot strategies to confront shortage.


BY GUY FIORITA

May 2018



The U.S. is an aging nation. According to a 2014 Census Bureau report, by the year 2050 the number of residents ages 65 and over is projected to be 83.7 million. The number increases to 98.2 million by 2060, and nearly 20 million of them will be age 85 or older. This, combined with the retiring of baby boomers in the health care industry, is causing a shortage of professionals, especially nurses. The U.S. Bureau of Labor Statistics is forecasting a 31 percent increase in demand for some nursing fields by the year 2024. That’s a huge number, especially when compared with the average expected growth of 7 percent for all other industries.

“The American Association of Colleges of Nursing estimates that by 2020 the demand for RNs will outweigh the supply,” says Dr. Sharon Chappy, dean of nursing at Concordia University Wisconsin. “Recently, a nursing leader at a large local hospital said that her greatest worry is having an adequate supply of registered nurses.” To help meet the demand, nursing schools have begun collaborating with state authorities, health care providers and other institutions to devise innovative programs with the purpose of attracting more nursing educators and students and preparing them for the health care needs of the future.

In 2013 a $3.2 million Nurses for Wisconsin initiative was funded through a University of Wisconsin System incentive grant. Four UW universities (Eau Claire, Milwaukee, Madison and Oshkosh) participated. The ultimate goals are to increase the number of nurses qualified to teach at the baccalaureate and graduate level, increase the number of baccalaureate prepared nurses available for employment by Wisconsin health care organizations, and to make postsecondary education more affordable. The schools offered a series of pre- and post-doctoral fellowships and a loan repayment program in exchange for a commitment to teach a minimum of three consecutive years within the state of Wisconsin. To date a total of 52 students have received funding or loan money. Dr. Kim Litwack, UW-Milwaukee’s dean of the College of Nursing, says that thanks to the grant her school was able to award a total of 10 fellowships ranging from $21,500 to $90,000 and they were able to use a loan repayment program of up to $50,000 in the recruitment of new faculty.

Last spring Mount Mary University announced a partnership with Milwaukee Area Technical College to create a program called Nursing 1-2-1. Together they have created a joint curriculum and course schedule that allows an accelerated path to a nursing degree. This March, Waukesha County Technical College was added to the program. Designed for incoming freshmen or transfer students, 1-2-1 begins in fall and offers the opportunity to earn an associate degree in nursing, licensure as a registered nurse, and complete a Bachelor of Science in nursing degree in four years. “Students take prerequisite and general studies courses in year one at Mount Mary, complete the associate degree in nursing and licensure as a registered nurse at MATC or WCTC in years two and three, and complete the Bachelor of Science in nursing degree in the year four at Mount Mary University. Plus they enjoy the full range of benefits associated with both Mount Mary and these partner institutions, including the option of living on the Mount Mary campus,” says Kathy Van Zeeland, director of marketing and communications, Mount Mary University.

Marquette University has designed a program that offers an accelerated path to nursing for those who graduated from college with degrees in other fields. It gives these returning students not only a chance to earn a second bachelor’s degree, they also earn a master’s degree in a similar amount of time. It’s not easy. The course load means students take 75 graduate credits over five consecutive summer, fall and spring terms. Those who make it through obtain their master’s degree and RN license in 18 to 21 months.  So far the course has been a great success. The College of Nursing’s Milwaukee-based direct entry program reached its 56-student capacity several years ago. In 2016 a second program opened in a new facility in Pleasant Prairie, where they combine online study and group work with in-person exams and clinical simulation. Students can then do clinical rotations at hospitals in Racine, Kenosha and northern Illinois. Beginning with just 13 students in the initial class, the site admitted an additional 24 students in January 2017 and another 52 students for fall of 2018. 

“We know that in the state of Wisconsin today, nursing schools graduate 3,000 nurses per year,” says Patricia Schroeder, director for strategic initiatives, Marquette University College of Nursing. By 2030, she says, there will be a need for more than double that figure. “Without the opportunity the program provides, a student could potentially spend close to a decade working toward becoming a nurse and achieving an advanced degree.”

The problem of the nursing shortage is not limited to new recruits. “Health care providers are also looking for ways to retain their existing staff, and they are investing in this goal by pursuing workplace enhancements and resource based rewards,” says Schroeder. “Health care workforce shortages have occurred in the past, and some of the strategies being employed have been tested before, and are being refreshed for new generations of professionals. Historically, health systems hosted dinners and events to raise the visibility of their organizations and the positions available. That no longer draws new professionals, so health systems are now using social media in new ways to reach out and invite people in. Now we are also seeing referral bonuses, sign-on bonuses, loan forgiveness plans, and residency programs are but a few of the resource related ways beyond initial salaries that organizations are appealing to new professionals.”

“Another problem that we need to address is that many new graduate nurses struggle with the transition from novice to competent nurse,” says Dr. Chappy. “An estimated 35-60 percent of nurses leave their first place of employment within one year of hire.” To give novice nurses additional education to help ease that transition, many health care organizations are offering residency programs during the first year of employment for new nurses, particularly for complex nursing positions like perioperative or intensive care nursing. In a similar move, the Aurora Health Care system is collaborating with schools of nursing in this area to support operating room clinical placement internships for senior-level nursing students, as leaders at Aurora recognize this as a high-demand and hard-to-fill specialty area for nurses.

The roles of nurses are changing too. Dr. Chappy believes that health care will look very different in the future. She says there will be far less emphasis on hospital stays and far greater emphasis on home care and post-hospital rehabilitation health care and nursing. “This is why we give our students hands-on clinical learning experiences in a wide variety of settings beyond traditional hospital nursing. For example, our students who are in the Community Wellness course this semester are doing clinical rotations with the Milwaukee Public Health Department; Milwaukee Public, LUMIN and Nicolet schools; the North Shore Health Department; working on an American Lung Association-funded Freedom from Smoking project; and in employee health centers at local businesses. These are where there will be jobs in the future.”

Increasingly, nurses are serving as primary care providers to meet the growing needs of our communities. “More than half of nurses now work outside of acute care facilities, and the number continues to grow,” says Schroeder. “It is said that many of the roles needed in the very near future have yet to be created – so today’s nurses and health care professionals must graduate ready to provide safe and effective care, but also to continuously learn and advance their knowledge and skills to meet health care needs and science as it evolves in this very fast changing industry.”

Where will the growth be most noticeable? “It is difficult to imagine any avenues of practice under the broad nursing career umbrella that will not be in demand at any time in the future,” says Dr. Andrea Lee, president of Alverno College. “Some specific examples include advanced nurse practitioners who will focus on primary, geriatric and mental health practice; nurse leaders who will move into increasingly important positions on high-quality interprofessional teams of caregivers; and health informatics specialists who will make technology a central part of affordable, high-quality care without losing the compassionate, personal care that is so integral to high-quality nursing practice.”
 

Alverno College

As one of Wisconsin’s top nursing schools, Alverno College offers future nurses an education that equips them to succeed in an evolving field. From a Bachelor of Science in nursing program to graduate and doctoral degrees focused on various specialties, Alverno prepares graduates to lead with skill and confidence. www.alverno.edu


Marquette University College of Nursing

Marquette University College of Nursing offers graduate nursing programs for individuals with – and without – a nursing degree. MSN, DNP and Ph.D. programs, as well as post-masters specialty programs, provide enhanced development in communication, interventions, ethics and multicultural competence. Marquette’s graduate programs offer the education and insight to make a difference. www.marquette.edu/nursing
 

Mount Mary University

Founded in 1913, Mount Mary University is a private, Catholic all-women’s university located in metro Milwaukee. Mount Mary offers 30+ programs including healthcare-focused degrees in nursing, dietetics and occupational therapy. One hundred percent of incoming, full-time students also receive scholarships up to $17,000 per year or reduced tuition.  www.mtmary.edu







 

This story ran in the May 2018  issue of: