No nurses, no nurses

I'm in the process of developing a lecture on the financial effects of the Affordable Care Act and the related Supreme Court opinion.  While driving to work today, I heard Morning Edition's piece on the shortage of nurses that already exists and that is going to get worse as the ACA begins to take effect.  Because of the increased demand for primary and preventative care, there will be an increased demand for nurses as a cost-effective way to provide this treatment.  This demand will also increase as baby boomers age and need more health care.  Great --- we need more nurses, which means we can provide more jobs in our economy.  Well, it's not that easy.  There is a nursing professor shortage.  Because of factors such as nurses wanting to take care of patients instead of going to school for many years beyond their 2- or 4-year degree and the pay disparity between experienced nurses or nurses in managerial roles versus nurses in professorial roles, among other factors, there aren't many nurses attaining PhDs.  Without a PhD, a nurse may not teach at a university.  (The program cited that fewer than 1% of nurses have their PhDs, which means the pool of qualified professors is very small.)  So the easy response may be, well, just increase the class size until we get more . . .  not so easy because laws require a minimum ratio of faculty to students considering how hands-on nursing education is.  Adding more complexity, there is also a serious diversity issue:  the nursing occupation desperately needs more Hispanic, African-American, and male nurses.  (As a personal note, when my mom was dying of cancer, one of her all-time favorite nurses was a male nurse named Pierre from a francophone country in Africa -- he was large enough to turn her 6'1" frame, and he had an extremely soothing voice and speaking cadence.  Ahhh, Pierre.  My dad also especially liked Pierre because they could speak French to one another.  We need more Pierres!) 

So, now that we've recognized this problem, what are the potential solutions?  Well, essentially we need to create an environment where we have temporary instructional changes to feed the demand and to buy the market time to create more nursing PhDs.  In addition, we need to create an environment where achieving a nursing PhD is seen as a desirable goal and where research and instruction of nurses is promoted.  I think that will need to start in the nursing schools themselves.  I think that any medical campus also needs to do more promoting and advising of students towards nursing PhD programs.  Undergraduate universities also would do well to promote nursing PhD tracks and attempting to provider those who bail out of pre-med to consider nursing as an alternative.  Given the scarcity of the number of nursing educators, it seems likely that students just aren't aware of the possibility and what it could provide for them.  

This nursing shortage and nursing professor shortage is and will continue to have an impact on Americans.  Let's keep an eye on this and see what changes schools and nurses make in order to meet the needs.  

Listen to or read the NPR story here:  http://www.npr.org/blogs/health/2012/08/03/156213925/nursing-schools-brace-for-faculty-shortage