Editor’s note: This story is reprinted from the August 2019 issue of GCU Magazine. To view the digital version, click here.
Story by Lana Sweeten-Shults
Photos by David Kadlubowski
GCU Magazine
Alicia Shields knows firsthand the effects of the nationwide nursing shortage – a shortfall Grand Canyon University and its partner, Grand Canyon Education, are at the forefront of battling.
For one, GCU graduates the most prelicensure nursing students in Arizona, with its students posting the highest first-time pass rate in the first two quarters of 2019 among the state’s major universities on a rigorous national licensure exam. The University also is addressing the need for more nurse educators, and then there is GCE’s acquisition of Orbis Education Services, which supports health care education programs for 19 U.S. universities.
As a chief nursing officer, most recently at the Tse’hootsooi’ Medical Center in Fort Defiance, Ariz., Shields saw the grueling hours nurses were willing to put in for patients.
“I have heard of nurses working 24-hour shifts,” she said, though she staunchly advocated for her fellow nurses. “We would actually close beds. It wasn’t safe for the nurse or the patient. … I’d rather lose income than see someone get hurt,” said Shields, who commuted five hours to Fort Defiance, near the Navajo Nation’s capital of Window Rock, before accepting her faculty position five months ago in GCU’s College of Nursing and Health Care Professions (CONHCP).
Those long hours translated to burnout and, even worse, nurses leaving the profession.
Shields felt the impact of understaffing even more at the rural hospital where she worked. It’s in rural settings where the shortages are most profound.
According to the Bureau of Labor Statistics’ Employment Projections for 2016-2026, registered nursing is among the top occupations for job growth. It is expected to grow from 2.9 million in 2016 to 3.4 million in 2026.
Yet the number of nurses emerging from higher education just isn’t enough. The bureau estimates the country will need more than 1 million registered nurses by 2024.
“That’s five years away,” said CONHCP Dean Dr. Lisa Smith.
The projection is even more dire in Arizona. While the number of registered nurses is expected to exceed the demand in 34 states by 2025, according to the Health Resources and Services Administration’s 2014 report “The Future of the Nursing Workforce,” Arizona won’t be among them. It will be one of 16 likely to experience the shortage through 2025.
“It’s important for people to understand why there is a nursing shortage at the bedside,” Smith said. For one, nurses have more options. “They’re leaving the bedside to take these other jobs.”
Nurses can now work in advanced roles such as nurse practitioner, midwifery and nurse anesthetist, as well as in areas such as education, administration, informatics and telehealth.
Stephanie Hill, a nurse manager at Phoenix’s Abrazo Arizona Heart Hospital who is pursuing master’s degrees in business and nursing at GCU, has seen nurses take those other opportunities.
“They get their experience and move on and do something like travel nursing,” Hill said, and those other opportunities can be more lucrative. “Our company has pretty good retention … but it really hurts our staffing in the meantime.”
Health care entities, Shields said, are trying to retain nurses through such incentives as tuition reimbursement, student loan repayment and bonuses. Other reasons for the shortfall: population growth – more people means a greater need for nurses – and the aging workforce. As the baby boomer generation retires, not enough new nurses are entering the profession to replace them or meet the increased demand, though GCU is ramping up its efforts.
Not only does GCU operate the largest prelicensure nursing program in the state, but the University’s nursing graduates are job-ready. On the National Council Licensure Examination, the standardized test that determines whether a graduate is ready to start working as a practicing nurse, GCU exceeded a 98% first-time pass rate for two consecutive quarters in 2019. That pass rate was the highest among the major universities in the state.
Smith said there are plans for an all fast-track program, in which students continually take classes, including in the summer, and can graduate from the prelicensure program in just 16 months.
“It gets nurses into the workplace sooner, and that is helping to address the shortage,” Smith said.
The University is meeting the need to provide more nurses for advanced health care roles, as well, since the demand for RNs with advanced degrees continues to grow.
The Institute of Medicine wants at least 80% of RNs to have earned their baccalaureate degrees by 2020. But according to a study by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers, only 64.2% of the nursing workforce can tout a bachelor’s degree or higher. Of those with advanced degrees, 45.2% have a bachelor of science in nursing, 17.1% a master’s, 1.2% a doctor of nursing practice, and 0.6% with a Ph.D.
“You’re looking at less than 2% of the nursing population with a doctorate,” Smith said.
The college is offering advanced clinical nursing programs, such as family nurse practitioner and acute care nurse practitioner, as well as advanced nonclinical programs, such as the Master of Science Degree in Nursing with emphases in education, informatics, public health and leadership. Students also can pursue their Doctor of Nursing Practice at GCU.
One major problem colleges are facing is they do not have enough facilities – or faculty – to teach the next generation. The national nurse faculty vacancy rate is 7.9 percent, according to a “Special Survey on Vacant Faculty Positions” released by the American Association of Colleges of Nursing in October 2018. Nursing schools turned away a little more than 75,000 qualified applicants from baccalaureate and graduate nursing programs in 2018 because of insufficient faculty, clinical sites, classroom space, clinical preceptors and budget constraints, said the American Association of Colleges of Nursing in its 2018- 19 report, “Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing.”
To try to help fill that void, GCU offers a Master’s or a Post-Master’s in Nursing with an Emphasis in Nursing Education, and a Doctor of Nursing Practice with an Emphasis in Educational Leadership.
“These degrees specifically prepare nurses to be nurse educators in academic institutions to take on faculty roles in addition to other teaching roles in nonacademic settings,” Smith said.
GCE, a shared services partner of colleges and universities, also is at the forefront of addressing the nursing and health care professions shortfall with its purchase this year of Orbis Education. The acquisition “made a significant investment to provide solutions for our nursing students,” said GCE’s Vince Grell, Executive Vice President of University Partnerships.
Orbis Education manages prelicensure health care programs at a pivotal time, when the demand for online health care education is growing because of the shortage. The company uses a hybrid learning model that incorporates online coursework as well as building off-campus laboratory facilities on behalf of their partners so students can practice their clinical skills. Orbis also guarantees clinical placements with health care partners. Grell said GCE/Orbis partner schools will offer 23 skills lab sites across the country by the end of the year to train the next generation of nurses, with the total projected to grow to 34 skills lab sites by the close of 2020.
Smith sees great things ahead for nursing and knows one thing’s for sure – nurses will always have a job: “There’s never been a better time for a nursing career than now.”
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