Why Telemedicine Must Play a Central Role in Solving the Nursing Staffing Shortage

Why Telemedicine Must Play a Central Role in Solving the Nursing Staffing Shortage

The COVID-19 pandemic transformed the healthcare industry, including how health systems coped with the ongoing shortage of qualified registered nurses. Dramatic surges in patient volumes led to hospitals bringing in travel nurses at unprecedented rates, hiking the demand for contract nurses by at least 35%  over pre-pandemic levels.

Health systems had to take quick action to cover the gaps. Many hired travel nurses, but it wasn’t the ideal solution to the problem. The salary disparities were unsustainable and inflammatory for health systems, drawing sharp criticism from employed nurses doing the same jobs for significantly less money.

The resentment affected both employed and contracted nurses, further eroded morale in a challenging time, and even prompted some employed nurses to leave their positions and take up more lucrative travel spots, perpetuating the cycle of staffing shortfalls.

Now that the Public Health Emergency has ended, reimbursement and demand have returned to more realistic levels, leaving travel nurses feeling burned out, expendable, and unsure of what comes next in their careers – while leaving health systems still lacking the nurses they need to provide safe, high-quality patient care.

Healthcare organizations need a different solution to the nursing shortage that doesn’t rely on flying in professionals in response to sudden spikes in need. Virtual nursing is that solution.

In addition to providing an attractive career alternative for travel nurses looking for a new role, virtual nurses offer the best of both worlds for health systems: they are available when and where they’re needed, yet they aren’t strangers to the organization or a perceived threat to employed nursing staff.

Instead, virtual nurses utilize advanced telehealth technology to provide expert assistance with complex clinical tasks, such as care in the ICU or emergency room, and more routine needs, like giving discharge instructions and answering questions from patients or caregivers.

Nurses are brought into the environment via wall screens or telehealth carts with high-definition audio/visual equipment. In addition, some nursing stations in the virtual care center (such as Critical Care ICU) are connected to telemetry feeds and other data streams to enable off-site nurses to watch patients and their vital signs continuously.

This frees on-site staff to focus on building relationships and delivering hands-on care – all while knowing their remote colleagues have their back if they need extra support.

The result is an environment less likely to breed burnout and more likely to help all nurses feel as if they are maximizing their skills and working together as a coordinated team. It represents the start of creating an organizational culture that minimizes turnover and supports safe and effective patient care.

Virtual nursing won’t be able to solve the massive shortage of RNs completely. Still, the strategy offers a more sustainable and potentially less controversial alternative to relying too heavily on travel nurses.

As health systems seek innovative ways to trim unnecessary spending while supporting optimal patient care, virtual command centers could improve patient care and sustain workforce morale without breaking the bank.

How to Fix the Nursing Shortage and Address Burnout: Veteran Nurse Leader Has the Answers

How to Fix the Nursing Shortage and Address Burnout: Veteran Nurse Leader Has the Answers

Dr. Anne Dabrow Woods has incredible insight into nursing as a practicing critical care nurse practitioner and nursing educator with over 39 years of experience and counting.

Amidst a sea of temporary band-aid solutions for nursing, like gig apps and travel nurses, Woods , DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, the Chief Nurse of Health Learning, Research and Practice, Wolters Kluwer spoke with Daily Nurse to discuss her practical, long-term solutions to address the nursing shortage and burnout. What follows is our interview, edited for length and clarity.

How long have you been in nursing, and what are some of your roles during that time?

I’ve been a nurse for 39 years and a nurse practitioner for 25 years. I’ve worked as a staff nurse, nurse educator, manager, and director of different critical care in hospitals, and then I went on and became a nurse practitioner. As a chief nursing officer, developing the right resources for nurses and other clinicians in education, practice, or research is imperative, so I’m out there doing it. As a critical care NP, I work weekends for Penn Medicine Chester County Hospital and teach undergraduate nursing. About ten years ago, I flipped over to working in graduate education at the master’s and doctoral levels for both Drexel University and Newman University as adjunct faculty. So, I wear different hats. I know what nurses need in practice. I’m a nurse practitioner, but I always work alongside nurses. I work in critical care, so I have my doctorate in nursing, a master’s degree, and a post-master’s certificate. And I’m a fellow in the American Academy of Nursing, so it’s just doing what I love.

You can talk about it because you’re living it.

What gives me street cred for people when they talk to me is that I know what’s happening out there and living it through what I do with nursing education, but also what’s going on in practice today. There are a lot of things in practice we have to change. There are going to be few nurses left at the bedside to care for patients. We’re on the precipice right now. We can change things for the better if we play our cards right.

There are several temporary solutions to address staffing shortages and burnout, like gig apps and traveling nursing. What insight can you share about practical, long-term solutions to the nursing crisis?

In travel nursing, you have an app to sign up for any shift you want, but they’re all band-aids. The more significant problem is we have a nursing shortage, and we knew it before we went into the pandemic. Then, post-pandemic, we’re seeing the effects that many more people either retired or decided to leave the bedside and go into other roles. Or some people left the profession together. So, what we anticipated with the nursing shortage coming in 2030 has hit us sooner than that. These quick, short solutions that people talk about, you hit the easy button, and they think it’s going to fix things, and it’s not. 

The bottom line is we have to increase our pipeline, which is an issue right now. And we need to ensure that the nurses graduating are practice-ready because they are not. We need to understand most nurses in acute care and long-term care settings now are novice nurses or nurses who have only been in the profession for a few years. So, the fact that we have less experienced nurses at the bedside is problematic. The other big thing we’re seeing is that nurses in the age group from 25 to 35, which should be who we are relying on over the next 10 to 20 years, are starting to leave the profession because they are very burned out. They’re unhappy and need to see healthcare organizations addressing the pitfalls that we’re seeing with staffing. So they’re deciding to leave. We need to do some things, not only in academia, to make sure our nurses are practice-ready, but we also need to make sure in practice that these new graduate nurses coming in are supported and trained so they can become competent. We need to make sure that we support them through more extended orientation programs or nurse residency programs. Then, we always have people available to the newer nurses as their support system or resource. And a lot of healthcare systems still need to invest in that.

The good news is they are starting to understand the importance of a resource nurse position to help these newer nurses when they have questions. But we need to fix this right now. And this means different care models, too. So before the pandemic, we had this primary nurse model, which we’ve been practicing for 25 years, where one RN took care of four, five, maybe six patients. Then the pandemic hit, and you have many more patients and nurses. So we switched to this team model where you had a more experienced nurse who oversaw the care that less experienced nurses delivered. So we now know, post-pandemic, that we can’t stay in the primary nurse model anymore. We have to use the team model as an alternative care model because there are not enough experienced RNs.

Can you discuss how a team-based nursing model can help offset today’s nursing shortage?

We’re redefining the work of nursing. Before, in the primary nurse model, the nurse did much of the patient’s care. In a team model, the nurses oversee the care by unlicensed assistive personnel. So people like certified nursing assistants or patient care techs will do many hands-on activities of daily living like bathing, dressing, and other things. So that’s what the team model does. It allows you to have one very experienced RN overseeing several less experienced nurses and the work of your unlicensed assistive personnel. It means you can care for more patients, yet you still have one experienced nurse overseeing everything. They won’t be in there doing the baths as much and that type of thing. They’re going to delegate that to other people. But we have to do that to care for our patients appropriately. And it doesn’t mean that the care of patients will suffer. If you put the model in place correctly, it means that the work of nursing will be more defined as someone overseeing, directing, and delegating the care. Of course, the RNs only have things they can do in their scope of practice. And they will continue to do that. But it means that the team leader will do a lot more delegation. So we’ll still have quality care, but all RNs won’t do it. Other people will do it.

What problems must be overcome with the team model of nursing?

I’ve been a nurse for 39 years and was taught the team model of care. But if you graduated in the 80s into the mid-90s, you learned the team model of care because that’s what we did. And then we shifted over to primary. So anybody who’s graduated in the last 20 years needs to learn the team model of care. The graduate nurses need to understand what it is, too. So, when the pandemic came, we had to switch from the primary nurse model to the team nurse model. We had to re-educate people quickly on working within a team model of care and how to facilitate delegation.

But most importantly, we had to facilitate the correct communication so patient care doesn’t suffer. We can drive quality patient outcomes. So that’s part of it. We have to educate people. And academia has got to start educating people as well. And they are now aware of that. Many programs are starting to include alternative models of care.

During our recent nursing strikes, you’ve discussed the importance of revealing systemic issues healthcare must address. Can you talk about how nurse-specific billing data makes nurses literally and figuratively invisible in terms of political and financial decision-making capacity within the U.S. healthcare sector and what we can do to overcome these issues?

Physicians and nurse practitioners, like myself, can bill for our services. So, whatever we do, we document it and get reimbursed. I work in acute care, so I never see a reimbursement because the hospital sees the reimbursement. So, nurses are looped in with the room and board charge for the patient. So, there is nothing that financially defines the value of nursing because they don’t bill for their services. Now, we can look at outcomes data. And we do know that if you have fewer nurses, your patient outcomes will suffer. There’s an increased mortality rate and all of that. The best way for us to show the nurses’ value and give them a voice is to quantify their value and what nurses bring to the healthcare system. If we can get to the point where nurses are reimbursed for what they do with patients, we’ll see the value of nursing. We look at patient outcomes, and that type of thing, but the fact that nurses are looped in the room board charge is ridiculous to me. The chief financial officer will clearly understand nursing’s value once we’re moved over to the other side of the ledger. So that’s where we need to get to now. Nursing informaticists and healthcare organizations are analyzing the data to see what we can pull out of the EHRs to demonstrate the value of nurses and what they bring to the healthcare setting and show if you don’t stop at a certain level, based on the nurse competency and patient acuity, you’ve worsened patient outcomes. And it’s going to cost the healthcare organization X amount of dollars. But we need to go further than this. And that’s why we need to see if we can get nurses to bill for their services.

The nursing workforce is 50 percent of a healthcare institution’s expenditure, and when trying to balance the books, they will look at their biggest costs. Nursing is taking up the most significant amount. So they start to chip away at it, which gets us into trouble. We will only stop that once we can demonstrate and show the evidence that what we do as nurses does make a difference. And we can tell you how much of a difference that is financially if nurses were able to bill. That’s where we eventually get to, and I don’t know if I’ll see it in my lifetime, but that would solve many of the issues.

Change across healthcare in the last few years requires a new path forward for nurse staffing and care models. How should nursing be optimizing recruitment, retention, and care models post-pandemic?

People always look at how much we pay a department and then ask what they produce. What is their output? You’re not aligned. You’re just constantly roped in with room and board. Healthcare is a business, and every business has to show a return on investment. If you invest in a group or a product, you need to see what the organization gains from it. If nurses bill for their services or are recognized for everything they bring, you can see that it’s worth investing in nursing to get a higher return. You’ll get better patient outcomes. You’ll get better reimbursement from Medicare, the big blues, and everybody else in insurance. But we have to invest in our nurses. That’s the secret here.

Everybody is focusing on recruitment. We have to recruit more but then recruit these new nurses who need to be more competent, and many need to be practice-ready. But you got to train them. You can’t just leave them floundering after you finish training. So that’s where the nurse residency comes in. The latest stats show the turnover rate is 22.5 percent. And for new nurses, it’s 33 percent. New graduate nurses leave within one year because they do not feel valued. So healthcare organizations that invest in training invest in large residency programs, which means they’ll be in orientation for six months to a year, and their turnover rate is much lower. But it’s not just about recruitment. We must retain our talent within our healthcare organizations and make every nurse feel valued.

We need to pay nurses what they’re worth. When you look at all the reasons people leave and what they want, and even the striking nurses, which I’ve talked a lot about, and ask them why they leave, of course, they mention salary. But the real reason is staffing because there are not enough competent nurses at the bedside. And we still insist on staffing by numbers and ratios. And we can’t do that anymore. We have to look at what is the competency of the nurse. And if they have the skills to care for the patients in that specific unit. So it’s the competency of the nurse, but also the patient acuity. So, ten years ago, if you had a 20-bed unit, you could get away with having four RNs. It will take a lot of work with patient acuity and nurses being less experienced today. You’re going to need better quality care. You have to look at all that, and you’ll have to step higher. So we look at competency-based staffing, which looks at the nurse’s competency, the patient acuity, the numbers, and what people consider safe. But you can’t just look at numbers alone. And that’s where we need to get to. Healthcare organizations must start investing in the nurses there to help them with training and help them move up in an organization or laterally to different roles. People would stay, but they don’t feel like they’re being invested in and burned out because more nurses are needed to work beside them. They’re going to leave, and that’s just the reality of the situation.

Should we encourage nurse leaders to talk more with nurses to learn about their concerns?

Nurse leaders have to get out of their offices. They must be up on the units, talk to the people at the bedside, and talk to their managers. We’ve talked a lot about the staff. We also have to think about that middle management layer, the nurse managers. Those people are leaving as well. We need to ensure that they are adequately trained to assume the competencies of the nurse manager role. The organization’s CEO, CFO, and directors must be up on the units visible. I talked to the people working to see the real issues and asked them what would help them. The big thing is that we have to change culture right now. And the best way to change culture is to get out there if you’re a leader and see what’s happening within your organization. So it’s about improving that communication, getting out of the office, walking the walk, and talking the talk. Or talking the talk, walking the walk, you have to be able to do both.

I work for Penn Medicine, Chester County Hospital, and we see our leaders on the floors. And I work weekends, and they come in on the weekends. And that is great. I won’t say we don’t have issues because we do like everybody else. They struggle sometimes with staffing, but the fact that our leaders are present, they see what’s going on, they hear when people say, “Look, we can’t do this anymore.” They listen. And that’s what all organizations need to do. If leadership is listening and provides the staff with the right resources, like information tools, that type of thing they can use in their practice. But changing the correct number of competent nurses is vital because they’re investing in the workforce.

Will new staffing models, partnerships with academic institutions, and being more mindful of techniques help retain workers and solve the staffing crisis?

That’s good and going to help. One thing to remember is they can’t do it by themselves. Academia can’t do it alone, and we have to work together. We cannot be in our silos anymore. We need help. When you look at enrollments in nursing programs around the country from undergrad, bachelor’s, master’s, and doctoral levels, all enrollments are down over the last year. So people look at our profession and say, “Wow, I don’t want to be a nurse.” Because they’re talking to nurses who say, “I’m exhausted.” We’re going to change that, but we need to start. First, we should be working with high school students when they decide what they want to do with their life. So nursing is challenging and can be hard, but it’s also so rewarding. And if we work together, then we can make change happen. It’s about ensuring we fill the pipeline and educating people correctly. The NCLEX test just changed in April to focus on clinical judgment, which is what every nurse needs to be able to use in their everyday practice. I’m excited they decided to do this because it will make these graduate nurses more practice-ready. If they graduate, pass the NCLEX exam, and get into practice, we need to support them because they’re just starting to understand clinical judgment. We need to foster and facilitate that education, even when they’re in practice, by giving them the training and skills they need. So when they get to be three years out, five years out, they’re truly competent nurses who could then help with the next group of new nurses coming in.

We have to work together, get out of these silos, talk to each other. We have to pay faculty more. The age range is higher than a staff nurse’s, so many are retiring. We need to get people in nursing 10-20 years to think of becoming faculty. They want to stay in their staff position because they get paid much less, so we must address faculty salaries. We need to ensure they have adequate resources in schools, like more simulations, and invest in adjunct faculty. So, somebody like me, I don’t work full time as faculty because they can’t pay me enough. I know how to teach because I was trained how to teach. We need to train nurses who are hungry and excited to want to help and teach them how to facilitate learning. And we need to do more of that.

I’m just doing what I love. I’m a nurse, and I love this profession. When you’re in it for a while, it’s our responsibility to give back to the profession. So, I do all these things because it’s my professional responsibility to do that. But the truth is, I love everything I do.

We’re at the best time in our profession because people are listening to us. And we have the ability, if we speak with one voice, to get the things we need to improve with great opportunities ahead for all of us.

Understanding Nursing Shortages in the U.S. for 2023

Understanding Nursing Shortages in the U.S. for 2023

Nurses are essential to healthcare, yet nursing shortages have persisted for decades. 

The COVID-19 pandemic has exacerbated these shortages to crisis levels, with demand for nurses outpacing supply in nearly every region. However, healthcare experts had already anticipated a significant nursing shortage before the pandemic, worsening the precarious situation. 

While certain states will experience a more severe impact from nursing shortages in the coming years, a surprising number of states may have a surplus of nurses.

What’s Causing Nursing Shortages?

The perfect storm for a nursing shortage isn’t brewing – it’s already here, and the shortages in nursing staff will only worsen without course corrections. Five significant issues impacting ongoing nursing shortages include:

Turnover: In February 2023, the National Library of Medicine reported that the average turnover rate nationwide was 8.8% to 37%, depending on the nursing specialty and geographic location. While some turnover can be attributed to new graduate nurses deciding the profession isn’t what they thought it would be once they began working, a significant portion could be due to burnout.

Burnout: Staffing shortages often lead to higher patient-to-nurse ratios that put more stress on the staff and result in poorer patient outcomes. Stress leads to burnout, worsened by the lengthy pandemic and compounded by insufficient staffing to create a vicious cycle that leads to further burnout and overall dissatisfaction with the job.

Retirement: Another issue is the substantial number of nurses nearing retirement age. Per a 2020 National Nursing Workforce Study conducted by the National Council of State Boards of Nursing, the average age for a registered nurse (RN) was 52 years old, potentially signaling a large wave of retirements over the next 15 years.

Aging population: As the nation’s aging adult population grows, the demand for complex care grows, as does the need for more nurses to provide this care. The U.S. Census Bureau predicts that by 2034, older adults will outnumber children, a first in U.S. history. It reports that 77 million people will be 65 or older compared to 76.5 million below 18.

Faculty shortage: According to the American Association of Colleges of Nursing, nursing schools turned away nearly 92,000 qualified applications of prospective students for baccalaureate or graduate nursing programs in 2021. This number was the highest in decades due to capacity issues, including insufficient clinical sites, classroom space, faculty, and clinical preceptors. Unfortunately, the salaries for faculty roles aren’t very competitive, making them less attractive to qualified applicants. The shortage in nursing faculty directly affects the number of nurses to fill future demands.Projected Demand for Registered Nurses

To understand the supply issue, we must first look at demand. According to employment information compiled by O*NET Online, an agency within the U.S. Department of Labor, the projected demand for RNs continues to rise in every state, some more than others.

Click here to view a table that provides a comprehensive view of the long-term projections for increased demand in all 50 states and the District of Columbia from 2020 through 2030. The table is sorted from the largest to the smallest change in demand and presents the base number of RNs in 2020, along with the estimated amount needed by 2030.

Projected Nursing Shortages

The American Association of Colleges of Nursing states that nursing is the largest healthcare profession in the nation, with nearly 4.2 million registered nurses nationwide. Furthermore, the U.S. Bureau of Labor Statistics projects that the employment of RNs will grow another 6% from 2021 to 2031, with an average of 203,200 RN job openings every year during the decade.

The Health Resources & Services Administration’s Bureau of Health Workforce projects a national shortage of 78,610 full-time equivalent RNs in 2025 and 63,720 in 2030. However, the data used to create these estimates is from 2020. Therefore, these numbers could be skewed without knowing the full impact of the COVID-19 pandemic on the nursing profession.

While the exact shortage won’t be available until the Bureau of Health Workforce can collect more data, a national shortage of some degree is almost guaranteed. However, not every state may come up short.

An in-depth U.S. Healthcare Labor Market Report created by Mercer in 2021 as a follow-up to its 2017 study explores which states will experience a shortage of RNs and which will have a surplus. If current trends hold, the report projects severe healthcare staff shortages in some states as soon as 2026. However, others will keep up with demand and surpass it.

The Mercer report provides details for the 48 contiguous states. Of those, 21 will fall short of filling the demand for qualified RNs by at least 1,000 nurses by 2026. So they’re already falling behind. The table below shows the five states with the most significant nursing shortages, followed by the remaining 16 states with estimated shortages rounded to the nearest 1,000.

The Mercer report projects that the District of Columbia will have a shortage of about 2,000 nurses during this period.

States Projected to Have a Nursing Surplus

Surprisingly, current trends indicate that 16 states will incur a surplus of nurses by 2026, particularly those in the South. As supply outpaces demand, it’s projected that the first five states in the following table will have the most significant pool of surplus nurses, followed by 11 states with a surplus estimated to be at least 1,000 nurses over demand, rounded to the nearest 1,000.

The report expects the remaining 11 contiguous states to have a shortage or a surplus of less than 1,000 by 2026, so they appear on the list as unchanged. These states include Alabama, Idaho, Nevada, Minnesota, New Hampshire, New Mexico, New York, Rhode Island, Utah, Vermont, and Virginia.

Projections Not Set in Stone

Many factors can impact supply and demand, so a projected surplus can quickly become a shortage and vice versa. Also, different studies may result in differing outcomes based on the parameters used for each.

For example, an August 2022 survey in California conducted by the University of California, San Francisco, indicated supply and demand projections estimate a shortage of RNs, at least for the short term. However, the data suggested that this shortage will dimmish as RN education enrollments return to and surpass pre-pandemic levels.

The Nurse Workforce Projection Report conducted in 2021 by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida also contradicts reports indicating that the state will have a surplus of nurses. Instead, this report projects a significant shortfall of 37,400 RNs and 21,700 licensed practical nurses by 2035 due to an uneven distribution of nurses across the state.

What’s Being Done About Nursing Shortages?

Some national, state, and local entities are attempting to do something about the nursing shortage to prevent it from worsening and eventually reverse the course.

On a national level, the National Council of State Legislatures (NCSL) issued a brief in June 2022 profiling various legislative approaches states could use to address the nursing shortage. These approaches included adapting nursing scope of practice laws and offering preceptors financial incentives.

State-level initiatives already underway address the shortage of RNs and the educators needed to train new nurses by examining various options to recruit and retain nurses. Besides changing the scope of practice laws and offering monetary incentives outlined by the NCSL, they’ve also explored loosening licensure requirements, such as adopting the Nurse Licensure Compact.

Most states also bolster education programs through student loan forgiveness or loan repayment. These programs help attract nurses to the state, and specific programs for nurse educators attract much-needed teaching faculty. For example, the Illinois Nurse Educator Loan Repayment Program repays up to $5,000 annually for up to four years to address the lack of qualified instructors to staff nursing education courses in the state.

Finally, on a local level, individual nursing schools seeking private support and forming strategic partnerships hope to help expand their student capacity. For example, the Minneapolis VA Health Care System committed $53 million to the University of Minnesota School of Nursing in a collaborative agreement to expand clinical placement sites and fund additional faculty.

How Nurse Demand and Shortages Impact You

Whether you’re a travel nurse or a staff nurse looking for a change of scenery, knowing which states expect to have a surplus of nurses versus those facing shortages can help narrow your options. States with nursing shortages will likely pursue recruitment strategies beneficial to nurses, such as offering higher salaries, better benefits, flexible scheduling, and other incentives to attract nurses to the area. On the flip side, states with a surplus of nurses may not offer the most competitive wages.

Some healthcare employment locations have historically paid more than others with or without a shortage. However, higher costs of living often offset these inflated salaries. When comparing your relocation or travel assignment options, make sure the salary is a livable wage.

Shenandoah University and Valley Health Partner to Tackle Nursing Shortage 

Shenandoah University and Valley Health Partner to Tackle Nursing Shortage 

In collaboration with Valley Health  and the Virginia Hospital and Healthcare Association (VHHA), Shenandoah University is working to tackle the region’s nursing shortage through a program that will enhance the training of aspiring nurses and create a sustainable pipeline of new healthcare professionals.

NextGen Nurses program draws upon the expertise of semi-retired and retiring nurses to help train the next generation of nurses before they leave the profession. The program, designed to provide a replicable model used throughout the state, will create a reliable source of new nurses in the Shenandoah Valley by increasing regional opportunities to meet clinical training requirements through preceptorship and simulation.

This project was partly funded by a $496,000 GO Virginia Economic Resilience and Recovery Grant, a state-funded initiative administered by the Virginia Department of Housing and Community Development (DHCD) that strengthens and diversifies Virginia’s economy and fosters the creation of higher-wage jobs in strategic industries.

“Shenandoah University is grateful to have the support and financial backing of GO Virginia and the Department of Housing and Community Development for such a vital program during a critical period for health and nursing care in Virginia and across the country,” says Lisa Levinson, MSN, acting dean of the Eleanor Wade Custer School of Nursing. “We’re proud to partner with Valley Health on such an important endeavor to facilitate an increased nursing workforce in the region. We aim to ultimately improve the quality of life in the Northern Shenandoah Valley and provide a model to be followed across the state to help address the nationwide nursing shortage.”

The pandemic exacerbated workforce shortages in the healthcare sector, including an exodus of nursing professionals and a need for clinical trainers for nursing students.

As part of the NextGen Nurses program, Shenandoah University’s highly skilled faculty in the Eleanor Wade Custer School of Nursing – which boasted one of the state’s highest National Council Licensure Examination (NCLEX) first-time pass rates (97.47%) for the 2021-22 academic year – will develop a series of scalable, relevant and easy-to-use educational on-demand modules designed to accelerate training for retired nurses, and other eligible nurses, to become clinical preceptors.

“Clinical training is one of the most pressing concerns in contemporary nursing education, making this NextGen Nurses program all the more important,” says Shenandoah University Provost Cameron McCoy, Ph.D. “We are grateful for the continued partnership of Valley Health, GO Virginia, VHHA, and DHCD as we collectively improve nursing education in the Shenandoah Valley. At Shenandoah University, our nursing faculty are perpetual innovators and, as such, are exceptionally well positioned to lead and partner in developing these essential modules.”

With the assistance of the Virginia Department of Health, Valley Health will recruit and onboard nurses who no longer work full-time at the bedside to complete the SU-developed training modules before being employed as clinical preceptors.

“This academic-practice partnership with Shenandoah University is an important element in our broader workforce development strategy,” says Theresa Trivette, DNP, Valley Health chief nurse executive. “It is critically important that we draw upon the knowledge of our most experienced nurses in the region to help train and support our newest nurses to assure we can continue providing the highest quality of care for our community.”

Additionally, NextGen Nurses will increase opportunities to use simulation as an additional option in clinical preceptorships. Shenandoah has hired a director of clinical simulation and obtained the necessary equipment to create a simulation lab capable of fulfilling up to 25% of the 500 clinical hours required for aspiring nurses. The simulation lab will reduce the need for SU’s School of Nursing preceptorships by 25%, relieving some of the burden on local healthcare providers to serve as preceptors and/or clinical sites. This role has become more challenging due to the growing nursing shortage.

*Pictured above are Theresa Trivette, Valley Health Chief Nurse Executive, and Lisa Levinson, acting dean of SU’s Eleanor W. Custer School of Nursing. Photo credit: Shenandoah University.

NY Bill Addresses State’s Critical Nursing Shortage 

NY Bill Addresses State’s Critical Nursing Shortage 

New York passed a bill addressing the state’s nursing shortage. The new legislation permits nursing programs to provide up to one-third of a student’s clinical work in a high-tech simulation environment.

A national study by the National Council of State Boards of Nursing showed that substituting clinical simulation for up to 50 percent of traditional clinical experiences was an effective model that ensured nursing students were fully prepared to enter their profession. As a result, New York joined 31 states currently providing simulated clinical training for nursing students, leveraging technology to provide hands-on learning in a safe environment while prioritizing patient safety.

New York is projected to need more than 40,000 nurses by 2030. Nursing programs across New York are ready to educate the next generation of nurses to resolve this shortage. Still, they face a significant obstacle: a need for quality clinical placements in hospital settings that nurses must complete before receiving their licenses.

These programs are turning away qualified applicants because more clinical training placements are needed. Without enough high-quality clinical placements, nursing programs across the state cannot expand to meet the demand from prospective students to fill the state’s nursing needs.

Permitting nursing programs to utilize simulation-based clinical education for one-third of clinical hours will enable nursing students to receive the training they need and nursing programs to expand to meet demand.

Overseen by NYSED to ensure standards of high-quality simulation are maintained, simulated clinical settings feature realistic cases in which students must deliver healthcare to a simulated patient, reacting to the same data they will use as professionals. Often, these scenarios expose students to cases and situations they may not otherwise experience in a clinical environment.

The Commission on Independent Colleges and Universities (CICU ), which represents New York’s 100+ private, nonprofit colleges and universities, the City University of New York (CUNY), and the State University of New York (SUNY) worked in partnership with the NYS Legislature and the New York State Education Department (NYSED) to draft this critical legislation.

Here are what those involved in passing this important legislation are saying about this historic collaboration between independent and public higher education sectors and the state education department.

“This legislation is a significant step toward addressing New York’s critical nursing shortage,” says Lola W. Brabham, President of the Commission on Independent Colleges and Universities. “Private, nonprofit colleges and universities in New York educate 67 percent of nurses and stand ready to help the state meet its nursing workforce needs. This legislation will enable those programs to continue to provide world-class nursing education to New York’s future healthcare heroes.”

CUNY Chancellor Félix V. Matos Rodríguez says, “CUNY graduates approximately 1,800 nurses per year – about half of all new nurses in NewYorkCity. This legislation will assist CUNY with the challenges nursing programs face with student placements and provide a mechanism for expanding enrollment in nursing. Nursing simulation-based learning is a nationally tested and proven model to deliver high-quality education.”

SUNY Chancellor John B. King, Jr. says, “New York faces a nursing shortage that threatens public health and limits workforce opportunity. Therefore, SUNY strongly supports this important legislation to improve access to modern, high-quality clinical training so more students can complete their degree and become nurses—including at the more than 70 nursing programs across SUNY campuses.”

Board of Regents Chancellor Lester W. Young, Jr. says, “Nurses are dedicated, vital healthcare professionals who serve some of our most vulnerable populations. The Board of Regents is committed to doing everything possible to help assuage the nursing shortage that is gripping our healthcare system with policies to improve and enhance clinical education to prepare more future nurses for real-world, life-saving situations.”

New York State Education Commissioner Betty A. Rosa says, “Our priority is always public protection. We worked closely with stakeholders on this important legislation to ensure that quality simulation experience in nursing education programs is clearly defined to prepare nursing students for safe, effective, entry-level practice.”

“New York is facing a nursing shortage,” says Senator Toby Ann Stavisky, Chair of the Senate Higher Education Committee. “This legislation will enable more qualified students to have access to a place in a nursing program by allowing nursing students to complete up to one-third of the clinical requirement through a simulation experience. These simulated experiences effectively replicate a nurse’s experience in the field. It is an effective tool that will

help New York train and license more qualified, quality nurses to help fill a growing and critical need.”

“Now that our nursing simulation bill has passed through both Houses, I’m looking forward to the Governor signing it into law. Allowing up to 1/3 of clinical training to be simulation-based will help address our nursing shortage and expose students to a valuable learning experience,” says Assemblywoman Donna Lupardo, who introduced the legislation in the Assembly.

“New York will need to hire 30,000 nurses over the next ten years just to fill current vacancies in our healthcare system,” says Assemblymember Patricia Fahy, Chair of the Assembly Higher Education Committee. “High-tech, simulated learning environments will help recruit and retain more nurses to meet demand while maintaining standards and quality of care for patients across New York State.”

“New York’s nursing programs stand ready to fill the state’s serious shortage of nurses, and this critical legislation will give us the flexibility to do that. The high-tech simulation education our nursing students receive ensures they are well-prepared to succeed in a healthcare career. We are grateful to the Legislature and the New York State Education Department for collaborating on this important issue. We are proud to be a part of this game-changing legislation that will benefit the well-being of New Yorkers for years to come,” says D’Youville University President Lorrie Clemo.

“Having educated the most nurses in the area, Maria College is taking charge of alleviating the nursing shortage. We know that this bill will help us graduate more-qualified nurses to enter the workforce, as it will allow students to use Maria’s simulation technology towards clinical hours. These technologies help create more confident, practice-ready nurses to provide compassionate health care to families in our community and beyond,” says Maria College President Lynn Ortale, Ph.D.