The United States is facing a critical shortage in all health care professions. With the nation’s baby boomer population approaching retirement age, the issue is twofold: the aging population requires more care, and the nation’s physicians, nurses, and other health professionals are retiring.
Too Many Students, Not Enough Options
The solution to filling this gap is replacing the departing health care professionals with nursing graduates of all academic levels. However, many higher education institutions are turning away suitable candidates in droves. In 2016, nursing degree programs in the U.S. rejected 64,067 qualified applicants from baccalaureate and graduate nursing programs alike citing a lack of budget, faculty, clinical sites and preceptors, and classroom space.
Currently, there is a serious shortage of physicians, which continues to grow. By 2025, there will be a projected deficit of nearly 35,600 primary care doctors alone. Nursing schools are facing the struggle and strain to increase the capacity of existing nursing programs, and explore other avenues like online courses and accreditation.
Higher Education Means Higher Pay
Enrollment is increasing in nursing masters and doctoral programs across the country, and it’s no wonder that nurses are applying to graduate schools en masse. RNs realize there are significant perks to training and becoming an advanced practice registered nurse. Evidence shows that the quality of care by an advanced practice nurse is comparable to physicians, while often more affordable.
The full-time annual salary for a Nurse Practitioner (NP) averages $105,546. The high pay range of the NP may be partly to blame for the faculty shortage—higher compensation in the clinical setting is luring potential educators away from teaching.
Most vacant faculty positions require a terminal nursing degree. If more nurses pursue a doctoral degree, the faculty shortage will be alleviated. What will the outcomes of the nursing shortage be? Only time will tell.
Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University.
When the first nurse practitioner residency programs began, the term “residency” left many in the nursing community unsettled.
“One of the concerns of residency programs and that terminology is the suggestion that nurse practitioners are not prepared upon graduation, which is not accurate at all,” Kitty Werner, MPA, executive director for the National Organization of Nurse Practitioner Faculties (NONPF), told MedPage Today.
In considering the language debate, Werner said, “[I]f people look at them [residencies or fellowships] closely they see how they are specific to their practice site, it’s much more like an intensive on-boarding experience for new graduates. Or it might be for existing nurse practitioners who transition to that particular practice environment, but they don’t replace formal educational preparation.”
The NONPF, as part of a broader statement on post-graduate education, declared that the term “residency” is “not an optimal description for NP post-graduate support” because it may be confused with medical residencies which are required for physicians to gain licensure. Four other major nursing groups signed the statement, which was later endorsed by the largest, the American Nurses Association.
“The residency in medicine fulfills the required clinical focus of a particular specialty. In NP preparation that clinical focus is embedded in the NP educational program centering on the population focus that is the center of NP practice emphasis (e.g., family, pediatrics, women’s health, etc.),” the statement read.
Even more confusing, some nursing programs use “residency” specifically for the clinical hours already included in their programs. The statement urged post-graduate support programs to keep things simple and call themselves “fellowships” instead.
Britney Broyhill, DNP, ACNP-BC, the director of the nurse practitioner program at Carolinas Healthcare in Charlotte, N.C., said she prefers the term “fellowship” since the programs are voluntary and offer advanced practice clinicians a chance “to go above and beyond their formal education and training in a subspecialty.”
But there are dissenters, among them Margaret Flinter, PhD, APRN, senior vice president and clinical director of the Community Health Center in Middletown, Conn., who founded the first nurse practitioner residency program and still prefers that name.
“My feeling is still — though I’m always open to the conversation — that this kind of broad-based, very intensive clinical training across the full gamut of primary care is best described as residency.”
She noted that the Department of Veterans Affairs also uses the term “residency.”
This story was originally posted on MedPage Today.
The Ohio University College of Health Sciences and Professions’ School of Nursing is putting virtual reality to use in the classroom. Assistant professor Sherleena Buchman helped create a Narcan simulation during the 2018 spring semester. Since then, the initial video simulation has been transformed into a virtual reality simulation.
A 360-degree video was made from cameras surrounding the Narcan simulation, which features two college students discovering a friend experiencing an opioid overdose. Throughout the scene, the students call 911 and work together to help their friend by administering Narcan.
“Using virtual reality goggles, the person can turn around and see everything. It’s really amazing,” Buchman shared with the CHSP Newsroom. “When you look down, you can see them going through the bag looking for Narcan. If you hear a noise, you can turn your head to look in that direction to see what’s going on. It’s just like you were physically in the room.”
Buchman believes that as the simulation becomes more realistic, the students will learn even more than they could in a traditional nursing education setting. Currently, this simulation is only available in the university’s GRID Lab, but Buchman is working to have the simulation eventually available on all smartphones. The simulation will help students learn not only about Narcan and how to administer it, but how to view and think about addiction without a stigma.
“It leaves you with a feeling of ‘Wow, I just watched someone overdose and watched them come back,’” said Buchman. “The reactions viewers gave were interesting and emotional. They showed compassion as we sometimes don’t consider the side of the actual person who overdosed and the feelings of those that found them.”
Currently this simulation is only available for laymen, but Buchman is working on another version specifically for Ohio University’s nursing students that can be used as a teaching tool. She feels excited and grateful about her success with the simulations so far.
“It’s been a pretty amazing journey. I love technology, simulation and education and the students today have grown up with technology in their hands. This is a way we can impact them that’s familiar,” Buchman said. “It’s amazing to think that we can help create something that will help patients and help our community by impacting this generation of students and community members who see this and will be able to carry out these actions on their own.”
Midland University and Methodist Fremont Health opened a new $1 million simulation lab earlier this summer, providing simulated learning to medical students. The lab, constructed inside of Methodist Fremont Health Center, is used both by medical professionals and Midland University students.
Located in a modern wing of Fremont Health Center, the lab includes five hi-fidelity Gaumard Manikins. Deborah Brester, MSN, RN, a professor at Midland University, has already seen how students are greatly benefiting from having access to simulated learning in addition to their classroom education. “The lab complements the traditional clinical experience by allowing our students to experience real-life scenarios,” Brester said. “You can simulate an entire birthing experience, cardiac arrest — anything. You can give IVs and draw blood. Instructors can even speak through them and simulate distress.”
Brester, who is currently leading Midland’s mother/baby nursing class, is also using the simulation lab for her own doctoral dissertation, as she pursues her Ph.D. in nursing education at Midland.
“We can create scenarios that [students] may not otherwise ever be exposed to in a clinical setting,” she shared. “This builds a tremendous amount of confidence and enhances critical thinking skills that they’ll use throughout their careers.”
The Gaumard Manikins use “Care in Motion” simulation technology, which allows students to treat the Manikins like actual patients in different environments. In addition to the manikins, students are able to practice on the same equipment that Fremont Health medical professionals use every day.
“The simulation lab represents our vision to provide relevant opportunities, dynamic experiences, and innovative programs for Midland students by working from the marketplace back,” Midland University President said. “Marketplace relevancy is twofold: educational programs that prepare our students for the careers of today and tomorrow, and partnership with organizations in our community to create opportunities for continuous employee development.”
To learn more about Midland University’s nursing program, click here.
The University of Nebraska Medical Center College of Nursing recently received a $91,500 grant from Women Investing in Nebraska (WIN) for geriatric and dementia services. The grant was given specifically to the UNMC Geriatric Cognitive and Mental Health Project for Rural Nebraska.
The project is being managed by UNMC assistant professor Dr. Nancy Meier, who teaches adult gerontology and psychiatric mental in the nurse practitioner programs. She explained that many older patients have to travel further for specialized services, which limits their access to care. “One of the reasons for my applying for this grant is that in the 11 Panhandle counties, almost 20 percent of the population is 65 or older,” Dr. Meier told the Scottsbluff Star-Herald. “That means almost 1 in 5 individuals living in the Panhandle are over the age of 65, yet there is really a lack of providers who have specialty in being able to evaluate them from a psychiatric standpoint, as well as geriatric.”
The grant will help Dr. Meier and other UNMC nurse practitioners get trained on performing geriatric assessments and psychiatric evaluations on patients in their own homes, in order to help access to care and help the nurse practitioners better see and understand their patients’ living situations, backgrounds, and other important details.
“I work with them to provide the details on what I think is the problem,” Meier shared with the Scottsbluff Star-Herald. “We are very specific into the needs of that older adult. Our goal is that they will be able to stay longer at home. Our goal is to be able to help them take care of the problem or give them a reference to another provider, such as physical therapy, occupational therapy or the right resource so that they are healthy and stay healthy.”
This grant from WIN is a huge boost for the program, which will also provide caregiver assessments, dementia education, and mobile services. This comes in addition to a four year, $2.6 million grant gifted in July to the UNMC College of Nursing by the U.S. Health Resources & Services Administration, aimed at improving engagement of registered nurses in patient management.
For more information about the grant awarded to the UNMC Geriatric Cognitive and Mental Health Project for Rural Nebraska, click here.