The Nursing Faculty Shortage:
Adding to the U.S. Nursing Shortage

— by Paula McNeil (Director, Western Institute of Nursing) and
Russell Poulin (Associate Director, Western Cooperative for Educational Telecommunications)

A serious and growing nursing shortage in the United States has grave implications for patient care for the foreseeable future. According to the Monthly Labor Review1, more than one million new and replacement nurses will be needed by 2010. The U.S. Department of Labor projects an increased need of 21% for nurses nationwide for the decade 1998-2008 as compared to only 14% for all other occupations. As a result, a Registered Nurse shortage of about 6% in the year 2000 is expected to reach 29% by 2020. Factors contributing to the demand for RNs include an expected increase of 18% in the general population, the aging of the “baby boomer” generation, and medical advances requiring skilled nursing care.

A serious and confounding variable in addressing the nursing shortage is the nursing faculty shortage within schools and colleges of nursing (SONs) across the U.S.

Nearly two-thirds (64.8%) of those responding to a recent survey conducted by the American Association of Colleges of Nursing (AACN) said that the faculty shortage is the main reason they turned away qualified applicants for their undergraduate nurse education programs.2 This problem has a particularly strong effect in the Western region of the U.S. An informal survey by the Northwest Educational Outreach Network (NEON) Project of 11 Western states early in 2003 showed a need for a minimum of 235 new doctorally-prepared faculty over the next five years. In 2004, a new survey of 35 colleges or SONs by the Western Institute of Nursing (WIN) reported a need for 147.5 new or replacement doctorally-prepared faculty over the next five years, even without data from three large SONs.

Respondents to the WIN survey cited the following difficulties in filling faculty vacancies: thirteen of the 20 respondents reported they are having difficulty finding qualified and PhD-prepared faculty, while others cited the high competition among SONs for a limited supply of well-qualified candidates. One respondent indicated that the lack of qualified faculty, both at the masters and doctoral levels, led her to fear that community leaders would begin calling for lessening the educational requirements for faculty.

Several factors indicate that the problem will not resolve itself any time soon:

• Western states are highly rural. Among the Western states, 116 counties have been designated as “nursing shortage counties” by the Division of Nursing, Bureau of Health Professions, Health Resources and Service Administration, Department of Health and Human Services (BHPr, HRSA, DHHS). Because most counties in Western states earn the “frontier” designation of fewer than six residents per square mile, it is difficult for residents to find access to programs in nursing. Six of the WIN states have no doctoral program in nursing, nor do they have plans to develop programs.
• Nursing faculty are retiring. The nationwide average age of doctorally-prepared nurse faculty is 56.6 for professors, 54.2 for associate professors, and 50.5 for assistant professors.3 The average age of doctorally-prepared faculty at retirement is 62.5 years. Between 200 and 300 doctorally-prepared faculty will be eligible for retirement nationally each year from 2003 – 2012.4 This problem is reflected strongly in the Western region. An April 2001 report on the nursing shortage in Oregon indicates that 57 of 140 (41%) faculty in baccalaureate and higher degree programs are expected to retire by 2005. An additional 65 (46%) are expected to retire from these programs by 20105. According to the American Association of Colleges of Nursing (AACN), it is anticipated that this pattern will replicate itself across the country.
• Doctorally-prepared faculty are needed. For accreditation purposes, SONs are allowed a mix of faculty with masters and doctorate degrees, but they must maintain a minimum core of doctorally-prepared faculty. As a short-term fix, SONs are allowed to remain below that minimum number by filling in with master’s-prepared faculty or with those possessing doctorates in other disciplines. However, to maintain accreditation, SONs cannot long persist without replenishing the number of faculty who are doctorally-prepared in the field.
• Graduation rates for doctorally-prepared students have dropped in the Western region. Enrollments in nursing doctoral programs at 11 SONs in the Western region increased by an overall 21 students between 2002 and 2003. However, the number of full-time students dropped by 30 and the number of part-time students increased by 51. More significantly, the graduation rates dropped by 3 in those two years. This trend follows that of the nation. While doctoral program enrollment increased by 5.6% nationwide, graduations decreased by 9.9% or 44 graduates 6. Clearly, the Western region graduation rate does not begin to address the need required to fill new or replacement faculty positions.
• Rural brain drain needs to be reversed. Nursing students who move to larger cities to pursue doctoral degrees often never return to their rural campus, taking valuable nursing talent away from the places that often need it the most. For example, two graduates of a baccalaureate nursing program in Alaska left the state to pursue a Nursing PhD. Upon completing their degrees, both accepted positions in the communities where they earned their doctorates and do not plan to return to Alaska. In contrast, 50% of the University of Alaska Anchorage’s current doctorally-prepared nursing faculty completed their doctoral studies in non-traditional programs that enabled them to retain their faculty positions while pursuing a doctorate. All but one of those faculty members who pursued a distance education format remain on the present faculty of the UAA School of Nursing.

Given the data in this report and additional information that can be found on the American Association of Colleges of Nursing (AACN) Web site7, it is clear that the nursing and nursing faculty shortages will expand the demand for nursing faculty. While not all nursing faculty positions require a doctoral degree, many universities will favor faculty with a history of conducting research to fill their tenure-track positions.

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1 U.S. Bureau of Labor Statistics, November 2001.

2 2003-2004 Report on Enrollments and Graduations in Baccalaureate and Graduate Programs in Nursing , American Association of Colleges of Nursing ( www.aacn.nche.edu ).

3 American Association of Colleges of Nursing (www.aacn.nche.edu).

4 The Shortage of Doctorally Prepared Nursing Faculty: A Dire Situation, Nursing Outlook , March/April 2002.

5 Oregon's Nursing Shortage: A Public Health Crisis in the Making , Issue Brief No. 1, April 2001, Northwest Health Foundation, Portland , OR .

6 Berlin , LE, Stennet J, Bednash, GD. (2004). Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing . Washington , DC : American Association of Colleges of Nursing.

7 AACN information on nursing shortages: http://www.aacn.nche.edu/Media/shortageresource.htm .