Thursday, March 12, 2009

Nursing School Faculty Shortage Solution? Have Nurses Teach

Article reprinted from Nurse Connect

By Glenna Murdock, RN, contributor


What three words pop up in nearly every conversation regarding health care these days? The nursing shortage. The insufficient numbers of nurses in our country is a problem that forces a look at nursing education with a creative eye, in an effort to find ways to produce more nurses and to better utilize the existing nurse workforce.
Due to its immense size and to the broad scope of services it provides, Cleveland Clinic in Cleveland, Ohio is the employer of one of the largest nursing staffs in the U.S. Those in nursing leadership at the Clinic, acutely aware of the expanding shortage problem, took a proactive step in 2005 by inviting area deans, directors and faculty of area schools of nursing to come together to discuss the problem and possible solutions. The meeting was labeled the Deans’ Roundtable Faculty Initiative.

Cleveland Clinic’s nursing leadership, along with the director of the Center for Health Affairs in Cleveland, focused their attention on the fact that, in the prior year, 1,500 qualified candidates had been denied admission to area nursing schools due to a shortage of faculty, particularly in clinical areas. In order to produce more graduates, formulating a strategy to increase the numbers of faculty would be essential.

A master’s degree is not required for a nurse to fill the role of a clinical instructor, so nursing leadership offered a proposal to the schools of nursing: “Use our nurses as clinical educators.”

“The idea was not well received initially,” said Joan Kavanagh, MSN, RN, director of nursing education at the Clinic. “The deans felt that nurses could not move easily from one program to another, given the differences and organizing philosophies of each school. But, we continued to meet and the Roundtable became a classic example of team building. Now we are friendly and cooperative with one another and laugh about the resistance to the idea that existed in the beginning.”

The idea has proven popular with the Clinic, schools of nursing, nurses and student nurses alike. Matching nurses with faculty positions is made efficient by the use of a database that keeps track of teaching opportunities and of the nurses who are seeking them. Nurses with BSNs can teach skills labs and clinicals. A master’s degree is required for teaching online and classroom courses.

The database went live in May 2007 and, to date, over 100 positions, 95 percent of them clinical, have been filled.

Because many of the nurses coming in as adjunct faculty have no prior teaching experience, the Clinic organizes a one-day Faculty Boot Camp orientation. The individual components of the orientation, including the roles and responsibilities of faculty, formative and summative evaluation, organization of the clinical day and critical thinking, are taught by experienced faculty from the schools of nursing.

Students are invited to voice their opinions regarding what they need and expect from clinical instructors. According to Kavanagh, the students are impressed that their views are sought and valued.

“Nurses who have accepted faculty positions tell us that teaching has truly re-energized and enhanced their nursing practice,” Kavanagh stated. “For many, it has also increased their interest in pursuing an advanced degree.

“Especially uplifting,” Kavanagh continued, “is the trust and goodwill that have developed among the Roundtable participants who had previously viewed one another as the competition. Now we know that all of us are in this together and we are working together to find solutions.”

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