By Lynne M. Dunphy
Who Will Teach The Nurses? A Shortage of Intellectual Capital
Where are the nurses? Are we making any progress with the nursing shortage that plagues the nation and this state? Certainly, the market has responded and nursing salaries have been on the rise. Registered nurses with 10 years of experience working at Rhode Island Hospital will be paid $81,078 a year in the last year of the new contract recently negotiated by Local 5098 of the United Nurses and Allied Professionals. This excludes overtime. Starting hourly salary for new registered nurses at Rhode Island Hospital is $23.69 per hour and in four years that will reach $26.52 per hour. A head nurse in a critical care unit with an associate’s degree in nursing may command a salary of $86,000 or higher. And yet Rhode Island hospitals must still turn to recruiting foreign nurses and so-called traveling nurses at exorbitant rates, to fill the ranks of Rhode Island hospitals’ nursing staff—especially our community hospitals—the ones “down the street,” the ones that care for you and me, and Mom and Pop, and your baby when they are sick on a holiday weekend, are going broke.
Most people are aware of the nursing shortage. It is part of what has increased salaries for nurses, forced better working conditions, and enhanced the desirability of nursing as a profession. Applications to schools and colleges of nursing have skyrocketed. Many bright and promising applicants are those with existing baccalaureate degrees and graduate degrees in other areas who wish to change their careers to nursing. The health care industry is the largest employer in Rhode Island, and nursing is one of the best-paid and most desirable jobs. An yet, lengthy waiting lists for admittance to nursing education programs, and a lack of nursing educational capacity have hindered the progress of many bright and promising potential nurses. According to National League of Nursing and American Association of Colleges of Nursing data, more than 146,000 qualified applicants nationally to schools of nursing were turned away! The nursing workforce pipeline has clogged to a dribble. The current and persistent shortage of nurses is no longer related to a lack of people interested in nursing—it is driven by an accelerating shortage of nursing faculty, who at an average age of 55 are rapidly retiring, depleting the ranks of experienced educators. And there is no one in the educational pipeline to take their places.
To teach nursing in Rhode Island, one must, minimally, have a master’s degree in nursing. Salaries for nurses with masters’ degrees in the practice arena have likewise risen. A nurse with a master’s degree and license as a nurse practitioner in Rhode Island has a salary range of $75,000 to $100,000 to higher in some specialty practices. The median salary for chief nurse executives (most of whom hold the master’s degree) as of January 2006 was $161,472; for a nurse anesthetist, salaries can range from a base of $146,478 to well over $200,000 a year in some practices, depending on overtime and on-call schedules. The average full-time starting salary for a master’s prepared nursing faculty member in a nursing education program in Rhode Island? Approximately, $43,000! The starting salary for a Ph.D.-prepared assistant professor at the University of Rhode Island begins at approximately $56,000!
The result is a severe lack of educational capacity in the state to accommodate eligible students desiring nursing careers. Lack of adequate clinical placements as well as classroom capacity also contribute to schools of nursing in the state being unable to accommodate additional qualified students. More space and new buildings are needed. But the most pressing issue is the shortage of faculty to teach in these classrooms.
The underlying reasons for the shortage of nursing faculty are complex, as are the causes behind the shortage of nurses. But increasing nursing practice salaries have yielded an increased interest in nursing as a profession and career choice. Clearly, increases in salaries for nursing faculty could yield similar results. Nursing remains a very hard and demanding job. Likewise, being a nursing professor amidst the ever-increasing complexity of today’s health care system is tough, challenging, and filled with responsibilities. The pay should be commensurate. While nursing education loan relief by the Rhode Island Student Loan Authority as announced this month is better than nothing, it does not provide the incentive an increasingly well-paid nurse needs to decide on a future as a nursing faculty member. An across-the-board $25,000 increase in the base pay of all nursing faculty across the state would be a beginning. The headline of the July 29th Providence Journal read: “Top state government salaries are in higher ed.” This is a good thing. An investment in higher education at all levels is critical to the state’s ability to remain competitive in a knowledge-based economy. At the top of the list should be professors of nursing!
Lynne M. Dunphy, a nursing professor, researcher and practitioner, is the first holder of Routhier Chair of Practice at the University of Rhode Island’s College of Nursing.