A Quiet Driver

By James X. Stobinski 

There are 3.4 million registered nurses in the United States.⁽¹⁾ Strong, sustained employment growth is projected for registered nurses through at least 2031.⁽²⁾ A higher proportion of older Americans with chronic conditions and greater demand for healthcare services to include surgery fuels the need for nursing care.⁽²⁾ According to the National Center for Health Workforce Analysis, “… there is a projected shortage of 78,610 full-time equivalent (FTE) RNs in 2025 and a shortage of 63,720 FTE RNs in 2030.”⁽³⁾ 

As Asin, in a 2024 post, tells us there is a salient but low profile issue limiting the supply of registered nurses – a shortage of nursing faculty.⁽⁴⁾ She refers to this issue as the “Quiet Driver” of our nursing shortage.⁽⁴⁾ It has long been assumed that enough younger nurses would take the place of the large contingent of retiring Baby Boomer nurses. It was anticipated that there would be enough interest in entering the nursing profession and that we would have sufficient capacity to educate the incoming students. But nursing education program capacity is inextricably dependent on an adequate number of qualified faculty.

The problem of faculty shortages has been well known for over two decades.⁽⁵⁾⁽⁶⁾ The American Association of Colleges of Nursing (AACN) explains that, “The current demand for master’s- and doctorally prepared nurses for advanced practice, clinical specialties, teaching, and research roles far outstrips the supply.”⁽²⁾ I must emphasize the teaching and research section of the last sentence. Over the last decade the number of American nurses with DNP level education has risen rapidly to comprise 1.6% of the total nursing workforce.⁽⁷⁾ During this same interval the number of Ph.D. prepared nurses has remained steady at slightly less than 1.0% ⁽⁷⁾ and enrollment in nursing Ph.D. programs has declined over the last decade.⁽⁸⁾

As a result of these shifts in doctoral education methods, we lack nurses with the needed educational preparation who are willing to teach in academic programs to include baccalaureate pre-licensure programs and nursing graduate programs. A shortfall in nursing faculty also means decreased capacity to prepare the next generation of educators and academics creating a downward spiral. The current faculty shortage negatively impacts on both the number of all nurses but also the future number of nursing faculty. 

Just as with the overall nursing workforce, nursing faculty are ageing. According to a 2017 projection by Fang and Kesten large numbers of nursing faculty will retire this decade.⁽⁵⁾ These authors also explain that these, “Younger faculty who are likely to replace the retiring faculty possess fewer doctoral degrees, lower senior faculty ranks, and more limited in ability for graduate-level teaching.”⁽⁵⁾ 

The relatively poor compensation of nursing faculty work potentiates faculty shortages. The American Association of Colleges of Nursing (AACN) reports that the median salary for APRNs is $129,480 while that of nursing faculty is $93,958; a 27% lower median salary.⁽⁸⁾ When we consider the time and expense of completing a Ph.D. program the shortfall in nursing faculty is easily explained. It is possible that, over the long term, nursing students may opt for clinically focused advanced education further exacerbating the faculty shortage. 

The AACN details a number of interventions which might ameliorate the projected faculty shortage.⁽⁸⁾ Loan forgiveness programs to offset education costs and increased public-private partnerships may provide some relief but the basic facts remain. Nursing faculty work does not pay well. If faculty wages remain low, recruiting issues will persist. The best and brightest early career nurses may be gravitating to better paying clinical roles with shorter, less expensive entry paths. The implications of a continued faculty shortfall loom large for American healthcare. 

– James X. Stobinski, Ph.D., RN, CNOR, CSSM(E), CNAMB(E), is a senior perioperative consultant.

References

1. Health Resources and Services Administration. (2024). Nurse survey fact sheet. U.S. Department of Health and Human Services. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Nurse-Survey-Fact-Sheet-2024.pdf
2. American Association of Colleges of Nursing. (2024). Nursing workforce fact sheet. https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet
3. National Center for Health Workforce Analysis. (2022). Nurse Workforce Projections, 2020-2035. In National Center for Health Workforce Analysis. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Nursing-Workforce-Projections-Factsheet.pdf
4. Asin, S. (October 28th, 2024). A quiet driver of the nurse shortage, explained. https://www.beckershospitalreview.com/workforce/a-quiet-driver-of-the-nurse-shortage-explained.html?origin=BHRSUN&utm_source=BHRSUN&utm_medium=email&utm_content=newsletter&oly
5. Fang, D., & Kesten, K. (2017). Retirements and succession of nursing faculty in 2016-2025. Nursing outlook, 65(5), 633–642. https://doi.org/10.1016/j.outlook.2017.03.003
6. Berlin, L. E., & Sechrist, K. R. (2002). The shortage of doctorally prepared nursing faculty: a dire situation. Nursing Outlook, 50(2), 50–56. https://doi.org/10.1067/mno.2002.124270
7. Smiley, R.A., Allgeyer, R.L., Shobo, Y. Lyons, K.C. Letourneau, R., Zhong, E. Kaminski-Ozturk, N., Alexander,  M. et al. (2023). The 2022 National Nursing Workforce Survey. Journal of Nursing Regulation, 14(1), S1 – S90.
8. American Association of Colleges of Nursing. (AACN) (May, 2024). Fact Sheet: Nursing Faculty Shortage.