The Generation Gap in Nursing

Every time you pick up a trade journal, there’s another article about the nurse shortage. Not only are there not enough people choosing nursing as a career, the average age of nurses is creeping up (as age does to all of us) and more and more nurses will be retiring just as the need for nurses in increasing. You know this; in fact you live it. But whatever you have read about this shortage does not begin to describe the dire situation in teaching of nurses.

In 2002, according to a survey by the American Association of Colleges of Nursing, schools had to turn away over 5000 qualified applicants. This was due to a variety of factors, all related to funding and facilities, but primarily because of insufficient faculty. Instead of the faculty to student ratio of 1:30 or 1:40 that is the norm for classes in other fields, nursing courses, particularly clinical instruction, require a ratio of 1:10 to ensure that all students get the basic training they need in acute care, outpatient care, public health and the like. If there aren’t enough teachers, schools simply can’t produce the numbers of qualified new nurses needed, regardless of the need. Even one or two vacancies have a considerable impact on the workload of the other faculty.

Even worse, in 2002 the mean age of nursing faculty was almost 49 years at the master’s level and over 53 for doctoral level. The long-term implication of these numbers doesn’t require us to look too far ahead. It’s estimated that, between the years 2004 and 2012, roughly 200 to 300 doctoral-prepared faculty will retire annually. Master’s-prepared faculty retiring annually will number around 250 between the years 2012 and 2018.

So there’s our problem today. During the ‘90s, nurses were encouraged to pursue clinical positions. Now they’re needed in the classroom.

Whether it’s in your dealings with patients or new nurses on your floor, teaching is often a part of a nurse’s job. Says Anne, a community health nurse, “Some people just need help taking care of themselves. A lot of my caring for them is teaching them how to do it.” This combination of care and compassion is what drove you into nursing in the first place. But how do you become a college teacher and inspire new nursing students?

The first requirement for becoming a college teacher of nursing is to attain a master’s degree. Community colleges require at least this level of education for their faculty members. While a few schools have considered becoming a bit more flexible in this requirement, it is still generally the rule.

If you are going to teach, you must have a thorough knowledge of what you are teaching so your master’s should specialize in the area you want to teach. For example, if you want to teach clinical nursing, you should pursue accreditation at least as a clinical nurse specialist. If adult or geriatric care interests you, pursue the master’s track for nurse practitioner. A Master’s in Public Health would help provide credentials for teaching adult health education and management.

To become faculty at a four-year college or university, you normally must attain a PhD, EdD or DNSc. Many schools offer a combined MSNDNSc program, with specialties such as adult, family, geriatric and psychiatric care and adult health education. From there, you can choose more defined specialties such as critical care, neonatal/maternal, emergency care, cardiac care, gerontology, oncology, etc.

Doctoral programs are meant to prepare nurses to teach, do research and generally expand the scientific knowledge of nursing. These programs are not necessarily easy, but they offer a great challenge and require a long-term commitment. In 2001, for example, the median time from entry into a nursing master’s program to completion of a doctorate in nursing was 15.9 years as compared to the average 8.5 years for other fields. Is this because once nurses have basic skills they are anxious to use them on the job? Is this because many nurses have families and responsibilities that prohibit them from easy pursuit of higher education? Even the combined MSN-DNSc mentioned above requires six years of part-time study.

Being selected to teach requires more than higher degrees, however. Colleges and universities look for extensive full-time clinical experience. They consider any teaching experience, perhaps in a clinical rotation affiliated with a community college or hospital-based nursing program. They look for published research and presentations at peer meetings and other professional conferences. Any other professional and community involvement is also important.

What’s the cost of higher education to be able to teach? Average tuition costs range widely from about $3600 to $11,000, depending on the type of institution at which you pursue your degree. This is the average, meaning that some will cost more. Add to this the cost of textbooks, uniform, lab coat, medical equipment, transportation to and from the clinical site and thesis and dissertation expenses. Then there is your net income forgone—your lost pay—due to your cutback in work hours to be able to attend classes. In response to these demands, many schools are developing online programs to try to accommodate nurses’ work schedules and some schools even have mock clinical settings, completely equipped, to spare students from having to travel to remote locations for their clinical work. Recognizing the difficulty of nurses in attending higher education classes, many states have passed and funded legislation allowing for loan relief. The federal government has also passed loan relief legislation but has yet to fund it. Many nurses are able to find loans and scholarships offered by schools in their area to encourage graduates to teach there.

What happens after you get your degree and are selected for a faculty position? You suddenly find yourself responsible for the thorough education of students who are looking to you to show them how to learn how to be a nurse. Courses in physical assessment; psychiatric disorders anatomy; pathology; infectious diseases; nutrition; medical/surgical/pediatric nursing and disorders and a wide range of clinicals await the students, with you teaching at least one of these subjects.

Think of all the questions you had when you left school. As a teacher, you have the opportunity to answer these questions for new nurses before they get their degrees, making them that much more qualified to hit the floors running, so to speak. Trained and experienced nurses bring a unique perspective to the classroom. Whereas a trained academician may have done extensive observation and research, you have actually experienced it all hands on. What do you do when a patient refuses to listen to you? What do you do when you adamantly disagree with the doctor? How should you talk to patients? Rae, a public health nurse, decided to give teaching a try four years ago and loves it, just because of her opportunity to really prepare the students for real life situations on the job.

With teaching, however, comes more responsibility than “simply” your instruction work. Teachers must advise students, stay current with new technology and techniques, conduct research and produce scholarship. In addition, it’s usually expected that teachers work within the community to help obtain outside funding for school programs and provide community service as effective public relations. Moreover, as an increasing number of nursing schools add distance learning options to their course list, teachers are as likely to find themselves providing lectures, assignments and tests online as in traditional classrooms. Answering emails and grading tests by computer may not be what you expected, but it is definitely the wave of the present.

Is being a college teacher more exhausting than your floor work? For many nurses, it’s highly rewarding to take young (and maybe not so young) students and show them the exciting and rewarding career that nursing is. Says Rae, instructor of case management, “I love it. I know I am teaching students how to enjoy their jobs and be more productive so they can be the confident, caring and compassionate nurses they aspire to be.”

Source:Today’s Nurse

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