How often do you show up for work and wonder if there will be enough staff to cover the shift safely? Unfortunately, this question is more likely the norm than the exception nowadays.
It’s no secret that hospitals, doctor’s offices, and other healthcare settings are reeling from workforce challenges. Unfortunately, there is no end in sight to the severe nursing shortage from which the U.S. is suffering.
To help ease the burden on providers and meet future demand for care, our country must more than double the number of new graduates entering and staying in the nursing workforce every year for the next 3 years. Utilizing the existing nurse workforce to help train student nurses is one solution that has the potential to realize immediate results.
I have been a nurse since 1986 and a nurse educator since 2002, and I have never known a time when we had enough nurses. There has always been challenges with the nursing workforce in certain parts of the country and in certain settings. But this time it is different.
This time we cannot simply look to open more nursing schools or increase the number of students as easily as we might have in the past. That’s because the country is experiencing not just a shortage of nurses, but also a shortage of the nurse educators who are dedicated to training the next generation of nurses. Nursing schools are facing faculty shortages that have almost one-in-ten faculty positions vacant. This limited program capacity has forced American nursing programs to turn away over 91,000 qualified applications in 2021 alone.
Turning away qualified applicants from nursing school should not occur when our nation is experiencing a crisis in healthcare, impacted by the nurse shortage, and exacerbated by the COVID-19 pandemic. Undoubtedly, one of the driving factors for the decline in nurse educators is a lack of adequate compensation; this must be addressed. In the meantime, the healthcare system can start to tackle current capacity challenges by using the existing nursing workforce to serve as preceptors to student nurses. Preceptors are critical because they work alongside student nurses, allowing them to gain hands-on experience working with patients. This complements what students learn in the classroom, as well as the virtual training simulations they need to further boost their skills.
One initiative to use the existing workforce, called the Student Nurse Apprenticeship Program, was launched this year in Alabama (where I live). In this program, students are paired with a nurse (preceptor) to get the on-the-job training they need to develop clinical judgment and master key skills. In addition to gaining valuable patient care experiences, this program allows the student nurse to become acclimated to the hospital setting, which will ease their transition to the hospital after graduation. Another bonus is the student gets paid, decreasing the need for the student to seek work elsewhere in a position that may not provide the experiences they need.
Apprenticeship programs, like Colorado’s, which help prepare certified nursing assistants, are especially important because they help address shortages in rural areas, while creating job opportunities for community members who face educational or economic barriers.
However, the number of nurses willing to serve as preceptors has decreased as nurses retire or exit the field. In addition, nurses are already working short-handed and struggling to care for multiple sick patients safely. Some may fret that taking on the added responsibility of working with a student nurse only increases their workload. But well-designed apprenticeship programs need not divide their attention, but rather, multiply their impact.
To provide students with the experience they need, current nurses need training from their institutions on how to provide high-quality training experiences to students. Resources to provide additional education to preceptors should be made more widely available since they would be well worth the price to adequately prepare nurses to become knowledgeable and well-trained preceptors to students. Finally, many nurses are willing to step up to the challenge but expect to be compensated (as they should be) for the additional skills and work involved with training student nurses. I believe this, too, is worth the cost.
After all, the cost of not doing so — to overstretched hospitals, the current workforce, and, ultimately, patients — is much, much higher.
Rochelle Hughes, RN, MSN, is a nurse educator with ATI Nursing Education, a provider of online learning programs for nursing.