The nursing shortage

The urgent problems — and UNMC's solutions.

PROBLEMS

Will enough nurses be there when you need them?

SOLUTIONS

What we're doing to end the shortage and elevate the quality of nursing care.

 

THE KEY QUESTION BEHIND TWO URGENT ISSUES:

Will enough nurses be there when you need them?

Like a tightening vise, two converging forces put exponential pressure on tomorrow's nursing care. At risk is the likelihood that there will be enough nurses, across all specialties, to care properly for you and your family.  

ISSUE #1:
Snowballing shortages.

Like the entire U.S., Nebraska faces a critical — and growing — shortage of nurses. The state's current shortfall is projected to jump to 20% — nearly 4,000 nurses — by 2020.
The problem is mirrored — and the nursing pipeline is choked — by a nationwide shortage of faculty. Not only is there not enough faculty, many teachers are nearing the end of their careers. Reflecting national numbers, the average age of nursing faculty at UNMC is 54.
Half of Nebraska's nurses with bachelor's degrees are UNMC graduates. But today, across the U.S., about half of all qualified applicants are turned away because of insufficient faculty, facilities and resources.
The nursing shortage, most severe in small towns and rural areas, affects both Nebraska's physical health and its economic health. Lack of care impedes the ability of communities throughout the state to draw and hold residents and the businesses that employ them.

Nebraska's nurses — fast facts.

  • In 2009, the average age of a Nebraska nurse was 46 years old.
  • About half of all Nebraska nurses will retire in the next 10 years.
  • By 2020, Nebraska will have a shortage of nearly 4,000 RNs.
  • Of Nebraska's 93 counties, 73 have a lower than national average ratio of registered nurses to patients, and more than one-third of Nebraska's counties have no nurse practitioners.
  • Nine counties in Nebraska have no registered nurses.
  • Four counties have just one registered nurse.

Source: Nebraska Center for Nursing  


A note about the recession's impact:
Since 2008, many health care providers — like other sectors of the economy — have been hit with budget cutbacks, sometimes resulting in a hold on new hiring. Such short-term signals are misleading. The nursing shortage is not suddenly over; it is merely disguised by a temporary jobs abatement caused by the worst economic downturn since the 1930s. Health care generally — and nursing specifically — remain among the few fields in which job demand will be strong over the next decade.

Nursing Shortage Fact Sheet — American Association of College of Nursing

ISSUE #2:
Tsunami demand.

As it ages, the largest generation in U.S. history puts unprecedented strain on health care.
Huge waves of retiring Baby Boomers will dramatically increase demand for nurses everywhere — at physician offices, community clinics, outpatient centers, hospitals and nursing homes. A gathering tsunami looms for geriatric care.
Completing the perfect storm: Rapid medical advances, rigorous new care standards and increasingly complex medical technologies demand more — and better educated — nurses across all specialties.  

OUR SOLUTIONS: A BOLD CHARTER OF PARTICULARS

What we're doing to end the shortage and elevate the quality of nursing care.

We're working on multiple fronts simultaneously. Efforts are focused in three primary areas:  

SOLUTION #1:

Big boost in student capacity via unprecedented construction.

Never before in the College's nine-decade history has there been so much building and renovation over such short time. In a difficult time of budget scarcity, this happy result owes to an abundance of donor vision and generosity and the confidence of state legislators and the governor.
Nationwide, the nursing shortage sprang from insufficient capacity — cramped, outdated facilities and not enough teachers. Our system-wide remedies for all Nebraska:

• New facilities opened in 2010:

  • New state-of-the-art, $14-million Center for Nursing Science — adjoining our existing facility on the Omaha campus.
  • A 5th division in Norfolk as part of a new $11.9-million collaborative nursing education center, the fruit of an amazing partnership among area residents, the region's health system, its community college and UNMC. This collaborative learning center stands as a visionary, homegrown nursing-needs solution that could serve as a national model of public-private cooperation.

• Slated for the future 2015:

  • New, state-of-the-art $18 million Health Science Education building for the College of Nursing's Kearney Division and programs from the UNMC School of Allied Health Professions. The building is a partnership with the University of Nebraska Kearney, UNMC and the community.
  • NU regents have assigned highest priority for new nursing building in Lincoln. It has been a critical need for years — currently, the College operates out of cramped rental space downtown. We expect this project to proceed when the economic outlook improves.

This is not about bricks and mortar. It's how we'll be able to:

  • educate more nurses
  • train more nursing faculty
  • strengthen research activity
  • support our advocacy and outreach programs throughout the state

SOLUTION #2:

New programs — plus accelerated and advancement options — to:

  • train new nurses
  • prepare nursing faculty
  • help current nurses acquire advanced knowledge, skills and degrees

We've aggressively expanded programs and pathways for nurse training, development and advancement, including:  

• Program additions that respond to nursing workforce needs:

  • Doctor of Nursing Practice (DNP) degree program — A terminal degree with advanced clinical and research-application training. Fast becoming the degree of choice in advanced practice nursing. Expands frontline access to primary health care.
  • Nurse Leader/Executive Advanced Development(LEAD) program — A distance education advancement program for RNs at all levels. Three points of entry:
    • RN to MSN — accelerated master's degree path for Associate Degree (ADN) and Diploma RNs.
    • BSN to MSN — for bachelor's-degreed RNs to advance to master's level.
    • PMC — Postmaster's certificate: advanced leadership preparation for master's-degreed RNs.
  • Nurse Educator Option — To prepare more nursing faculty to solve the teacher deficit that mirrors the nurse shortage. Three points of entry:
    • MSN— concurrently with any MSN specialty track. In other words: dual preparation in a specialty and as a teacher
    • PMC— as a Postmaster's certificate
    • PhD — as cognate courses in the PhD program
    • DNP - as elective courses in the DNP program
  • Transformed RN to BSN program — Fall 2011 launched a streamlined, completely restructured distance-education program for RNs with an associate degree (ADN) or diploma in nursing to advance to a bachelor's degree.

• Accelerated program options to get more nurses into service faster:

We've expanded student capacity in our:

Plus — through federal educational grants awarded in response to faculty proposals — we've added accelerated pathways to advanced credentials in urgently needed specialties and nurse leader executive roles:

  • Geriatric NP — Accelerated Postmaster's Certificate — PMC (GNP-MAP)
  • Psychiatric Mental Health NP — Sprint Track Postmaster's Certificate (PIPN)
  • Accelerated RN to MSN — An advanced distance-education program for current associate degree (ADN) or diploma RNs who want to advance to nurse leader/executive roles that require master's degree preparation.

SOLUTION #3:

Recalibrate entire curriculum to elevate and integrate:

  • academic standards for care quality, patient safety and systems efficiency.
  • dynamic learning, independent thinking and clinical judgment.
  • team-based care, interprofessional training, transitional care and care coordination, research applications and evidence-based practice focused on the 360-degree patient.
  • needs-based programs that anticipate and respond quickly to the demands of modern nursing — including preparing more nurses and nurse educators to end the nursing deficit — with students expertly equipped for fast-changing health care technologies, leadership roles and specialty care urgently needed by our diverse and aging population.
  • help current nurses acquire advanced knowledge, skills and degrees
  • learning technologies, including high-fidelity patient manikins; interactive, virtual-reality training; online learning resources; and advanced applications in web-based distance education.

Our entire BSN-MSN-DNP-PhD curriculum now embeds benchmarks suggested by the American Association of Colleges of Nursing, The Institute of Medicine, the Carnegie Foundation and the Robert Wood Johnson Foundation — all leading advocates of progressive, evidence-based health care education.

MIA? Who will care for you and yours?
The nursing shortage,
by the numbers.

The nursing deficit affects all 50 states.

3,838
Projected Nebraska registered nurse (RN) shortage in 2020. When you include licensed practical nurses (LPN), the shortfall jumps to nearly 5,600.

1, 200,000
Projected U.S. RN shortage in 2020.

For most of the next two decades, huge waves of retiring Baby Boomers will dramatically increase demand for nurses at all levels, in all care settings. This demographic shift, coupled with other rapidly changing forces in health care, accelerates an already serious nursing deficit.

Our state and nation needs not just more nurses. We’ll need more and better educated nurses.

The looming gap:
Nebraska’s projected
RN demand/supply


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