Good Example Of Causes And Solutions Of Nursing Faculty Shortage: An Article Review Article Review
Nursing shortage is undoubtedly one of the most pressing problems in healthcare provision globally. And while it is true that the global problem of shortage of nurses in clinical and/or medical setting is one that needs urgent solution, shortage of nurses in educational and/or academic setting is also a problem that needs to be addressed as soon as possible—especially when taking into account the strain that it puts in the entire nursing industry. In order to fully understand the depth and importance of addressing the problem of nursing faculty shortage, a review of an article that closely follows the problem as well as the solutions offered by various other researches is important to be reviewed and referred to.
In an attempt to fully understand the problem of nursing faculty shortage while taking into consideration nurse shortage in clinical and/or medical setting, the paper titled The Global Nursing Faculty Shortage: Status and Solutions for Change, written by registered nurses with doctorate degrees in nursing Deena A. Nardi and Charlene C. Gyurko, endeavors to find the unifying themes and trends of solutions between various articles that tackle the problem at large which is believed to be caused by a confluence of factors including poor salary and incentives, global migration of nurses, and the small population of nurses who actually earn baccalaureate degrees in nursing such as BSN or Bachelor of Science in Nursing (Nardi and Gyurko, 2013). Serving as an article that reviews various other articles, the paper applied what the authors referred to as SR or systematic review methodology: A review process that is comprehensive, unbiased and “systematically locates, appraises, and synthesizes evidence from published documents to obtain a reliable perspective or more compelling findings” (Polit and Beck, 2012 as cited in Nardi and Gyurko, 2013, p. 319). Using the key words “nurse faculty shortage,” “nurse faculty global migration,” global nurse faculty shortage,” and “nurse faculty shortage solutions,” the authors reviewed and searched various legitimate and scholarly databases such as Cumulative Index to Nursing and Allied Health Literature (CINAHL), CINAHL PLUS, PubMed Central, Google Scholar, Ebsco Full Text, Medline, Medscape, and Proquest to yield various documents that largely discuss the topics of nursing faculty and shortage as well as it causes, implications, and themes and trends of solutions (Nardi and Gyurko, 2013). Of the 1,287 documents that resulted from the search, only 174 were actually considered for they matched the content as well as the date (2002-2012) deemed necessary and useful by the authors (Nardi and Gyurko, 2013). However, the 174 documents were further narrowed into 62 documents as the authors looked for those publications that largely discussed and offered possible solutions to the problem (Nardi and Gyurko, 2013). Investigating the solutions offered by the 62 carefully selected publications, the authors found 181 solutions offered by various researches to solve the global problem of nursing faculty shortage (Nardi and Gyurko, 2013). Studying such 181 offered solutions to the problem, the authors found eight (8) distinct themes and trends that encompassed the 181 solutions (Nardi and Gyurko, 2013). Those eight (8) themes and trends of solutions consist of (1) centralization of data recording and strategy management, (2) change of educational paradigm, (3) international cooperative policies and programs, (4) removal of barriers to advanced practice, (5) stabilization of funding of all educational programs, (6) management of migration, (7) improving nursing scholarship, and (8) making faculty salaries for nurses more competitive (Nardi and Gyurko, 2013).
The centralization of data recording and strategy management is the most common theme of solution expressed by 30.83% of selected publications that closely tackled the problem (Nardi and Gyurko, 2013). Addressing the negative impacts of the ambiguity of terms as well as the common vagueness of tools, research designs, settings and sample numbers as they are used in various researches, this theme of solution is directed towards centralizing the description of common tools and strategies used to address the problem of nurse shortage in the academe (Nardi and Gyurko, 2013). As expressed by most publications, the need for a unified nursing voice in an international nursing workforce center is critical as such is the way to collect and disseminate important data on nursing across countries worldwide (Nardi and Gyurko, 2013). Addressing the need for a more thorough body of literature that will tackle the crises in nursing worldwide, it is important to centralize data and strategy management in order to yield solutions that will be uniformly effective globally (Nardi and Gyurko, 2013).
Another theme found in the solutions garnered by the authors is the educational paradigm change in nursing (Nardi and Gyurko, 2013). As a second common solution theme, 28.32% of selected publications expressed educational paradigm change in the solutions offered to solve the problem of nursing faculty shortage (Nardi and Gyurko, 2013). In US, 60% of registered and practicing nurses have completed an Associate of Science in Nursing (ASN) degree while only approximately 21% of those nurses actually continue to baccalaureate degree, making the majority of nurses in US prepared only at the associate degree level (Nardi and Gyurko, 2013). Such is seen as a problem as nurses who stay only at the associate degree level are inapt to enter the nursing academe, making the pool of qualified nursing faculty shrink continuously (Nardi and Gyurko, 2013). In response to such, various professional nursing organizations have recommended to make BSN or Bachelor of Science in Nursing as the basic level of education for nurses—a campaign that has lasted for more than 40 years (Nardi and Gyurko, 2013). However, nurses who have completed ASN and practice as full-time nurses have few motivators aside from personal desire, thus keeping the pool of nurses qualified to teach limited (Nardi and Gyurko, 2013).
Another solution theme offered by the publications reviewed by the authors is the international cooperative policies and programs that will promote nursing training (Nardi and Gyurko, 2013). Seen as necessary by 10% of the publications reviewed, international cooperative policies and programs rank as the third most common theme of solutions for the problem of nursing faculty shortage (Nardi and Gyurko, 2013). As recommended by several publications, offering more workshops and trainings for nurses through collaborative training and international exchanges will support current nursing faculty and also attract more nurses into pursuing educational career (Rosenkoetter and Nardi, 2007 as cited in Nardi and Gyurko, 2013).
The removal of barriers to advanced practice is the fourth theme of solutions expressed by 9.17% of the reviewed publications (Nardi and Gyurko, 2013). Barriers that prevent advanced practice nurses (APNs) from practicing in medical and/or clinical setting is one of the main contributor to the poor outcomes associated with healthcare provision in USA and other countries globally (Nardi and Gyurko, 2013). Removing such barriers that keep APNs from practicing their craft and letting them collaborate with their physician colleagues would mean improvement in the quality of healthcare delivered as well as encouraging more nurses to pursue higher education degrees in nursing (Nard and Gyurko, 2013).
Stabilization of funding of BSN degree and higher education programs is another theme of solutions expressed by 8.33% of the reviewed publications (Nardi and Gyurko, 2013). Funding cutbacks and a shortage of clinical placement sites are often seen compounded with the problem of nursing faculty shortage (Nardi and Gyurko, 2013). As a response to such, it is largely suggested that a dedicated funding stream shall be used by countries globally in order to stabilize support for nursing education and training instead of depending on arbitrary appropriations that are not usable when taking into account long-term budget strategies (Nardi and Gyurko, 2013).
Managing the migration of nurses is the fifth trend of solutions to the problem of nursing faculty shortage as expressed by 6.67% of reviewed publications (Nardi and Gyurko, 2013). Migration as used by the reviewed body of literature pertains to “nurse educators or researchers leaving their country of origin to work in a different location” (McLaughlin and Walker, 2010 as cited in Nardi and Gyurko, 2013, p. 323). Migration is considered detrimental to some countries especially if its rate continues to rise which may eventually lead to shortage of nurses as well as those qualified to work in the academe (Nardi and Gyurko, 2013). Responding to such conflict in nursing globally, several publications suggest that management of nurses’ migration shall be implemented through better monitoring of migrant nurses as well as the compliance with international codes on ethical recruitment applying to nurse educators and nurses qualified to enter the academe (Nardi and Gyurko, 2013).
The sixth theme of solutions expressed by 3.33% of literature reviewed is the improvement of nursing scholarship (Nardi and Gyurko, 2013). Nursing scholarship links nursing input to patient outcomes and increasing such area of nursing education increases the visibility of the contributions done by nurses in healthcare planning and research (Nardi and Gyurko, 2013). Improvement of nursing scholarship empowers more nurses to pursue higher education degrees, thus broadening the pool for qualified nursing educators (Nardi and Gyurko, 2013).
Last of the solutions themes identified by the author is making the salary for nursing faculty more competitive as suggested by 3.33% of published articles that tackle the problem at hand (Nardi and Gyurko, 2013). As reported by the American Association of Colleges of Nursing, nursing faculty salaries must be competitive with other positions in the private and public sectors that also attract graduate-prepared nurses with background of advanced practice (Nardi and Gyurko, 2013). Aside from improved salary, incentives such as “access to research funding, opportunities to work with expert peers and participate in research collaboratives, and changes to minimum educational preparation” may be offered to beginning nursing faculty in order to attract other nurses to also pursue an academic career (McLaughlin and Walker as cited in Nardi and Gyurko, 2013, p. 323).
Supplying ample information regarding the status of nursing faculty shortage at this present time, the article written by Nardi and Gyurko is very informative. The narrowing-down of 181 solutions into eight (8) themes is also revolutionary and helpful in easily understanding the large body of literature dedicated to acknowledging nursing faculty shortage. Furthermore, the themes yielded through the process of systematic review may serve the purpose of being the rubric for other research designs done to further address the problem of nursing faculty shortage in the future. While it largely addressed the problem at the global level, evidence and resources that actually reviewed nursing faculty situations in other countries aside from USA were poorly presented and the paper largely focused instead on the current implications of the problem in the USA alone.
Nardi, D.A., and Gyurko, C.C. (2013). The Global Nursing Faculty Shortage: Status and Solutions for Change. Journal of Nursing Scholarship, 45(3), 317-326. DOI: 10.1111/jnu.12030