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Opinion: Nursing not immune to COVID-19

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COVID-19 has altered nearly every facet of health care, and nursing is certainly no exception. The effect is magnified in a profession that already has experienced a workforce shortage for nearly two decades. Nurses have been at the front line of the pandemic response since its infancy.

The long-term impact of COVID-19 on the nursing shortage is still to be determined; however, challenges such as a national personal protective equipment shortage, nurse furloughs in some regions and nurse scarcity in others are certain to impact the nursing profession profoundly. What remains to be seen is how nurses, the largest segment of the health care workforce, can adapt to a new normal.

The nursing shortage is well documented, both nationally and in Missouri. The Missouri Hospital Association noted that nearly 20% of new registered nurses leave the profession within one year and nearly one in three exit within two years. According to the National Council of the State Boards of Nursing in 2018, 50% of the nursing workforce was aged 50 or older.

In 2019, the Missouri State Board of Nursing indicated the southwest Missouri region is hit particularly hard by the nursing shortage. At any given time, there are between 700 and 750 nursing positions open in Springfield. The Bureau of Labor Statistics estimates that an additional 200,000 RNs will be needed each year through 2026 in order to fill the gap. An aging nursing workforce combined with limited capacity in nursing schools due to a low amount of faculty are two of the greatest drivers of the current shortage.

According to an American Association of Colleges of Nursing survey in 2018, the national nurse faculty vacancy rate is 7.9%. This deficiency led nursing schools to turn away over 75,000 applicants to baccalaureate and graduate nursing programs in 2018 alone. Several factors have been identified that led to the faculty shortage, including an oncoming wave of faculty retirements and lower compensation for nurse educators compared with nurses with similar educational attainment in the clinical setting. These factors and more lead to a smaller pool of academically prepared nurse educators ready to take on the task of preparing future nurses.

Efforts are currently underway to mitigate the impact of the nursing shortage, both locally and nationally. In 2019, the MSBN approved expansions for five nursing programs in Missouri, including two in Springfield. The MSBN also has encouraged the development of apprenticeship programs between hospitals and schools of nursing to facilitate student growth and development prior to graduation. Many hospitals in Missouri have created residency programs for new graduate nurses that include extensive mentoring and training. These residencies allow new nurses to further skill attainment and critical thinking, all while assimilating into the culture of the hospital. The MHA also recommends closer integration between employers and schools of nursing to better facilitate the transition from student to professional registered nurse.

In order to address the nurse faculty vacancy, the Health Resources and Services Administration has implemented the Nurse Faculty Loan Program. This funding opportunity authorizes the cancellation of up to 85% of a student’s loans from earning an advanced nursing degree, which is required to teach at the baccalaureate level.

Additionally, area nursing schools can and do offer various incentives to nurse educators such as flexibility and the opportunity to continue practicing as a bedside nurse. Much like the transition to registered nurse, the transition to nurse faculty can be challenging. The implementation of faculty mentorships and ongoing training are critical to impacting the nurse faculty shortage.

One could argue that the role of the nurse has never been more critical than it is today. Nurses have long been identified as a trusted and resilient profession, ready to fill in the gap wherever there is a need. At no time in recent memory has this been more true than in the current COVID-19 pandemic.

Every day, nurses are rising to the challenge and leading in the fight to improve care for critically ill patients, as well as advocating for their colleagues across all health care disciplines. From volunteering to work in COVID-19 specific units to taking on whatever role is needed in a given moment, nurses are marching on, ready to address whatever challenge a day might bring.

While the future of the nursing shortage may be unclear, what is sure is that the calling of nurses as compassionate caregivers will remain constant.

Amy Townsend is the vice president of student nursing at Cox College. She can be reached at amy.townsend@coxcollege.edu.

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