In the midst of a national nursing shortage, Indiana nursing programs rejected about 2,500 qualified applicants because of a lack of full-time faculty, according to a survey of state nursing programs.
The 2008 survey by the Indiana Nursing Workforce Development Coalition said faculty shortages prevent nursing programs from maintaining a supply of qualified applicants.
With a looming shortage of 260,000 nurses across the country by 2025, schools are trying to graduate as many nurses as possible. An additional 30,000 nurses need to graduate each year to meet the nation's health care needs, according to the Council on Physician and Nurse Supply, a national organization of health care leaders.
Nationwide, nursing programs have turned away tens of thousands of qualified applicants because a lack of educators limits how much a school can increase enrollment.
"We need more nurses out there," said Lisa Rhodes, 37, who is a nurse practitioner for Hammond Clinic in St. John and an adjunct clinical professor at Purdue University Calumet's School of Nursing.
When hospitals have large numbers of patients for every nurse, patient health can be compromised, studies show. Patients who have common surgeries in hospitals with lower nurse-to-patient ratios have up to a 31 percent increased chance of dying, according to a 2002 study by the University of Pennsylvania.
On some days, Rhodes writes her own patient physical reports, and on others she grades reports written by the students she oversees.
"Basically, the clinical setting is where they learn to function as a nurse practitioner," she said.
"That is their practice setting where they grow and evolve and learn how to diagnose, treat and manage patients across the life span with acute illness."
Almost half of Indiana's nursing faculty in 2008 were adjunct professors such as Rhodes, working part time for universities while still practicing, according to the Indiana Nursing Workforce Development Coalition.
Both Indiana University Northwest's and PUC's enrollments for the nursing schools have been able to increase over the past few years, in part because they are able to hire adjunct faculty from local hospitals and clinics.
The hospitals, for their part, benefit from sending nurses to act as faculty at local schools, said Anthony Ferracane, vice president of human resources for Community Health System. Community owns The Community Hospital in Munster, St. Mary Medical Center in Hobart and East Chicago's St. Catherine Hospital.
"What (the schools) do, in return, is help us with some of our educational needs," Ferracane said.
Carol Schuster, chief nursing officer at St. Anthony Medical Center in Crown Point, said clinical partnerships also help hospitals see if a student would be a good hire. But right now, hospitals do not have many openings, she said, because of the economy.
"What's happening with the recession is there are a lot of nurses coming back to work, whether (they are) not retiring like they expected to, or because their spouses were laid off or had hours cut back," she said.
But once the recession ends and those nurses leave, Schuster said hospitals will feel the impact of the nursing shortage with high nurse-vacancy rates. The situation will be compounded by a surge in patients from the aging baby-boom generation and, if congressional health care reform goes forward, newly insured patients, she said.
"I think we'll see salaries go up in a fight and competition to get nurses," Schuster said.
Pay gaps, lack of full-time faculty
While hiring adjuncts helps increase enrollment and, in turn, adds to the number of future nurses, schools cannot just replace full-time faculty with part-time faculty.
"It impacts the quality of our programs and our accreditation status," said Peggy Gerard, dean of nursing at PUC.
Nurses who are qualified to teach full time need doctoral degrees, and they are getting harder and harder to find, said Linda Rooda, dean of IUN's School of Nursing. The nursing school has been looking for candidates to fill a full-time faculty position since November, Rooda said, while it hired at least three adjunct faculty last year.
"The faculty shortage is probably the greatest issue of all," Rooda said. "It's basically due to an aging population of nursing faculty and difficulty attracting young potential faculty into academia."
One of the difficulties is the gap in pay, Rooda said. A registered nurse takes home an average salary of $65,000, according to the U.S. Department of Labor. An assistant nursing professor with a master's degree earns about $50,000, while a professor with a doctoral degree earns about $74,000.
The average age of Indiana's full-time nursing faculty is 51, according to the state nursing coalition. And in the next 10 years, more than half of the state's full-time nursing faculty will have reached the retirement age of 65.
There needs to be nurses in the pipeline to fill those vacant positions, PUC's Gerard said.
"Basically, the number of new faculty positions have outpaced the number of newly graduated master's and doctorally prepared nurses," Gerard said.
And for those few nurses who do pursue higher education, she said, there now are more medical than teaching opportunities vying for graduates' attention, including technology-based positions created by the digitization of patient records.
PUC's Rhodes said the number of nurses pursuing doctoral degrees may increase if institutions were to give incentives, such as tuition reimbursement.
"(But) if you have that personal drive to succeed and desire, a profession that requires more schooling isn't going to deter you into another career," Rhodes said.