Nursing: The Faculty Famine

In 2005, I wrote a story called “Critical Condition” — my first for FLORIDA TREND — about Florida’s nurse faculty shortage. Back then, Florida had about 18 million residents and was grappling with 3,000 RN vacancies. The state’s nursing schools, meanwhile, were scrambling to fill instructor slots and turning away hundreds of applicants.

At the time, Kathleen Long, then dean of the University of Florida’s College of Nursing, called the nurse faculty deficit Florida’s “dirty little secret” — the problem that no one wanted to discuss. Nearly two decades later, plenty are talking about it as the state looks for ways to bolster its nurse pipeline.

Florida has more than 22 million residents now, and some project the state will have a shortage of 59,000 nurses by 2035. The faculty shortage remains a key contributor to the problem. A survey by the Florida Center for Nursing reported a 12% faculty vacancy rate among 100 bachelor of science in nursing (BSN) programs last year, and those vacancies are limiting the number of nurses the state can produce. Of the 13,412 qualified applicants who applied to those programs in 2022- 23, only 9,841 (73%) were accepted. Fewer than 8,000 (60%) enrolled.

It’s not just a Florida problem. “What we’re seeing in Florida, our colleagues across the country are also experiencing,” says Rayna Letourneau, an associate professor of nursing at the University of South Florida and executive director of the Florida Center for Nursing (FCN). “There just aren’t enough nursing faculty.”

The trend has several root causes. For one, nurse educators are fast approaching retirement. Most nurse faculty with doctorates are in their 50s and 60s, data show, and those with master’s degrees are 48 to 55, on average. Graduate programs are not replenishing the supply quickly enough: They, too, have faculty shortages. The biggest barrier, though, is pay. Nurses with advanced degrees make less teaching than they do in clinical settings. In 2021, the average annual nurse instructor salary in Florida was $76,835, according to the FCN, whereas the average nurse practitioner earned $104,632.

Nursing schools also are having trouble finding qualified preceptors, the experienced hospital nurses who train and mentor nursing students during their clinical rotations. They show students things they don’t necessarily learn in the classroom — everything from how to program an IV pump to how to comfort a family member when a loved one is dying. Beyond the didactics, nurses who have good experiences with their preceptors report better job satisfaction and are more likely to stay in the profession, research shows. But many bedside nurses today, Letourneau says, are too “tired, or not adequately prepared” to take on the role because they are new to the profession themselves.

Who then, will teach the next generation of nurses?

Letourneau and others are working on it. The FCN recently developed a continuing education activity, free to nurses, spotlighting faculty careers. “We hope that exploring the role will really pique the interest of some nurses for them to say, ‘Well this is interesting, this is something I’d like to pursue,’” says Letourneau. She’s encouraged that nurses across the state have enrolled in the course.

The state and federal government, meanwhile, have been chipping in funds to help address immediate needs. In 2022, state lawmakers allocated $25 million to create a “Linking Industry to Nursing Education (LINE) Fund,” a competitive grant program to help schools recruit faculty and clinical preceptors with funds matched dollar-to-dollar by health care providers. And the U.S. Department of Health and Human Services is awarding money to nursing schools to provide low-interest loans to those studying to become nurse faculty and loan forgiveness to those who go to work as educators.

Some schools and hospitals are pioneering their own strategies to cope with the challenge. An approach out of AdventHealth and Orlando’s AdventHealth University — the hospital system’s higher education branch — merits attention. In the wake of the COVID-19 pandemic, the school was having trouble recruiting adjunct faculty to teach its nursing students in the clinical setting. In response, AdventHealth in 2023 created “Clinical Scholar” positions that allow select nurses to spend one of their three weekly 12-hour shifts teaching AHU nursing students. To incentivize potential instructors, the hospital pays them at their usual rate, not the reduced rate adjuncts typically earn.

Hannah Schumacher, a neuro-ICU nurse who started her first nursing job in 2020 at the height of the pandemic and worked through subsequent waves, says becoming a clinical scholar has reinvigorated the career that at one point she’d been rethinking. “It’s still very, very difficult to be a bedside nurse. It’s emotionally and physically draining,” she says, but she looks forward to her teaching day each week and finds mentoring students rewarding. “Since I’ve taken on this role, my job satisfaction has increased. I’m feeling much less burned out.”

Letourneau is excited by AdventHealth’s Clinical Scholars program — calling it a “win-win” and “prime example” of the benefit of innovative academic-practice partnerships, where hospitals and schools share resources to meet a common goal.

At the end of the day, she sees no one easy fix for the nursing professions’ complex workforce challenges, but she remains optimistic. “It’s going to take several solutions, it’s going to take a lot of research to develop evidence and best practices, and it’s going to take time,” she says. “If we all continue to work together and move the needle, we’re heading in the right direction.”

— Amy Keller, Executive Editor akeller@floridatrend.com

Tags: Editor's column