Nationwide Nursing Faculty Shortage Hits USF

Despite being ranked 22nd on Niche’s list of best nursing programs in the country, USF is struggling to gain clinical instructors, just like other programs nationwide, leaving students without their practice in hospitals.

Part of USF’s nursing program is performing clinical hours, during which students get the hands-on experience in hospitals necessary for passing the Nursing Council Licensure Examination (NCLEX) and becoming a nurse.

One cohort consisting of eight senior nursing students has not had a single clinical session since the school year started because the school has not replaced an instructor who resigned in early September. The students were supposed to be doing their clinical hours at California Pacific Medical Center.

Senior Caitlin Mayo is in the nursing cohort affected by the situation. Clinicals are essential to the nursing program, she said, as they offer opportunities to work with patients, medical staff and fellow students.

“You’re basically a nurse when you’re being a student,” Mayo said.

Mayo is supposed to be in pediatric practice for the first half of this semester. She has participated in simulation hours, which are a classroom-based space where students practice different skills on robots, which counts as clinical experience.

However, the simulation experience does not make up the hours in the hospital she lost when three clinical sessions were canceled.  

These clinical sessions, amounting to 27 hours of hospital experience, were canceled for lack of an instructor.

“I’m supposed to be in the part of the semester where I work with kids. I haven’t even seen a kid at this point,” Mayo said.

Steffi Zarifis, who was a pediatrics clinical instructor, unexpectedly resigned at the beginning of the semester, according to USF Associate Dean for Pre-Licensure Programs and Accreditation Dr. Scott R. Ziehm. Though students received an email from the former instructor on Sept. 9 announcing her resignation, no reason was given for her departure.

“You can’t just send us to the hospital without a clinical instructor,” Mayo said. “They’re supposed to be supervising us, and if we do something like insert an IV or any of those more high-risk procedures, we’re supposed to call in our instructor. Also, at the end of our clinical day, we debrief [with them]. They’re supposed to facilitate a learning experience within your clinical.”

Pediatrics is a highly sought-after speciality, so it can be challenging to find clinicals, Ziehm said. But the University has found a new site and faculty to meet the students’ needs. Ziehm did not specify to the students where this new site is or who the new faculty are, though he said they should be starting their clinical hours soon. The students received an email from Assistant Professor Amanda Burke-Aaronson on Sept. 20 telling them that more details about their pediatrics hours would be coming in the near future.

“As a university, we are required to make sure that the students meet their hours. [They] will probably choose days that they’re available to meet those hours so it doesn’t interfere with classes or other clinical hours,” Ziehm said.

Despite the missed clinicals, the students will not be delayed in meeting requirements for this course of licensing, according to Ziehm. Mayo said that usually if students miss or have two or more clinicals canceled, they must do an alternative assignment.

“You have to write a paper, do a project or do a case study,” Mayo said. Her cohort has not been offered any makeup work or assignments.

There are 20 credits of clinical labs required for graduation built into the USF nursing program. Different specialties require different numbers of hours. For nursing students earning their bachelor’s degree, these hours total an average of 966.5, including those spent in inpatient care, outpatient care and in the skills labs, according to the California Board of Registered Nursing 2016-2017 Annual School Report.

The challenge of finding clinical instructors is not a problem unique to USF.

“There is a national nursing shortage for faculty,” Ziehm said.

Schools across the U.S. have been turning away nursing school applicants as they struggle to hire instructors and faculty for the programs, CNNMoney reported.

Ziehm is also the President of the Board at the California Association of Colleges of Nursing and attended the Regional Nursing Summit in Irvine, Calif. on Sept. 21. One of the goals of the event was to “identify practical solutions to address the pre-licensure nursing clinical placement dilemma California is experiencing,” according to the event’s website.

Additionally, salaries are increasing for working nurses, resulting in a 7 percent vacancy rate for national nursing faculty, the Daily Nurse reported. In order to teach a clinical, an individual needs a baccalaureate degree and one year of nursing experience. To teach theory, they need a masters or doctoral degree and have teaching and clinical experience, Ziehm said. Together, these make the occupation of nursing, as opposed to teaching nursing, more desirable.

As a solution, clinical simulation programs are increasingly being adopted in California nursing education programs to replace clinical experience hours. UCSF Medical Center, where USF students have clinicals, conducted a survey in 2015 for the California Board of Registered Nursing exploring simulations as a replacement for clinicals.

The survey found that finding clinical experience for students was challenging, causing a decrease in the number of students allowed on a patient unit or limiting students to observation-only. This was due to limited clinical sites, Health Insurance Portability and Accountability Act (HIPAA) regulations and patient safety initiatives.

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