Testimony of Susan Bakewell-Sachs
Dean and Professor of Nursing
School of Nursing, Health and Exercise Science, The College of New Jersey
Before the Senate Health, Human Services and Senior Citizens Committee
New Jersey State Legislature, Trenton, New Jersey
Thank you, Chairman Vitale, Vice Chair Weinberg and all the Senators on this Committee for holding this hearing. Nursing workforce issues are critically important to New Jersey’s health, now and in the future. I commend you for examining this issue now, before today’s nurse faculty shortage leads to tomorrow’s crisis: a registered nurse shortage that will harm the quality of patient care in our state.
Thank you also to Dr. Lavizzo-Mourey, and to the Robert Wood Johnson Foundation, for doing so much to address this issue in New Jersey and devoting resources to solutions. I want to specifically recognize Dr. Susan B. Hassmiller, your senior advisor for nursing, who was instrumental in getting the New Jersey Nursing Initiative in place.
I am Susan Bakewell-Sachs, PhD, RN, PNP-BC, Director of the New Jersey Nursing Initiative and Dean of the School of Nursing, Health, and Exercise Science at The College of New Jersey. I would like to ask some of the experts—including college presidents and deans to stand and be recognized. I would also like our stellar New Jersey Nursing Initiative workgroup chairs and committee members—who have joined us today to stand. Thanks to all of you.
We are here to address an issue of tremendous importance to everyone in this state who is a patient, may be a patient, or expects to need health care in coming years—in other words, to all of us. I’ll begin by sharing some stark numbers. According to New Jersey Collaborating Center for Nursing 2008 survey data, there are 567 full-time nurse faculty working in our state. Their average age is 55, and 74 of them are expected to retire within five years. More than half our nursing schools already limit student capacity due to limited faculty lines and ability to fill vacancies. For doctorally prepared faculty in particular, it can be challenging for schools to find qualified faculty applicants. Unless we take action, it will get worse.
The nurse faculty pipeline is at the center of a looming registered nursing shortage that should alarm us all. Nurse faculty must have at least a master’s degree in nursing and four-year colleges and universities need nurses with doctorates. But nurses tend to practice first and get advanced degrees later. In addition, they are more likely to pursue graduate study part-time due to lack of scholarship funds. The average age of nurses at completion of the doctoral degree is 46 years, compared to 33 years for those in other disciplines; it takes nurses an average of 8.3 years to complete their doctorates, compared to 6.8 years for others. The median time span for nurses to proceed from masters to doctorate is 15.9 years. Therefore, few practicing nurses have the qualifications to teach; only nine percent have a master’s degree, and just one percent of registered nurses have a doctorate.
Because nurses tend to continue their education later in life, and because of demand for nurses with masters degrees and doctorates in practice settings, nurse faculty may not have long full-time teaching careers. The mean age of nurse faculty prepared at the master’s level is 49 years for the nation. The mean age of nurse faculty prepared at the doctoral level is 54 for the nation. That’s a significant problem at a time when we lack the nurse faculty we need to prepare the next generation of nurses to meet growing demand for health care.
We need to attract younger nurses to faculty roles, and that’s what the New Jersey Nursing Initiative will do. Investing in the advanced education of younger nurses offers a longer term payback as nurse faculty. Younger nurse faculty will teach for longer, and will prepare many more of the nurses our state and our country need.
That’s one reason I am so proud to be the Program Director of the New Jersey Nursing Initiative, which we launch here today. Dr. Lavizzo-Mourey described what this Initiative will do. I’d like to provide some details, focusing on its four main components.
First, the New Jersey Nursing Initiative Faculty Preparation Program, led by Nicholas Pelzer of the Robert Wood Johnson Foundation, will produce at least 46 new nurse faculty for the state. We call them Robert Wood Johnson Foundation New Jersey Nursing Scholars. They are being selected now and you will hear from one of them shortly. Each Scholar receives full tuition and fees, a $50,000 per year stipend—and a laptop computer. These full-time graduate students will complete masters and doctoral degrees. In this way, our Faculty Preparation Program will directly fill nurse faculty positions and hopefully expand the number of available seats at New Jersey schools of nursing. It also is working to develop, implement and evaluate new curricula that will provide students at the master’s and doctoral levels with the education and expertise they need to pursue careers as nurse faculty. We expect the curricula to become a model for the country.
Second, the Initiative is engaging diverse partners, including business and government leaders, who have a stake in ensuring that our health care system has enough registered nurses to provide the care the Garden State needs. These partners will help develop policy, lead local and regional collaborative efforts and identify funding to ensure that there are faculty to educate the nurses who will be needed in the state. Our strategic working groups have the charge to: create innovative approaches to increase faculty capacity; make New Jersey nurse faculty a preferred career; lead focused policy initiatives; increase sustainable funding; build local, regional and statewide collaboration; and develop creative strategies to increase nurse education capacity.
Third, to help students interested in pursuing nursing find programs with seats available, in 2010 the New Jersey Nursing Initiative will begin developing and piloting a centralized online application service that will allow prospective students to complete a single application and send it to schools of nursing across the state. This is part of a national initiative, being spearheaded by the American Association of Colleges of Nursing, and New Jersey is one of its lead states. We have invited nursing program deans and directors to confer with us as we pilot this groundbreaking tool that will help keep well-qualified nursing candidates in our state.
Fourth, we have a comprehensive website, www.www.njni.org, that features key information on New Jersey nursing, news, data, emerging issues, and more. I encourage you to visit it to view profiles of some of our state’s remarkable nurse faculty and more, and to come back often to see the rich materials we will post in the months ahead.
The slogan for the New Jersey Nursing Initiative is, “so a nurse will be there for you.” We all hope that will be the case, for ourselves and our families. Right now, New Jersey is on a path to have a significantly smaller nursing workforce than we will need in coming years. A nurse won’t be there for many of us, unless we change course very quickly and increase our capacity to educate nurses.
I want to conclude by warning you not to be distracted, or lulled into complacency, by the current recession. We face a serious nurse faculty shortage right now, today. Applications for nursing remain strong but have slowed in the past two years compared to three to five years ago. The College of New Jersey for the entering nursing class of 2009, had 440 applicants for 60 seats. The same is true at nursing schools across this state because the programs are at or above capacity. The number of nurse faculty is a top reason for this limited capacity. Turning qualified applicants away, combined with a temporary easing of the nursing shortage due to the recession, is creating a false view of the situation. In fact, we face a critical shortage of nurse faculty and nurses just as baby boomer nurses are beginning to retire.
The result will be a serious—and avoidable—shortage of registered nurses that will jeopardize health care for all of us, from children with health problems, to women with high-risk pregnancies, to people in middle age who are beginning to develop preventable diseases, to seniors with multiple chronic conditions or who need palliative, end-of-life care.
We can avoid this crisis, and the New Jersey Nursing Initiative is committed to helping the state do so. Thank you.