Solving the Nursing Shortage, One Nursing School at a Time

Children's Minnesota CNO works with local nursing schools to help create a practice-ready workforce.  

When Caroline Njau, MBA, BSN-RN, NEA-BC, became senior vice president of patient care services and chief nursing officer (CNO) of Children's Minnesota in the state's Twin Cities last March, one of her first-year goals was to know and forge partnerships with the deans of local colleges of nursing.

The nursing shortage isn’t just about nurses leaving the profession: There's also been a significant disruption in staffing pipeline thanks to nursing schools that are turning away qualified applicants.

In 2019, U.S. nursing schools turned away 80,407 qualified applicants from baccalaureate and graduate nursing programs for lack of faculty, clinical sites, clinical preceptors, and classroom space, along with budget constraints, according to the American Association of Colleges of Nursing (AACN) report on 2019-2020 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing.

To combat the nursing shortage at the nursing school level, hospitals and schools of nursing are partnering to find creative ways to bolster the number of students in programs. Recent examples include:

• Fisk University in Nashville, Tennessee, and Galen College of Nursing, based in Louisville, Kentucky, recently announced an articulation agreement to create a new pathway in nursing for Fisk students. Fisk students enrolled in science programs who wish to explore nursing can transfer their coursework credits to Galen College of Nursing, allowing them to go directly into Galen's Bachelor of Science in Nursing (BSN) program.
• Missouri State University’s School of Nursing is piloting a Mercy Hospital Springfield program called “Earn as You Learn," which allows nursing students to earn money while completing clinical time and evaluating whether they would like to work at Mercy post-graduation.
• The University of Oklahoma has partnered with hospitals in Norman and Duncan, providing additional sites for students studying for a bachelor’s degree in nursing and the opportunity for the hospitals to retain nurses educated in their own communities.

Addressing the challenges

Even without formal programs in place, hospitals and nursing schools can and should work together.

One proactive Minneapolis nursing dean reached out to Njau even before she arrived at Children's Minnesota.

"She said, 'Caroline, how can we be allies?  How can we partner?'" Njau recalls. "Early on she said, 'I'd love for you to be an affiliate professor for us in the event we ever need to use your expertise in the academia side of things.'"

Njau now meets often with the dean and her team to address such fundamental issues as the number of students they're bringing in and how many they're turning away; how they're preparing the workforce for critical thinking; and whether they're ensuring diversity and inclusion in recruiting students.

Thanks to that work, she's already seeing success with diversity initiatives through the hospital's highly sought-after paid internship program, which now requires the nursing schools to provide a diverse slate of internship candidates, Njau says. When those interns graduate—and, as Njau hopes, start their career at Children's Minnesota—they will help further diversify her workforce, she says.

"I want to talk about what the challenges are," Njau says, "because the more I understand what the challenges are, the more I can be an ally."

Stepping into the real world

Njau's collaboration with local nursing schools helps better prepare students to confidently step into the challenging real world of nursing.

"Being an affiliate professor for a school of nursing really gives me an opportunity to be able to go and give them some real-life experience," Njau says. "It takes intentionality to make sure they are preparing them well."

It also requires honesty and communication, so Njau can inform nursing school deans whether students doing their clinicals need further instruction in particular areas.

"I can say, 'Here are my challenges with the team that's coming up: they're struggling with critical thinking and struggling with medication errors. How can you better prepare them for that?' And they take that back and use those scenarios," she says.

Another local college has been increasing the number of adjunct faculty from Children's Minnesota so they can precept and provide feedback, she says.

"Promoting that adjunct faculty in a role with a local college is a good thing to do to help us make corrections before they start, and that's something I keep promoting to my team," Njau says.

Nursing school-hospital partnerships won't solve the nursing shortage overnight, but they can keep the staffing pipeline trickling with new nurses who will be better prepared for their new career.