Jul 15, 2019

Disappearing nurses

The average person waits four and a half hours in a California emergency room. There is a shortage of 60,000 nurses in the state. These two facts are directly related. But both California universities and the government are taking steps to correct the problem.

In order to address the nursing shortage in California, which has contributed both to the immediacy and to the quality of care, a new bill has been introduced to allow California State Universities to award the Doctor of Nursing Practice (DNP) degree. Currently Fresno State only offers a bachelor’s degree and some components of a master’s program.

This news comes as two major hospitals, Community Regional Medical Center and Clovis Community Medical Center, are expanding.

Mary Contreras, the corporate chief nursing officer for the hospitals, said that they just hired 72 nurses, many of which were “traveler nurses” – nurses who work on 13 week contracts in an area before moving to a new hospital. Due to the short-term contracts, they cost the hospital more than regular staff, Contreras said.

Hospitals, however, won’t see an immediate impact from the bill. While there are some nursing specialties that require a DNP degree, most of the time, students get a DNP so that they can teach, Contreras said.

But that will help in the long run; more teachers means more nurses can get trained.

“There is not enough education being provided to create and educate the nurses we need,” Contreras said.

She added that California only educates half of the nurses it needs to staff its hospitals and clinics.

Part of the challenge in getting more teachers is changing attitudes about DNP degrees in the nursing industry. Dr. Mike Russler, the chair of the nursing department, said that traditionally, nurses were encouraged to get their bachelor’s and spend some time working in the field before coming back for their DNP. However, Russler said, the majority of people never return. This has created a shortage of qualified teachers within the industry.

Russler said he has started encouraging his students to consider getting their masters at 27 or 28 years old, and beginning their career, rather than having to interrupt their career at 47 or 48 years old to get their degree.

Lack of teachers is one of the main reasons for the shortage, according to Russler. Nationwide, 42,866 applicants were turned away from baccalaureate and DNP nursing programs in 2006. In the San Joaquin Valley, there are 1,000 students turned away every year.

“If we had more faculty, clearly we would be able to address that,” Russler said.

Russler said that other schools in California sometimes have to cut classes because they don’t have the teachers, and he has sometimes been left “scrambling for faculty at the end of the semester.”

It’s becoming more critical to increase qualified teachers, as most of Fresno State’s nursing teachers are in their early to mid 50s, and are reaching retirement age.

Fresno State is already working to address this shortage of teachers – there are five people in the program who are getting their DNP degree through distance learning in schools as far away as the University of Nebraska.

But, Russler said, many of the department’s students would stay local if they could.

Russler said that the department has been prepping to get a DNP program set up for several years. He said that if the bill was passed, Fresno State would be able to start producing nursing graduates with DNP degrees within the next year and a half, to two years.

“This isn’t something that would take years to develop,” Russler said.

He added that President John D. Welty, as well as the provost and the dean of the College of Health and Human Services, have all been very supportive toward expanding the nursing program.

This has included highlighting the nursing program in Fresno State’s fundraising campaign, called “Powering the New California.” The campaign’s goal is to increase donations into the school for a variety of departments and projects.

Independent funding is going to become increasingly important if the bill is passed, as it does not provide state funding for the DNP program. In fact, the bill specifically states that it “would require the California State University to seek nonstate funding to establish the program.”

This means that grants and other donations are going to be a large part in funding a DNP program. The Fresno State nursing department already does this with one of its components, the Clinical Nurse Specialist/Nurse Educator master’s program.

The master’s program is in its fifth year at Fresno State, and was just awarded another $364,947 grant on Feb. 15, which will go to fund the summer 2008 coursework.

Russler said that despite the name “master’s program,” the course is not a full certification program, and does not fulfill all of the requirements for a master’s. Instead, it gives additional training to nurses who have some, but not all, of the qualifications to be nursing teachers. Once they complete the program, they agree to be “on-call” to work for Fresno State if asked.

Currently, Russler estimated that there are five or six part-time teachers in the nursing department that have completed this course, and are teaching at Fresno State while also working part time as nurses for clinics and hospitals in the Valley.

Some of the money will also be used to add 20 more students to the nursing program at Fresno State, over the course of the next two years.

Contreras said that, from Community Medical’s perspective, 20 more nurses is “not going to solve the nursing shortage.”

“But,” she said, “every nurse helps.”

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