Addressing the Shortage of Nurses with Essential Skills and Concept-Based Curricula

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By Kathy Mayle, MA, MNEd, MBA, RN

The U.S. Bureau of Labor Statistics expects the need for registered nurses to grow by 15% from 2016 to 2026—about 438,100 new jobs—which is more than double the average growth expected for all occupations. But there aren’t enough nurses to fill these jobs or enough nursing program faculty to train more.

According to an American Association of Colleges of Nursing report, nursing programs in the U.S. have had to turn away 64,067 qualified nursing applicants because they don’t have enough faculty, clinical sites, classroom space and/or funding.

Numerous factors are contributing to the nursing shortage: an aging baby boomer population, which includes thousands of practicing RNs nearing retirement; climbing rates of chronic conditions requiring nursing care; and a growing emphasis on preventative care. Also, many once terminal diseases or medical conditions are now survivable as a result of advancements in medicine and technology. People are living longer and, thus, need more medical care over the course of their lives.The shortage is further exacerbated by nurse burnout and high turnover, side effects of understaffing and a crippling workload.

It’s not just the United States that is experiencing a nursing labor shortage; it is a global issue. Of course, some places feel the shortage more than others, particularly rural areas, but every health care provider needs to be strategic in developing partnerships with educational institutions that produce the most skilled, highly qualified nurses to fill future workforce needs.

At a minimum, nurses need to have the academic knowledge and technical education to deal with patient needs and current medical technology and equipment. But the best nurses need more than this. Nurses problem-solve and make split-second decisions about patient health all the time, and developing these skills requires a learning environment that teaches students how to think, react, adapt, communicate and evaluate. 

When health care providers look for an educational partner, they are looking for an educational institution that produces nursing graduates that will meet their workforce needs. A concept-based curriculum approach that focuses on students actively engaged in thinking through overarching concepts and highlighted exemplars in a systematic and logical manner is a more sound way of educating students for the role of a professional registered nurse. The concept-based nursing curriculum builds essential high-level cognitive and soft skills such as clinical judgment, critical thinking, problem solving, communication, ethics, leadership, professionalism, adaptability, compassion and teamwork. These skills are vital to preparing students for the daily physical and mental strain of providing medical care and are what really set nurses, and those who employ them, apart.

Correctly taking blood pressure readings, performing drug calculations and safely administering medication are all important technical skills, but critical thinking skills and decision-making are crucial during patient assessments and evaluations of medication effectiveness. In a short period of time, nurses need to be able to decipher a patient’s concerns and provide the proper treatment for the patient’s symptoms, often while having to think and act quickly to save a person’s life.

Having a concept-based curriculum that teaches students legal-ethical and disease theory helps cultivate those skills. While they won’t know everything about every single disease, students will learn how to identify various symptoms and conditions and develop the problem-solving skills necessary to help care for patients.

Communication is an important soft skillset that nurses need to master. For example, solid verbal and nonverbal communication skills enable nurses to effectively interview patients during head-to-toe assessments. If they don’t know what questions to ask, or how to use results-oriented patient interview techniques to get the best, most accurate information from their patients as possible, the health and wellness outcomes of the patient may be compromised. Nurses also need to be able to teach patients how to properly manage their care, how to take their medications, and how to live healthier lives.

Communication is also crucial for patient advocacy and for ensuring optimal working relationships with other nurses, doctors and hospital staff. And it is necessary when supporting patients and their family members after the physician has delivered bad health news. Just how does a nurse sympathetically talk to a patient who is terminally ill or facing a life-threatening situation? It starts with solid communication skills that first involve listening carefully to the patient.

Ultimately, addressing the critical need for nurses in this country comes down to a successful partnership between health care providers and their educational partners, whose primary focus is to graduate nurses with the critical thinking, problem-solving and other essential skills to provide the best care possible to patients. These educational service partnerships are crucial so that our nation can overcome the current shortage and reverse the nursing field’s vicious cycle of staff burnout, turnover and attrition.

Kathy Mayle, MA, MNEd, MBA, RN is Dean of Nursing for Community College of Allegheny County.

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