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The UTHSC School of Nursing is
educating nurses to serve San Antonio
and South Texas. The School of
Nursing offers the bachelor of science
in nursing degree and collaborates with
the Graduate School of Biomedical
Sciences to offer the master of science
in nursing and doctor of philosophy
in nursing and doctor of philosophy
degrees. We sat down with Dr. Janet
Allan, dean of the school, and
Dr. Brenda Jackson, associate dean, to discuss today's shortage of nurses and
the school's response.
||How do we know what types nurses are in the scarcest supply?
||We get figures from the Nursing Workforce Center, which collected the
data for the Texas Nurses Association (TNA). Dr. Antonio Furino, professor
in the department of family and community medicine, led the group compiling
the figures. TNA is the only organization that has elicited comprehensive
statistics statewide. The Texas Board of Nurse Examiners has data on the
number of licensed registered nurses (RNs) in the state, and a similar board
keeps data on licensed vocational nurses (LVNs). We also receive informal data
from our clinical partners — local tertiary, skilled nursing and community
health facilities. The shortage affects both "generalist" nurses with associate's
or bachelor's degrees and "advanced practice" nurses with master's degrees.
||What does the School of Nursing do to meet the nursing shortage?
||In the last two years, we have increased the undergraduate enrollment.
We began admitting larger classes in the spring of 2000. We have gone from
60 students admitted per semester to 100. But last fall we admitted an even
larger number — 170 new students (120 generic and 50 flexible-process RNs
and LVNs) — and our total undergraduate enrollment is now 485. The
undergraduate program is general in that the students rotate through all the
clinical specialties of nursing. The graduate programs are devoted to specialties.
Students can study to become pediatric nurse practitioners, family nurse
practitioners, acute care clinical specialists or nursing administrators. In the
last few months, we received federal funding to develop a major for students
who want to become geriatric nurse practitioners.
||Do we have figures on how many School of Nursing graduates are
practicing in the various counties of South Texas?
||We monitor the percentage of our graduates who work in South Texas.
From our undergraduate program, it's close to 90 percent. Most of the
graduates with nurse practitioner majors also work in South Texas.
||We encourage some nurses to stay in South Texas by offering courses
in their own cities, such as Del Rio. How is that going?
||A number of nurses who are already LVNs or RNs are coming to us to
get their baccalaureate degrees in nursing. They need the advanced education
to move into nursing administration roles. This strengthens nursing professional
practice in South Texas. One of the problems in the state of Texas, and
particularly in South Texas, is the shortage of baccalaureate-prepared and
advanced practice nurses. We are meeting that need by providing distance-education
classes in Del Rio and other cities. The nurses with baccalaureate
and advanced practice backgrounds can function in less structured settings,
such as community health and other rural practice sites, where they would
need to be more independent.
In another initiative, we helped UT Brownsville develop its baccalaureate
and master's degree programs in nursing between 1990 and 1998. We sent
faculty to the Rio Grande Valley to teach the courses. We still consult with
UT Brownsville. In that way, we helped meet the region's need and strengthened
another university. We also offer our doctoral program through a combination
of interactive video and on-site instruction at Texas A&M University,
||What other ways is the School of Nursing addressing the nurse shortage
||One of the direct ways is working with the Greater San Antonio
Hospital Council. A Health Care Summit was held under the leadership of
County Judge Nelson Wolff and the Greater San Antonio Hospital Council to
address five critical community health issues — financial challenges, trauma
care, the workforce, disease prevention and mental health. Dr. Marilyn
Harrington, dean of the School of Allied Health Sciences, Dr. Mickey Parsons,
associate professor in the School of Nursing, and [Dr. Allan] developed the
briefing paper on workforce issues. For the workforce issue, four task force
panels have been appointed to address issues including recruitment of nurses
and faculty, developing clinical experiences for students and developing the
health care team of the future, and resources to accommodate the increased
numbers of students and faculty through scholarships and support for
I want to emphasize that the faculty shortage is as acute as, if not more
troubling than, the shortage of clinical nurses. To educate increased numbers of
students, we must educate more faculty. To be hired in a faculty position, an
individual must have either an MS in nursing or a doctoral degree. The
average age of current employed faculty in nursing programs in the state is 55.
The rate-limiting factor to increasing nursing enrollments is the lack of
sufficient faculty. The Board of Nurse Examiners requires a 1 faculty to 10
students ratio for clinical instruction. We must increase our recruitment and
enrollment of students into master's and doctoral programs.