Why there’s such a shortage of clinical placements
The number of available nursing educators dramatically impacts the number of students accepted into nursing programs. As educational institutions remain unable to scale up the number of nursing educators in desperately needed ways, they are faced with another growing crisis.
There are also critical shortages of clinical placement sites willing to accommodate nursing programs. Because of this, an integral piece of nursing education that student nurses need is left hanging in the balance.
Hospitals across the nation are struggling to continue operations related to extreme nursing shortages, and yet it has never been a more difficult time to become a nurse. This paradox is one that remains a constant battle in a post-pandemic world where the need for nurses continues to grow at the same alarming rate that nurses are exceedingly leaving traditional bedside roles or the profession altogether.
An insufficient supply of nursing instructors and clinical placement sites directly affects the ability to increase enrollment. A 2020 study conducted by the American Association of Colleges of Nursing (AANC) found that among 386 schools, 66,274 qualified applicants to baccalaureate nursing programs were rejected.
There were many reasons cited, however, the most frequently reported reason (254 schools, 69%) was a lack of clinical sites. Furthermore, 150 schools (40%) reported that inadequate availability of clinical sites was the single deciding factor in their inability to accept all qualified applicants. This is also considering that the AANC reported in 2019 that 80,407 eligible nursing students were turned away, further establishing a very concerning pattern.
Nursing educational institutions and those in nursing leadership roles are met with the dilemma of deciding the best approach to fix this mounting problem that many thought would resolve as the pandemic dwindled down. With many COVID-19 restrictions lifted, some organizations have begun receiving students in person again.
Yet many have limited student learners for a variety of reasons. Hospitals are still extremely overburdened and many feel taking on students would further tax an already stressed system.
Nurses are reluctant to take on students due to extreme burnout, concerns regarding already overwhelmed work environments, and staffing ratios that have units flexed to capacities unable to accept any additional workload. Many nurses feel taking on a student would further hamper their ability to complete their work and provide required patient care, which is already challenging.
Strategies used to innovate hands-on learning through the use of the internet, distance learning, and simulation labs have been successful alternatives during the pandemic. However, real-life, hands-on learning is crucial to nursing students' critical thinking and development to become successful, proficient nurses. Clinical experiences are essential to building the vital skills necessary to effectively care for patients and provide quality care, all proven incredibly difficult to cultivate in a virtual environment. Significant gaps in student nurse competencies have been a strong concern after several years of practically all remote learning.
A multi-faceted approach to dealing with a complex problem needs substantial consideration. One alternative is creative and innovative strategies to provide clinical experiences and expand on what is already in place with a blend of virtual and in-person learning.
Finding non-traditional locations for students to gain the needed experience should also be strongly considered. Healthcare organizations and higher education must forge strong alliances that promote cohesive environments conducive to learning that are amenable to students.
Hospitals must also work with existing staff and work environments to make them more receptive and accommodating to students. Strong support of staff willing to take on students is another key consideration. A vital component of the education of nursing students is their clinical experiences.
This is dramatically shaped by the nurses who bond with their student nurses while precepting them. Nurses who have disengaged from their work roles and organization are less likely to volunteer to take on students or provide optimal learning experiences.
The fate of the nursing profession is in the hands of those innovating nursing education in ways that provide effective learning environments for students. Clinical experiences are the best way to bridge the gap between critical thinking and the development of nursing students with theoretical learning inside the classroom. Clinical sites must be made widely available to nursing programs. We must ensure the success of nursing students, who are the future of healthcare.