What’s being done locally to solve the national nursing shortage? Barbara Haas, dean of UT Tyler’s School of Nursing, explains the root causes and the measures being adopted to tackle this crisis. Understand the effects of the declining college-age population and the evolution of higher education’s role, while getting a look into the pioneering strategies of UT Tyler, from year-round programs and online learning to collaboration with the new UT Tyler School of Medicine. Haas shares her expertise on the expansion of nursing facilities, the value of simulation in training, and the essentials needed to retain skilled nurses in the workforce.
TRANSCRIPT
LANDESS:
A study in 2019 predicted that a nationwide nursing shortage would continue to spread across the country through 2030. What’s the problem, and what’s being done about it? I’m Mike Landess. UT Tyler Radio Connects with School of Nursing Dean Dr. Barbara Haas, to find out. Now, you’ve just been appointed to a state committee that’s going to be looking for answers.
HAAS:
Yes, that’s correct. This committee is actually looking at refining an existing rule in which the Coordinating Board has funded schools of nursing to help with enrollment and retention.
LANDESS:
Well, yeah, exactly. The issue is that even when nurse retirements and workforce exits are factored in, the Bureau of Labor Statistics of Labor Statistics projects that more than 203,000 openings for RNs will happen each year through 2031. What is the UT Tyler School of Nursing doing to help meet that need?
HAAS:
Oh, goodness. Well, we’ve got several initiatives going. Some of them we maybe talked about in the past, Mike. We went to a year-round program, so we could admit many more students each year. We offer some programs online for students who are geographically bound, so that they’re able to return to school. We’re starting new programs to get more people in. So, there’s several things that we’re doing as a school of nursing to address the shortage, but the shortage is a nationwide problem, and there’s a lot of factors that are contributing to it.
LANDESS: Such as?
HAAS:
Well, for example, the number of college-age students is taking a sharp decline starting in 2025. And we know that over the next 4 to 5 years, we’re going to see a 15% decline in college enrollment across the country, across all disciplines, not just nursing. So we’re seeing this very sharp cliff where the numbers of students going to college is going to be much lower because there’s just fewer. There was a population decrease at that time, so there’s fewer students eligible to go to school. And there’s less faith in higher education than there used to be, because there’s so many opportunities for really good careers that don’t require a college education any longer. So even those who are eligible to go to school aren’t necessarily returning to school.
LANDESS:
But nursing to some extent, from my perspective for whatever that’s worth, is somewhat of a calling.
HAAS:
It is. Yet across the country, nursing enrollments are down and particularly for a couple of the programs, the BSN programs. The Bachelor of Nursing Science is still fairly strong and has stayed fairly level this past year. The American Association of Colleges in Nursing just released a report that looked at the numbers of students in different programs across the country and, as I said, the BSN has stayed fairly stable. Very slight increase, like 0.3% perhaps. It had had a dip the year before. But programs like the RN to BSN completion program have taken a very significant drop in enrollment, and a lot of the master’s degrees and graduate degrees are taking dips. So there’s concern for the advanced practice.
LANDESS:
Big challenges there. Let’s go back to the committee thing we were talking about earlier. There’s an old joke about a camel being a racehorse created by a committee. Do you have confidence that this 19-member committee is going to be able to come up with some substantive solutions to what you’re facing?
HAAS:
Well, the committee is an advisory committee, so we can only make suggestions, and we had a day-long meeting, and I think it was productive. We had several thoughts about how the program could be improved to make it more accessible to more programs that would give more support to schools of nursing across the state.
LANDESS:
The UT Regents supported your nursing school to the tune of $35 million for improvement and expansion. And that expansion is going up right outside our studios. If you listen closely, it’s out there. Groundbreaking was a year ago, April. Is it on schedule?
HAAS:
It is on schedule. We’re so excited. We should be moving into the new building later this summer, hopefully late July or early August. Now that’s only the first floor of the new addition that will be completed, but that’s an important part, because that is the new simulation center and all of our skills lab and health assessment labs.
LANDESS:
That must be very, very exciting for you.
HAAS:
It is very exciting. And it really will increase our capacity to have more students in simulated environments, which is very important to prepare people before they go take care of patients in the real world.
LANDESS:
In the real world, yeah. Tell us about the benefits of the new addition, the complete addition, not just that first floor.
HAAS:
Well, it’ll be another year before the second floor is completed, at least another year, and then also the remodel of the existing older building. But once everything is completed, we will have space not only for a much larger simulation area, but then there’ll be more space on the second floor for student engagement with the community, education, research, data analytics lab. So a lot of activity is going to go on in that new building.
LANDESS:
Tell me about the connection between the new medical school that’s being built, the School of Medicine, and the nursing school. How closely will you work with those folks? I see their buildings going up, too. How closely will you be working with those folks? Tell us more about that.
HAAS:
Well, across all health professions, not just medicine and nursing, but also our College of Pharmacy and our School of Health Professions. And within Health Professions, we have things like public health and occupational therapy, speech-language pathology and hopefully, we’ll have physical therapy in the future. So all of those health professions come together, and we meet on a regular basis already–the deans do, along with our executive vice president for health affairs, and we have what’s called interprofessional education. So activities are planned both in a classroom setting where the students across those disciplines can work together, solve problems, do case studies, and then we also have a component where the students are out in the community, volunteering, doing service projects, again working together.
LANDESS:
Tell us about the benefits and challenges to retention in the nursing field these days. Are they the same that they’ve always been, or are there mitigating factors now that make it tougher?
HAAS:
Wow, that is a great question. Retention has always been an issue. I think it’s probably–
LANDESS:
Is it because of burnout?
HAAS:
It is because of burnout and interestingly, everyone assumes that it is salaries, and certainly salaries play a part of it. But more than the salaries, it’s whether the nurses who are employed are feeling valued and heard and respected and engaged, that they’re a part of something. And so a lot of the organizations are doing things to acknowledge the importance of nurses. You know, nurses have been the most trusted profession for over 20 years now, so they’re respected and trusted, and yet they don’t get the same accolades as some of the other health professions, and it isn’t that we expect them to be: “Oh, there goes our heroes again,” which happened during the pandemic.
LANDESS:
Absolutely.
HAAS: They were heroes.
LANDESS: And they were heroes.
HAAS:
They were, and now they’re still doing that same work, but no one looks at them as heroes anymore, so it’s just kind of an expectation. So I think it’s a difficult, very complex problem, and I wish I had an answer, because if I did, I’d probably be a really wealthy woman.
LANDESS: Yes, you would be.
HAAS: But I guess I’ll say this: Everyone is working on trying to solve that problem, to make workloads more reasonable, to make that life-work balance more reasonable, to give people more autonomy. That’s an important part of what nurses value in their work life, because they are highly educated, and they want to be able to put that education to use.
LANDESS:
Gosh, for a lot of people, if they haven’t had someone in the hospital or had medical issues in which they were dealing with the health profession on a regular basis, most of their information comes from TV shows. I mean, this must be how that really works, and there’s always a constant tension, it seems like, between nurses and doctors. Are docs getting the message that they need these people and they need to change their attitudes?
HAAS:
Oh, I don’t think doctors are the problem. I really don’t.
LANDESS:
OK.
HAAS: I think that the—
LANDESS: See, I’m getting my information from TV, too.
HAAS:
No, I think our medical colleagues highly respect their nursing colleagues that they work with. Now, maybe not 100%, but no profession is 100%, right. But I think overall, the physicians recognize the importance of the nurses and they value — our own President (Kirk) Calhoun, you know, has said over and over again, you know, smart physicians will recognize the good nurses because the nurses are the eyes and ears, and you know, they make the decisions up front.
HAAS:
Shall I call a physician or shouldn’t I? Is this something I can handle, or should I get a new order? Or do I need a new order? I was in a teaching hospital many, many years ago, and I remember having to call those residents. And they’d say, “Well, what should I do?” And I’d have to tell them well, I really need an order for XYZ, because I’d been in practice a long time and I knew what was needed. But they had the authority to do that. So they work side by side, and it’s an important relationship. But I don’t feel like for the most part, physicians don’t recognize that. So I don’t see that that is really the issue.
LANDESS:
Is it a cultural issue?
HAAS:
Well, as you pointed out, I think there’s a lot of misunderstanding about what is it that nurses do, and television shows do not help, because it is not accurate; it just isn’t.
LANDESS:
There’s no TV show called “The Nurses,” it’s “The Doctors.”
HAAS:
Exactly, and the nurses are kind of in the background.
I mean it’s unrealistic for everybody.
HAAS:
I mean the physicians, the way they’re portrayed. That is not how a physician spends his or her day, transporting patients to X-ray. It’s just so not real. Tell me what STAT stands for. I’ve always wondered that when somebody yells “STAT,” what does that mean? S-t-a-t, I guess that’s what it is.
HAAS:
Great question. I don’t know.
LANDESS:
You need to watch more television.
HAAS:
It means right away. But whether it’s an acronym, I don’t know.
LANDESS:
I don’t know either.
HAAS:
It means immediately.
LANDESS:
I got that part of it. I was pretty sure that was true. Code Blue, there we go. So how many nurses are expected to graduate this year from this facility here on the UT Tyler campus, and how many do you hope to graduate in the coming years?
HAAS:
Well, what I’d like to say: We’d hope to graduate about 600 undergraduates a year, because that’s about how many we admit every year. Now they don’t all make it, and we would like them to, and that’s why a lot of effort has been put into retention, because if they’re good enough to get in, we would think they’d be good enough to finish. But life gets in the way. Maybe sometimes they see the real world oh, it’s not like it is on TV, so they change their mind. So, we’d like to see at least 600 undergraduates. And then, with a graduate program, probably another 200 to 300 graduates. Now, we are really growing our graduate programs, although those numbers are declining across the country. At UT Tyler, our numbers of graduate students are increasing.
LANDESS:
Oh, that’s nice, it is. That’s good to hear. What’s the best kept secret about the UT Tyler School of Nursing? What don’t people know that you’d like for them to know?
HAAS:
Well, I think there’s a lot of things that people don’t know about us, Mike. But one of the things they may not realize is how highly respected this program is across the state and the nation. We have a very high pass rate on our NCLEX scores. That’s for the undergraduates to become registered nurses. So our most recent class is somewhere between 97 and 98% pass rate, well above the national average and well above the state average as well. Our advanced practice nurses — their pass rates on their certification exams is 100%.
LANDESS:
Wow.
HAAS:
And that includes both the family nurse practitioner and the psychiatric mental health nurse practitioners. So our programs are excellent. So that’s one thing. We are also very innovative. We’re the first in the country, not the first in the country, I’m sorry — the first in the state to offer the preceptor program. That was many years ago, and that spread throughout the state. We were the first.
LANDESS:
What is a preceptor program?
HAAS:
Oh, that’s when, in addition to having the faculty making rounds with the students and spending the day with them, and the facilities that currently license registered nurses serve as their mentor, their coach, while they’re in the hospital. So they pair up and have a close relationship built. So we were the first in the state to do that. We were the third program in the country to do an online Ph.D. program in nursing, and now that has spread, and most programs have gone online. There are still some that are solely face-to-face, but even those that have a face-to-face component are often a hybrid where they have some online, some face-to-face. We were one of the first to go year-round. And now several programs in the state are switching to a year-round nursing program because we can admit more students that way, and we can get them out faster, both of which will help address that nursing shortage. So we’ve been innovative in that way. We’ve been innovative in the types of programs we offer. I’d love to talk to you about our Critical Care Pathway sometime because we’re doing some real exciting things there. So we’re innovative in that we are a strengths-based program. What that means is every student who comes into our program – they are evaluated for their strengths, their natural talents. And we like to build upon that and recognize that, although people have different talents, they’re all important, they all contribute to the team, they’re all important and not just point out like, oh, you need to fix this, do this better. But you know, you’ve got this real skill set at XYZ, so let’s invest in that and make it even better because you can shine in this area. So we have that kind of a focus.
HAAS:
Our newest thing — this is hot off the press! Starting this fall, we are going to be admitting students directly to the BSN program. In most places you have to go to what’s called a pre-nursing program where you’re admitted. You have to do all these prerequisites, and then you may or may not get into the program. Well, what that does is it sets students up to spend 2 years of their life taking all the courses they need to get into nursing, and then maybe there’s not room, and they don’t get in. And now what do they do? So instead, what we’re doing is we’re going to say, from the minute you walk in as a freshman at UT Tyler, you are already in the nursing program. And we are going to have courses that start at the end of the freshman year and throughout the sophomore year that are more introductory courses, so they can start learning about what is nursing like because it’s not like TV. So make sure that this is really the career they want, and then give them that a little bit of exposure and then have milestones along the way.
HAAS:
So before they can start clinicals, they have to maintain these milestones. They have to maintain a certain grade point average. They have to do well in certain courses, these science courses that are so foundational to what we do. So that is going to be a game changer, I think, for a lot of students, because we hope that it would help with retention. It would help identify those students early who might be struggling and need more assistance. And it would help students who perhaps really didn’t know what nursing was, and it really wasn’t, they weren’t cut out for it, help them identify early that I’d like to go a different direction.
HAAS:
And maybe what I really wanted to do is get a degree in business, so I think it’s a win-win-win for everybody.
LANDESS:
Any final thoughts you’d like to share?
HAAS:
Only that I would hope that your listeners would remember how nurses are just really that backbone of health care. And when you think about when you’re born, who’s there? It’s a nurse, right? And then all through your life there’s nurses in the school, in your industries, in the hospitals, of course. But who’s holding your hand when you die? It’s often a nurse. So the nurses are there from birth to death and everywhere in between.
LANDESS:
Thanks for listening as UT Tyler Radio Connects with Dr. Barbara Haas, dean of the UT Tyler School of Nursing. For UT Tyler Radio News, I’m Mike Landess.
(Transcripts are automatically generated and may contain phonetic spellings and other spelling and punctuation errors. Grammar errors contained in the original recording are not typically corrected.)
