1. Lowe, Adonna RN, CHE, MA

Article Content

Many states share the irony of having more quality nursing school applicants than nursing programs have the capacity to handle. The ability to increase program enrollment is restricted due to the limited numbers of qualified faculty available to meet the academic accrediting agency requirement for instructor-to-student ratios. This challenge proves greatest for the clinical component of academic curriculum, in which a 1:10 nurse faculty-to-student ratio is required.


The plan

The JPS Health Network, located in the Dallas/Ft. Worth metro area of northern Texas, has seen significant increases in patient volumes over the last 5 years, due to population growth of 5% to 7% annually. To address the clinical faculty challenge, JPS nurse executives devised the Clinical Faculty Loan Program, which provides a staff nurse as a qualified, master's-prepared clinical instructor on loan to an accepting school of nursing, at no fee.


JPS serves as the clinical site for all instruction. Should the staff nurse not meet the requirements of the school of nursing as a clinical instructor, with prior notice JPS will either provide the school with a replacement staff nurse who meets the regulatory requirements or pay the school of nursing the wage and benefits for a clinical instructor equal to the agreement. Also through the program:


[white diamond suit] JPS pays the salary and benefits to the nurse as an employee of the health network under the human resources' rules and benefits.


[white diamond suit] The staff nurse instructs in the clinical setting as established by the school of nursing curriculum plan.


[white diamond suit] The staff nurse may pick up additional hours on the hospital schedule to maintain a full paycheck when school isn't in session.



In turn, the school of nursing will:


[white diamond suit] evaluate all qualified candidates for clinical teaching skills and performance


[white diamond suit] provide orientation to the staff nurse in the provision of clinical education and school curriculum


[white diamond suit] involve the staff nurse in faculty and curriculum meetings, orientating the nurse to the school of nursing programs


[white diamond suit] provide liaison support to the staff nurse to augment clinical education techniques, theory, and skills


[white diamond suit] provide a faculty designation status and college benefits to the staff nurse, as appropriate


[white diamond suit] increase the number of students admitted to the program.



The outcome

Five schools of nursing accepted the offer to participate in the Clinical Faculty Loan Program as outlined. The curriculum spans five semesters. The staff nurse provides clinical instruction for approximately 450 hours during each of the five 18-week semesters, totaling 2,250 hours for the program or 0.6 full-time equivalent annually. While serving as a clinical instructor, the staff nurse is available to teach up to two rotations of 10 students, for a total of 20 additional students to the school of nursing program. At an average of $25 per hour, the five-semester cost for each staff nurse on loan as clinical faculty is $56,250, or $28,125 per year.


At JPS, approximately 60% of the student nurses working in the organization have been hired as permanent nurse employees upon graduation. Applying this hire percentage to the faculty loan program of 20 students could result in 12 new graduates hired as staff nurses upon graduation, at a cost of $33,750 or 60% of the total clinical faculty salary cost. This equals $2,812 in salary cost per new-hire graduate nurse. The program provides JPS quicker access to new graduate nurses and potentially reduces recruitment-to-hire time for a nurse from 75 to 30 days.


Currently, JPS orientation for newly hired staff nurses includes a minimum of four weeks for those hired into the medical/surgical areas and 12 weeks for those hired into specialties. Using staff nurses as clinical instructors provides student nurses with an increased understanding of these clinical competencies, thus potentially reducing the required orientation time by at least 1 week per new graduate nurse hired. This reduction results in a $780 salary savings per new hire, or $9,360 of orientation savings for the class of 12 hired. The program represents collaboration between academia and hospitals to increase student enrollment without increasing the cost of education-truly, a priceless benefit.