The United States is mired in a critical nursing shortage that’s expected to last through 2030, according to a host of academic research cited by the University of St. Augustine for Health Sciences (USAHS) in its report “The 2021 American Nursing Shortage: A Data Study.” Combined with the exodus of senior nurses, who are heading for retirement, we’ll not only see a deficit in skilled nurses but in nurse leaders. We all know nursing schools are severely impacted, so it may be time to revisit online learning and how it can empower travel nurses to expand their skills as leaders and mentors to others.

The Working Strain and the Retirement Drain

The United States has experienced periodic nursing shortages throughout its history, beginning around 1900. However, the magnitude intensified after 2012, becoming more profound and enduring. Now—exacerbated by the COVID-19 pandemic, the lackluster and delayed response by the government, PPE supply shortages, and the mental and physical tolls of treating an unprecedented volume of patients—the situation is dire. 

“Given the growing demand for healthcare services across a multitude of specialties, reports project that 1.2 million new registered nurses (RNs) will be needed by 2030 to address the current shortage,” noted USAHS. That figure represents the overall existential problem. There is, however, a more nuanced and less acknowledged challenge: retiring leaders in the field. 

“The population surge from the baby boomer generation has led not only to a greater number of aging patients but also means that a large portion of the nursing workforce is heading toward retirement,” USAHS explained. “Between 2000 and 2018, the average age of employed registered nurses increased from 42.7 to 47.9 years old. And nearly half (47.5%) of all RNs are now over the age of 50. A 2015 study predicted that over one million RNs will retire from the workforce between now and 2030. As they go, they take with them their invaluable amount of accumulated knowledge and nursing experience.”

What’s interesting is the correlation between these obstacles and the relevance to travel nurses, who seem ideally poised to help resolve this dilemma from the nexus of the intersection.

Why Travel Nurses?

Travelers are already a unique group of healthcare professionals. And yes, many chose this lifestyle for variety, professional development, personal growth, and adventure. Yet, as the outbreak of the novel coronavirus swelled—and more recently resurged because of variants—many nurses began working as travelers to help curb the disease’s spread in locations with high demand. Their skills and itinerant characteristics could address some very pressing factors. 

• The pandemic influenced a wave of early retirements due to extended periods of limited access to medical facilities for patients and staff. As patients avoided hospitals and with elective surgeries canceled, hospitals had less income, which led to forced furloughs. Some nurses simply elected to retire early.
• The shortage is not universal or straightforward. California, for instance, will likely deal with the largest nursing shortage of any state. USAHS projects a 44,500 shortfall by 2030. Meanwhile places like Florida could have a surplus of 53,000 RNs during that same interlude. 
• “Rural communities absorb greater impacts of the nursing shortage than do metropolitan areas,” USAHS said. “Only 16 percent of RNs live in rural areas, where they serve over 52 million Americans who reside there.”
• In 2020, over 80,000 qualified nursing school applicants were turned away from baccalaureate and graduate programs due to a lack of qualified faculty, clinical study sites, classroom space, and budget constraints. This not only means that fewer nurses will graduate, it means that fewer nurses will continue their education for leadership roles. 
  

As Nursing Management, a publication of Wolters Kluwer, concluded: “Selecting the most appropriate replacements for these nurse leader positions before their departures may be helpful to ease the transition and hand off the workload.” Understanding the existing educational constraints, the team at Nursing Management recommended taking a “fresh look at online learning” (Sherrod, Dennis EdD, MSN; Holland, Cecil EdD, PhD, MSN; Augustus, Tisha MSN, “Nursing Management (Springhouse): August 2021 - Volume 52 - Issue 8 - p 26-33”).

Online Education in the New Normal

As we wrote in our eBook “New Talent Strategies for our New Normal,” learning is becoming increasingly virtual, and COVID-19 will only accelerate this trend. Consider the transformative growth of Massive Open Online Course (MOOC) programs and the now widespread acceptance of online learning in universities across the globe. 

“As nurse managers and nurses consider career options, many are choosing online learning programs to complete their RN-to-BSN, MSN, and doctoral degrees,” wrote Nursing Management, echoing similar trends. In the past decade, online learning has witnessed steady growth.

• From 2004 to 2016, the proportion of students taking one or more online undergraduate courses increased from 15.6% to 43.1%.
• From 2008 to 2016, undergraduate students enrolled in online degree programs also increased from 3.8% to 10.8% and graduate students enrolled in online degree programs quadrupled from 6.1% to 27.3%.
• In that same time period, the percentage of graduate students who took one or more online courses significantly increased from 16.5% to 45.6%.
• A national survey found that the majority of students enrolled in online education are women, who make up 65% of online undergraduate students and 54% of online graduate students. In nursing, according to statistics from the U.S. Census Bureau, 3.2 million (91%) nurses are female, while 330,000 (9%) are male.

“Studies in a number of health education disciplines report that online learning methods achieve academic outcomes equivalent or superior to traditional classroom methods,” Nursing Management illustrated. “Studies in nursing education support the use of online learning for teaching nurses in academic and service settings. Online nursing students are also reported to value connections and interactions with faculty and feel faculty care about them and their success.”

Though variations and differences exist across programs, online education programs are widely available to support RN-to-BSN, MSN, and DNP degrees. For travel nurses, the accessibility of distance learning can become a tremendous boon to increasing their skills, gaining new degrees, and advancing into leadership positions.

Tips for Choosing a Program

Just as with brick-and-mortar universities, online programs have differences. It’s important for nurses to compare schools carefully and take every consideration into account.

Research the School and Program

• Visit the school’s website and review the information provided. Request any additional information to help compare the program to others you have been researching.
• Look for institutional and nursing program accreditation. 
• Make sure the program has a process in place to ensure quality online courses. Quality Matters certification is a respected standard. It’s a nationally recognized peer-review process that verifies online, hybrid, and blended courses are meeting quality education standards regardless of the university, instructor, or teaching strategy being used. 

Accreditation

Just because online learning has evolved into a reputable and effective alternative, there are still diploma mills out there. Making sure the school carries the proper regional accreditation is crucial. Here’s a list of what to look for.

Higher Learning Commission: Arizona, Arkansas, Colorado, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, West Virginia, Wisconsin, Wyoming.

Middle States Commission on Higher Education: Delaware, the District of Columbia, Maryland, New Jersey, New York, Pennsylvania, Puerto Rico, the Virgin Islands.

New England Commission of Higher Education: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont.

Northwest Commission on Colleges and Universities: Alaska, Idaho, Montana, Nevada, Oregon, Utah, Washington.

Southern Association of Colleges and Schools Commission on Colleges: Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia.

Western Senior College and University Commission: California, Hawaii, American Samoa, Territories of Guam, Republic of Palau, Commonwealth of the Northern Mariana Islands, Republic of the Marshall Islands, Federated States of Micronesia.

Consider How Programs Are Taught

• Is the program entirely online, hybrid, or blended?
• Is the program synchronous or asynchronous? 
• Synchronous programs occur in real time, have an established class schedule, and require logging in at specific times to participate in live courses. Learning activities are also scheduled and take place in groups.
• Asynchronous learning delivers a lot more flexibility. Content is available on-demand and assignments are predicated on deadlines, not milestones.
• Courses identified as hybrid or blended may include synchronous and asynchronous methods. More importantly, make certain to clarify if the terms “hybrid” and “blended” are describing a combination of online and face-to-face learning.

Research Timeframes and Pacing

Look into the structure, in the sense of pacing and timeframes, of how courses are taught. Are they based on quarters, semesters, trimesters, or do they allow you to navigate courses at your own pace? 

“Self-paced programs are generally competency-based,” wrote Nursing Management. “In a competency-based nursing program, competency is identified for individual courses and learners can move rapidly through content they know so they can focus on subjects they find more challenging. Courses have no specific start and stop times and are offered in asynchronous formats. ​​Students who do well in the competency-based option are self-directed and motivated to learn. Also, costs for competency-based programs are generally paid on a per semester basis, so if it takes longer for you to complete the program, tuition costs can be higher.”

Review and Compare Courses

Examine course descriptions, objectives, credit hours, clinical hours, and time requirements. 

• See if you can take a course before program admission and if the credits will be applied to your program of study. This allows you to test drive the school’s educational vehicles.
• Understand the number of clinical hours and clinical sites required. Competition for clinical sites runs high across nursing programs. You’ll want to know whether you’ll be expected to negotiate your own clinical site or if the program helps secure one.

Other Considerations

• Investigate the faculty and its role in your education. Are instructors actually teachers or just facilitators? Are they available to assist outside the course, just as traditional professors have office hours? Are academic advisors provided?
• Ensure that the online program has a solid technological foundation and a strong support team.
• Inquire about online student support services, such as an online library, tutoring, mentoring, student forums, and peer networks. 
• Nursing Management suggests asking about feedback policies. “Because online learning can be perceived as more ‘hands-off’ than face-to-face learning, ask how and how often feedback is provided. If one assignment builds upon another, you should expect to receive written feedback on the first assignment before you begin the second. A general rule for many nursing programs is for the faculty member to provide written feedback on an assignment within 10 business days.”
• Consider tuition and related costs. In-state and out-of-state rates for universities vary. In-state is often cheaper because the program is subsidized by local taxes. Are there activity fees? Are there lab fees? Private schools are generally more expensive than public ones.
• Look into scholarships, grants, and student loan options. These too will differ by institution.

Questions to Ask

Once you’ve decided on a program. Nursing Management recommends asking the following questions.

• What's the faculty-to-student ratio?
• How do students contact faculty members?
• How many clinical hours are required?
• Can I complete clinical hours in my work setting or do I need to find another local clinical site?
• How do students interact with their peers?
• What technology is required for online courses?
• Is technical support provided?
• Is financial aid available?

Keep Progressing

Whether nurses are looking to begin their careers, progress to the next level, or transition into leadership, online programs can deliver undergraduate, graduate, and professional programs for further development. This option provides a needed alternative to bridge the gap left in the wake of complications that continue to plague traditional nursing schools. And for travel nurses, who want to grow but are on the road, online learning may be the solution that ensures ongoing care and a path to a new generation of desperately needed leaders.

Image by Tumisu from Pixabay