The challenges facing nursing higher education necessitate that academic administrators have a focused vision for their schools of nursing. Never before has nursing education faced such challenges from both the profession and the academic institutions in which it exists. Three major challenges, which began in the late 1900s, affect the way nursing schools function in the 21st century: the shortage of the faculty workforce, the need to be fiscally responsible in the face of declining resources (Minnick & Halstead, 2001), and consumer demand for new products and services. Each of these challenges influences the creation of a vision for schools of nursing.
Nursing faculty drive the work that occurs in schools of nursing. Therefore, a ready supply of appropriately educated nursing faculty is critical to the health of a school. However, the United States is currently facing one of the most critical nursing faculty shortages due to the unprecedented shortage of RNs, the aging of the faculty workforce (American Association of Colleges of Nursing [AACN], 2003), and the career opportunities for doctorally prepared nurses outside academia, especially in clinical practice and industry.
In 2000, the AACN surveyed schools of nursing to determine the vacancy rate for faculty. A national sample of 220 schools had 5,132 full-time faculty positions, of which 7.4% were vacant. Other studies have estimated the vacancy rate as high as 9.2% (Farino, Gott, & Miller, 2000). While the nursing shortage has contributed to the current nursing faculty vacancy rate, the impending faculty vacancy rate will be complicated by the projection of the large number of faculty retirements in the next 10 years. Retirement projections for individuals who were faculty members in 2001 suggest that between 2004 and 2012, 200 to 300 doctorally prepared faculty will be eligible for retirement yearly (AACN, 2003).
Career opportunities for doctorally prepared nurses outside academia have also contributed to the shortage of nursing faculty. The number of doctoral graduates who choose careers outside teaching has steadily increased since 1984. Reasons for this choice include salary differentials, faculty workload, job satisfaction, and faculty role expectations (AACN, 2003), each of which can severely affect the ability of schools of nursing to enroll and educate students.
While the cost of higher education has continued to increase, the percentage of that cost that can be appropriately shifted to the students in tuition and fees is small. At The Pennsylvania State University, a large, public, land-grant institution, the percentage of the budget allocated by the legislature has decreased, and tuition increases have reached double digits for the first time in the University's history, a situation with which the University Board of Trustees is less than pleased. Decreases in public funding for higher education reflect social skepticism and a reordering of governmental priorities (Montez, Wolverton, & Gmelch, 2002), a view that is likely to continue. While tuition increases cover some of the deficit, academic administrators must be fiscally conservative if they are to further reduce the effect on the student population.
Schools of nursing are always vulnerable to losses in other sources of funding from foundation grants, industry sponsorships, and private donations. Organizations dependent on revenues from the stock market are now feeling the financial effects of its low performance in recent years. This may lead to fewer dollars to disperse and fewer revenue streams for schools of nursing.
Finally, as students, our “customers,” have changed over the years, the need to provide new services and products has also become more compelling. The average age of a student graduating from a basic nursing program is 30.9, compared to 23.9 in 1984 (Spratley, Johnson, Sochalski, Fritz, & Spencer, 2000). These adult learners are, at times, in need of remedial support, since they may have been out of the educational system for a period of time. They also want and value alternative teaching models, ones that combine Web-based learning with classroom instruction. These newer models allow students to incorporate the pursuit of education into their complex lives. New models of education that streamline the process to advanced degrees also provide educational opportunities that were previously unavailable.
Setting Priorities and Leveraging Resources
Nursing, like other areas of higher education, embraced the concept of strategic planning to set priorities, use resources wisely, and take advantage of available opportunities that were consistent with the strategic direction. For schools of nursing, this process seemed like a rational tool for orderly, systematic management, a disciplined effort to produce fundamental decisions and actions that shape and guide what an organization is, what it does, and why it does it (Bryson, 1988). The 1980s were also a complex time in nursing higher education, given the focus on nursing research and the need to shift from faculty as exclusively clinical experts to faculty as both clinical experts and researchers.
Yet little has been written in the current nursing literature about the need, process, or outcomes of planning in the academic program. In the 1990s, many business leaders and academic administrators, including nursing deans, questioned the value of strategic planning. They thought the process was cumbersome and that academic units spent more time developing the plan than implementing the initiatives. In industry, there were a number of positive stories in which companies found success with a much less-structured planning approach (Dooris, 2002). Others found it was impossible to project the future for the length of time the strategic plan encompassed, and responsibility and interest for initiatives waned (Minnick & Halstead, 2001). Still others believed the strategic planning process discouraged creativity, entrepreneurship, and positive change. The result is that some leaders abandoned strategic planning completely, while others invented new approaches to rational decision making.
While there has been a shift toward a less-structured approach to planning, nursing deans need tools to assess the environment, make rational decisions, set priorities, plan for change, and develop strategies to meet the short-term and long-term goals of the unit. New models of strategic planning include dimensions of flexibility, creativity, and strategic thinking within the educational, economic, and political contexts (Rhoades, 2000). Plans are no longer simple roadmaps for the future. Instead, they are vehicles for moving along a trajectory toward a series of goals.
It is widely accepted that planning is most important in times of significant and rapid change, as a method of coping with that change (Baker & Martin, 1993; Gilbert, 1991; Hall & Eliott, 1993). Given the challenges facing nursing education and higher education, the need for a planning approach is critical. The case study in this article (see pp. 508–509) describes a flexible and creative approach to the planning process that helped the University of Virginia School of Nursing set priorities and achieve its goals.
This approach came after years of trying to use a more conventional strategic planning approach. Like many companies had already learned, the more traditional approach was cumbersome and too much like a recipe. Times changed, and the more prescriptive plans became outdated. In contrast, using the envision process, which is discussed in the case study, faculty were able to agree on strategic directions and determine which areas in the school would be maintained, which would be strengthened, and what new areas would be developed.
Strategic Challenges for the Future
Fiscal Management and Resource Procurement
Fiscal management and resource procurement will continue to be the cornerstones of academic leadership, for, without them, academic units cannot achieve their missions. After an academic unit sets its priorities, the budgetary implications of those decisions must be examined and addressed. Resource allocation, through either existing or new funding streams, must follow a clear set of priorities. Planning failures can often be tied to an ambiguous link between the allocation of resources and the strategic initiatives of the academic unit (Minnick & Halstead, 2001).
Academic deans must have a clear and complete understanding of the unit's budget, including current revenue sources and expenditures. Existing revenue sources must be fully mined to ensure all opportunities are developed. New revenue sources must be found to fund new streams of activity. These new revenue sources can be found by answering the question, “Who benefits from the end product of the school's activity?,” whether it is education, research, clinical practice, or outreach. For example, if a community hospital is paying $2 million in bonuses to traveling nurses each year, perhaps they could be encouraged to fund the tuition for graduate students in exchange for part-time work during the academic year and full-time work during vacations and summers. These graduate students may remain at the institution after they graduate, resulting in a steady stream of permanent employees for the hospital. The benefit for the school of nursing is an increase in the number of full-time graduate students. Research centers may receive financial support from foundations that are interested in the scientific area. Alumni and donors must be cultivated based on strategic priorities. Through education and engagement, deans can make the school's priorities the donor's priorities.
Entrepreneurship is essential to the evolution of any academic unit; yet, overcoming change and resistance is often difficult in academic institutions (Hanna, 2003). Bennis (1989) described the academic leader as a conceptualist, someone who understands the mission, has a strong vision, and is entrepreneurial within that mission. Longstanding traditions, coupled with strong and independent faculty who strive for autonomy, may resist strategic efforts. However, the organizations that have been most successful are those that have embraced change and encouraged faculty members' creativity within the context of the organizational mission. The opportunity to begin the change process with a “discussion,” as described in the case study, may reduce the resistance to innovation.
A clearly defined organizational and unit mission will aid decision making related to setting priorities. Schools of nursing must identify their core values—those activities and outcomes that define the fundamental elements of the school. Plans for innovation, growth, and change can be evaluated based on those core values. For example, The Pennsylvania State University and the School of Nursing have missions that include teaching, research, and outreach—three dimensions clearly defined and described by the University. The School of Nursing has been challenged to make decisions about strategic initiatives within this mission, given limited resources and faculty time. Through discussion with the academic leadership and faculty of the School, it was decided that clinical outreach would only be done if it furthered the School's academic or research missions. For example, clinical outreach in the form of health screenings or health education would be conducted by students as a service-learning activity or as part of a research project. Outreach activities could then continue to be important and visible, while strengthening the other two dimensions of the mission. As resources or priorities change, or if an exceptional opportunity presents itself, the School will be able to adapt to the current environmental context.
Through every step of the planning process, the faculty must have an integral role in setting direction, critiquing plans, and implementing activities. Without faculty consultation early and at every step of the process, the best plans will not be successful. As described in the case study, faculty members are integral in setting the direction for the academic unit.
Investment in the Future of the Faculty
Given the changes in the characteristics of the academic nursing population, it is essential that academic units invest in the future of the faculty. Nursing deans who help foster positive, supportive, and intellectually rewarding work environments encourage faculty longevity and inspire young professionals to choose careers in academia. Many strategies have been used to improve the work environment for faculty, including the development of mentorship programs for young faculty, the growth of interdisciplinary and intradisciplinary collaborations, and the examination of faculty workload within the context of individual strength and goals.
The impending retirement of faculty members in the coming years and the need to replace them with individuals new to teaching will require nursing deans to develop approaches to “teach the teachers how to teach.” The trend in master's education is toward nurse practitioner education and preparation as scientists at the doctoral level (AACN, 2003). While some of these individuals may have taken an elective course in teaching, it is likely they could begin an academic appointment with exceptional clinical or research skills but without an understanding of the teaching role. Providing summer institutes, teaching academies, and mentored teaching experiences will help these new faculty members become effective educators.
Telling the Story of the School of Nursing
Historically, the nursing profession, including academic nursing programs, has been less than effective in sharing the scope and significance of its work. While nursing has contributed much to the health of the nation through both practice and research, there has been little visibility of the contributions to that work. By developing priorities, identifying goals, and measuring outcomes, nursing schools can identify those scientific, academic, or clinical areas that make them distinctive. Those areas that define the academic unit can be highlighted in the effort to tell the story of the school of nursing. Deans and faculty should be encouraged to share the positive work of the school with others within the college or university, as well as with alumni, the board of trustees, legislators, and the public. By “telling the story,” it becomes clear to constituents how the school of nursing is advancing the mission of the university and the school.
While the strategic planning process of the past is outdated, nursing higher education continues to need a conscious process by which it assesses its current state and the likely future condition of its environment (Swenk, 1999). Contemporary planning processes include listening to the market, encouraging the emergence of good ideas, engaging employees in the process, recognizing opportunities, and helping the organization flourish in the face of change (Dooris, 2002). Through the planning process, academic nursing programs will proactively guide their future through inevitable change.
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