When it comes to nursing education in Arkansas, the trends are toward more highly educated nurses including an emphasis on preparing more nurses with Bachelor of Science in Nursing (BSN) degrees, and Advanced Practice Registered Nurses (APRNs) with Doctor of Nursing Practice (DNP) degrees. Currently there are four Arkansas universities approved to offer the DNP degree.
“Certainly the data has shown the more highly educated the nursing workforce is, the better patient outcomes are, and the less issues there are with safety,” said Patricia A. Cowan, PhD, RN, dean of the College of Nursing at the University of Arkansas for Medical Sciences (UAMS).
About 40-45 percent of the graduates from programs in Arkansas are baccalaureate prepared. The other 55-60 percent go to two-year, associate degree programs (two nursing programs in Arkansas recently transitioned to associate degree programs).
Cowan said there is a goal of having 80 percent of nurses baccalaureate prepared. This recommendation comes from the Institute of Medicine’s 2010 report, The Future of Nursing: Leading Change, Advancing Health. Having nurse managers with at least a BSN is one of the qualifications for a hospital to receive Magnet Recognition from the American Nurses Credentialing Center (ANCC), an affiliate of the American Nurses Association, recognizes hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing.
Cowan said hospitals with Magnet designation are also more likely to retain nursing staff who are qualified at a higher level.
While there are over 35,000 RNs licensed in Arkansas, according to the latest report available, there are still plenty of vacancies in hospitals, especially for nurses with a BSN.
“There are areas within Arkansas where we are not meeting the need for healthcare professionals,” Cowan said. “Information from the U.S. Department of Health and Human Services shows that there are 80 primary care provider Health Professional Shortage Areas (HPSA) in Arkansas.”
APRNs are playing a particularly important role in these areas where there are shortages of primary care providers. Data coming from the Arkansas State Board of Nursing indicate there are approximately 2,800 APRNs licensed in Arkansas, with the majority being nurse practitioners and fewer nurse midwifes, nurse anesthetists, and clinical nurse specialists.
“We are filling the health professional shortage gap,” Cowan said. “The demand for APRNs is certainly a growing field. UAMS has nurse practitioners at many of the regional centers, previously called the Area Health Education Centers. Part of what we do is provide education to nurse practitioner students in rural areas throughout the state. If we can train APRNs close to where they live, they are more likely to work in those areas once they graduate. The UAMS Regional Centers are located in Batesville, Fort Smith, Magnolia, Texarkana, Fayetteville/Springdale, Pine Bluff, Jonesboro and Helena\West Helena.”
One barrier to training more nurses is a faculty shortage in Arkansas, as well as the rest of the country. Often nursing instructor salaries lag behind what the nurses can make elsewhere.
“Unfortunately, a good number of faculty across the country are aging out,” Cowan said. “The average age of a faculty member is 51. But here at UAMS, as at many other colleges, we have faculty continuing to work into their 70s. It shows their strong commitment to preparing the next generation for the nursing workforce.”
One trend in training of all types of healthcare professionals is simulation.
“Simulation provides students with safe opportunities to not only practice skills, but deal with tough situations in a simulation before they do it in a real world setting,” Cowan said. “A great simulation is someone comes into a clinic or hospital and the healthcare worker suspects child or elder abuse,” Cowan said. “How do you deal with it? What agencies need to be involved and how do you deal with the agencies? I’ve also seen simulations with end-of-life care that are very effective. It is helpful to explore your feelings about these situations. Debriefing following the simulation provides a means for reflecting on the simulation learning experience.”
Another trend involves more inter-professional education. Cowan said it is important to provide educational experiences in both didactic and in clinical situations with other healthcare professionals.
“It is hard to practice collaboratively and professionally unless you have some training on how to do it,” she said. “All of the professions bring a different insight. The goal of inter-professional education, respecting what each brings, is a better patient outcome. The efforts that have been made to do more inter-professional education allow people to develop more trust in the knowledge base of individuals and the expertise they bring.”
Nursing instruction is also offered at all 22 state community colleges.
“Not only is nursing in high-demand in Arkansas, it’s also a great career pathway that leads to high-paying jobs,” said Collin Callaway, chief operations officer, Arkansas Community Colleges. “Many of our students start out with a Nursing Assistant certificate. They may go to work for a while, and then come back to college to add courses that lead to a Practical Nursing certificate or a Registered Nursing associate degree. Each level along the career pathway requires more education and skill, which results in a higher paycheck.”
The colleges, in partnership with UAMS College of Nursing, just wrapped up a four-year grant funded through the U.S. Department of Labor and the Department of Workforce Services called Arkansas Partnership for Nursing’s Future (APNF).
“One thing we learned through this project is that finding enough clinical training sites for students can be a challenge,” Callaway said. “To help address this shortage, simulated clinical environments are becoming more sophisticated. We were able to use APNF grant funds to help our colleges purchase equipment and develop curriculum to create or enhance their simulated training facilities. In a simulated clinical setting, students are exposed to real world medical scenarios that they may never actually see in a traditional clinical setting. Plus, it creates a safe environment for students to learn.”
Eight community colleges are working together through the Arkansas Rural Nursing Education Consortium (ARNEC) on an on-line program specifically designed to advance students from Practical Nurses to Registered Nurses. Courses are delivered to the eight college campuses via distance education. This allows colleges to share nursing faculty and allows students to advance their careers without leaving their hometowns.
Another university that trains nurses in the state is Arkansas Tech University in Russellville.
“The faculty of the Department of Nursing at Arkansas Tech University seeks, through its professional program, to implement the mission of the university; a mission committed to prepare students to meet the demands of an increasingly competitive and intellectually challenging future,” said Rebecca Burris, PhD, RN, head of the Arkansas Tech Department of Nursing and a professor of nursing. “The university provides opportunities for intellectual growth, skill development and career preparation.”
Burris said the curriculum is designed to prepare the student for basic nursing practice, to be competent, self-directed and capable of demonstrating leadership in the application of the nursing process in a variety of healthcare settings. The graduate should demonstrate initiative for responsible change, the ability to think critically and a lifelong quest for knowledge and growth.
To learn more:
American Association of Colleges of Nursing (2015). Nursing Faculty Shortage
American Association of Colleges of Nursing (2015). Arkansas State Profile.
Arkansas State Board of Nursing (2015). Annual Report 2014-2015.
Populations (MUA/P) State Summary of Designated MUA/P.
Photo notes: , , , UAMS nursing action shots