A 2021 report by the Florida Hospital Association projects that Florida will face a shortage of over 59,000 nurses by 2035.
The University of South Florida College of Nursing plans to address the problem by utilizing nearly $40 million in recently allocated state funding to expand facilities, boost faculty numbers, increase enrollment and retain graduates in local hospitals.
Usha Menon, dean of the USF Health College of Nursing that spans all three campuses, said the industry experienced workforce issues since the 1990s that were “completely exacerbated” by Covid. Menon said the pandemic caused nurses to become so burned out and fatigued with their jobs that they began leaving the profession much faster than anyone anticipated.
“The first word that comes to mind is ‘crisis,'” said Menon. “It truly is a professional crisis, but also a national crisis and a crisis for Florida.”
Increasing enrollment and retention
Menon explained that over the last few years, nurses were not just resigning from jobs, but established professionals are retiring from the industry 10-15 years earlier than expected. She said the first step to mitigating that problem is to graduate new, competent nurses and add them to the regional talent pipeline.
The second step, she said, is increasing retention rates in the Tampa Bay area for new graduates. She believes the $40 million recently approved in the state budget for the college will go a long way toward achieving those goals, starting with expanding critically needed facilities on the Tampa campus.
“Specifically, to add classrooms and really transform the way we are delivering our pedagogy,” said Menon. “We have simulation labs … nurses don’t immediately go into the hospital setting or clinical.”
Menon called the spaces in the school’s current labs very small, and she believes providing a larger simulated hospital environment attached to group learning areas will better prepare students. State leadership approved $33 million for the expansion and upgrades to the Tampa campus.
The overarching goal, said Menon, is adding 500 more graduates to existing numbers over the next five or six years.
The college is also working closely with area hospitals to institute retention programs that help provide nurses with the tools they need to become more resilient and better handle the stress that comes from working in a high-pressure environment.
“The other ways are by embedding our students sooner into the hospital setting,” added Menon.
One of the new programs is an externship that places nursing students in local hospitals immediately after finishing their first levels of coursework. Menon said they are mentored through the process at the hospital with the hope that they will see that facility as a good work environment when it comes time to choose where they want to begin their careers.
The second program, Preceptorship-to-hire, is currently offered at Sarasota Memorial Hospital, Moffitt Cancer Center and Tampa General Hospital. Menon said senior students choose a facility they would like to spend their entire clinical session at before graduating, with the goal of that hospital extending an employment offer and the students accepting.
“So, in a way, the health care organization has almost onboarded its own employee,” said Menon. “You’re reducing the cost of onboarding because you’re bringing in the student and then transitioning them to professional practice.”
Increasing faculty and staff
The remaining $6.9 million in recurring funding, said Menon, will allow the college to hire more faculty and staff.
Menon said that many people remain unaware that the industry also faces an acute nursing faculty shortage to teach students. She added the challenge extends far beyond USF and presents a critical impediment to boosting enrollment numbers.
“We have accreditation standards – faculty to student ratios that we have to maintain, especially in their clinical settings,” explained Menon.
The new funding, said Menon, will allow her to hire about 40 new faculty and 30 new staff members over the next five years. She added that as programs increase in scope, it can become easy for a student “to get lost in the system.”
Menon said she wants every nursing student across all three campuses to know that the college’s leadership recognizes and pays attention to them and will help them “every step of the way” through graduation.
An aging population, said Menon, increases the demand for skilled nurses – and their workload. The nursing workforce is also getting older, and Menon said as those health professionals approach retirement, schools struggle to refill the talent pipeline fast enough to offset the losses.
She added that increasing turnover rates exacerbate the problem, as many people are unhappy with their caseload and pay.
“Nurses will tell you, ‘we don’t just want another pizza party,’” said Menon. “We want better working hours. We want respect. We want to be able to practice through the full scope of our practice, whether you’re a registered nurse or an advanced nursing practitioner.
“It’s very difficult when you’re educated to do something, but you’re not allowed to practice the full scope of what you’re trained to do.”
Menon said USF plans further expansion of the St. Petersburg campus’s nursing program, but it could take some time.
She said she is working closely with campus leadership to ascertain how they can increase the program’s size and noted that last year, despite funding and faculty limitations, she was able to raise nursing enrollment in St. Pete from 30 to 70 students.
Menon said that many nursing schools throughout the region find it difficult to acquire clinical placements for students, essentially competing against each other for training locations. Menon added that even if she has enough faculty to meet ratio requirements, she also must ensure she has enough places for students to train in a clinical setting.
“In the St. Petersburg area, part of what we’re doing now is kind of redesigning the partnership we have with the area hospitals and healthcare organizations,” said Menon. “And really talking with them about coming up with a dedicated plan to take USF students.
“And when we get to some level of capacity is when I think I’d feel comfortable increasing the program in St. Pete.”
The College of Nursing’s faculty members work across the three campuses, so Menon believes USFSP can meet the teaching requirements for expansion moving forward. She noted that outgoing Regional Chancellor Martin Tadlock was very supportive of the program “from day one” and said she looks forward to having in-depth conversations with incoming Chancellor Christian Hardigree to realize her vision for the program.
In the meantime, Menon said she has met with the St. Petersburg Area Chamber of Commerce, members of the surrounding Innovation District and various hospitals to acquire dedicated clinical spaces. Menon was pleased to announce a new partnership in St. Pete with HCA Florida’s Northside Hospital.
The College of Nursing is partnering with the facility to launch a pilot program for a dedicated education unit. Menon credited Mary Tabor, chief nursing officer for Northside, for collaborating with the college to create a department devoted to teaching USF students.
“It means that students get a more consistent kind of clinical experience instead of having to hop to different hospitals for different experiences,” said Menon. “The big advantage for the hospital is that you are developing a relationship with the faculty, the clinical preceptors and the students.
“But also, the students are spending enough time there, that we hope this will lead to retention – when they are close to graduation, they are going to think about this as their place that they want to work.”
Menon noted that while nurses may complain about certain aspects of the job, they love their profession. She said that when people ask about her career, she does not refer to herself as a dean or a nurse scientist. Instead, she tells them she is a nurse.
“Because that’s who I am at my core,” added Menon.
She explained that most nurses keep their “little warm and fuzzy files” with notes from patients and families that they refer to when times are tough, to remind them of their impact on the community.
With a lack of available seats, Menon realizes the program was previously challenging for many prospective students to enter. However, she wants them to know that the college is increasing its enrollments, and anyone interested should reach out to her or her staff.
“What we want is a student who wants to be a nurse,” said Menon. “It isn’t just about the grades.
“If somebody comes to us a year early and says, ‘I really want to do this, I’ve wanted to do this since I was 7 years old – help me get ready for it’ … we would welcome that person with open arms.”