Nursing schools turning away qualified applicants in part because of instructor shortage on Long Island, in U.S.

Long Island nursing schools are turning away students as they struggle to find enough instructors, exacerbating an already serious nursing shortage, experts say.

A wide gap between what nurses can earn teaching compared with working in health care facilities is a key reason, nursing school deans say. Fewer nurses per patient leads to a greater chance of patient harm, research shows.

Nationwide, more than 78,000 qualified applicants were turned away from nursing schools in 2022, according to a May report from the American Association of Colleges of Nursing, which surveyed programs.

The number of students in entry-level bachelor’s programs declined last year for the first time in 21 years, and declines continued for graduate and PhD students, the survey found.

Those declines in nursing students studying for advanced degrees may make the nursing shortage even worse, said Robert Rosseter, spokesman for the association. Full-time nursing faculty typically must have a master’s or doctoral degree, so the declines mean a smaller pool of future potential instructors, he said.

“We always say if you’re going to address the nursing shortage, you have to also address the faculty shortage,” he said. “That’s the only way we’re going to fix the pipeline.”

New York hospitals reported nursing shortages

All New York hospitals surveyed in 2022 by several hospital associations reported nursing shortages. A 2019 study published in the American Journal of Medical Quality predicted that New York would have a shortage of nearly 40,000 nurses by 2030.

Studies show that higher patient-to-nurse ratios lead to greater risk for patients, including death.

“Assigning increasing numbers of patients eventually compromises a nurse’s ability to provide safe care,” said a 2021 article published by the federal government’s Agency for Healthcare Research and Quality.

Long Island nursing school deans said they want to graduate more nurses to help alleviate the shortage. 

St. Joseph’s University in Patchogue and Brooklyn, which has about 500 students, rejects qualified candidates each semester, said the associate dean for nursing, Maria Fletcher.

The biggest reason she can’t expand the program is the difficulty in finding enough faculty.

“Nurses who are nurse practitioners are earning more than twice what I can offer them,” she said.

Nurse practitioners, who need a master’s degree and perform certain duties that registered nurses cannot, earn an annual average salary of $188,152 on Long Island, according to state Department of Labor data released in July. The average salary for nursing instructors is $111,911, and for entry-level instructors, it's $55,315.

Marybeth Heyden said she took an annual pay cut of more than $25,000 when in 2021 she began teaching part time at Stony Brook University’s School of Nursing, and reduced her nurse practitioner hours.

“I did it because I truly have a passion for it,” she said, referring to teaching.

But nurse colleagues who want to teach beyond a limited adjunct role tell her they don’t do so because of the pay gap.

Heyden, 61, said when she joined the faculty, her children already were adults.

“But if you’re raising young children or are in the years when they’ll be going away to college, you need that money,” she said.

Deans of most of the 10 nursing programs the state lists on Long Island — one, Nassau Community College, did not respond to interview requests — said they had difficulty finding faculty, and all of those deans said pay was a key factor.

In response, Stony Brook, which has “had qualified students we have turned away,” has been hiring more part-time faculty, nursing school Dean Patricia Bruckenthal said.

“It allows you to continue to make that nurse practitioner salary at least two days a week, if not three,” she said.

An incentive is that working as part-time faculty “really enhances work-life balance,” because many tasks, such as grading papers or writing curricula, can be done at any time, she said.

Allison Hotze, 36, began teaching part time at Stony Brook in the summer, in part because of that flexibility. She teachers graduate-level classes, which are primarily virtual, so she can visit family in Illinois on long weekends and work from there, and take her teenage stepchildren to doctor appointments.

Even full-time faculty typically continue working as nurse practitioners, often one day a week, deans said. Some colleges require that.

Sharon Friedman-Urevich, an associate professor of nursing at St. Joseph’s, said when she joined the faculty in 2011, she closed most of the pay gap by working once a week as a nurse practitioner and extra hours over the summer, when she didn’t teach.

“Taking the pay cut was a choice,” she said. “I always knew I wanted to teach.”

Nurses often too busy to train students

The instructor shortage isn’t the only reason some colleges limit enrollment or don’t plan to expand. Deans also cited budgetary and space constraints, and limited access to on-site clinical training.

The clinical-training crunch is in part due to the nursing shortage, said Robert Martiniano, senior program manager of the University of Albany’s Center for Health Workforce Studies and co-author of a June report that found that nearly half of New York nursing programs rejected qualified applicants. Nurses often are too busy with patients to have enough time to help train students, he said.

A new state law allows more nursing training to be through simulation.

But, said Cheryl Shaffer, associate dean of Suffolk Community College’s School of Nursing, “that has its own barriers, because you’re going back to [having enough] faculty who are properly trained.”

Every year, Suffolk turns away 100 to 150 applicants who passed a nursing school admission exam, Shaffer said.

At Farmingdale State College, several hundred applicants each year are not accepted, nursing department chair Virginia Peterson said.

The college only enrolls 100 new students a year, she said, and test scores and high school grade-point averages help determine who to admit, she said.

Nursing programs rely heavily on adjunct faculty — nurses who may teach one day a week, often in clinical settings. Deborah Hunt, dean of Adelphi University's College of Nursing and Public Health, said the university has raised the pay of its adjunct faculty to roughly what they'd earn per hour as RNs. The average salary for RNs on Long Island is $111,011 a year, similar to the annual salaries for full-time nurse educators, according to state labor department data — although RNs aren't required to have a master's or doctorate.

Deans said full- or part-time, non-adjunct faculty are critical.

Rose Schecter, Molloy University’s associate dean for undergraduate nursing and administrative affairs, said full-time faculty offer “more commitment, because more is expected of them,” including teaching multiple classes, serving on committees and helping shape programs. 

When the Hofstra Northwell School of Nursing and Physician Assistant Studies started its undergraduate program in 2021, there was a deliberate cap instituted of 118 new students per year, Dean Renee McLeod-Sordjan said. That cap could be increased if there were enough faculty and access to clinical training, she said.

The university is aiming to stimulate interest in teaching by requiring that all graduate students take an academic teaching class, which is uncommon in master’s programs, she said.

Adelphi, where most faculty have doctorates, is working to attract more nurses to study for doctoral degrees, Hunt said.

The university participates in a federal program that pays up to 85% of nursing school debt for students, who agree afterward to teach at any nursing school for at least four years after graduation.

Northwell Health, the region's and state's largest health care system, provides tuition reimbursement at Hofstra Northwell and other colleges and universities, including for those obtaining advanced degrees, said Launette Woolforde, Northwell's deputy chief nursing officer and its former vice president of nursing education and professional development.

Even if a nurse leaves Northwell to become a nurse educator, "they have the opportunity to increase the profession exponentially," she said. "They are educating multiple future nurses."

Northwell is "concerned" about the nursing shortage, but is taking steps to preserve patient care by, for example, reducing nurses' workload through increased use of technology, such as artificial intelligence, Woolforde said.

“I believe we will be able to meet the care needs of the populations that we serve,” she said.

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.