The solutions on the table include legislation to provide a state personal income tax credit to nurse practitioners and other healthcare workers who serve as a clinical preceptor for students—a kind of structured mentorship that bridges the gap between classroom education and clinical hands-on training.
The Healthcare Association, which represents hundreds of systems, nursing homes and other facilities across the state, and the Greater New York Hospital Association are urging lawmakers to devote funding in the upcoming state budget to nursing residency programs. The hospital group, which represents 140 facilities in New York, said in written testimony to the Assembly that funding would go toward a dedicated nurse educator, curriculum development and backfill costs for preceptors.
Stephen Ferrara, associate dean of clinical affairs at the Columbia School of Nursing, said efforts need to start earlier in the nursing career path—as early as primary school, where nurses can help students learn about healthcare careers and encourage them to pursue nursing as a profession.
Creating more space for aspiring nurses is also critical, Ferrara said. An aging faculty population at nursing schools presents the looming possibility of a shortage of educators for the next generation—which he attributed in part to salaries that are lower for teaching than working at the bedside.
“If we don’t have a faculty to educate the incoming amount of workforce that we need,” he said, “then we’re going to end up turning away qualified candidates.”
There are limited spots at hospitals and nursing homes for nursing students to gain clinical experience they need to graduate, observers say. Some stakeholders have suggested the state allow hours of clinical training done through virtual simulation labs to count toward the graduation requirement, although nurses caution that in-person and virtual experiences are not interchangeable.
Pat Kane, executive director of the New York State Nurses Association, a union that represents more than 42,000 members, said she theoretically supports the expanded use of simulations, but she said they lack the mentorship aspect of the in-person clinical experience.
“When you’re coming into that med-surge unit, the instructor doesn’t stay with you the whole time—I’m staying with you,” she said during the Nov. 17 Assembly hearing. “That mentoring and talking about what the career is like … are really important conversations.”
Ferrara said the state should at least explore the possibility, given evidence that simulations are quality educational tools to prepare nursing students.
The nursing pipeline has big shoes to fill. According to the governor’s office, there are more than 9,300 openings across the state for registered nurses alone.
This story first appeared in our sister publication, Crain's New York Business.