August 27, 2009
Grateful patient became a nurse educator -- and many more like him are needed
When ironworker Neil Foltz suffered a brain injury after a 28-foot fall during an I-90 construction project in 1991, nobody could have guessed that it would be a good thing for him and the profession that helped put him back together. “I am so pleased with my life since I got hurt,” he says.
He was put into a coma in the hospital and had multiple brain surgeries. All the while, nurses took care of him — and his family.
“The nurses that worked for me stayed there. One that was supposed to go to Hawaii canceled her trip to Hawaii and would not go home until I stabilized. (She) was with me by my bedside for four days nonstop. They would call my family every hour on the hour to make them feel comfortable,” Foltz says.
When worker retraining time came around — and the potential for seizures meant he could no longer do construction-related work — Foltz’s aptitude testing indicated he’d be a good nurse. He jumped at the chance, eager to give back and show his appreciation for nursing. He eventually earned a master’s degree in nursing.
“I am a nurse because they cared so well for my family when they were stressed out over my injury,” Foltz says. “I can’t say enough for what they did for me.”
In 2005, a chance encounter with the dean of Allied Health at Renton Technical College led him away from clinical nursing and into the classroom. The dean found out Foltz was a nurse and asked him if he’d like a teaching position as a nurse educator. A short time later, Foltz was at the head of the class.
“I decided I wanted to pay back what was given to me through my teachers,” says Foltz.
Nurse educators like Foltz are rare. In fact, nursing instructors in general are hard to come by. While it’s common to hear about the shortage of nurses, a root cause is the lack of instructors to train them.
According to the American Association of Colleges of Nursing, “U.S. nursing schools turned away 49,948 qualified applicants from baccalaureate and graduate nursing programs in 2008 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints. Almost two-thirds of the nursing schools responding to the survey pointed to faculty shortages as a reason for not accepting all qualified applicants.”
Foltz says nurse faculty positions at his school have been open since he started. Almost every area college that teaches nursing has openings for nurse educators. The University of Washington needs eight.
Marla Salmon, dean of the UW School of Nursing, calls the shortage the beginning of the “constricted pipeline.” She says, “It is no longer a question of interest in nursing, it’s a question of capacity.”
The lack of nurse educators has several causes — including an aging nurse population that will lead to a wave of retirements in the next 10 years, and broader workplace opportunities for women in the 1980s and ’90s — but the main snag is pay. Compared with nurses in clinical practice with the same education, “starting salaries for faculty are probably 25 to 40 percent less,” Salmon estimates.
“I get paid for eight hours a day,” says Foltz, who works many more than 40 hours a week and makes himself available to students 24/7. Averaged out over a nine-month school year, “I don’t get paid much more than $38 an hour to do what I do as a licensed nurse at the master’s level. If I go to the VA or something like that I could make over $50 an hour. I would get five weeks of paid time off a year, plus your regular holidays paid off, plus your differentials, plus they’d help me to go back to school.”
But pay isn’t the sole motivating factor for faculty. “Salary is the bread-and-butter issue, but that’s not the only set of rewards,” says Salmon. “Some of those rewards you just can’t quantify in terms of their value. They’re just beyond measure.”
Foltz says it’s those intangible rewards that fulfill him as a teacher. “I really can’t say enough good about it. I love my students,” he says. “My students let me know they care about me and that they know that what I do for them is very valuable.”
When he visits hospitals for clinical teaching, he says it’s common for him to see staff nurses that he has taught. “The other day a student stopped me and said, ‘Neil, I would not be where I am today if you wouldn’t have done what you did,’ ” he says. “That to me is more rewarding than anything I could ever do.”
Nurse educators also have a far-reaching impact. “To really have a chance, not only in making a difference in a person’s life that you’re educating, but knowing that that person will be touching thousands of lives, is just a really wonderful thing,” says Salmon. “We’re not just teaching someone knowledge. We’re teaching them skills that can have a life-and-death impact on another person’s life. So I think there is almost that haunting commitment to make sure we’re doing a good job teaching.”
Until faculty salaries rise — and college budget cuts are halted — there are no easy answers to the shortage. Salmon is hopeful that awareness campaigns, such as a nurse educator commercial released recently by Johnson & Johnson, can help steer nurses toward the classroom.
Organizations such as the Washington State Nurses Association and the American Association of Colleges of Nursing are working with lawmakers to try to increase salaries and scholarship opportunities for nurse educators.
Such increased awareness shines a light on the trickle-down effect of inadequate funding for education. “It says to me that we’ve overcome one of our biggest challenges, which is getting society to understand that this isn’t a nursing problem, it’s a societal problem,” Salmon says.
This article was originally published in May 2009.
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