NArdi and GYurko SRGlobal NUrsing Faculty SHortage (1)

PROFESSION AND SOCIETY
The Global Nursing Faculty Shortage: Status and Solutions
for Change
Deena A. Nardi, PhD, PMHCNS-BC, FAAN1
& Charlene C. Gyurko, PhD, RN, CNE2
1 Alpha and Delta Upsilon, Professor and Director, DNP Program, University of St, Francis, Joliet, IL, USA
2 Mu Omega, Assistant Professor, Purdue University North Central, Westville, IN, USA
Key words
Global nursing faculty shortage, nursing faculty
shortage, solutions to the nursing faculty
shortage, systematic review
Correspondence
Dr. Deena Nardi, Director DNP Program,
University of St. Francis, 500 Wilcox St., Joliet, IL
60435. E-mail: dnardi@stfrancis.edu
Accepted: February 25, 2013
doi: 10.1111/jnu.12030
Abstract
Background: In addition to a global shortage of nurses, there is also a shortage
of academically qualified faculty available to teach in schools of nursing.
Methods: A systematic review examined proposed solutions to the global
shortage of nursing faculty. Metasynthesis was used to compare and critically
appraise strategies offered for solving or ameliorating the global nursing faculty
shortage by premier nursing organizations.
Findings: 181 recommendations in 62 publications were categorized into
eight major themed solutions, including centralizing data management, inter-
national collaboration in nursing research, and increased funding for full-time
faculty positions in nursing programs.
Discussion: The nursing faculty shortage is due to a confluence of factors,
including the global migration of nurses, a seeming persistent devaluation of
faculty by academic programs, disincentives, and an overall reduction in full-
time equivalent faculty positions.
Conclusions: Results point to a needed change in direction and approach to
solving the nursing faculty shortage. By designing new education models that
fit global healthcare needs and pooling teaching resources, designing and us-
ing the same databases across organizations to track and project faculty needs,
and collaborating between schools and businesses to create mutually benefi-
cial agreements for services, nursing faculty capacity can be enhanced, and
nursing’s capacity to meet global healthcare needs can be expanded.
Clinical Relevance: The results of this systematic review can be used as a
rubric for the design and development of strategies to end the nursing faculty
shortage and expand global nursing capacity.
The International Council of Nurses (ICN), the largest in-
ternational health professional organization in the world,
considers the global shortage of nurses a serious cri-
sis that continues to adversely impact health care for
everyone (Oulton, 2006). In addition to a shortage of
nurses with at least a baccalaureate degree, there is also
a shortage of academically qualified faculty available to
teach in schools of nursing. Over 75,000 qualified ap-
plicants to nursing programs in the United States alone
are turned away each year because of a lack of nurse
faculty, clinical sites, and inadequate education budgets
(American Association of Colleges of Nursing [AACN],
2010). This need for an increased educational capacity
is not being met, however, since there is a correspond-
ing critical shortage of nursing faculty, the major edu-
cation resource used in the preparation of tomorrow’s
nurses (Allen & Aldebron, 2008). The nursing faculty
shortage is due to a confluence of factors, including the
global migration of nurses, an aging faculty, a reduced
younger faculty hiring pool, decreased satisfaction with
the faculty role, lack of funding and poor salaries, a
seeming persistent devaluation of faculty by academic
institutions, increased dependence on contingent fac-
ulty, and overall reduction in full time equivalent (FTE)
Journal of Nursing Scholarship, 2013; 45:3, 317–326. 317
C 2013 Sigma Theta Tau International

The Global Nursing Faculty Shortage Nardi & Gyurko
faculty positions. Additionally, the number of master’s-
prepared and doctorally prepared advanced practice
nurses planning to teach has decreased throughout the
years.
After tracking the nursing faculty shortage for the past
6 years, we noted that the number of documents pub-
lished about it was increasing, with no consensus or or-
ganized plan to address this ongoing problem, one that
nursing organizations would collaboratively work on or
commit to. We decided a systematic review (SR) of pub-
lished solutions to the problem was needed to determine
if there were common threads or themed solutions em-
bedded in the now numerous published recommenda-
tions to address the shortage. This article uses an SR ap-
proach to the examination of the economic, social, and
educational factors that contribute to the global shortage
of nursing faculty, and its resolution. Metasynthesis was
used to compare and critically appraise recommended
strategies for attracting qualified nurses to the full-time
faculty role and supporting them once they arrive, by
premier nursing organizations such as the International
Council of Nurses (ICN), Tri-Council of Nursing, Royal
College of Nursing, AACN, American Academy of Nurs-
ing, Sigma Theta Tau International, and Robert Wood
Johnson (RWJ) Foundation. Results of this SR point to
a needed change in direction and approach to solving the
nursing faculty shortage. These results can be used as an
evidence-based rubric by nursing organizations and lead-
ers globally to combine strategies and resources to more
effectively manage this problem of decreasing nursing ed-
ucational capacity.
Background
Nurses who pursue academia as a career often do so
later in their careers. This does not lend itself to lengthy
employment in an academic setting. One major drawback
that causes nurse educators to leave the academic arena,
arrive to it late, or never enter it is that faculty salaries
are not competitive with positions outside of academia
(Lewallen, Crane, Letvak, Jones, & Hu, 2003). This fact
was further supported by research findings of the AACN
and reported in a Congressional Briefing in Washington,
DC, on September 8, 2004 (Valiga, 2004).
The AACN, national voice for its baccalaureate- and
higher-degree nursing education programs in the United
States, stated in its White Paper in 2005 that the nursing
faculty shortage is a grave and persistent problem threat-
ening the United States’ health professions’ educational
infrastructure (National League for Nursing, 2010). By
2012, the AACN reported that there was a 7.6% national
nursing faculty vacancy rate (AACN, 2012).
Several proposed solutions from international and
state-based professional nursing organizations stress the
need to aggressively intervene in the areas of recruitment
and retention, with attention on funding and macroe-
conomics. One such response to this proposed solution
is the International Nursing Education Network (NEN)
and its collaboration between the ICN and the U.S. Na-
tional League for Nursing (NLN) to address the inter-
national shortages of nurses and nurse faculty that ex-
ist in many countries. Its inaugural meeting occurred in
Durban, South Africa, in 2009, at the 24th ICN Quadren-
nial Congress. The network created a forum for the global
nursing education community to share resources in the
examination and response of global issues surrounding
issues of nurse educators worldwide (ICN, 2012; Se-
nior, 2010). By September 2012, membership had grown
to 1,400 members from 89 countries (NEN, 2012). Al-
though its mission includes addressing the nurse faculty
shortage and it shows promise as a think tank to ad-
dress issues challenging nursing educators, it currently
functions as a formal venue for information sharing
and informal communication network through Internet
forums.
The RWJ Foundation advocates efforts that persuade
more nurses and nursing students to pursue academic ca-
reers, and to do so at an earlier age. In May 2010 in its
document “Charting Nursing’s Future,” the RWJ Foun-
dation announced that it was working with the Center
to Champion Nursing in America, the U.S. Department
of Labor, and the Health Resources and Services Admin-
istration to address issues associated with increasing the
capacity of nursing schools to include changes associ-
ated with redesigning educational programs in their states
by deploying revised curricula, new technology, and up-
dated clinical education models. It was felt that these
initiatives would increase faculty capacity and diversity
(RWJ Foundation, 2010).
In 2010, the Tri Council of Nursing reported that the
health of the nation will be put further at risk unless there
is a more educated workforce. This organization also en-
couraged all nurses, regardless of entry point into the pro-
fession, to continue their education at all program levels,
including master’s and doctoral (Tri Council of Nursing,
2010).
A White Paper published by the American Academy
of Nursing Expert Panel on Global Nursing and Health
advocated for the promotion of faculty exchanges, more
budgeted full-time nursing faculty positions, and funding
“required to support advanced educational preparation
of nurses who would (a) commit to teach nursing, and
(b) conduct research that will enhance the educational
preparation of nurses” (Rosenkoetter & Nardi, 2007,
p. 311).
318 Journal of Nursing Scholarship, 2013; 45:3, 317–326.

Nardi & Gyurko The Global Nursing Faculty Shortage
Equitable academic compensation salaries are not only
a problem in the United States. For instance, the United
States seems to fare a little better, with nursing faculty
averaging salaries between $70,410 and $81,552 as com-
pared with nursing faculty salaries in the United Kingdom
averaging between $52,662.97 and $62,079.73.
The Institute of Medicine’s (IOM’s) “Future of Nursing”
seminal report proposed an increase in number of bac-
calaureate prepared nurses from 50% to 80% and to dou-
ble numbers of doctorally prepared nurses by 2010. In ad-
dition, the IOM addressed the need for salary and benefits
for faculty that must be market competitive while remov-
ing the scope of practice barriers to advanced practice reg-
istered nurse practice (Institute of Medicine, 2010). Pro-
posed recommendations were to create an international
body to coordinate and recommend national and inter-
national workforce policies (Institute of Medicine, 2010).
In 2000, The European Union European Higher Educa-
tion Area launched the Bologna Process, meant to ensure
more comparable, compatible, and coherent systems of
higher education in Europe. Its goals are, in part, to help
facilitate mobility of students, graduates, and higher ed-
ucation staff, and to help prepare students for their fu-
ture careers and for life as active citizens in democratic
societies, while supporting their personal development.
It continues to offer broad access to high-quality higher
education, based on democratic principles and academic
freedom. Currently 47 countries are participating in the
Bologna Process (Adelman, 2009).
Global nurse faculty migration is defined as nurse ed-
ucators or researchers leaving their country of origin to
work in a different destination. Following the adoption
of the Code of Practice of International Recruitment of
Health Personnel at the World Health Assembly in 2012,
the World Health Organization and the Organization for
Economic Cooperation and Development have joined to
begin work on its implementation, and to monitor the
problem of international nurse migration (International
Centre on Nurse Migration, 2011).
In 2013, the global faculty nursing shortage contin-
ues. It is exacerbated by global migration and brain
drain, most prevalent in countries such as the Philippines
and Ireland, causing further shortages of nurses in these
countries. Associated with these problems are the ubiqui-
tous inequality in basic levels of nurse training and incon-
sistency in how training is provided. Therefore, inconsis-
tency in expectations and hiring for qualified faculty is
also a problem.
Methods
An SR is a comprehensive and unbiased review pro-
cess that systematically locates, appraises, and synthesizes
evidence from published documents to obtain a reliable
perspective or more compelling findings (Polit & Beck,
2012). This SR methodology required a re-analysis of
published documents, white papers, and position state-
ments. The key words of nurse faculty shortage, nurse
faculty global migration, global nurse faculty shortage,
and nurse faculty shortage solutions were used to search
the databases of the Cumulative Index to Nursing and Al-
lied Health Literature (CINAHL), CINAHL PLUS, Pubmed
Central, Google Scholar, Ebsco Full Text, Medline, Med-
scape, and Proquest. A total of 1,287 unfiltered cita-
tions were received; 225 citations were discarded due
to the mismatch of actual content to search criteria.
1,062 citations were filtered by date (2002–2012), leaving
174 citations with a filtered match of date match and
no duplicates, and the publication must have been peer
reviewed. Of these 174 documents, 62 documents of-
fered solutions, and 181 separate solutions were then
identified and entered into the database. The next step
reviewed, aggregated, and analyzed these 181 solutions
to identify commonalities and themes among them, us-
ing open coding methodology and comparative analy-
sis. Interrater consensus was used to first decide cat-
egories of recommendations, and then to extract so-
lution themes from the categories. Table 1 lists the
global professional nursing and health organizations
that expressed their concerns about the shortage, and
whose position papers and solutions were reviewed for
this SR.
Results
When the 181 recommendations by these interna-
tional nursing organizations were separated out and com-
pared, eight common solution themes emerged. The
first solution, to centralize international data gathering
and evidence-based strategies design, was expressed in
30.88% of these solutions. This was followed by creating
an educational paradigm change (28.33%). Developing
international cooperative policies and programs was ex-
pressed in 10% of these recommendations, and removing
barriers to advanced practice was identified in 9.17%. The
eight common solutions are described in the ensuing text
(Table 2, Figure 1).
Centralize Data Recording and Strategy
Management
This strategy was expressed by 30.83% of the pub-
lished recommendations. The terms and definitions used,
tools, research designs, settings, and sample numbers
were widely divergent in the material reviewed, leav-
ing us to wonder what many authors meant by the

Table 1. Documents Analyzed for Solutions Are From These Professional Organizations
World Health Organization American Association of Colleges of Nursing
International Council on Nurses American Association of Nurse Executives
International Centre on Nurse Migration U.S. Department of Health and Human Services
International Centre for Human Resources in Nursing American Academy of Nursing (AAN)
Sigma Theta Tau International AAN Expert Panel on Global Nursing and Health
Bologna Secretariat, European Commission USA Institute of Medicine
Royal College of Nurses, United Kingdom Robert Wood Johnson Foundation
Global Alliance for Leadership in Nursing Education and Science Carnegie Foundation for the Advancement of Teaching
Global Alliance for Nursing Education and Scholarship American Association of University Professors
International Academy for Nurse Editors American Association of Retired People
Commission on Graduates of Foreign Nursing Schools, International Association of Academic Health Centers
Medical Association of Jamaica Truth About Nursing: Center for Nurse Advocacy
Registered Nurses Association of Ontario Georgia Nurses Association
National Advisory Council on Nurse Education and Practice
word faculty. Few publications defined their terms, mak-
ing the results and recommendations useless for appli-
cation or adaptation by the global nursing community.
For instance, the term faculty can be used to describe
a full professor, a clinical instructor, an adjunct teacher
who can contract for as few as one credit hour of teach-
ing, or even a preceptor, who usually receives no pay
or employment benefits for supervising and directing
students in a wide variety of practice settings. Many
publications expressed the critical need for a unified
nursing voice, with an international nursing workforce
center, or think tank, to collect and disseminate all
nursing workforce data as well as related data such as
education planning projections and treatment trends
(Allen & Aldebron, 2008; AACN, 2010; Kingma, 2007).
One of the purposes of such a centralized data and strat-
egy management source for nursing would be to create
a more rigorous body of literature on the nursing fac-
ulty crisis (Aiken, Buchan, Sochalski, Nichols, & Powell,
2004), the trends in healthcare and concomitant trends
in nursing education.
Educational Paradigm Change
This strategy was expressed by 28.32% of recommen-
dations published. In many ways, nursing education ap-
pears to be stuck in the 19th and 20th centuries’ appren-
tice model of a small group of nursing students following
a clinical instructor around a hospital ward of inpatients
for instruction and experience. In the real world of out-
patient and nontraditional settings, quick and fragmented
encounters, and high-tech delivery systems, this process
is anachronistic and inefficient. It also makes nursing ed-
ucation, with its additional clinical practice component, a
very expensive and time-consuming endeavor.
Even though there is a call for a higher-educated nurs-
ing workforce, the shrinking of the faculty pool is per-
petuated by the persistence of the associate degree pro-
gram model of education. In the United States, approxi-
mately 60% of registered nurses (RNs) are prepared at the
associate degree level, and of these, only approximately
21% continue their education, even to the baccalaure-
ate level (Stokowski, 2011). Although professional nurs-
ing organizations have recommended the bachelor of sci-
ence in nursing (BSN) as the basic level of education for
nurses for over 40 years, there have been few motiva-
tors, other than personal desire, to compel associate of
science in nursing (ASN)-degreed nurses to pursue higher
education—thus the pool of qualified faculty continues to
shrink. More emphasis on the recruitment of nurses into
faculty roles, as recommended by Evans (2009), must be
paired with other motivating factors such as targeted tu-
ition reimbursements for practicing working nurses. In
addition, a planned out, determined ending of 2-year ed-
ucational programs in the United States must be imple-
mented in order to end the mixed messages that nurses
receive from their profession, which is that higher edu-
cation levels are required for competent practice in the
complex healthcare field, yet ASN-prepared nurses prac-
tice competently.
There are relatively few PhD or doctor of nursing prac-
tice (DNP) role models with whom nursing students can
work and emulate in the practice setting. However, many
publications, such as Educating Nurses: A Call for Rad-
ical Transformation (Benner, Sutphen, Leonard & Day,
2010), offer many specific recommendations for curricu-
lum, student recruitment, learning activities, entry to
practice, and organizational oversight change. New roles
for nurses must be created and expanded, and these roles
must address the gaps between professional practice and
classroom education (Oulton, 2006). Employment-based
transition to practice, or nurse residency programs, for
new RNs and APNs is another transformative recommen-
dation espoused by several organizations, including the

Table 2. Eight Solutions to the Nurse Faculty Shortage and Their
Sources
Solution Year Source
1. Centralize data 2004 Health Affairs
recording and 2009 Nursing Economic$
strategy 2008 Nursing Outlook
management 2005, 2006, 2009,
2010, 2011
ICN
2010 Nursing Forum
2010 AACN
2008 Tri-Council for Nursing
2009 ANA
2011 CFAT
2004 Nurse Educator
2010 WHO
2011 European Hospital
2009, 2011 GANES
2007, 2012 AAN
2012 Journal of Nursing Scholarship
2010 NACNEP
2010 Medical Association of
Jamaica
2007 Health Services Research
2009 NLN
2012 Milbank Memorial Fund
2009 Educational Dimension
2010 Georgia Nurses Association
2011 Robert Wood Johnson
Foundation
2008 Institute of International
Relations
2011 RCN
2007 AAHC
2009 AACN
2008 Australia and New Zealand
Health Policy
2010 Journal of Critical Care
2012 International Migration
Research Centre
2. Educational 2009 Nursing Economic$
paradigm 2005, 2006, 2010, ICN
change 2011
2009, 2010 AACN
2008 ANA
2009 CFAT
2011 Nurse Educator
2010, 2011 International Nursing Review
2009 Medical Surgical Nursing
2010 Japan Journal of Nursing
Science
2009 Journal of Nursing Education
2012 Japan Journal of Nursing
Science
2010 Nursing Outlook
2009 NCSBN
2006 NLN
2009 Nursing Management
2009 Educational Dimension
Table 2. Continued
2012 Nurses Association of Ontario
Foundation
Relations
2007 AAN
2009 GANES
2011 Nursing Perspectives
Research Centre
2010 AONE
3. International 2008 ANA
cooperative 2011 International Nursing Review
policies and 2010 Japan Journal of Nursing
programs Science
2006, 2009 ICN
2010 Nursing Outlook
2007 AAN
2009 GANES
2008 Australia and New Zealand
Health Policy
4. Removal of 2009 Nursing Economic$
barriers to 2011 ICN
advanced 2010 International Nursing Review
practice 2011 RCN
2010 Georgia Nurses Association
Foundation
Relations
Research Centre
5. Stabilize funding 2009, 2011 GANES
of all 2006 NACNEP
educational 2010 Nursing Outlook
programs. 2007 Health Services Research
2012 Milbank Memorial Fund
2006 ICN
6. Managed 2004 Health Affairs
migration 2010 Medical Association of Jamaica
2006, 2009, 2010 ICN
2007 Int. Centre on Nurse
2012 Migration Milbank Memorial
Fund
7. Improved 2012 Journal of Nursing Scholarship
nursing 2006 NACNEP
scholarship 2010 Georgia Nurses Association
Continued.

Table 2. Continued
8. Competitive 2010 AACN
faculty salaries 2009 Medical Surgical Nursing
2010 Medical Association of Jamaica
2010 ICN
2010 Nursing Forum
2011 Robert Wood Johnson Foundation
2009 GANES
Note. ICN = International Council of Nurses; AACN = American
Academy of Colleges of Nursing; ANA = American Nurses Association;
WHO = World Health Organization; GANES = Global Alliance for Leader-
shipinNursingEducationandScience;NACNEP=NationalAdvisoryCoun-
cil on Nurse Education and Practice; NLN = National League for Nursing;
RCN = Royal College of Nurses; AAHC = Association of Academic Health
Centers; CFAT = Carnegie Foundation for the Advancement of Teaching;
NCSBN = National Council of State Boards of Nursing; AONE = Ameri-
can Organization of Nurse Executives. For the full systematic review table
of all 181 recommendations, linked to the themed solutions, e-mail the
corresponding author, Dr. Nardi, at dnardi@stfrancis.edu.
RWJ Foundation in partnership with the IOM (Commit-
tee on the Robert Wood Johnson Foundation Initiative
on the Future of Nursing at the Institute of Medicine,
2011; Olmstead, 2009). In addition, a move to incorpo-
rate global health in the curriculum, such as using and
creating global nursing education standards, can better
prepare faculty to practice and teach among diverse pop-
ulations, thus improving their satisfaction with their pro-
fessional identity (Baumann & Blythe, 2010; Berent &
Anderko, 2011).
International Cooperative Policies and
Programs
This solution was expressed by 10% of the recom-
mendations published. More workshops, training, and
conferences can be offered through collaborative train-
ing and international exchanges in order to support cur-
rent faculty and attract more nurses to the faculty role
(Rosenkoetter & Nardi, 2007). There should be more
cooperation between educational institutions across na-
tions so that nursing students can transfer credit from
one academic bridging program to another if they move
or migrate to other countries (Kolawole, 2009). Oulton
(2006the chief executive of the ICN in 2006, called for a
globally unified nursing voice in order to create stronger
alliances to combat the nursing shortage and insufficient
numbers of faculty. These international cooperatives and
collaborative teaching would make possible more sharing
of new simulation and distance-based learning technol-
ogy across academic institutions, and sharing of curricu-
lum and faculty (Rukholm et al., 2009).
Figure 1. Eight common solutions emerge.
Removal of Barriers to Advanced Practice
This solution was expressed by 9.17% of the rec-
ommendations published. For nursing education in the
United States, this solution gains even more currency
after the release of the new IOM report that ranks the
U.S. healthcare system dead last among developed coun-
tries in many health outcomes, including overall mor-
bidity and mortality rates and outcomes of chronic yet
treatable conditions such as diabetes, hypertension, and
cardiac disease (IOM, 2013). It cites a weak foundation
in primary health care and a shortage of family practice
physicians as a major weakness and contributor to these
poor outcomes. These weaknesses can be addressed by
removing barriers to full practice by all advanced prac-
tice nurses, primarily nurse practitioners, whose educa-
tion is grounded in primary health. Removing barriers
to practice would allow APNs to partner and collabo-
rate more fully with their physician colleagues to pro-
vide health care to a wider population of patients. This
in turn will encourage more nurses to pursue higher
education degrees in nursing (i.e., master’s and doctor-
ate) and increase the pool for qualified nursing faculty
(AACN, 2010; Committee on the RWJ Foundation, 2011;
Reinhold & Hassmiller, 2009).
Stabilize Funding of BSN Degree and Higher
Nursing Education Programs
This solution was expressed by 8.33% of the recom-
mendations published. The Global Alliance for Leadership
in Nursing Education and Science (2011) noted that the
faculty shortage is compounded by funding cutbacks and
a shortage of clinical placement sites. Furthermore, fu-
ture planning for academic program support and faculty

enhancement is inefficient when funding is arbitrary and
significant changes are made to the funding sources’ cri-
teria within funding periods. Countries can establish and
use a dedicated funding stream to stabilize nursing edu-
cation support and training instead of relying on annual
arbitrary appropriations that cannot be depended upon
by schools of nursing when projecting long-term budget
strategies. This funding should also support faculty aca-
demic and scholarly productivity (Geolot et al., 2008).
In addition, more emphasis and resources must be di-
rected to preparing master’s- and doctoral-level prepared
nurses, who would then be mentored into nursing faculty
careers (Registered Nurses Association of Ontario, 2012).
Managed Migration
This solution was expressed by 6.67% of the recom-
mendations published. Migration has been defined as
nurse educators or researchers leaving their country of
origin to work in a different destination (McLaughlin &
Walker, 2010). Local workforce development planners
and employers take a narrow, local view and do not con-
sider future demands for nursing education, nursing fac-
ulty, and direct line providers when developing plans or
allocating resources. These actions contribute to future
nursing shortages (i.e., determining clinical sites needed,
and projecting future number of nurses to be trained or
recruited, and global recruiting needs). Many countries
do not collect data on who migrates (Kingma, 2007),
thus preventing a clear picture of the human capital drain
from countries of export, as well as preventing the collec-
tion and use of accurate data that are necessary for the de-
velopment of relevant education policies, workforce hir-
ing projections, and healthcare infrastructure. Countries
that are major importers of international nurses, such
as the United Kingdom and United States, must make
a concerted effort to follow ethical recruiting practices
and not contribute to the brain drain and human capi-
tal waste that follows in many countries of export. This
can be done through better monitoring of those who mi-
grate and compliance with international codes on ethical
recruitment as it applies to nurse educators and nurses
qualified to be faculty (Little & Buchan, 2007; Registered
Nurses Association of Ontario, 2012).
Improved Nursing Scholarship
This solution was expressed by 3.33% of the rec-
ommendations published. Nursing scholarship must link
nursing work to patient outcomes. In some countries,
nursing leaders could insist that Medicare and Medicaid
plus all other reimbursers cost out nursing services in or-
der to concretely link nursing practice to patient health
outcomes. This increases the visibility of nursing’s con-
tribution to healthcare planning and research, empower-
ing more nurses to further their education, thus widen-
ing the pool for qualified nursing faculty. Global research
and practice linkages or partnerships among faculty and
educational institutions must be encouraged and sup-
ported to make the most of human capital in these areas
(Geolot et al., 2008; Rukholm et al., 2009). These part-
nerships can provide for the sharing of costs, resources,
and other goods among faculty across the globe, regard-
less of in-country economic resources and opportunity.
Funding of nursing education should thus support and
require faculty research productivity (Geolot et al., 2008),
particularly as it addresses global questions and con-
tributes to the infrastructure needed to strengthen nurs-
ing education and improve patient outcomes (Gennaro,
2012).
Competitive Faculty Salaries
This solution was expressed by only 3.33% of the rec-
ommendations published. Nursing faculty salaries, how-
ever, must be competitive with other private and public
sector positions that attract graduate-prepared advanced
practice and advanced role nurses (AACN, 2010). Reten-
tion must be a priority. Recruitment of nurses into faculty
positions should be a major strategy in ending the nurs-
ing faculty shortage. Nurses practicing in clinical settings
should be educated about the rewards of a faculty ca-
reer (Evans, 2009). There are too few graduate-prepared
nurses to meet the need for healthcare providers who are
fully prepared to address the complex healthcare needs
of the 21st century, yet there is a lack of interest in a
faculty career (McLaughlin and Walker, 2010). The rela-
tively newly created DNP degree was considered one so-
lution to the faculty shortage, but as one document con-
cludes, there is no evidence to support that DNP-prepared
nurses would be any more willing to a accept a signif-
icantly lower wage from one they could earn in other
careers than PhD-prepared nurses (Kelly, 2010).
Incentives such as access to research funding, oppor-
tunities to work with expert peers and participate in
research collaboratives, and changes to minimum edu-
cational preparation for beginning nursing faculty can at-
tract new nursing audiences to faculty careers (McLaugh-
lin & Walker, 2010). Most data on faculty salaries do not
account for the customary 9- or 10-month appointments
of full-time faculty, but these are then compared with 12-
month salaries of comparably prepared nurses practicing
in the clinical or medical settings. If the data are faulty,
then the conclusions drawn from it are flawed. The first
themed solution in this study, however, can be applied to
obtain a correct picture of faculty salaries. Terms should

be defined in comparative studies, and data and strategy
management should be monitored and centralized to cre-
ate a more rigorous body of literature on faculty salary,
benefits, and trends in healthcare and nursing education
(see the first solution theme, “centralize data recording
and strategy management”).
Conclusions and Recommendations
To conclude, these eight main solutions that the 62
documents containing 181 recommendations hold in
common speak to the critical need by nursing organi-
zations to work together as one collaborative body to
solve the common challenges related to the nursing fac-
ulty shortage. Nursing leaders must strive to use the same
terms to describe data. They must develop plans within
a global context, collaborate globally on projects to in-
crease the number and qualifications of nursing faculty,
and consider the effect of increasing globalization and mi-
gration as they project local faculty needs.
Nursing faculty recruitment and retention is critical to
increasing the global capacity of the nursing professions’
education infrastructure. The need for more full-time,
tenure-track nursing faculty positions should be empha-
sized to university administration. To retain qualified fac-
ulty, benefits should include reimbursement for confer-
ences, support for clinical research, and teaching release
time for professional, research, and scholarship activities.
Faculty should have reasoned input into clerical and ad-
visory workload. Retired faculty would receive incentives
to continue teaching. All strategies point to the need for
the role and work of nurse educators to be as highly val-
ued as, and comparable with, the advanced roles of grad-
uate level-prepared nurses in direct care and direct line
positions.
For the past several years, nursing leadership seems to
be on a carousel of forming more task force and meet-
ings to explore the problem of faculty shortages and its
causes and challenges. Yet the published results of these
meetings are not uncovering new evidence. Qualitative
research has a name for this process—it is called satu-
ration, and it occurs when there is no more new infor-
mation to learn about a particular construct, because ev-
ery new note, data source, or story becomes redundant,
describing the same phenomenon (Polit & Beck, 2012).
We submit that a similar process is happening in nursing
education, and it is time to move on. The themed solu-
tions emerging from these documents strongly point the
way to a shift in focus, energies, and action by nursing
leaders. This change in direction would be to implement
these evidence-based strategies now, collaborating to use
the best resources across nations to increase the number
of qualified nursing faculty essential to expand nursing
capacity worldwide.
The eight solutions provide a rubric that identifies
the dimensions, or areas, these strategies should address,
since the faculty shortage problem is multifactorial with
no easy answers. New education models that fit global
healthcare needs can be designed. By abandoning the ap-
prenticeship model for clinical education, pooling teach-
ing learning resources, designing and using the same
databases across organizations to track and project fac-
ulty needs, ending associate degree nursing education
programs, and collaborating between schools and busi-
nesses to create mutually beneficial agreements for ser-
vices (i.e., international faculty exchanges, professional
development for staff, and preceptors for students), nurs-
ing faculty capacity can be enhanced, and nursing’s ca-
pacity to meet global healthcare needs can be expanded.
Clinical Resources
r American Association of Colleges of Nursing Nurse
Faculty Shortage Fact Sheet: http://www.aacn.
nche.edu/media-relations/fact-sheets/nursing-
faculty-shortage
r Global Alliance for Leadership in Nursing Educa-
tion and Science: http://www.ganes.info/
r Nursing Education Network: http://www.icn.ch/
networks/nursing-education-network/
r Tri-Council for Nursing: http://www.
tricouncilfornursing.org/
r International Centre on Nurse Migration:
http://www.intlnursemigration.org/
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