The HRSA projection also found that North Carolina has one of the largest nursing shortfalls projected, at 22% by 2037. To combat this, Durham, N.C.-based Watts College of Nursing shared plans in late February 2025 to relocate to Duke University’s campus, also in Durham, in July 2025.
WCON will be located on Duke Health’s Interprofessional Education and Care Center and will “co-locate” with the Duke University School of Nursing and the Duke Health Clinical Education and Professional Development team.
Becker’s connected with Terry McDonnell, DNP, RN, Senior Vice President and Chief Nursing Executive at Duke University Health System, to discuss how the move will improve academic and clinical training connections to ensure students have hands-on experience prior to entering the healthcare workforce.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: How will relocating Watts College of Nursing to Duke Health’s Interprofessional Education and Care Center help address the nursing workforce shortage?
Dr. Terry McDonnell: Every nurse we train who feels competent, confident and well-supported is one more nurse who is likely to stay in the profession. One of the biggest challenges we see is early-career turnover, with nurses leaving within their first one to three years at higher rates than any other role in healthcare.
The reasons vary, but when we dig into it, it comes down to feeling supported, engaged and confident in their work. By co-locating undergraduate, graduate and clinical education within the Duke Health system, we’re building innovative transition-to-practice programs that reduce the anxiety and uncertainty new nurses often experience. This approach ensures that nurses step into the workforce feeling ready, rather than overwhelmed.
Q: Why is early hands-on training crucial for reducing nurse burnout and improving retention?
TM: When a new nurse walks into a patient’s room and has to make decisions under pressure, it’s a lot to process. They’re balancing patient care, protocols, critical thinking; it’s a huge amount of responsibility. And if they don’t feel prepared, that uncertainty builds into stress, which leads to burnout. We’ve seen that over and over again.
Burnout happens when a nurse constantly feels like they’re barely keeping up. That’s why early hands-on experience is so important. When nurses have already been in those real-world situations during their training, they’re more confident, they can manage their time better and they don’t feel like they’re drowning every shift. It’s about reducing that anxiety so they can actually focus on caring for their patients instead of questioning whether they’re ready for the job.
Q: What impact will this move have on the future of nursing education and workforce readiness at Duke and beyond?
TM: This is about thinking differently about how we train nurses. Historically, education and clinical practice have been separate. You go to school, graduate and, suddenly, you’re expected to manage a full patient load. That approach just doesn’t work anymore. If we want to solve the workforce shortage, we have to rethink how we integrate clinical training from the start.
Our aim at Duke is twofold: first, to deliver the best training and onboarding experience possible, and, second, to ensure nurses see a long-term career path within a system that is investing in their future.
By embedding education and practice in one environment, we’re breaking down barriers and creating a seamless transition into the workforce. Our students are training alongside experienced nurses, building confidence early and developing the skills they need in modern healthcare. Further to this, we also are creating a blueprint for how to better train and retain nurses. We’re strengthening our own workforce and we’re shaping a model that can benefit the entire healthcare industry.
Q: How is Duke Health helping ensure new nurses are fully prepared for the demands of modern healthcare?
TM: We’re always reassessing and adapting our methods based on outcomes and the feedback we receive from our staff. The same playbook won’t work anymore. We have to think differently about how we train and retain nurses. The healthcare landscape is changing rapidly, and we need to make sure our nurses aren’t just trained for today but for what’s coming next. That means expanding hands-on learning, strengthening mentorship, and ensuring clear career pathways so nurses feel supported and prepared from the start.
In a time of uncertainty, we remain committed to investing in the success of our people. That means continuously evolving our programs, integrating new approaches like AI-driven decision support and telehealth training, and making sure our workforce has the tools they need to thrive.