At Danville, Pa.-based Geisinger, around 90 registered nurses work full time at the bedside and part-time in adjunct faculty roles at local universities.
Those 90 employees make up about 47% of all clinical faculty supporting 5,000 students who rotated through Geisinger.
“To me, that shows we have nurses who want to teach, who want to precept and mentor the next generation of nurses,” Janet Tomcavage, MSN, RN, executive vice president and chief nurse executive at Geisinger, told Becker’s. “And we need to give them the support and structure to do that — without burning them out. We need to help them find a work-life balance that allows them to contribute in this incredibly meaningful way.”
A call to step up
Traditionally, individual nurses decide whether they have the time to manage their full-time nursing role before adding part-time teaching duties. The demand for nurse faculty has increased in recent years with consequences for schools, nurses and systems:
1. For years, universities have struggled to expand or open new nursing programs due to faculty shortages and limited clinical site availability.
2. Some new nurses also leave the field shortly after graduating because they do not feel like they were prepared for the role.
3. Many experienced nurses would like to teach, but cannot fit two jobs into their lives.
4. Most hospitals and systems are facing a shortage of nurses.
“We’ve got to step up,” she said. “If we don’t, several things start to happen.”
Faculty-to-student ratios increase, which can make it difficult for clinical faculty members to provide quality experience. Geisinger tries to keep its ratios at no more than eight students per faculty member.
If schools don’t have enough faculty, they substitute some clinical time with simulation lab hours.
“While today’s sim labs are impressive, they still can’t replace the value of working with real patients,” Ms. Tomcavage said. “The state boards of nursing allow a percentage of clinical hours to be completed in sim labs, but the less time students spend in real settings, the more training we’ll need to provide after graduation.”
If new graduates don’t have a solid clinical experience, systems have to fill the gap with longer onboarding times. This can mean a student is onboarding for 12 weeks, instead of eight.
Schools may reduce enrollment if they don’t have the faculty to teach, which reduces the recruitment pool for systems.
This is why split nurse roles can be a “win-win-win-win” for everyone.
Geisinger’s strategy
Geisinger is still developing its strategy with hopes of launching a pilot this fall. Here are some of the working details.
“We’re working with several interested partner schools to develop a model where, for example, a nurse could work 24 hours at Geisinger and spend another 12 to 14 hours as faculty at a partner school,” Ms. Tomcavage said. “That keeps them within a full-time, 36- to 40-hour workweek, rather than adding 15 to 20 hours of overtime. It helps maintain work-life balance — something I think many of us are striving for.”
Under this model, nurses would remain Geisinger employees with their primary workload at the bedside, while schools would “essentially lease them to serve as clinical instructors for student rotations,” she said.
It’s a win for schools who urgently need more faculty. It’s a win for nursing students who will receive up-to-date and deep knowledge about the clinical environment, as well as better clinical experiences. It’s a win for nurses who teach who can make the transition seamlessly without sacrificing work-life balance. Finally, it’s a win for Geisinger, as it supports its professional development of nurses while acting as recruitment to its system.
“So, yes, this split-faculty model is something we’re seriously pursuing,” Ms. Tomcavage said.
The investment comes at a cost to the hospital. It anticipates that every full-time nurse will cost the system around $75 per hour, “and no school is going to reimburse us at that full rate.”
While it’s a financial hit upfront to the hospital, the strategy could save money over time on recruitment, onboarding and retaining experienced staff.
“It’s not a straightforward calculation — it’s not just dollars in, dollars out — but it’s real value,” she said.
Geisinger has around 6,500 registered nurses and partners, with about 15 to 20 nursing programs across its network.
