In 2023, nearly 66,000 qualified applicants were turned away from nursing schools due to deficits in the nurse educator space. To help reduce the nurse shortage, health systems are stepping up to increase the number of educators by creating split faculty roles.
The issue
For years, universities have struggled to expand or open new nursing programs due to faculty shortages and limited clinical site availability. Some new nurses also leave the field shortly after graduating because they do not feel like they were prepared for the role. This is where a split nurse-faculty role can fill gaps.
“When an adjunct faculty member also works at the hospital, they can speak to real-life experiences and share what nursing is really like, not just what’s in textbooks,” Tiffany Murdock, DNP, RN, chief nursing officer at New Orleans-based Ochsner Health, told Becker’s. “It’s about giving nursing students a real perspective on the profession. If students are taught by faculty who haven’t been bedside in 25 years, there’s a missed opportunity. This model helps new nurses adjust better and aligns with curriculum updates as practice changes.”
Split nurse faculty roles address a few issues: low pay in teaching positions, ensuring students get up-to-date education, allowing experienced nurses to share their expertise without leaving the bedside and helping to give schools the capacity for more nursing students, which turns into more nurses entering the field.
“I think it also extends the career life of nurses,” Dr. Murdock said. “This gives retiring nurses a way to stay engaged. We’re meeting them where they are, tapping into their expertise while keeping them connected to the profession. It’s a win-win: They help precept and teach future generations while continuing to contribute in meaningful ways.”
Experienced nurses teaching college courses is not new. Many nurses work directly with universities to teach courses while still working at the bedside.
“Right now, most of these nurses work full time at the bedside and take on adjunct roles on top of their full-time duties,” Janet Tomcavage, MSN, RN, executive vice president and chief nurse executive at Danville, Pa.-based Geisinger, told Becker’s in an April 3 podcast. “That takes a special kind of person — someone willing to add more hours to their week.”
What is new is the number of systems formalizing a dual role and supporting nurses who want to be educators, too.
Split-role solutions
Here is how three systems are handling the shift:
1. Houston-based Memorial Hermann Health System partnered with Huntsville, Texas-based Sam Houston State University and Austin-based University of Texas to create a hybrid model. Nurses split their time, working two days a week on their unit and another day as a faculty member. The model started in 2022 after conversations that emerged through Memorial Hermann’s Institute for Nursing Excellence. It began as a way to explore what attracted nurses to educator roles and then turned into a program that makes it easy for nurses to do both. Initial feedback has been overwhelmingly positive, not just for those teaching at universities, but also nurse preceptors at the bedside who are responsible for onboarding students.
2. Geisinger created a training program for preceptors and nurses interested in teaching. The health system also is working to build a program that would allow nurses to work 20 to 24 hours with the system and 20 to 24 hours with an academic institution.
3. Ochsner Health launched its split-role program in 2018 and is taking a multi-pronged approach. First, it has funded five staff who want to pursue their master’s degrees. In exchange, these staff members agree to teach as adjunct faculty after graduation. The system is also encouraging any master’s-prepared staff to teach, including those working as advanced practice registered nurses and working in the quality department, Sylvia Hartmann, director of academics at Ochsner, told Becker’s.
The system also created a forum for staff nurses interested in teaching. They provide educational resources on how to become educators, match experienced staff with staff who are new to teaching and reach out a few times a year with teaching opportunities as they arise.
“I’ve actually been surprised by how much interest we’ve seen, not just from those nearing retirement but also from younger nurses,” Ms. Hartmann said. “There’s real enthusiasm from early-career nurses who are already thinking about teaching.”
Currently, Ochsner has almost 30 staff who serve as adjunct instructors per semester across its service area. These dual-role nurses have their schedules adjusted to account for their time at the bedside and in the classroom, and they receive an adjusted pay rate.
“When you have practicing nurses teaching, it helps bridge the gap between the academic content and real-life clinical scenarios,” Dr. Murdock said. “It also raises the bar for our nurses — it deepens their understanding of the curriculum and challenges them to grow professionally.”
What comes first
All these programs started the same way: by identifying interest. Knowing how many staff are interested in teaching, how many have been educators before, and providing information sessions that explain what the roles would look like and how compensation and scheduling will be managed are the steppingstones needed to get a program such as this off the ground, Ms. Hartmann said.
“Having someone lead the program and be available to answer questions is key,” she said. “It’s also important to offer continuing education on becoming an effective clinical instructor. Precepting is not the same as teaching in an academic setting, which has specific rules, paperwork and expectations. Providing the resources they need to succeed in that role has made a big difference for us — and administrative support to offer scheduling flexibility is essential.”
A nuance to consider
Unionized nursing workforces are growing more common across the country, which can play a role in how health systems begin and build programs like this. If nurses in a union want their systems to formalize a dual-role in nursing, it would have to come from the nurses themselves or the union. Otherwise, hospitals risk being perceived as governing employees’ personal time or stepping outside of workplace contracts.
Alesia Coe, DNP, RN, chief nursing officer at UChicago Medicine’s University of Chicago Medical Center, told Becker’s that she’s served as adjunct faculty since 2017 and knows many other colleagues — from frontline nurses to other administrators — who do as well.
“Professionally, I believe the more of us who give back — especially in helping support and mentor the next generation of nurses — the better,” she said. “And what better faculty is there than faculty who actually works in hospitals and can explain to students what to do and what not to do? But it’s important to have all parties on the same page to support both the program and the nurses who are lending their expertise to students.”
