Nurses are a crucial part of the US healthcare workforce, delivering care from birth to the end of life. However, the healthcare system faces nurse shortages due to inequitable workforce distribution, high turnover, and insufficient educators to train replacements.[1] Kansas is among the states experiencing a nurse shortage. To address this problem, two top universities partnered to create a first-of-its-kind nursing program. Wichita State University (WSU) and Kansas State University (K-State) students will take classes and complete simulation-based clinical hours at both schools, earning a BS and BSN in five years, helping to fill vacant positions across the state with highly trained professionals.

The causes and effects of the nursing shortage in Kansas

According to the Kansas Board of Nursing, undergraduate admissions to nursing programs have decreased over the past five years, with an 11.5% drop from the previous average for BSN programs.[2] Moreover, vacancy and turnover rates increased during the COVID-19 pandemic, as already overworked nurses experienced greater stress and burnout due to the surge in patients.[3] Nurse-to-patient ratios rose dramatically, putting additional pressure on the state’s healthcare system and workers.

A study examining the effects of nurse-to-patient ratios showed a direct correlation between staffing levels and patient outcomes. Mortality within the hospital increased by approximately 7% with each added patient when nurse-to-patient ratios exceeded 1:4.[4] The study found that nurses with a high workload have less time with each patient and experience greater physical and mental exhaustion, compromising their ability to provide safe care.

Many factors are causing nurse-to-patient ratios to rise across the United States. Among them is that a significant portion of the nursing workforce is reaching retirement age. The American Association of Colleges of Nursing (AACN) reports that more than one million RNs expected to leave the workforce by 2030.[5] Not only will this affect nurse-to-patient ratios, the number of nursing faculty and clinical preceptors will be insufficient to expand admission to baccalaureate and graduate programs.

Higher education is critical in alleviating the nursing shortage by supplying the healthcare system with enough graduates to replenish nursing staff and educators. Colleges and universities must have the resources to enroll and graduate more students, but state governments have responded slowly with policies and funding that could address this need.

Nursing students gain clinical experience using the Pediatric HAL® S3005 simulator.

What is the Pathway to Nursing program?

Graduating more highly qualified nurses is key to resolving Kansas’s nursing shortage. However, many programs do not have the staff to increase enrollment, which is a problem not just in Kansas but nationwide. In fact, the AACN reports that baccalaureate and graduate nursing programs turned down about 91,000 qualified applications between 2021 and 2022 for this reason.4

WSU and K-State saw a demand for more nurses in Kansas, but neither had the resources to expand student capacity. K-state, in particular, had no nursing degree options for their students. So, leaders from each institution met to devise a partnership wherein they share resources, including staff and training spaces, so the two schools could produce highly-qualified nurses faster and at a higher rate than they could separately.

Initially announced in the spring of 2020, WSU and K-State created a dual-degree nursing program called Pathway to Nursing. The program is the first of its kind in Kansas. Students will first earn a BS from K-State after three years and then a BSN from WSU after two years. The goal is to produce highly qualified nurses who are better prepared to fill workforce vacancies.

According to Voncella McCleary-Jones, associate dean of the WSU College of Health Professions, the program allows students to earn two degrees in five years, shortening the overall time to graduation and increasing the number of bachelor’s-prepared registered nurses in Kansas. Likewise, the program will be an attractive recruitment tool for both universities as its benefits set them apart from other institutions.

Pathway to Nursing was approved in March 2022 by the Kansas Board of Nursing. Twenty students will enroll each semester. The inaugural class began their coursework at K-State in the fall of 2022 and will finish in 2024. The program is a milestone for both universities that will help positively impact local healthcare.

How Pathway to Nursing will produce more highly-qualified nurses

Modern-day healthcare is increasingly complex, so unsurprisingly, a better-educated workforce is associated with better outcomes. As such, one of the goals of the Pathway to Nursing program is to introduce more BSN-educated nurses into the Kansas healthcare system.

In a statement regarding the benefits of the program, Gregory Hand, dean of the WSU College of Health Professions, said, “It is well-established that bachelor’s degree-trained nurses provide for high patient outcomes, and our graduates will play a very important role in improving the health of Kansans.”

Research from the past two decades has shown that hospitals with many BSN-educated nurses experience several benefits, including fewer patient deaths, shorter hospital stays, and fewer readmissions.[6] These nurses can provide better quality patient care because their knowledge and experience help mitigate errors and ensure patients receive effective and timely care.

Moreover, BSN-educated nurses demonstrate better communication and teamwork skills. Therefore, they can effectively communicate and collaborate with other nurses and members of interdisciplinary teams. This helps reduce the risk of common mistakes, such as medication errors or delays in treatment,  improving patient safety.

As such, the National Academy of Medicine (NAM) has called for increasing the number of baccalaureate-prepared nurses in the workforce to at least 80% to enhance patient safety.4 However, the US nursing workforce is falling short of this goal, and without some form of intervention to ease the nursing shortage, many hospitals may never achieve it.

Nurses who graduate from the Pathway to Nursing program will enter the workforce with two bachelor’s degrees. The additional education and training these nurses receive means they are more attractive candidates to employers, so they can potentially fill vacant positions faster than other candidates. Moreover, they have the skills to provide effective care and better meet the challenges of the modern nursing workforce.

Nursing students hone skills using VICTORIA® S2200

Simulation will help nursing students practice critical skills and interventions

Along with attending classes on the WSU and K-state campuses, Pathway to Nursing students will get hands-on training at various clinical sites, including WSU’s newly expanded simulation center. In late 2021, WSU began an expansion of its clinical simulation capabilities to provide training for its clinical degree programs. Students now have more opportunities to practice and develop skills needed for effective patient care.

Students will continue to attend clinical rotations in local hospitals. But they will supplement their training with simulation as the traditional clinical setting rarely offers opportunities to practice complex procedures and low-frequency, high-risk cases. Thus, simulation ensures students can practice these skills and avoid gaps in their knowledge that could negatively impact patient care.

The WSU simulation center has various patient simulators that allow students to safely prepare for clinical situations, including life-threatening emergencies, in a controlled environment. For example, students will gain experience with labor and delivery scenarios using VICTORIA® S2200 as students would not take an active role during a difficult delivery due to the risk to the patient’s life.

However, VICTORIA’s advanced features can simulate the stressful realities of these time-sensitive scenarios. So students have to think critically and engage in decision-making and effective communication during the simulation as they would in the real world. These scenarios are also experiential as students practice complex interventions using real tools and equipment.

Likewise, pediatric patients pose a challenge for even experienced clinicians, especially during trauma scenarios, as they tend to be more susceptible to multisystem injuries.[7] Students will first practice on Pediatric HAL® S3005 to develop their ability to assess injuries quickly, determine the course of action, and provide critical interventions. Thus, students will enter the workforce better prepared to manage these cases and reduce the risk of errors caused by inexperience or knowledge gaps.

Moreover, cameras placed throughout the simulation center record the scenarios so students can review their performance and receive feedback from the instructor. Then, the scenarios are repeated as often as needed to address the instructor’s feedback, hone skills, and ensure students can provide effective care during real emergencies.

Conclusion

While nursing shortages are common in the US, the COVID-19 pandemic has shown the dangerous strain a healthcare emergency can cause on understaffed institutions. COVID-19 will not be the last emergency the US healthcare system faces, so resolving the nursing shortage is crucial to ensure better patient care. The Pathway to Nursing will help increase student capacity in WSU and K-State nursing programs so more highly-trained nurses can enter the workforce. As these nurses fill vacancies in hospitals across the state, nurse-to-patient ratios will decrease, improving patient care and reducing staff turnover and burnout rates. Universities and clinical sites will also have more nurse educators who will increase student capacity until Kansas reaches the NAM recommended number of baccalaureate-prepared nurses in the workforce.

Learn more about the program on the WSU News page or the Pathway to Nursing Program webpage.

[1] Annamaraju, Pavan, et al. “Nursing Shortage.” StatPearls Publishing LLC, https://www.ncbi.nlm.nih.gov/books/NBK493175/. Accessed 1 May 2023.

[2] “Nursing in Kansas.” Kansas Hospital Association, Jan. 2023, https://www.kha-net.org/DataProductsandServices/STAT/Workforce/NursinginKansas/.

[3] Russell, Kyla. “About 100,000 nurses left the workforce due to pandemic-related burnout and stress, survey finds.” CNN, https://www.cnn.com/2023/04/13/health/nurse-burnout-post-pandemic/index.html. Accessed 1 May 2023.

[4] Coustasse, Alberto, et al. “Burnout syndrome and nurse-to-patient ratio in the workplace.” 54th Annual MBAA Conference, April 2018, Chicago, IL. Conference Presentation.

[5] “Nursing Shortage.” American Association of Colleges of Nursing, Oct. 2022, https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage.

[6] Aiken, Linda H. & Joshua Porat-Dahlerbruch. “Hospital Nurses and Patient Outcomes: A Matter of Degree?.” The Leonard Davis Institute of Health Economics, https://ldi.upenn.edu/our-work/research-updates/hospital-nurses-and-patient-outcomes-a-matter-of-degree/. Accessed 2 May 2023.

[7] Bhananker, Sanjay M., et al. “Initial assessment and management of pediatric trauma patients.” International Journal of Critical Illness and Injury Science, vol. 2, no. 3, 2012, pp. 121-127.