The salary gap between clinical and faculty roles.
There is a national shortage of nursing faculty to educate the future nurse workforce. The biggest barrier to recruiting and retaining nursing faculty is the salary gap between the faculty and clinical nursing roles. Nurses routinely take pay cuts of as much as $40,000 when leaving clinical practice to teach full-time. The faculty role is vital to the health of the profession, and it is particularly important to recruit excellent educators with relevant clinical experience.
The salary gap raises a clear question: why would one choose to leave clinical practice and take a pay cut? Unfortunately, many nursing advocacy organizations have been silent on this issue, a silence that has contributed to the worsening of the nurse faculty workforce shortage. In 2023, there were 1,977 full-time faculty vacancies that were unfilled, or 7.8% of the faculty workforce. Faculty shortages are projected to worsen over the next decade as an aging faculty workforce approaches retirement.
Proposed federal measures to clarify salary gap.
Federal policymakers have also addressed the salary gap and have proposed solutions, including H.R. 7002 (the Nurse Faculty Shortage Reduction Act of 2024) and S. 2815 (the Nurse Faculty Shortage Reduction Act of 2023), which if enacted will better define the scope of the problem.
These bills would compel a federal entity to clearly define clinical and faculty salaries, as there is currently ambiguity around how to compare salaries given differences in contract length and varying levels of education. Attaining precise information on the nature of the salary gap is an important first step toward solving the nursing faculty shortage. But despite the importance of documenting the problem, there remain only seven co-sponsors on the House bill and one sponsor on the Senate bill—out of a potential 535 members of Congress.
Lack of nurse involvement in policy.
The lack of engagement on the aforementioned bills may be related to the reluctance of many nursing faculty to participate in policy development. Nurses have identified a lack of formal training in policy as well as interprofessional/social dynamics that marginalize or diminish their expertise as key barriers to participating in the advocacy process. As the largest group of health care professionals, nurses must engage with policymakers to self-represent and work toward meaningful change to influence patient care, scope of practice laws, and workplace empowerment.
The key role of professional organizations.
Participation in professional organizations is an important component of advocacy, and nurses should consider advocating within and among existing organizations like state and national nursing associations and discipline-specific nursing boards. But nurses should also extend their influence beyond their professional organizations.
Getting informed.
Professional nurses must endeavor to increase their knowledge on policy issues that affect their practice. They can do this through a variety of avenues, including (but not limited to) reading professional journals, attending forums and workshops, subscribing to professional organizations’ policy briefs, and engaging with proposed policy changes through public comment.
What can you do?
Nurses should also reach out to their legislators directly with personalized emails or phone calls to share their perspective on specific legislation and its potential impact on nursing and patient care. Another important way for nurses to engage in health policy advocacy is to participate in grassroots networks and/or social media platforms to amplify their voices and connect with like-minded individuals.
The nursing faculty shortage affects all nurses. Addressing the pay gap between clinical and faculty rolls is a key first step in solving the national shortage. Nurses must use their voices, both within their professional organizations and as professionals, to support efforts to ease the nursing faculty shortage.
Jacqueline Christianson, PhD, FNP-C, is an assistant professor in the Marquette University College of Nursing whose program of research centers around improving workplace well-being among healthcare professionals. Their academic work is informed by ongoing clinical practice as a locum tenens (travel) nurse practitioner in emergency departments and intensive care units.
Christine Schindler, PhD, DNP, RN, CPNP-AC/PC, is a critical care pediatric nurse practitioner, health systems leader, and educator. She currently holds a joint appointment between the Marquette University College of Nursing where she serves as a clinical professor and the Medical College of Wisconsin/Children’s Wisconsin, where she currently serves as the advanced practice provider director for critical care.
Lisa Grabert, MPH, is an expert policy maker with nearly 20 years of experience crafting and implementing Medicare regulation and legislation. She currently holds a visiting appointment in the Marquette University College of Nursing and teaches a graduate course on health policy, politics, and advocacy.
What happens if legislation decrease the pay gap? So that the clinical nurse is forced to make what the faculty nurse makes. Also wouldn’t this set a precedence for legislation to put a limit on what nurses can make.
While the legislation referenced in this post don’t include a cap on bedside nurse salaries, this is a very reasonable concern to have and an excellent reason that nurses need to be involved in policy advocacy. We plan to discuss the specifics of the proposed legislation highlighted in this issue in future blog posts here at AJN Off the Charts, as well as on how nurses from all walks of life can and should make their voices heard to policy-makers.
-JC
The National Consortium of Academic Nurse Educators (N-CANE) is actively working and researching in the area of ANE retention and recruitment. We are always looking for partners to engage with in this endeavor. Come check us out at https://nc-ane.org/