UNIVERSITY OF SOUTH ALABAMA SENIOR VICE PRESIDE!'I.T TELEPHONE:(251) 460-6261 ACADEMIC AFFAIRS AD 300 MOBILE, ALABAMA J6688.0002 FAX: (251) 460-6575 April3, 2014 Ms. Natalie Lopez Education Policy Analyst Maryland Higher Education Commission 6 N. Liberty Street, I O'h Floor Baltimore, MD 21201 Re: Stevenson University's March 18,2014 objection regarding the University ofsouth Alabama's proposal. Dear Ms. Lopez: Thank you for the opportunity to respond to Stevenson University's objection to the University of South Alabama's program proposal to offer Bachelor of Science in Nursing and a Master of Science in Nursing. The University of South Alabama offers the following responses: I. Response to Stevenson University's statement that "Approval of the University ofsouth Alabama Bachelor of Science in Nursing and Master of Science in Nursing Programs would constitute unreasonable program duplication and cause demonstrable harm to Stevenson University's RN to BS and graduate programs in nursing." The American Association ofcolleges ofnurses (AACN) 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing report revealed U.S. nursing schools denied 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. Faculty shortages were cited as a reason for not accepting all qualified applicants into baccalaureate programs by two-thirds ofthe responding nursing schools. Further, the Special Survey on Vacant Faculty Positions released by AACN in October 2013 reported a total of 1,358 faculty vacancies from 680 nursing schools with baccalaureate and/or graduate programs across the country and a need to create an additional 98 faculty positions to accommodate student demand. The data show a national nurse faculty vacancy rate of 8.3%. A limited pool ofdoctorally-prepared nurses was one ofthe top cited reasons schools had difficulty securing faculty (AACN, 2014). The Maryland Statewide Commission on the Crisis in Nursing (2005) has recommended that the pipeline for future faculty continue to be primed by increasing opportunities for advancement by making registered nurse to baccalaureate degree in nursing programs more widely available, expanding access to master's degree programs throughout the state, AN EQUAL OPPORTUNITY/EQUAL ACCESS INSTITUTION
2 implementing distance-learning options, expanding and promoting associate to master's degree programs in nursing. According to the Council for Adult and Experiential Learning [CAEL] 2012 Innovation in Maryland Nursing Education to Meet Anticipated Demand - Policy strategies to support advances in educating and building the nursing workforce, Anthony Brown, Maryland's Lieutenant Governor, discussed the need for innovation in nursing education to a group of nurse educators and health care employers in Maryland in February 2012largely due to a critical concern surrounding the projected shortage ofregistered nurses stemming from a growth in demand for health care resulting from an aging population and the Affordable Care Act. The CAEL reported that national nursing leaders are advising all nurses to achieve bachelor's degrees and higher, yet many potential nursing students are being turned away. Further, it was noted that projections from the Maryland Department oflabor, Licensing and Regulation (DLLR) indicated the total RN employment in the state was expected to grow 22.3% from 2008 to 2018. The CAEL called for "more innovations that transform nursing education in order to achieve greater student learning, greater enrollment capacity, and improved access to the profession, especially for racial and ethnic minorities and men." Several programs designed to increase the nursing workforce in Maryland currently exist, but a significant shortage ofnurses is expected due to the state's aging population requiring more health services and because nurses are retiring from the profession as they grow older. In the December 10,2010 issue ofthe Boston Sun, Andrea K. Walker reported "Maryland is facing a shortage ofnursing as the population ages and needs more medical care. Some health care experts think the problem could worsen as federal reform extends insurance coverage to thousands of new patients when it is fully implemented in 2014." Ofnote, Judith Fuestle, an associate dean ofnursing in the graduate and professional studies school at Stevenson University, was quoted as stating "Schools can't accept all the interested applicants." She further affirmed, "We know we need to get more educators." The University of South Alabama is poised to help meet the critical and compelling regional and statewide need and demand to increase the nursing workforce (COMAR 138.02.03.08) without causing demonstrable harm to another institution (COMAR 138.02.03.09) in Maryland as qualified applicants are accepted into our baccalaureate and graduate programs. The University of South Alabama is an educational system that promotes seamless academic progression at the various levels (from the ADN-BSN to the terminal DNP degree) with distance education. The graduate specialty options offered at the University gives applicants a wide variety ofchoices to fulfill student demand and promote a higher level ofeducation. With the transformation ofhealth care, graduates ofthese specialty options will be able to practice to the full extent oftheir education and training and will be positioned to help redesign future health care. Further, graduates ofthe DNP program will be positioned to help fulfill the growing need for nursing faculty. Notably, the Advanced Emergency Nursing (Family NP/Adult-Gerontology Acute Care) Dual Role specialty option is considered an innovation to accommodate demand and improve
access as it traditionally attracts a higher number ofmales, an underrepresented minority. In fact, ofthe 66 students who will graduate this May, 14 (21%) are male. These graduates are prepared to provide care for individuals across the lifespan in primary care as well as individuals in acute care settings. 2. Response to Stevenson University's statement that "Approval ofthe University of South Alabama program would lead to excessive competition for practicum sites and cause demonstrable harm to Stevenson University's graduate program in nursing." 3 As for the RN-BSN program, no Maryland students are currently enrolled. Past enrollment records indicate that no Maryland students were enrolled in this program for the previous two years (2012 and 2013). In response to Stevenson University' s statement about the course descriptions for the RN to BSN option not indicating a specific course related to community health nursing, we would like to clarify that such an experience is indeed required in the curriculum. The practice integrated experiences at the University ofsouth Alabama for RN BSN track students meet the expectations outlined in the AACN White Paper Expectations Specifically, the RN to BSN curriculum provides for a clinical experience in community nursing. The practice integrated experience in NU 461 Integration ofprofessional Practice is substantive, requiring prior planning and collaboration. The course is grounded in evidencebased practice literature with a final evaluation of outcomes and deliverables. Practice integrated experiences in other courses reflect course objectives for demonstrating health assessments, identifying a quality improvement issue, or describing an application of evidence to practice. Community health activities include the student's local community The University has an even smaller number ofmaryland students enrolled in the Nursing Executive Administration specialty option. In fact, no students were enrolled in 2012, two Maryland students were enrolled in spring 2013, one student was enrolled in summer 2013, and two students are currently enrolled in this specialty option. These students are placed with an administrator (preceptor) in a health care organization who holds a minimum ofa The University of South Alabama's proposal to offer Bachelor of Science in Nursing and Master ofscience in nursing programs does not present unreasonable duplication that would cause demonstrable harm to another institution (COMAR 13B.02.03.09). The University of South Alabama APRN and non-aprn specialty options allow students to complete clinical experiences at variable times with preceptors in a health care setting in their home communities, and these experiences should not cause undue hardship on existing programs. The APRN students are placed with preceptors who are nationally certified in the same population-focused specialty. They may also be placed with an interdisciplinary mix of preceptors credentialed and licensed to practice in his/her population-focused and/or specialty area ofpractice in order to provide the student with the best clinical experiences to meet program objectives. Traditionally, the University has only a small number ofstudents from Maryland enrolled in the various APRN specialty options. circumstances the preceptor may be an administrator who has a master's degree in public health administration, health care administration, or business administration. for Practice Experiences in the RN to Baccalaureate Curriculum (AACN, 2012). master's degree. Commonly the preceptor has a MSN degree; however, in special
assessment. For most ofthese students, the practice integrated experience can be completed at their own employment site where they are not likely to be in competition with other programs. The aforementioned details provide substantiation that the University ofsouth Alabama's proposal meets the intense student nursing demand for Maryland and will not cause demonstrable harm to existing programs. Please consider this response in making the program approval decision. Sincerely, G. David Johnson, Ph.D. Senior Vice President Academic Affairs 4
References American Association of Colleges ofnursing [AACN]. {20I4). Nursing Faculty Shortage Fact Sheet. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-facultyshortage 5 http://articles.baltimoresun.com/20i O-I2-19/health/bs-bz-nursing-programs 20I 0 I219 _ ]_nursing-shortage-new-nurses-current-nurses Czwses, Effects, and Suggestions for Resollllion. Maryland Statewide Commission on the Crisis in Nursing. (2005). Nursing Faculty Shortage Education to Meet Anticipated Demand. Retrieved from Walker, Andrea K. The Baltimore Sun. December 19,2010. Local Universities Addressing American Association ofcolleges of Nursing [AACN]. (2012). White Paper - Expectationsfor Code ofmaryland Regulations (COMAR) 138.02.03.08 Practice Experiences in the RN to Baccalaureate Curriculum. Retrieved from http://www.aacn.nche.edu/faculty/faculty-link/20 I2/november http://www.cael.org/pdfs/maryland_innovation_in _Nursing Code ofmaryland Regulations (COMAR) 138.02.03.09 Nursing Shortage - New programs being created to train new nurses, faculty. Retrieved from Council for Adult and Experiential Learning [CAEL]. (2012). Innovation in Mmyland Nursing