Closing the Gap

CareFirst’s Project RN program helps alleviate region’s shortage of nurse educators

By Scott Graham, Media Relations & Associate Communications

Thinking about it still makes Charmaine Hutchinson cry. Talking about it – she can hardly talk about it, either.

But more than three decades later, Hutchinson still clearly remembers when she realized she was destined to teach.

As a young girl in her native Jamaica, Hutchinson spent summers teaching other children in her poor neighborhood the basics of reading, writing and math to help them pass entrance exams for Jamaican grade schools. She had a blackboard set up in her front yard, and she charged each student 50 cents per day to take her class.

“It’s from those days – going back to when I was as young as 12 years old -- that I knew I really wanted to teach, that I wanted to help other people,” Hutchinson said. “So when an opportunity came along, I was like, I am on this.”

Today, Hutchinson, a nurse by trade, is still teaching, thanks in part to an opportunity offered by CareFirst BlueCross BlueShield, the mid-Atlantic’s largest health insurer. In exchange for agreeing to teach nursing students in Maryland, Washington, D.C., or Northern Virginia for at least three years, Hutchinson accepted an $80,000 stipend from CareFirst to pursue a master’s degree in nursing from Howard University in D.C.

Hutchinson has been a member of Howard’s nursing school faculty since earning her degree in 2009 – she taught master’s level students this past semester -- and her goal is to one day be the dean of a nursing school.

The money Hutchinson received is part of a $3.2 million investment CareFirst is making in 44 nurses representing at least 13 universities through its Project RN program, which launched in 2007. The program is designed to help alleviate one of the factors contributing to the ongoing shortage of bedside nurses nationwide – a dearth of nurse faculty to teach the next generation of nurses.

Last year, the vacancy rate of nursing school faculty was nearly 8 percent, according to a report released by the American Association of Colleges of Nursing (AACN) in fall 2012.

“The majority of the nursing shortage stems from a lack of teachers,” said Maria Harris Tildon, CareFirst’s Senior Vice President of Public Policy and Community Affairs. “We thought the best way we could make an impact was to find a way to support the expansion of nurse educators.”

Instead of earmarking scholarship money for anyone looking to break into the nursing profession, CareFirst aimed Project RN at nursing students and registered nurses (RNs) interested in obtaining an advanced degree who commit to teach in the region for at least three years. Fourteen of the first 15 students to receive a Project RN stipend are teaching at schools in Maryland, D.C. and Northern Virginia; 16 more will graduate by 2015, and 13 new stipends will be awarded this fall.

Still, the shortage of bedside nurses continues to grab the headlines. Spurred by growing demand for health care caused by the aging of baby boomers and federal health reform, the nursing shortage could reach 260,000 nationwide by 2025, according to the AACN. In Maryland, more than 10,000 registered nurse positions could be unfilled by 2016, according to the Maryland Hospital Association.

Nursing experts say the story won’t change until something is done to increase the number of teachers qualified to train new nurses. In 2012, U.S. nursing schools turned away almost 80,000 qualified applications to baccalaureate and graduate programs because of an insufficient number of faculty and clinical training sites, according to the AACN report.

Many nursing schools are limited by budget constraints that have affected their ability to admit students, employ more nurse educators and develop new technologically advanced training space, said Catherine Crowley, director of the Maryland Hospital Association’s Who Will Care campaign targeting the state’s nursing shortage. Since 2007, the campaign has given over $15 million -- $1.5 million donated by CareFirst -- to 23 Maryland colleges expanding their nursing programs.

“We’re going to start seeing nurse educators of baby boomer age retire in larger numbers, just like in nursing and other health care jobs,” Crowley said. “We can’t all work until we’re 70, and the schools’ resources are constrained. So the question is how do you address the need to replace them?”

Programs like Project RN that help offset the cost of seeking an advanced degree a nurse can use to land a faculty job are beginning to help, said Jane M. Kirschling, AACN’s president and dean of the University of Maryland’s School of Nursing in Baltimore. The number of RNs returning to school for a bachelor’s degree is up 19 percent since 2011, and enrollment in post-graduate programs is growing, too, she said.

“Those are encouraging first steps,” Kirschling said.

Still, one of the greatest challenges nursing schools face when recruiting nurse faculty, Kirschling said, is convincing nurses who already are well compensated and settled in their careers to go back to school to get the training they need, often forgoing the higher salary their clinical job offered. CareFirst’s Project RN gives students $80,000 to put toward their cost of living and tuition, books and other expenses related to school.

The allure of a stipend certainly helped persuade Sandy Rogers to apply for a Project RN scholarship and pursue a full-time faculty position. Rogers worked 20 years as a trauma, emergency and medical/surgical nurse before moving to Northern Virginia, where she joined the adjunct faculty at George Mason University in Fairfax in 2009.

While working toward her doctorate, or Ph.D., degree as a part-time student and adjunct faculty member, Rogers applied and was awarded a Project RN stipend that allowed her to go to school full time and spend 15 hours a week as a graduate research assistant studying patients with moderate brain trauma.

“Being able to receive the stipend was a huge enabler for me. With my years of experience, I could do better financially as a bedside nurse working three days a week, but that isn’t what I wanted to do,” said Rogers, who will graduate with her Ph.D. this year. “It [the Project RN stipend] took a lot of the stress off of needing to have a full-time job and was an incentive for me to get my work done and become a member of the faculty myself.”

To date, CareFirst has invested about $2.2 million in 31 Project RN nurses at such schools as the University of Maryland, Johns Hopkins University, Salisbury University and Coppin State University in Maryland, Howard and Georgetown University in D.C., and George Mason and Marymount University in Northern Virginia.

CareFirst announced this month an additional $1 million investment in the program to fund scholarships for another 13 post-graduate nurses in the region. Bowie State University is considering applying for funds to help lure more students to a new nurse educator program it plans to open this fall at the Southern Maryland Higher Education Center, a satellite campus in St. Mary’s County, said Renee McQueen, the program’s administrative assistant.

University nursing schools can now apply for funds for Project RN candidates who would begin their coursework in 2014. CareFirst expects to announce the next round of awardees by fall 2013.

“CareFirst is proud of the success the Project RN program has had so far to help address one of the underlying factors in the nursing shortage,” CareFirst’s Tildon said. “We’re optimistic that with this next round of scholarships the universities will again find candidates committed to the success of the nursing profession in our region.”

Candidates like Anthony Cerniglia, the most recent Project RN beneficiary. Cerniglia just completed the first semester of the master’s nursing education program at Towson University, where he took classes two days a week and was the clinical instructor for a team of students at Greater Baltimore Medical Center one day a week.

Forecast to graduate by December 2015, Cerniglia -- who grew up in the Baltimore area and whose fiancé, older sister, younger brother and two cousins also are nurses -- said he wants to join Towson’s faculty to help train the nurses who one day could help end a nursing shortage that already has spanned a decade.

“It all starts with education,” Cerniglia said. “If you don’t have the teachers to teach students, how are you going to get nurses to fill the spots bedside?”