The Urgent Need for More Nurse Preceptors

Nurse preceptors play a critical role in preparing health care’s next generation of nurses. These experienced nurses help train nursing students “on the job” at hospitals, clinics, and other health care locations — in addition to their own nursing duties. They also help onboard recent graduates as they begin their first nursing jobs, and help orient new hires and visiting nurses.

In this Q&A, Dr. Brandy Hershberger, UPMC’s Chief Nursing Officer/Vice President, UPMC Centers for Nursing Excellence and Academic Affairs, discusses why hospitals, health care systems, professional groups, and policymakers need to recognize and support their efforts.

Health care in America is facing a crisis of skilled providers on virtually every front. What are the factors impacting the current nursing shortage?

The demand for skilled health care professionals — in every field — has been growing for decades. Nursing is no exception. The National Institutes of Health had forecast that a serious nationwide nursing shortage would begin in 2020. Then COVID-19 hit.

The pandemic accelerated the pace and impact of that projected shortage. Many nurses retired. Even more left or are leaving the profession — burned out by workload or dissatisfied with working conditions. A Drexel University study shows Pennsylvania now ranks among the top-five states in the nation with the highest need for nurses.

Never Miss a Beat!

Get Healthy Tips Sent to Your Phone!

Message and data rates may apply. Text the word STOP to opt out and HELP for help. Click here to view the privacy and terms.

Nursing schools here in Pennsylvania and across the country are struggling to expand their capacity to meet this demand. The problem is there simply aren’t enough educational institutions, nurse educators, and nurse preceptors available to meet the growing demand for new nurses.

Why are nursing schools struggling with capacity?

First, it’s important to recognize that people want to become nurses. Each of UPMC’s six schools of nursing have wait lists of applicants who are eager to enter the field. Our students range in age from traditional high school graduates to career changers in their 50s. The same holds true with many of our academic partners at area community colleges and four-year colleges and universities.

But schools face two challenging barriers to educating and preparing new nurses:

  • First, there’s a shortage of nurse educators in nursing schools — including those at colleges and universities. Experienced nursing faculty are at the center of classroom-based instruction and training for student nurses.
  • Second, there’s a shortage of nurse preceptors in clinical care settings. Preceptor shortages are particularly challenging in rural areas where resources are thin and in specialty areas like medical/surgical nursing.

Why are nurse preceptors so important in building a new pipeline of nurses?

The use of nurse preceptors began in the 1980s. They literally are a lifeline to new nurses.

It’s a demanding and intensely personal commitment as they:

  • Provide daily, on-site one-to-one guidance and mentoring.
  • Help novice nurses navigate staff, patient, and family interactions.
  • Teach hospital protocols.
  • Introduce nurses to nursing processes, culture, and values.
  • Serve as a trusted “go-to buddy” for constructive criticism, advice, and support.

At UPMC, nurse preceptors have played an invaluable role for decades. In fact, they play an even more important role as we return to team nursing.

Our preceptors work with nurses at every phase of entry in our clinical settings:

  • All student nurses doing a clinical experience with UPMC spend between four to 12 weeks with their nurse preceptor before graduating, depending on their year of study and area of interest.
  • All newly graduated nurses hired at UPMC work with a nurse preceptor for at least six to 12 weeks (and possibly longer in some areas, such as med-surg floors). Studies show that nearly 1 in 5 nurses quit before completing their first year on the job. Nurse preceptors play a vital role in helping new nurses work through early challenges that may discourage them.
  • All new hires and visiting nurses work directly with a nurse preceptor for on-the-job orientation and support. The time spent varies based on each nurse’s experience and area of work.

What can be done to address the need for more nurse educators and nurse preceptors?

The Commission on Collegiate Nursing Education (CCNE) is an independent nursing education accrediting organization that is officially recognized by the U.S. Department of Education. CCNE is now reviewing a proposal that would allow RNs with strong clinical experience to teach if they are enrolled in a graduate program or otherwise qualified for the area(s) in which they teach. In our state, the Pennsylvania Board of Nursing requires that all nursing faculty hold a master’s in nursing (MSN) or a doctor of nursing practice (DNP) degree to teach nurses.

We need to immediately take advantage of this wealth of talent and experience. If CCNE adopts a national policy allowing experienced nondegree nurses to teach in nursing schools — and the Pennsylvania State Board of Nursing aligns its standards with it — that would be a tremendous help in expanding opportunities for both nurse educators and nurse preceptors.

At UPMC, we’re committed to recognizing the investment of time and energy that nurse preceptors make. For example, My Nursing Career — a structured nursing career ladder offered through UPMC employee benefits — provides pathways for nurse preceptors to qualify for hourly salary increases and professional development. Nurse preceptors also can take advantage of advanced degree tuition support, another UPMC employee benefit.

What other steps can be taken to address the state’s nursing shortage?  

First and foremost, we must work to retain the nurses we have in Pennsylvania. Health care employers need to provide salary, staffing, and professional development incentives.

The state legislature also can help. For example, Gov. Josh Shapiro has proposed a three-year tax credit incentive of up to $2,500 a year for newly certified nurses (as well as teachers and police officers). This incentive also would be a welcome benefit for current nurses. Other states have introduced similar incentives with successful results.

Last fall, Pennsylvania joined the Interstate Nurse Licensure Compact. This will allow registered nurses and licensed practical nurses from 40 other states who hold a multistate license to practice in person and via telehealth in our state. However, it’s more expensive for Pennsylvania nurses to get or renew their nursing licenses. Pennsylvania Board of Nurses could consider changing license rates to be more competitive with other states.

How is UPMC supporting new and current nurses?

Educational costs continue to be a concern for students considering a nursing career. To help students enrolled in UPMC’s six schools of nursing, we have introduced a nursing tuition loan forgiveness program that begins while they are still in school. We also have created a new monthly loan repayment incentive for new nurses joining UPMC that begins six months after starting employment.

The UPMC Center for Nursing Excellence also partners with schools of nursing across the region to promote transitions from RN to BSN. These efforts to increase the number of BSNs further enhance our nursing workforce and patient outcomes.

There’s a long road ahead to solving the nursing shortage, but by working together, we can find real solutions. These efforts will ensure quality patient care — and satisfying careers for nurses.

Brandy Hershberger, DNP, RN, MSN, CEN, is chief nursing officer/vice president, UPMC Centers for Nursing Excellence and Academic Affairs. Since joining UPMC more than a decade ago, she has served in a variety of clinical and emergency care roles at UPMC Altoona, UPMC Bedford, UPMC Children’s, and UPMC East/UPMC McKeesport. With 20+ years in nursing, Dr. Hershberger is a recognized leader in team building and departmental collaboration, optimizing organizational processes, and promoting excellence in patient care, patient outcomes, patient satisfaction, and the patient/family experience.

She is a certified emergency nurse and a member and mentor of the American College of Healthcare Executives. A member of the Emergency Nurses Association, Dr. Hershberger also serves on the advisory board of Capella University’s School of Nursing and Health Sciences and is a contributing doctoral faculty member at Walden University.

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.