By Mona Dougani

Queens University News Service

At around 4 p.m., nurse Lydia Bohinski begins her day.

She puts on her scrubs and packs her lunch before heading to a 12-hour shift at Duke Hospital in Durham, only to get home and repeat the same schedule the next day. Or sometimes even for the next five days — a harsh reality for many nurses.

Across North Carolina, nurses at major hospital systems, like Bohinski, are experiencing stress and low morale caused by staffing shortages. Although Novant Health recently fired almost 200 employees for failing to comply with COVID-19 vaccination requirements, low staffing levels may not be as linked to the pandemic as people think.

And recent reports from national nursing and professional services organizations indicate nursing shortages will get worse — especially in North Carolina.

“The amount of overtime texts we have gotten in the past couple of months is ridiculous,” Bohinski said recently. “It’s usually twice a day, we get overtime texts. And the problem is, nobody wants to come and work overtime…. Burnout is real among the nurses, among the providers, among the attendings…. You just feel tired all the time and get to a point where you don’t want to go back.”

One of the biggest contributors to nursing shortages is the declining number of educators who can train the next generation. A survey released in September 2021 by the American Association of Colleges of Nursing indicates the vacancy rate for faculty positions increased from 6.5 percent in 2020 to 8 percent in 2021. The association reports that U.S. nursing schools turned away more than 80,000 qualified applicants for nursing programs in 2019, mostly because of faculty shortages.

Fewer nursing educators mean fewer nurses

To ensure faculty are not overwhelmed when teaching, and can give adequate attention to students, the North Carolina Board of Nursing sets a firm faculty-student ratio of 1-10 for clinical experiences.

“Schools are turning away hundreds of qualified students from East Carolina to Wilmington to your other major programs,” said Linda O’Boyle, a professor of nursing at Barton College in Wilson, North Carolina. “They meet the criteria to get in, but we are limited in pre-licensure education by our regulations of how many students we can take to clinicals. It is a safety issue. We have to protect the public.

“If you don’t have the faculty, you can’t accept the students, it doesn’t matter. If you have seat space, it doesn’t matter,” O’Boyle said.

By turning away students because of the lack of nursing educators, fewer students are graduating and entering the field of nursing.

Even with a 1-10 clinical ratio, O’Boyle said that she and other faculty find that number overwhelming and would prefer a 1-7 or 1-6 teacher-student ratio.

In North Carolina, it gets worse

A report issued Sept. 29 by Mercer, a professional services firm focused on workforce changes, retirement and benefits, indicates that North Carolina will be among the five worst states for nursing shortages by 2026. If current projections hold, the firm estimates national demand for nurses will increase by 5 percent by 2026, and North Carolina will be 13,000 nurses short. Only Pennsylvania is projected to face a larger nursing shortage.

A Sept. 29, 2021, report by Mercer, a professional services firm focused on workforce changes,
retirement and benefits, indicates North Carolina will be among the five worst states for nursing
shortages by 2026. Map courtesy: Mercer

Nursing faculty shortages

Of the roughly 125,000 nurses in North Carolina, only around 3 percent are nurse educators, according to statistics from the NC Board of Nursing.

“Faculty salaries are a big thing for universities and community colleges to be able to expand their ability to graduate more nurses and try to meet the demand of nurses in the health system,” said Thompson Forbes, an assistant professor of nursing at East Carolina University.

Even more alarming, according to data from the North Carolina Nurses Association, North Carolina community colleges pay faculty with a bachelor’s degree in nursing $14,923 less on average than they could make in the hospital setting, and faculty with a master’s degree in nursing make $17,618 less than what they could make in a hospital.

Forbes and other nursing faculty have experienced this firsthand.

“I myself transitioned from health systems to academic work, and took a 20 percent pay cut to do it because it’s what I wanted to do,” Forbes said.

But many nurses cannot afford to take the pay cut.

Dr. Elizabeth Snow, a nursing professor at Randolph Community College in Asheboro, North Carolina, said that without her pension, she would not be able to follow her passion and teach.

“I could do this because my income is supplemented by a pension,” Snow said. “If I was 40 years old, I could not afford it, and as a retired nurse manager, I took a huge cut in pay, huge. If I was 40 years old, I couldn’t go into nursing education.”

Additionally, a 2019-2020 report from the American Association of Colleges of Nursing indicates that the average age of nursing professors with a doctoral degree is 63, which leads many to wonder who will replace those in current teaching positions.


To mitigate shortages of nurse educators, many U.S. states are trying to increase nursing instructor salaries to attract more students, according to the American Association of Colleges of Nursing. These initiatives include:

Similar initiatives could potentially be implemented in North Carolina. One possibility is the state budget passed by the North Carolina General Assembly each fiscal year. This past year, a bill was heard in the House to potentially increase pay for direct care workers. Advocates could propose an increased budget to the general assembly in hopes of bolstering pay for the UNC system and for community college faculty.

But for now, nurses like Bohinski hope for better days and less overtime at the hospital.

Mona Dougani was one of NC Health News’ interns for the summer of 2021.

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4 replies on “COVID-19 didn’t help the North Carolina nursing shortage”

  1. We get what we pay for and not paying nurses a decent salary to either teach or work in a hospital or in private practice is abominable! They spend more time with patients than doctors, do the physical and emotional heavy lifting , and get payed less. For God’s sake stop this crisis now and pay them better. We see the shortages now and in the future. Don’t wait for it to get even more critical!

    I was in the hospital for almost a month after a car collision. Nurses supported me beyond medical care. Their concern was a gift I’ll never forget.

  2. THERE”S NO NURSING Shortage in North Carolina or Anywhere!!! as we have a plethora of older experienced and willing nurses who want to work, have been and still are applying for work, everywhere. I and other older nurses go unemployed and ignored! For the past 2 and 1/2 months, I’ve averaged 60 hours/week in 1) applying, 2) interviewing (phone & face to face), 3) scanning/ sending multiple forms, 4) the driving time for interviews and some the old fashioned way of dropping off a resume at facilities, healthcare corp. headquarters of all kinds, health departments, 5) 4-5 online sites. And yet, I and other older nurses who were all working before Covid are still unemployed! When Covid hit, I often stayed at a computer for 36-40 hours straight without ay Sleep constantly applying, filling out everything, taking multiple Indeed assessments, etc., etc. The problem is there’s an abundance of young managers moving up the career ladder and using and expecting the older workers to use the ‘Hot’ & ‘Sexy Cute’ management terms, and if you aren’t cool like that….then forget it. Also, even though hiring dept/managers aren’t supposed to do a google search on anyone, we all know it’s done, sometimes. Also, it’s often easy enough, to figure out someone’s age from their resume and work history. Myself and other older nurses are applying at Lowe’s Home improvement, Tractor Supply, other stores, restaurants, and farms that only want to use migrant workers! Good Grief, Doesn’t that tell ya something??….So, I REPEAT…THERE’S NO NURSING SHORTAGE!

    1. That seems to fly in the face of all of the data. But if you are a licensed nurse, of any age, and need a position where you can make a difference, then please get in touch with me. We are hiring nurses all day, every day…when we can find them. And you don’t have to be “hot and sexy cute” (your words)! Just want to make a difference in people’s lives.

  3. Hello! Thank you for keeping us up to date! More information regarding the coronavirus vaccine, in my opinion, should be shared. Because, more than ever before, a large number of individuals accept false vaccination stories and misconceptions. Nobody wants to break you or make you worse, believe me. Vaccines have been shown to be beneficial for a long time, and this is an undeniable truth. Polio has been eradicated thanks to immunization. Those who tell you differently are lying to you.

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