Nursing Educator Shortage Contributing to Hospice Labor Pressures

When retiring hospice nurses are ready to pass the torch, often no one is there to take it. The same applies to instructors in nursing schools who could help replenish their ranks.

A dearth of nursing educators is contributing to hospice workforce shortages, leading providers to compensate by expanding in-house training programs.

Currently, nursing schools and hospices are experiencing some of the same difficulties. For one, more of their employees are reaching retirement age without sufficient numbers to replace them.


Generational gaps among educators represent one of the most pressing obstacles to ensuring a sustainable supply of trained hospice clinicians, according to Terese Acampora, COO of MJHS Hospice and Home Care, part of the New York-based MJHS Health System.

“To train new [clinical] staff, we need more educators,” Acampora told Hospice News during the virtual Staffing Summit. “There needs to be additional infrastructure to change. We need to make meaningful investments in that sector. We would be supportive of any legislation that would create investment in nursing education programs that would train additional nurse educators and bring forward more nursing schools and different opportunities to train.”

The average age of nursing professors nationwide was 62.2 between 2015 and 2016, according to a report from the American Association of Colleges of Nursing. The average ages for associate and assistant nursing professors that year wasn’t far behind at 57.6 and 51.1, respectively.


To date, the limited national efforts to address the lack of educators have been unsuccessful.

The reintroduction of the Palliative Care and Hospice Education Training Act (PCHETA) last May died in committee. The bill would have authorized $100 million over the course of five years to support programs designed to bolster clinical education in hospice and palliative care, along with related interdisciplinary professions such as chaplaincy, pharmacy and social work.

It also would have established fellowships through new palliative care and hospice education centers to provide short-term, intensive training, as well as incentivized award programs across all the relevant disciplines.

The age gap may be hitting hospices particularly hard, as most clinicians already receive little to no exposure to those types of care during their training. Case in point, a 2018 study showed that most students in clinical disciplines do not feel prepared to provide family care at the end of life.

Amid these difficulties, hospice providers are ramping up training and developing expanded career pathways for current and prospective clinical staff.

Some have developed their own in-house residency programs, offering clinical education to help prepare new hires to work in the field and help attract prospective employees. These programs can help foster sustainable retention.

MJHS Hospice and Home Care is among them.

“We’re trying to provide additional educational support and opportunities for tuition reimbursement and [provide] clinical advancement opportunities,” Acampora said.

Though hospices’ in-house initiatives are reaching for improvement, they may not be enough to meet demand.

Retirements of hospice nurses and other clinicians are outpacing the rate of graduates coming out of educational institutions, according to Jennifer Nycz, chief clinical operations officer at AccentCare.

The hospice and post-acute care provider has roughly 30,000 active employees and is “working hard” to stay ahead of this curve, Nycz said during the Staffing Summit.

“It’s really increased using our capacity in education to bring in more frontline staff,” Nycz told Hospice News during the summit. “One thing that we’re doing is really partnering with academic institutions to try to create a pipeline and also to create the opportunity for advancement from within. Whether it be our personal care services and care partners, our hospice aides, we’re trying to retain them internally to help provide them opportunities for increasing education.”

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