Elizabeth Poster: The TT Interview

As dean of the the University of Texas at Arlington's College of Nursing, Dr. Elizabeth Poster has overseen an era of tremendous growth in student enrollment and graduation rates, from 1,912 students in 2008 to 5,949 students today.  Three years ago, the college became the state's largest nursing program after implementing an online studies program that now includes courses for more than 4,000 students seeking a bachelor of science in nursing (BSN) degree, registered nurses wanting their BSN and undergraduates aspiring to earn a master's in nursing administration.

The need for UTA's graduate output has never been greater. There is a critical shortage in Texas because of the aging workforce, growing health-care demand and a lack of nurses with professional degrees. Meanwhile, thousands of qualified students are turned away each year because of a lack of classroom space and faculty.

Poster, a psychiatric nurse by training, became the dean of UTA’s nursing school in 1995. She is convinced of the importance of training nurses on all levels to meet the needs of the state’s fast-growing population. “If there are not enough nurses, that puts our hospitals and our patients at risk,” she said. State numbers indicate the demand for full-time nurses already exceeds availability by 22,000 and is on track to reach 70,000 by 2020.

Though UTA has been able to weather some of the massive state budget cuts to nursing education programs, Poster argues funding must remain consistent if the state has any hope of filling the gap. She said UTA has benefited greatly from the state's Nursing Shortage Reduction Program, a fund that rewards colleges that enroll and graduate a high number of nurses.

Below is an abbreviated transcript of the interview:

TT: Are we at a critical point right now with the nursing shortage?

Poster: We have been for some time. The shortage has been for a number of years, and it will continue. The reason that one might believe the shortage has lessened some is based on the economy. Those nurses who would have retired, have stayed at work because they can’t afford to retire. But as soon as the economy gets better, those nurses will retire — and we want to be sure that we have new nurses available to ensure adequate patient-care levels.

TT: How have state budget cuts affected your nursing program specifically?

Poster: It has not impacted our program in the same way because we have the budget for our faculty, and then we have our Academic Partnership programs, which create a revenue stream for us as well. And we receive Nursing Shortage Reduction Program funds. Because we have so many students, we’ve received hundreds of thousands of dollars' worth of funding.

TT: So you’re in a little better shape than other programs around the state?

Poster: Absolutely, and the reason we are is because our RN to BSN program and our master's in nursing administration program are online, and those online programs really result in additional enrollments. We don’t have the barriers of having to fit those extra students into classrooms.

TT: How unique is that online program?

Poster: In 2008, we had 100 students in the RN to BSN program. Today, we have almost 5,000. On Jan. 16, we admitted 1, 021 students into the program. We admit every eight weeks.

TT: Any concerns about online education versus having that face-to-face contact between faculty and students?  

Poster: Actually, no. We believe it’s extremely valuable. We have a robust evaluation program to ensure that our students are getting the same quality education. The employers feel the benefits of that education. Our students’ satisfaction and grade-point-averages are comparable to “in the seat.” And even with our traditional four-year BSN program, we’ve developed an accelerated program that’s online except for the clinicals. We’ve now graduated over 100, and their licensure rates and graduation rates are comparable to “in the seats,” and we’re very comfortable with it.

TT: Do you still have to turn away students?

Poster: For every 100 we admit, we turn away three to four times that. And that’s true across the state. We turn away a large number of qualified students.

TT: You’ve been at UTA since 1995. What drives you, and why are you so passionate about being the dean of that program.

Poster: I can’t tell you how exciting it is to be in a setting where the faculty and the staff work together closely on agreed goals. We have a strategic plan that’s clear. We’re committed to it. And when we have new opportunities, they’re willing to step forward to try them and to be successful at them. When we started [the online programs] and we went from 100 students to 4,000 students, it took an enormous amount of work to get there. There are always challenges whenever you make a large change, but our faculty and staff is willing to make them. As a result, there was a survey on campus and the College of Nursing faculty is the most satisfied. I think it speaks well to the program, and they feel as though they are making a difference.

Whether you’re a psychiatric nurse or a critical-care nurse, you have to care about people, you have to care about your students, you have to care about your patients and you have to be collaborative. None of us can work alone to be successful. It really takes a team. While it sounds trite, it’s absolutely a fact — and our faculty and staff do.

TT: Why should Texans care about the shortage of nurses in Texas?

Poster: Every citizen cares about his or her health. Each one of us is going to need health care sooner or later. The bottom line is it’s nurses who give 24-hour care when you’re in a hospital. Physicians are critical. The health care team is critical. But nurses are the day-to-day providers of care.

TT: How would you advise other programs that are struggling to graduate more students? How has UTA been able to thrive and survive?

Poster: We could not have done the online project and grown the way we have without the support of the university. No program can make decisions on its own. For us to admit every eight weeks requires the admissions department, the registrar, etc. Every component of the university had to be ready to change, which means the upper chains of the university — the president, the provost — had to be committed to a new model. And they had to be willing to do what was needed to inspire the units to make these changes. Because when we make these changes, there are implications for liberal arts. It’s not a 15-week semester anymore.

TT: What’s your message to public policy makers who influence the budgeting process?

Poster: I would say that incentives for nursing programs to be able to grow has been absolutely critical. If we didn’t have initially the help of the Nursing Reduction Shortage Program, we wouldn’t have been able fund [our online programs], because the university doesn’t have the funding to hire more faculty to increase our enrollment. And not just faculty; we needed more advisers. We’ve had to almost double our number of advisers because we don’t admit students without close advisement to make sure they have their GPAs, they have their transcripts ready and are qualified for nursing. To actually support that infrastructure — the Nursing Shortage Reduction Program was important. Not just for our program, but for other programs.