Breaking New Ground
By Ashley Rabinovitch
The college is poised to begin construction on the Croley Nursing Building, a brand-new facility that will create educational opportunities and fill a vital need for more nurses in Tennessee and beyond.
The College of Nursing’s current building was constructed in 1978, when around 500 students were enrolled. With 500 students, 43,000 square feet of space felt roomy. With 1,000 students, it feels chaotic.
“Our nursing faculty are very creative and have provided top-level nursing education for our students with scarce resources and crowded space,” says Dean Victoria Niederhauser. “But we have reached our limit.”
Limited space doesn’t just restrict educational possibilities for students and faculty members. It also prevents the college from addressing the acute shortage of nursing students and faculty members across the country.
To solve the problem, the College of Nursing will initiate construction on a brand-new facility, the Croley Nursing Building, in the fall. When it is completed, students and faculty members will enjoy unparalleled opportunities to learn, teach, and discover.
The US needs more nurses, and its top nursing schools are doing everything they can to meet the demand. But it’s not enough.
An aging population—with 10,000 baby boomers turning 65 every day—requires a growing number of health care professionals entering the job market. The US Bureau of Labor Statistics projects a 9 percent increase in the employment of registered nurses from 2020 to 2030, with close to 200,000 job openings every year. Closer to home, the US Health Resources and Service Administration estimates that Tennessee will be able to meet only half of the state’s demand for nurses next year.
Most of these numbers were released before the onset of the COVID-19 pandemic and don’t reflect the mass exodus of bedside clinical nurses from the profession. The unrelenting heavy demands placed on nurses in recent years has led many to retire early, scale back to part-time work, practice in a different setting, or pursue a different career.
The resulting shortage has alarmed even the most seasoned nursing veterans. “Nursing shortages are nothing new, but this one is profoundly different than anything we have witnessed before,” says Sandy Leake, chief nursing officer and senior vice president at the UT Medical Center. “We need nursing schools to maintain a robust pipeline of graduates to confront this ongoing challenge.”
Meeting the need for more nurses also hinges on maintaining a steady supply of new faculty members. A 2019 report released by the American Association of Critical-Care Nurses highlights a national nurse faculty vacancy rate of 7.2 percent. “The average age of nursing faculty members across the country is in the ballpark of 55 to 65 years old, and we see this at the College of Nursing,” says Allyson Neal, assistant dean of graduate programs. “We are facing the difficult task of recruiting a new generation of faculty members.”
Nearly 90 percent of the faculty vacancies require or prefer a doctoral degree, pointing to the need to educate more graduate students. Only a minority of PhD students will enter academia, so the challenge is to boost enrollment high enough to ensure a stable pipeline of faculty members.
The College of Nursing is rising to the challenge by admitting and graduating more students. It currently enrolls more than 1,000 students, up from approximately 800 in 2016, with a growth trajectory planned for close to 1,400 students over the next five years.
The only thing holding it back is space.
Students, faculty, and staff members routinely shuffle between three different locations on campus for classes, labs, and meetings. Large classes of students are often split into several groups, forcing instructors to deliver the same multiple times and extending class time into the evenings. There is no place for students to eat, congregate, or take a break between classes.
“The lack of space is especially glaring when it comes to research capacity,” says Tami Wyatt, associate dean of research. Approximately 150 graduate students and 16 undergraduate honors students are required to engage in some form of scholarship, whether it consists of evidence-based projects or research, but there are no laboratories or other dedicated research spaces in the current College of Nursing Building. “As a Research 1 institution, it is part of our mission to engage in the discovery of knowledge,” says Wyatt, “but there is no space in our building to carry out this mission.”
And, as students can attest, the quality of space matters just as much as the quantity. “Some days, I spend all my time attending classes on the ground floor, and the walls are so thin that we can hear an entire lecture while taking an exam,” says Eva Karnowski, a rising senior who is part of the last group of BSN students learning in the current building. “There are many good things about the building, but there is a general feeling that it no longer reflects the status and accomplishments of our program. We’re really looking forward to a change.”
The quality of simulation spaces, too, needs improvement. The building was designed for a traditional classroom experience in which a professor delivers a lecture and students take notes. Now, every clinical course at the College of Nursing incorporates some element of simulation, carefully mimicking the environment of a hospital room or primary care office with live actors and human-shaped models called manikins. Educational spaces were reconfigured for simulation in the past decade, but even a 10-year-old space is out of date considering the rapid evolution of simulation technology and best practices, says Susan Hébert, director of simulation.
“The building has lived a good, long, useful life, but it has reached the end of it,” says Randy Jenkins, chair of the College of Nursing Advisory Board. “It’s showing its age with respect to construction methodology, materials, design, and space. If we are going to improve the quality of education and meet the wider demand for more nurses, we have to step up.”
“I am a firm believer that facilities matter to a student,” says Jenkins, whose company plays a role in providing facilities development services to institutions of higher education. “I once heard a university president say that a student will assess their ability to thrive within 15 minutes of visiting a building. The College of Nursing has been trailing behind, but that is changing now.”
From the day it opens its doors, the new building will enhance the quality of education by accommodating larger, more functional research, simulation, and instructional spaces. Every student, faculty, and staff member can identify something about the new building that will allow them to flourish.
The first thing many students will notice is the addition of new research space. The new building will feature a state-of-the-art wet laboratory that will accommodate the college’s microbiome scientists as well as collaborators from other disciplines. Among those who will benefit are Assistant Professor of Nursing Ji Youn Yoo, who is investigating how life and work stressors affect the microbiome of local firefighters, and Assistant Professor of Nursing Katherine Morgan, who is studying microbiome in neurodegenerative diseases such as Parkinson’s and Alzheimer’s and microbiome imbalance in premature infants with very low birth weights.
“There is research taking place in the College of Nursing that is reshaping the landscape of patient care,” says Jenkins. “This is not a story that is being told loudly enough.” The college has already secured more than $4 million in research funding in fiscal year 2022, he notes, and the Advisory Board anticipates even greater funding success when the new building is fully functional.
In addition to a new wet lab, the new building will house a unique innovation lab. The College of Nursing regularly hosts mini think tanks, which give a researcher who is struggling to move forward on a project the opportunity to troubleshoot with a group of three people: one from their discipline, one from a similar discipline, and one with no knowledge or experience in their area of study. “To make this model effective, we need a comfortable space that accommodates creative flow and energy,” says Wyatt.
Students as well as faculty members will benefit immensely from new research space, Wyatt points out. “Our students are the cream of the crop,” she says. Most undergraduate nursing students will eventually pursue a graduate degree, and they will need exposure to research to be leaders in their fields. In the college’s new wet lab, they will gain valuable hands-on experience in the cycle of continuous discovery that translates into better clinical care.
According to Neal, the new research spaces will be a valuable tool in recruiting graduate students, since they typically spend a significant portion of their time conducting research. “Potential PhD and DNP students tour a facility that is small and outdated, with research spaces spread across campus,” she says. “Creating high-quality research space sends a signal that the College of Nursing is committed to the success of its graduate students. We will be able to support them from start to finish under one roof.”
One-third of the new building will be dedicated to simulated specialty learning, replacing three simulation lab spaces that are currently located in three different buildings. The new building will house four major simulation spaces: a physical assessment lab, a lab that focuses on improving psychological and motor skills, a high-fidelity acute care area that mimics hospital care, and a high-fidelity primary care area that mimics a primary care office.
“We’re excited to have more space in general, but we’re especially excited for spaces that are designed with best practices in mind,” says Hébert. For example, new debriefing spaces will enhance the psychological safety of students by creating space for private feedback. “Establishing a safe learning environment means that you have privacy when discussing what went well and what needs improvement,” Hebert explains. The installation of better AV technology will facilitate this evaluation process by enhancing the ability of faculty observers to see and hear what is happening in a simulated care setting.
“Everything we do in simulation is geared toward preparing a student to hit the ground running in a clinical setting as soon as they graduate,” says Hebert. “This new building will equip us to accomplish our goals.”
It will also catalyze the transformation of classroom space. New classrooms will be spacious enough to accommodate large classes of nurses, who will finally be able to learn in the same room at the same time. Faculty members will save time by delivering lectures to entire classes at once, and students will avoid having to travel across campus to attend class. Students who learn remotely will benefit from a dedicated space for distance education learning and a green room that enables high-quality recordings. Doctoral students who visit campus twice a year for classes and meetings will finally have a central space to learn instead of spreading out between four or five buildings.
Students will benefit from improved classroom interactivity as well. “Each classroom space will transform into whatever environment we are trying to create,” says Sadie Hutson, executive associate dean of academic affairs. “If it’s a large classroom with 250 students, we might have screens on three different walls. If we want to hold an event, all the furniture and technology is easily movable.”
Serving the Community
While the Croley Nursing Building will improve and expand education and research opportunities, it also enables the college to make a greater impact in the community.
According to AACN, the American Association of Colleges of Nursing, US nursing schools turned away more than 80,000 qualified applicants from baccalaureate and graduate nursing programs in 2019, in part due to insufficient building space. Like other leading nursing schools, the College of Nursing has had to turn away qualified candidates who would make exceptional nurses.
The new building will allow for a significant increase in enrollment, which translates into more clinical hours in partner institutions throughout Knoxville and beyond. In an environment where nurses are overworked and underresourced, student nurses will offer vital support. Greater student numbers will also allow the college to become an even more active leader in serving campus needs during health crises like the COVID-19 pandemic.
Perhaps most significantly, increasing the number of students will go a long way in addressing the ongoing nursing shortage. By investing in a new building, the college is uniquely positioned to expand the pipeline of qualified nurses in Tennessee, says Hutson. At the same time, she adds, the building will “generate recognition and visibility by sending the message that the college is committed to training highly skilled nurses to meet the needs of Knoxville and beyond.”
The college will accomplish this mission by sending more graduates out into clinical settings and equipping more students to become faculty members. The task of converting graduate students into faculty members is complex, Neal acknowledges. The college must offer compensation packages that compete with the private sector while maintaining robust mentoring programs that ensure the success of new faculty members. “But without a doubt, a new building is a huge factor in recruiting the graduate students we need to teach undergraduate students and eventually become faculty members,” she says.
“Ultimately, the Croley Nursing Building will allow us to serve the world by serving more Vol nurses,” says Martha Weeks, a member of the College of Nursing Advisory Board. “It’s a really exciting time.”
Putting the Plan into Motion
The college’s leaders began to articulate the need for a larger, more modern building more than a decade ago. Recently, UT System President Randy Boyd and UT Knoxville Chancellor Donde Plowman worked with the state legislature to partially fund the cost of a new building as a vital tool for relieving nursing shortages.
At the same time, the college launched a campaign to raise donor funds in support of the effort. In October 2021, the UT Board of Trustees approved the naming of the building after
Sara Croley (BSN ’00), and her husband, Ross, who together made a landmark $7.5 million donation to support the new building in 2019.
With most of the state, university, and donor funding in place, the Croley Nursing Building will begin to take shape in September 2022. “We initially envisioned a renovation and expansion, but it quickly became clear that it made more sense to knock down the old building and start from scratch on the same site,” says Lindsay Burke-Melton, assistant dean of finance, administration, and operations, who is leading the building project on behalf of the college.
With an estimated date of completion set for fall 2025, plans are coming together quickly for the $85 million, 117,000-square-foot building. Over the summer, the college will relocate into two spaces on campus: the Nursing Education Building (previously a nuclear engineering building), and Service Building A. After demolishing the old building in September 2022, the construction team will spend 18 months constructing a new foundation and 18 months constructing the building above ground.
Four floors of traditional classroom spaces, simulation spaces, laboratories, offices, and common areas will bring all the college’s education, research, and social activities together in one warm, modern space. A floor-to-ceiling glass façade, combined with skylights on the top floor and a lightwell in the center of the building, will flood the space with natural light. “Our goal with the design was to create an open, airy space that makes everyone feel welcome and invited,” says Burke-Melton. The Croley Nursing Building will even feature a fresh food dining option on the first floor, providing a space to refuel and build social ties.
Sara Croley, who has described the existing building as frozen in time from her days on campus, looks forward to watching the vision for the new building become reality. “I almost teared up when I saw the initial design mockup of the building, because I thought about how excited I would be to learn in this environment,” she says. “Finally, Vol nurses will have a space that matches the caliber of their program, right in the heart of campus.”