Higher Education’s Role in Solving the National Nursing Shortage
With a projected national nursing shortage of 800,000 over the next 15 years, higher education institutions are being asked to fill the gap. But
with high costs and a lack of credentialed faculty, colleges will face significant challenges in training enough students to save lives. Policymakers
and higher education leaders at all levels must support programs that build capacity and produce nursing graduates.
Context
As American society grows and advances, consequences of this evolution are being felt. The nation’s population is expected to grow 13 percent
over the next 15 years and developments in the field of medicine have raised the average lifespan significantly over the past fifty years.
The nursing field will need to confront these trends, along with many others, as it finds itself with an aging workforce, high turnover and the emergence
of alternative job opportunities. All of this has created shortfalls in the field of nursing, where by 2020, experts believe there will be a national
shortage of registered nurses reaching more than 800,000. According to the U.S. Department of Health and Human Services, 44 states and the District
of Columbia are expected to have nursing shortages by 2020 impacting hospitals, nursing homes, ambulatory care and schools.
In the face of these troubling statistics, higher education institutions and federal and state policymakers must be prepared to take action. Strategies
to increase the capacity of nursing programs as well as attract sufficient numbers of students are needed.
Observations
While enrollment at nursing colleges has increased significantly over the past few years, many colleges are facing difficulties in keeping up
with demand.
While years of hard work to recruit more students into the nursing field have finally proven successful, many universities now find themselves unable
to accommodate the number of prospective nursing students. A recent survey by the American Association of Colleges of Nursing (AACN) found a 14.1 percent
annual jump in enrollment of entry-level nursing baccalaureate programs in 2004 and a 14 percent increase in the number of degrees conferred in these
programs.
While these numbers are a welcome change from previous declines in nursing graduates, many colleges have had to turn away scores of students. The National
League for Nursing estimates that more than 125,000 qualified applicants were rejected by nursing programs in the 2003-04 academic year, more than 36,000
of those from baccalaureate programs. The high costs associated with nursing programs, the lack of hospital space for clinical work and a shortage of
nursing faculty are the most commonly cited reason for limiting the number of students accepted to a nursing program.
Figure 1.
More than three-quarters of institutions cite a lack of faculty as the reason they turned away qualified nursing applicants. To widen the number
of nursing instructors across the country, campuses and policymakers are working to expand the number of registered nurses with postgraduate degrees.
A shortage of qualified nursing faculty can be traced directly to the scarcity of individuals with a master’s degree in nursing and the higher
salaries found outside of academe. One approach to address this shortage is using non-nurses in faculty positions. Health care professionals, such as
physicians, statisticians and health policy analysts would give students a quality education while filling open positions.
Additionally, many schools have found success in looking within their programs. Counselors at New Mexico State University encourage students in the
bachelor’s program to continue their college career. Students learn about the graduate program when they are first admitted to the baccalaureate
program and financial aid options available to graduate students are discussed during a student’s exit interview.
Legislators also are looking for ways to help. Pending legislation in states such as New York, Ohio and Texas would grant incentives such as loan forgiveness,
low-interest mortgages and tax credits to nurses who either pursue a postgraduate degree or switch careers from one in a hospital to one in a classroom.
The federal Nurse Faculty Education Act of 2005 (SB 1575) would create a grant program for nursing schools that demonstrate an increase in the number
of doctoral degrees granted. The Nurse Faculty Higher Education Act (HR 3173) would create a pilot program authorizing scholarships to qualified nurses
pursuing an advanced degree with the goal of becoming a faculty member in a nursing program. It would also authorize grants encouraging partnerships
between nursing schools and hospitals that fund time for nurses to earn a salary while obtaining an advanced degree in nursing for the purpose of become
an instructor.
Collaboration between two- and four-year colleges, high schools and the health care industry are proving effective in expanding nursing education
programs, including recruiting more non-traditional students.
Reaching out beyond their campuses, public colleges and universities have been able to attract the interest of high schoolers, community college students,
corporations and lawmakers. For example, in 2002 Alaska’s five largest health care providers announced that they would commit $1.8 million over
three years in partnership with the University of Alaska-Anchorage in an attempt to double the number of Alaska’s nursing graduates. Additional
funding from both the university and Legislature allowed the state to reach its goal.
At Indiana University-South Bend, high school students are able to earn college credit for several nursing courses such as Medical Terminology and Introduction
to Health Careers. Administrators at California State University Fullerton were able to partner with a local community college to establish an on-site
program for registered nurses with an associate’s degree to earn a baccalaureate nursing degree.
While minority students have historically been underrepresented in nursing, active steps are being taken to recruit such students as both hospitals
and higher education institutions continue to discover the benefits of having a diverse nursing staff. At the University of Mississippi Medical Center
(UMMC), administrators created the Early-Entry program in collaboration with historically black Jackson State University and Tougaloo College. Through
the program, students complete their prerequisites at Jackson State or Tougaloo and are then admitted to the University of Mississippi Medical Center
for their junior and senior years. Once at UMMC, students receive mentors and tutors to help them adjust to the new university and are encouraged to
attend graduate school.
Conclusion
While the nation's colleges and universities will be called upon to fill the gaps in production of nurses, they cannot do it alone. Significant state
and national investments are needed to help increase the capacity of nursing programs, to attract qualified students, and to help keep nurses in the profession.
At the same time, campuses must take it upon themselves to explore new ways to make efficient use of available resources, provide adequate support and
counseling for students, and collaborate with others to improve their programs and increase capacity.
RESOURCES
The July 2002 report Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020 published by the U.S. Department of Health and
Human Services, Health Resources and Services Administration. It chronicles the nation’s expected nursing shortage through the next 15 years,
detailing the causes and impact of the shortfall in different areas of the country.
Report
The American Association of Colleges of Nursing published an in-depth report of successful partnerships undertaken by nursing colleges
and universities to expand their programs. Using Strategic Partnerships to Expand Nursing Education Programs offers comprehensive information
about such collaborations, including recommendations and contact information.
aacn.nche.edu
The latest survey by the National League for Nursing analyzes data on nursing programs at all educational levels. Data includes the
number of qualified students rejected by nursing programs, increases in the number of nursing school applications and graduations from all nursing programs.
nln.org (pdf)
Annual reports on enrollment, graduation and faculty salaries of baccalaureate, masters and doctoral nursing program are published by the American
Association of Colleges of Nursing. These reports can be purchased on their website.
aacn.nche reports
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