As the economy regains its strength and the nurse population continues to age, older nurses are once again taking a serious look at retirement. On the other end of the professional spectrum, interest in nursing is strong, and qualified applicants are applying in droves to nursing programs at colleges and universities across the nation.
So, we’re good, then, right?
Due to a lack of both nursing instructors and clinical sites willing to host student nurses, enrollment in nursing programs is frustratingly limited. Waiting lists to get into schools are common, with some aspiring nurses biding their time as long as 6 years before they can begin their nursing classes.
At least one program has put a temporary stop on applications altogether.
"We have placed a hold on accepting applications in order to reconsider the impact the wait list has on students and the cost to maintain a wait list,” Glenn Burgess, director of nursing at Solano Community College, Fairfield, CA, recently told Inside Higher Ed. “Currently, we have decided to not keep a wait list, and students will need to reapply each year in September, and all qualified applicants will be placed in a lottery to fill the next class.”
Waiting lists and lotteries are hardly ideal for a profession that experts warn will be short some 130,000 nurses by 2025.
The Inside Higher Ed report included other troubling examples:
"[T]he real issue remains that in terms of applicants to programs, not 100 percent of qualified applicants are admitted to programs," Marshall Alameida, dean of health sciences at College of Marin, Kentfield, CA, said in the article.
Given the demand for nursing degrees and the demand for nurses in the workforce, why not just expand nursing programs to accept and prepare more students?
“There just aren't enough faculty, and the only reason students, potential applicants, are turned away is the lack of faculty and lack of clinical placement," Beverly Malone, chief executive officer, National League for Nursing, told Inside Higher Ed. "When you come in, there's not enough space in hospitals or community health clinics to get experience. So you have to clamp down on the number coming in."
Salaries are a big issue. Nurses can often make more working in hospitals than they can in higher ed. What’s more, higher ed requires more educational preparation than clinical practice — usually at least a master’s degree.
Finally, finding clinical sites for nursing students at nearby hospitals and clinics is a challenge for many of the nursing programs that already exist. Expanding enrollment would make clinical placements even harder to find.
But there is good news. Nursing programs have adapted by looking for clinical placements at organizations beyond hospitals and clinics.
"So a lot of places are looking at what we call alternative clinical sites," Donna Meyer, chief executive officer of the National Organization for Associate Degree Nursing, told Inside Higher Ed. "So it's much more about going out to public health and long-term care facilities. We've changed our thinking in that way, but healthcare is moving out of the hospitals and into places like rehabilitation centers."
The Affordable Care Act, and its emphasis of keeping patients out of the hospital whenever possible, has helped paved the way for that change. Another government initiative—Title VII funding for health professions and Title VIII funding for Nursing Workforce Development — could also help relieve the bottleneck by easing the financial strain of earning a master’s degree for aspiring nurse instructors.
Because when it comes to shortages, the money to fund a master’s degree can be a real deficit, too.
"The shortage is in the lack of resources to pay for those nurses to go back [and become instructors],” Malone said in the article. “I believe the interest is there."