Solutions for Our Future: Seeking Collaborative Solutions to the Nursing Shortage

In November 2007, the U.S. Bureau of Labor Statistics announced that registered nursing is the top occupation in terms of job growth through the year 2016. Though good news for practicing nurses and students in the pipeline, this projection underscores the dire need to produce more nurses and amplifies the call for a vigorous response to the nursing shortage.

Why is the nursing shortage a national concern? Nurses make up the largest single component of hospital staff, are primary providers of patient care, and deliver most of the nation’s long-term care. Nurses are truly the key to patient safety and the most likely health-care provider to spot errors and signal the need for life-sustaining interventions. An insufficient supply of nurses creates an environment in which clinicians are overburdened, access to care is limited, and the quality of care is compromised.

With workforce analysts projecting a shortfall of more than 500,000 nurses by the year 2025 (Buerhaus, Staiger & Auerbach, 2008), the health-care system is looking to the nation’s nursing schools to increase student enrollments and bridge this gap. The challenge to nursing education is daunting. Though interest in nursing careers is high, the ability to expand student capacity is severely limited by a shortage of nurse educators, budget cuts, and limited space for educational experiences in practice settings.

On the bright side, the American Association of Colleges of Nursing (AACN) recently reported the seventh straight year of student enrollment increases in entry-level baccalaureate nursing programs. However, even with this welcome news, schools are not coming close to meeting the projected demand for new nurses. To make matters worse, 40,285 qualified applicants to schools of nursing were turned away last year due to faculty, funding, and resource constraints.

Despite the challenges, nursing schools are finding creative ways to expand student capacity. To address one of the primary drivers of the nursing shortage—the limited supply of nurse educators—many institutions are forming partnerships with clinical agencies to support mutual needs. Some hospitals allow expert nurses to serve as adjunct faculty, which helps increase the availability of teachers. In exchange, these health-care facilities gain access to students whom they hope to recruit after graduation. Besides faculty arrangements, some service partners share physical resources and infrastructure with schools as a means of overcoming limitations in clinical, classroom, and research space. Still others form partnerships to provide tuition forgiveness to students in exchange for work commitments.

In an effort to “grow their own,” many nursing schools now offer baccalaureate-to-doctorate programs to retain bright students in their programs with the goal of preparing future faculty. Typically, top baccalaureate students are identified in their senior year and encouraged to pursue this rigorous program that acculturates them to research, advanced clinical practice, and academic careers. According to AACN’s latest survey from fall 2007, 63 baccalaureate-to-doctorate programs are now enrolling students nationwide, and 10 new programs are in the planning stages.

Finally, nursing deans and faculty are taking their message to Capitol Hill and state legislatures and have been successful at rallying support. From Rhode Island’s Nursing Rewards Program to Georgia’s Nurse Faculty Loan Cancellation Program to Colorado’s Nurse Teacher Loan Forgiveness Program, nursing’s academic leaders are having a positive impact by advancing legislation that increases support for graduate nursing education. AACN and colleague organizations at the national level are leading the efforts to sustain funding for Nursing Workforce Development programs while seeking to establish new funding streams. More than a dozen new bills benefiting nursing programs have been introduced in Congress this year, including the Nursing Education, Expansion, and Development Act and the Nursing School Capacity Act.

Resolving the nursing shortage is a national priority that requires a collective response from those preparing and employing nurses as well as those who will some day require nursing services. Working together, nurse educators, health-care agencies, consumers, big business, and policy makers can play important roles in advancing solutions. Together we must ensure that the nursing workforce is adequate in number and educated to provide the best care possible. The health of our nation depends on its nurses.

References

Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2008). The Future of the Nursing Workforce in the United States: Data, Trends and Implications. Boston: Jones and Bartlett Publishers.

American Association of Colleges of Nursing (2008). 2007-2008 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. Washington, DC: Author.