The Robert Wood Johnson Foundation released a report that looks at what state-level partnerships have done to expand America's capacity to teach and graduate more nurses.
With baby boomer nurses poised to begin retiring in the next few years and the market for healthcare services growing fast as America ages, nurses are in high demand. Experts have projected that we could face a shortfall of at least 260,000 nurses by 2025. And that's a conservative estimate, because it account for the increased demand for care due to the new healthcare legislation.
But nursing schools can't produce enough nurses to meet demand.
There aren't enough slots in each class, so they're rejecting qualified applicants. In 2009, entry-level baccalaureate nursing programs rejected more than 42,000 qualified applicants, according to the American Association of Colleges of Nursing (AACN). That was up from 16,000 in 2003.
Major barriers to expanding admissions to BSN-RN programs include a shortage of faculty, clinical sites, and classroom space. Sixty-one percent of nursing schools cited lack of faculty as a barrier, according to the AACN.
In Michigan, half of the nursing faculty in many state schools are eligible to retire, according to the report. To help students speed their way to teaching positions, the governor established the Michigan Nursing Corps, with $7 million in appropriations (2008-2010), to train clinical and classroom faculty. Participants receive tuition and stipends in exchange for agreeing to teach in Michigan nursing programs. Michigan has added 277 new clinical instructors, and 150 new faculty-in-training (for MSNs or PhDs) since 2005.
Concern about a nursing shortage is especially acute in Texas, which faces a projected shortage of 70,000 nurses by 2019, up from 22,000 in 2009. Texas Workforce Shortage Coalition leaders noticed that the graduation rates of state nursing programs were all over the map, ranging from: 22 percent to 98 percent, according to the RWJF report. A resulting legislative proposal took a pay-for-performance approach to incentivizing nursing programs to produce a high percentage of graduates. It divided nursing programs into high grad producers (70 percent or more) and lower producers (below 70 percent).
The proposal called for new and continuing funding. Most of money would be earmarked for high producers to expand enrollment. The lower producers would receive much less new money to improve graduation rates. Schools in both groups that failed to meet set target percentages would have to return state money.
The legislature ultimately appropriated $50 million in new and continuing capacity-building funds. High-producing schools will receive approximately $20.5 million over two years in new money. Lower producers will receive approximately $9.5 million.
The efforts to ramp up the number of nursing school graduates also included:
- The creation of a statewide nursing corps to quickly educate faculty and students;
- Multi-state partnerships among community colleges and baccalaureate programs to bridge the gaps between programs offering associates degrees and BSNs;
- Alliances of nursing programs from institutions around the state to share curriculum, administrative resources, faculty, admissions standards, and reliance on web-based instruction and mobile simulators to maximize reach; and
- A focused program of distance-learning and web-based simulation to overcome geographical challenges.
To learn more:
- read the Robert Wood Johnson Foundation's report
- check out The Hill's Healthwatch blog