HHS to invest $100M to train nurses, bolster clinician workforce

The Biden administration announced a $100 million investment to train more nurses and grow the workforce as the healthcare industry faces a critical nurse shortage.

Officials with the U.S. Department of Health and Human Services (HHS) said Thursday the investments will help address the increasing demand for registered nurses, nurse practitioners, certified nurse midwives and nurse faculty. 

The funding, announced Thursday, will go toward increasing the number of nursing school faculty, supporting the career ladders for licensed practical nurses and vocational nurses to become registered nurses and training more nurses to become primary care providers to address mental health issues, substance use disorder issues and maternal health, Carole Johnson, administrator for the Health Resources and Services Administration (HRSA) within HHS, said during a call with reporters Thursday.

"We're going to do everything we can to stand up nurses to help those who wish to become nurses get through the process and not make the decision to forego nursing school because they can't afford it. We're going to do everything we can to expand the number of nurses we have in the field of mental health. We're going to try to make sure that we address burnout," HHS Secretary Xavier Becerra said during the call.

A recent study found that 100,000 nurses left the field during COVID-19, and 800,000 are likely to follow them out the door by 2027.

Many of the nurses surveyed reported burnout and feeling emotionally drained.

The U.S. is projected to experience a shortage of registered nurses (RNs) that is expected to intensify as baby boomers age and the need for healthcare grows, according to the American Association of Colleges of Nursing. The RN workforce is expected to grow from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 nurses, according to data from the Bureau of Labor Statistics.

But, the bureau also projects 203,200 openings for RNs each year through 2031 when nurse retirements and workforce exits are factored into the number of nurses needed in the U.S.

According to a recent poll, 94 out of 100 senior health system executives described their nursing shortage as “critical,” and just over two-thirds said they don’t have adequate nursing staff to handle a large-scale health crisis.

Labor shortages are impacting healthcare organizations financially as well. The increased use of contracted workers, including contract nurses, helped fuel a 20% growth in labor expenses in the healthcare system from March 2022 to March 2023, a Kaufman Hall analysis found.

"We don't have enough doctors or nurses and nurses practicing. We don't have enough psychologists or counselors to address the rising rates of substance use disorders. We don't have enough midwives, pharmacists and professional caregivers to meet the needs of Americans. We need more," Becerra told reporters.

In conversations with education leaders across the country, the No. 1 issue that comes up is the shortage of faculty to teach the next generation of nursing students, Becerra noted.

"The president of Portland State University told me they are turning away qualified, eligible applicants for their nursing program because they don't have enough nursing faculty," he said. "It's tough to lure an experienced nurse practitioner, a licensed practitioner to teach because they lose so much income."

As part of the $100 million investment, HHS awarded $34.8 million to 56 organizations to increase the number of primary care nurse practitioners, clinical nurse specialists and certified nurse midwives trained and prepared to provide primary care services, mental health and substance use disorder care, and/or maternal health care.

Those awards, which average about $250,000, are part of HRSA's Advanced Nursing Education Workforce Program, Johnson said.

"We're providing tuition assistance and other support to trainees and really building partnerships between academic medical training programs and community settings where we want nurses to practice so that nurses can lead when it comes to delivering primary care, maternal health care support, mental health and substance use disorders, all the places where we know there are gaps in services. And we know advanced practice nurses can fill those critical gaps," she said.

The agency awarded $30 million to 45 organizations as part of its Nurse Practitioner Residency and Fellowship Program to increase the number of trained advanced practice nurses in primary care.

"We train physicians in residency programs all the time. That is part of the natural training process for physicians; they spend multiple years in clinical practice with preceptor oversight and good mentoring to be able to make sure that they can do the things that they need to do once they launch themselves in their individual practices," Johnson said. "This is our program where we create a similar residency-led model for nurses to get intensive training to provide and then launch their own primary care practices. We're also focused on integrating behavioral health into this training."

To support more nurse faculty, HRSA also awarded $26.5 million to 88 schools, through its Nurse Faculty Loan Program, to provide low-interest loans and loan cancelation to incentivize careers as nursing school faculty.

That program provides up to 85% loan cancelation of the original loan amount, plus interest, upon completion of up to four years post-graduation of full-time nurse faculty employment.

"We think, through this investment, we could produce 3,000 more faculty," Johnson said.

Close to $9 million will go to nine organizations as part of a pathway program for licensed practical nurses to become RNs. "These funds support things like stipends and tuition assistance and other social support, like transportation and childcare assistance, that can really help individuals who were able to get their certificate and their credential to be an LPN to get them on a pathway to be an RN," Johnson said.

HRSA also awarded $2.2 million to 64 schools to support a nurse anesthetist traineeship program. "These are smaller awards to help build the pipeline of nurse anesthetists who are really filling critical gaps in rural and underserved communities when it comes to access to things like surgery and other support," Johnson noted.