With shortages abounding, nurses training needs some TLC
Teacher, facility shortages limit next generation
Nursing is one of the few professions that has not been affected by the recession. Colleges report more students are interested in it; pay and benefits are up; and health care facilities report more jobs than they can fill.
There’s just one problem: not enough teachers and schools to educate the next generation.
Nursing schools are turning away thousands of qualified applicants because of a lack of instructors and classroom space.
“We see rising demand for nurses, but we need to enlarge the pipeline. Growth has slowed because schools are at capacity,” said C. Fay Raines, president of the American Association of Colleges of Nursing.
Schools have expanded their programs, but it’s still not enough. Signs are evident at all the nursing programs in Western New York.
• Erie Community College’s fall nursing courses for an associate degree already are full. Niagara County Community College has a substantial waiting list.
• The University at Buffalo has more than doubled enrollment in its undergraduate nursing program to 716 in 2008 from 346 in 2004, and it still can’t meet demand.
• Enrollment for a bachelor’s degree at D’Youville College, likewise, nearly doubled to 225 in 2007-08, when the program had 608 applicants, from 118 in 2003-04, when the number of applicants totaled 267.
“Like other schools, we’ve expanded in response to community and national needs,” said Kathleen Mariano, chairwoman of D’Youville’s program. “Nursing is also a desirable profession again.”
Nationally, enrollment in nursing schools has more than doubled since 2000. Enrollment rose by 2.2 percent in 2008, the eighth consecutive year of growth. The annual percentage increases, however, have been declining since 2003, according to a survey by the American Association of Colleges of Nursing.
The group’s survey also found that 49,948 qualified applications to professional nursing programs were rejected in 2008, including nearly 7,000 applications to master’s and doctoral programs. The higher-degree programs produce those qualified to teach.
In this state, fewer nursing programs reported turning away qualified applicants in 2007 compared with 2006. How many applicants are turned away from programs in Buffalo remains unclear, and the extent of the problem varies from school to school.
Last year, UB accepted 419 students from more than 1,200 applications. Those it turned away included 132 it considered qualified.
At ECC, Christine Lezynski, nursing department head, said the school turned away 12 students last year it couldn’t accommodate on the City Campus but gave them the option of taking classes on the North Campus in Amherst.
Cherie Mavissakalian, division chairwoman at NCCC, said this is the first time the school has had a significant waiting list so early in the year.
At Daemen College, Mary Lou Rusin, chairwoman of the department, said turning away qualified applicants has not been a major issue at the school.
The experts said nursing schools are getting about as large as they can get because of limited numbers of teachers, as well as limited funding to expand classroom space.
Schools also must balance the demand for nursing classes with the need to maintain graduation rates and other measures of quality.
“The larger you get, the more you risk diluting your standards, the more difficult it becomes to weed out the maybes among the students who want to become nurses,” Mavissakalian said.
Some aspects of nursing programs are not altogether within the schools’ control, such as the capacity of hospitals to accommodate more students for the clinical portion of their training.
“Programs already compete for time to train in hospitals. Like other schools, we’ve moved rotations at hospitals to evenings and weekends, but there are only so many clinical sites, and you’ve got to maintain a certain student-teacher ratio,” Lezynski said.
On a recent weeknight, for instance, Amanda Cramer spent an evening with her class in Erie County Medical Center.
“I was inspired to get into nursing by my mom, who is a nurse. But a lot of people I know are going into it because of the economy,” said the 22- year-old senior at D’Youville. “It’s a stable job. You’re always going to need nurses.”
The supply of nursing teachers has not kept pace with the growth in the number of students primarily because nurses with advanced degrees have so many other opportunities. Many of those jobs pay significantly better.
Mariano said nurse practitioners — who have earned master’s or doctoral degrees — can expect to make around $70,000 a year in Buffalo, while a college faculty member would likely make at least 15 percent less.
“Academic salaries have not kept pace,” she said.
Nationally, the association and other nursing groups are lobbying Congress and the Obama administration to provide grants to schools to expand programs and to forgive loans to students who pursue advanced degrees and commit to teaching for four years.
Schools also are broadening students’ training beyond the classroom to nonhospital settings, such as primary care clinics, and investing in simulation labs in which students can practice on lifelike mannequins programmed by computers to mimic realistic situations, such as giving birth.
Despite the cost, Raines expressed confidence that the measures will receive support, citing recent comments by President Obama about the critical need for nurses in the future.
“We all need health care, and nurses are the backbone of the system,” she said.
Nearly 13,000 registered nurses work in Western New York, according to the University at Albany Center for Health Workforce Studies. On average in the state, they are older and more likely to have an associate degree instead of a bachelor’s, master’s or doctorate.
Of greatest significance, studies agree that there are not nearly enough of them.
The downturn in the economy, according to some reports, is easing the shortage. Hospitals and other facilities have instituted hiring freezes. Some nurses close to retirement are hanging on longer than planned, and others who retired have returned to work.
But in the years ahead, demand is expected to far exceed supply.
Research by Peter Buerhaus, an expert on the nursing work force, suggests a shortfall of 500,000 nurses in the United States by 2025, coinciding with the aging of the baby boomer generation.
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