Though
Enrollments Rise at U.S. Nursing Colleges and Universities,
Increase Is Insufficient to Meet the Demand for New Nurses
Labor
Department Projects the Need for 1 Million New and
Replacement Nurses by 2010
WASHINGTON,
DC, December 20, 2002 - According to the results of the annual
survey released today by the American Association of Colleges
of Nursing (AACN), enrollments in entry-level baccalaureate
programs in nursing increased by 8 percent in fall 2002 over
last year. This increase comes at a time when the need for
nurses with baccalaureate and graduate degrees is expanding
in the U.S. health care system. Though this increase signals
a shift in enrollment trends, the number of students in the
educational pipeline is still insufficient to meet the projected
demand for a million new and replacement nurses over the next
10 years.
AACN
findings are based on responses from a total of 578 (84.8
percent) of the nation’s nursing schools with baccalaureate-
and graduate-degree programs that were surveyed in fall 2002.
The survey found that total enrollment in all nursing programs
leading to the baccalaureate degree was 116,099, up from 106,557
in 2001. By comparison, the total enrollment in 1995, the
year enrollments began to dip, was 127,683 for all baccalaureate
nursing programs.
Enrollment
trends are determined by comparing data from the same schools
reporting in both 2001 and 2002. Data show that nursing school
enrollments are up in all regions of the United States with
the greatest increase realized in the North Atlantic states
where enrollments in entry-level baccalaureate programs rose
by 10.7 percent. Looking at enrollment levels in other regions,
schools in the South were up by 6.7 percent, and schools in
the Midwest and West were up by 8.0 percent.
"Schools
across the country have done an excellent job in responding
to the nursing shortage and getting the word out about career
opportunities in the nursing," said AACN President Kathleen
Ann Long, PhD, RNCS, FAAN. "We are encouraged by the
upswing in enrollments, but understand that we have a long
way to go before we come close to meeting the projected demand
for nurses into the foreseeable future."
Though
enrollments are up at the majority of nursing schools, slightly
more than 30 percent of schools with baccalaureate or higher
degrees in nursing reported no change or declines in enrollments
this year resulting in unfilled seats. Almost 40 percent of
schools with increased enrollments attracted only 20 or fewer
new students this year.
Though
entry-level baccalaureate programs saw increases this year,
programs that enable registered nurses (RN) prepared with
a diploma or associate’s degree to earn a bachelor’s
degree and enhance their skills continue to register declining
enrollments. From 2001 to 2002, enrollments in RN-to-baccalaureate
programs declined 2.1 percent, continuing the downward trend
that began in 1999. The survey also found that enrollments
in master’s degree programs in nursing rose 3.5 percent
with a total population of 33,976 students now enrolled in
programs nationwide.
Enrollments
Rise Despite Many Challenges
Nursing
schools across the country are struggling to find creative
ways to expand student capacity despite many obstacles. A
shortage of nursing faculty, funding cuts, inadequate facilities,
competition for students, and a lack of clinical placement
opportunities are hampering efforts to attract and retain
more students. To overcome these challenges, schools are forming
partnerships with clinical agencies to support mutual needs,
lobbying for continued state and federal monies, retooling
marketing strategies, and stepping up efforts to expand diversity
and recruit new populations into nursing.
To
strengthen these efforts, some states including Texas, Pennsylvania,
and Florida have passed new legislation to provide more funding
for nursing schools to expand their programs and accommodate
more students. Faculty shortages are being addressed to a
limited degree through partnerships between schools and health
care facilities that allow their personnel to serve as teachers
and provide clinical support. Schools are also reaching out
to career changers and those impacted by the economic downturn
with accelerated baccalaureate programs that offer the fastest
route to becoming a registered nurse for those already holding
a degree in another field. (See
the Enrollment Success Stories and Challenges to Future Growth
section below.)
Student
Enrollments and the Nursing Shortage
"Though
enrollments are moving in the right direction, we are far
from satisfying the demand for nursing care in this country,"
explained AACN’s Executive Director Geraldine "Polly"
Bednash, PhD, RN, FAAN. "The shortage is having a devastating
effect right now on our health care system’s ability
to provide safe patient care, and much more must be done to
dramatically expand student capacity at our nation’s
nursing colleges and universities." The most recent projections
from the U.S. Bureau of Labor Statistics indicate that one
million new and replacement nurses will be needed by the year
2010.
In
2002, many national reports attempted to quantify the nursing
shortage and explain the threat this problem poses to health
care delivery. According to a report released by the Health
Resources and Services Administration within the U.S. Department
of Health and Human Services in July 2002, the number of states
with a shortage of registered nurses is expected to grow from
30 states in 2000 to 44 states in 2020. Surveys and studies
published this year in the New England Journal of Medicine,
Journal of the American Medical Association, and by the Joint
Commission of Accreditation of Healthcare Organizations all
confirm that the shortage of registered nurses is impacting
the delivery of health care in the U.S and negatively affecting
patient outcomes. The shortage is expected to intensify over
the next decade as baby boomers age and a large percentage
of the current nursing workforce retires.
"Though
the task facing nursing education is daunting, we must rise
to the occasion in the interest of patients we serve,"
added Dr. Long. "Nursing must join with stakeholders
within the health care community to find solutions to the
faculty shortage, lobby collectively for resources to expand
student capacity and improve infrastructures, create career
ladders for nurses as a retention mechanism, and reach out
to diverse students." AACN will lead the effort to advocate
for legislation that benefits nursing education, seek appropriations
for the newly created Nurse Reinvestment Act, share best practices,
innovations and opportunities with the full body of nursing
schools, and form collaborations to seek solutions to the
nursing shortage.
About
the AACN Survey
AACN’s
22nd Annual Survey of Institutions with Baccalaureate and
Higher Degree Nursing Programs is conducted each year by the
association’s Research Center. Information from the survey
forms the basis for the nation's premier database on trends
in enrollments and graduations, student and faculty demographics,
and faculty and deans' salaries. Complete survey results are
compiled in three separate reports, which will be available
in February 2003:
-
2002-2003
Enrollment and Graduations in Baccalaureate and Graduate
Programs in Nursing
-
2002-2003
Salaries of Instructional and Administrative Nursing Faculty
in Baccalaureate and Graduate Programs in Nursing
-
2002-2003
Salaries of Deans in Baccalaureate and Graduate Programs
in Nursing
Editor’s Note: News media may obtain selected
tables from these data reports by contacting Robert Rosseter
at (202) 463-6930, extension 231.
The American Association
of Colleges of Nursing is the national voice for university
and four-year-college education programs in nursing. Representing
more than 580 member schools of nursing at public and private
institutions nationwide, AACN's educational, research, governmental
advocacy, data collection, publications, and other programs
work to establish quality standards for bachelor's- and graduate-degree
nursing education, assist deans and directors to implement
those standards, influence the nursing profession to improve
health care, and promote public support of baccalaureate and
graduate nursing education, research, and practice.
#
# #
Enrollment
Success Stories and Challenges to Future Growth
"We
realized that we needed to take dramatic steps since our clinical
partners and the citizens of Oregon were in desperate need
of nurses," said Terry Misener, PhD, RN, dean of the
University of Portland School
of Nursing. "In response, we admitted an additional 50
students at the junior level this year and rallied support
from local chief nurse executives to provide facilities for
clinical rotations needed to educate these new recruits."
At
schools around the country, education-community partnerships
have been key to expansion efforts. "The increase in
nursing program enrollments at San Diego State University
is the direct result of partnerships with ten health care
agencies and two foundations," said Patricia Wahl, PhD,
RN, dean of the School of Nursing. "Altogether our partners
have committed a little over $4 million to this project which
is truly a win-win situation for the school and the community
we serve." This financial and clinical support has enabled
the university to grow its nursing program by 94 students
this year.
"Clinical
partnerships have played a key role in the school’s success,"
said Carol Winters-Moorehead, PhD, RN, dean of nursing at
Hawaii Pacific University. "We actively secured
student clinical placements with over 55 health care agencies
on the island of Oahu, and are always looking for new partnership
opportunities." The school’s ability to increase
enrollments by 60 students was also facilitated by the construction
of a new nursing skills laboratory and the addition of professional
nursing academic advisors and personal counselors.
At
many institutions, enrollment growth is a factor of how well
schools have been able to bridge the faculty shortage gap.
A new "loaned faculty program" involving a consortium
of area hospitals was key to Texas Woman’s University
(TWU) increasing their baccalaureate student population from
596 to 699 students. In an organized effort supported by the
Greater Houston Partnership and the Gulf Coast Workforce Commission,
hospitals in the Houston/Galveston area provided qualified
staff to teach clinical sections of undergraduate courses
for all nursing programs in the region. "This fall we
had 16 hospital employees, fully paid by the hospital, assigned
to teach with us which enabled TWU to enroll more students,"
said Carolyn Gunning, PhD, RN, dean of the College of Nursing.
"This represents a huge financial investment by hospitals
and has contributed significantly to the increased enrollment."
"There
is a noticeable greying of the professoriate in nursing and
few entries in recent years," noted Bernadette Curry,
PhD, RN, chair of the Department of Nursing at Molloy College
in New York. "To that end, Molloy is focusing on the
nurse educator track in our graduate program to prepare nurses
with an educational foundation and encourage them to take
vital roles in nursing education." Molloy College realized
a 24 percent jump in baccalaureate enrollments this fall.
State
and federal funding support has enabled many schools to add
faculty and improve the infrastructure needed to educate the
future nursing workforce. Last year, the Texas legislature
devised a mechanism to provide additional formula funding
to schools that demonstrate an increase in nursing enrollment.
"Texas Woman’s University received $517,000 last
year from this fund and were able to add six new faculty positions
and nursing admissions coordinators in Dallas and in Houston,"
explained Dr. Gunning.
"A
multifaceted strategy engaging policymakers, business and
community leaders, and healthcare providers is essential to
building the momentum for change," said Betty Rambur,
DNSc, RN, dean of the School of Nursing at the University
of Vermont. This year, the school saw a 74 percent increase
in applications this fall and a 31 percent increase in enrollments.
Vermont’s success was facilitated by state-sponsored
loan repayment and loan forgiveness programs and scholarship
funding provided by the Stowe-based Freeman Foundation.
"Our active participation on statewide commissions formed
to address the nursing shortage has given us an opportunity
to have valuable input into solutions that address both student
and faculty shortages," explained Donnie Booth, PhD,
RN, dean of College of Nursing at Southeastern Louisiana
University. This institution was able to add 146 new students
in fall 2002 boosting the enrollment level to 1,317 students.
Reaching
out to new audiences and building collaborations are also
factors in effectively increasing enrollments. At College
Misericordia in Pennsylvania, administrators have focused
their efforts on reaching out to nontraditional students by
offering a part-time, accelerated and evening programs. "The
school is extremely sensitive to the specific needs of non-traditional
adult students, and we have designed programs to provide this
special population with the same quality in nursing education
afforded to our traditional full-time students," said
Donna Snelson, MSN, RN, chair of the nursing department.
At
the Newark campus of Rutgers, The State University of New
Jersey, the nursing school was able to enroll an additional
114 nursing students this fall due largely to well coordinated
outreach efforts. "The College of Nursing and the University's
Admissions Office have improved communication and awareness
of the nursing programs through collaborative initiatives"
said dean Felissa R. Lashley, PhD, RN. "We now effectively
reach out to high schools, associate degree programs, health
care agencies, and diploma nursing programs in an effort to
grow enrollments."
Though
baccalaureate enrollments have increased this year, schools
are faced with a number of barriers to further expansion,
chief among them being the shortage of faculty. "The
major obstacle to expanding further is faculty," said
Dr. Gunning. "We do not have enough faculty positions
to accommodate future growth, and we cannot find enough faculty
to accept positions for the salary we pay." This fall,
TWU turned away about 75 qualified applicants, and administrators
expect more students will be turned away this spring.
"In
spite of accepting additional students into the clinical component
this fall, we were still unable to admit 40 eligible applicants,"added
Dr. Booth from Southeastern Louisiana University. "The
major barriers to future enrollment increases are the lack
of qualified faculty and the growing competition for clinical
space."
Though
many nursing schools are at capacity, some regions of the
country are still struggling to find qualified applicants.
"Though the University of Portland experienced a 24%
increase in nursing enrollments this year, some seats went
unfilled," said Dr. Misener. "There is a myth out
there that all nursing programs have waiting lists, but this
is simply not true."
CONTACT: Robert Rosseter
(202) 463-6930, x231
rrosseter@aacn.nche.edu
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