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Though Enrollments Rise at U.S. Nursing Colleges and Universities, Increase Is Insufficient to Meet the Demand for New Nurses

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Press Release
For Immediate Release

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.

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The American Association of Colleges of Nursing (AACN) 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. www.aacn.nche.edu.

CONTACT:

Robert Rosseter, 202-463-6930, ext. 231
rrosseter@aacn.nche.edu


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."