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Enrollment Increases at U.S. Nursing Schools Are Moderating While Thousands of Qualified Students Are Turned Away

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For Immediate Release

Enrollment Increases at U.S. Nursing Schools Are Moderating While Thousands of Qualified Students Are Turned Away
 
More than 25,000 Applications Denied Due to Faculty and Resource Constraints

Read Enrollment Success Stories and Challenges to Future Growth

WASHINGTON, D.C., December 15, 2004 - The American Association of Colleges of Nursing (AACN) announced today that enrollment in entry-level baccalaureate programs in nursing increased by 10.6 percent in 2004 over the previous year. Though this increase is welcome, nursing colleges and universities denied 26,340 qualified applications this year due primarily to a shortage of nurse educators. With the government projecting a shortfall of 800,000 nurses by the year 2020, AACN is concerned that too few nurses are entering the workforce given the growing demand for nursing care.

"Nursing schools nationwide are struggling to expand student capacity in response to the nursing shortage, and their success is showing," said AACN President Jean E. Bartels. "Though we are pleased to see an enrollment increase, we are still very concerned that access to quality healthcare may be compromised since nursing schools are not graduating enough nurses educated at the baccalaureate and graduate levels to stabilize the workforce."

AACN's preliminary survey data is based on the same 459 schools reporting in both 2003 and 2004. This year's 10.6 percent enrollment increase means that 10,596 new students are now enrolled in entry-level baccalaureate nursing programs. Based on data supplied by 498 schools, a total of 112,081 students are enrolled in these nursing programs. This is the fourth consecutive year of enrollment increases with 16.6, 8.1, and 3.7 percent increases in 2003, 2002, and 2001, respectively. Prior to the recent upswing, baccalaureate nursing programs experienced a six-year period of declining enrollments from 1995 through 2000. See graph of enrollment changes from 1994 to 2004.

The more moderate enrollment increase this year indicates that some nursing institutions have reached the limit on how far they can expand without jeopardizing quality. Even though enrollments are up nationally, almost 20 percent of nursing schools experienced enrollment declines or no growth in 2004. AACN is concerned that a portion of the reported enrollment growth may reflect only students' intention to pursue a nursing degree, rather than an actual increase in the number of students admitted into the nursing major. Many freshmen and sophomore students included among those currently enrolled will face competition for upper level nursing courses and may switch majors as a last resort. "Nursing cannot afford to lose bright college students to other professions given the growing nursing shortage and the need to expand the pool of future nursing faculty," added Dr. Bartels.

The AACN survey also found that graduations from entry-level baccalaureate nursing programs were up sharply in 2004 with a 14 percent increase over 2003. This increase translates into 27,378 new graduates available for practice in the nursing workforce. The recent rise in graduations follows 4.3 and 3.2 percent increases in 2003 and 2002, respectively. This upward trend was preceded by a six-year period of graduation declines from 1996 through 2001.

AACN's latest data confirm that interest in nursing careers continues to grow, which is good news considering the projected demand for nursing care. For the first time, the U.S. Department of Labor has identified Registered Nursing as the top occupation in terms of job growth through the year 2012. According to the latest projections, more than one million new and replacement nurses will be needed by 2012. The growing interest in nursing careers can be attributed in part to outreach efforts by nursing schools as well as sustained image campaigns launched by Johnson & Johnson and the Nurses for a Healthier Tomorrow coalition.

Expanding the Nursing Student Population

Nursing colleges and universities employed a number of successful strategies to increase student capacity last year, including forming alliances with practice partners to identify expert nurses who could serve as faculty and working collaboratively to overcome classroom and clinical space constraints. Some schools have expanded their accelerated nursing programs for second-degree seeking students looking to transition into nursing while others have taken advantage of state and federal funding aimed at strengthening the nursing workforce.

Despite this year's enrollment increase, AACN's preliminary findings show that 26,340 qualified applications to entry-level baccalaureate programs were not accepted in 2004 based on responses from 377 schools. The primary barriers to accepting all qualified students at nursing colleges and universities continue to be insufficient faculty, clinical placement sites, and classroom space.

To address these issues, AACN has focused its advocacy efforts on increasing funding for existing Nursing Workforce Development programs administered by the federal Division of Nursing and shaping new legislation to support faculty development and enrollment growth. Earlier this year, AACN worked with Representatives Nita Lowey (D-NY) and Lois Capps (D-CA) to introduce the Nurse Education, Expansion, and Development Act of 2004 (H.R. 5234). This legislation would authorize capitation or formula grants for nursing programs to hire and support faculty, purchase new equipment, and build learning labs to expand infrastructure. AACN is working to reintroduce this legislation next year when the 109th Congress is installed.

"One of the most effective ways to accommodate all qualified applicants in nursing programs is to ensure continuous funding at the local, state and federal levels," said AACN Executive Director Geraldine "Polly" Bednash. "AACN has heard many reports about promised funding never materializing which devastates efforts to increase student capacity. We are working to ensure that more qualified students have the opportunity to achieve their goal of becoming professional nurses."

About the AACN Survey

Now in its 24th year, AACN's Annual Survey of Institutions with Baccalaureate and Higher Degree Nursing Programs is conducted each year by the association's Data and 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.

The annual AACN survey is a collaborative effort with data on nurse practitioner programs collected jointly with the National Organization of Nurse Practitioner Faculties and data on clinical nurse specialist programs collected with the National Association of Clinical Nurse Specialists. Complete survey results are compiled in three separate reports, which will be available in February 2005:

  • 2004-2005 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing
  • 2004-2005 Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs in Nursing
  • 2004-2005 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 rrosseter@aacn.nche.edu or 202-463-6930, extension 231. Requests for regional data and local enrollment success stories are also welcome.

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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 575 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

Below are snapshots of how some four-year colleges and universities are addressing the strong surge of interest in nursing careers. Academic leaders also address some of the opportunities and challenges confronting schools trying to expand student capacity.

At Vanderbilt University, collaboration has been the key to impressive enrollment growth in entry-level nursing programs. Last year, Vanderbilt partnered with two liberal arts schools in Nashville, Fisk University and Lipscomb University, to launch new Bachelor of Science in Nursing degree programs. “These arrangement between an Academic Health Center and liberal arts schools are unique and serves as a new model for national collaboration,” said Dr. Colleen Conway-Welch, dean of the School of Nursing.

The School of Nursing at Oregon Health and Science University (OHSU) was able to expand its enrollment due to a shared vision within the university that nursing education is extremely important to health of the State of Oregon. "Without additional federal or state funding, the OHSU leadership and Board committed to take a one-time additional cohort of undergraduate students to ease the local shortage of nurses," said Dr. Kathleen Potempa, dean of the OHSU School of Nursing. "While we still turn many qualified students away, OHSU and its School of Nursing are deeply committed to the critical role nurses play in health care."

Dr. Silvana Richardson, dean of the School of Nursing at Viterbo University in La Crosse, Wisconsin, is "thrilled by the growing interest in nursing as a viable career. Our program has benefited from both national and local efforts to recruit people into the nursing profession." Enrollment growth at this institution is attributed to outreach to local high schools and middle schools, collaboration with a neighboring associate degree nursing program, and the creation of a summer camp for youth to promote interest in all of the health professions. Dr. Richardson added that "we would like to increase enrollment further based on the high demand but are limited by funding for and availability of qualified faculty as well as by the short supply of clinical education sites."

To accommodate the larger nursing student population at Pace University in New York, administrators used a variety of creative strategies, including hiring part-time faculty from affiliated agencies to teach students in clinical settings, reconfiguring the school's Learning Resource Center to add classroom space, and expanding the accelerated baccalaureate program to a second location in New York City. "Pace's accelerated program for adults with non-nursing degrees has proven to be an effective way to bring a diverse group of highly educated professionals into nursing," said dean Harriet Feldman. "We recently surveyed our new students to learn more about their backgrounds and found that 39.5 percent are male, 58.1 percent are from minority backgrounds, ages range from 23-49, and students were born in 18 different countries. Also, 14 students have master's degrees, one is a dentist, and one is a doctorally-prepared physical therapist. We are excited by the rich diversity these students bring to the nursing profession."

Dr. Feldman added that "the shortage of nurse educators, particularly those prepared at the doctoral level, continues to be a major barrier to program expansion. A second barrier relates to space at the university, and we are actively seeking additional space to meet our growing needs. We have outgrown the space for computerized testing as well as clinical practice."

Launching a new accelerated baccalaureate program and doubling the size of an existing fast-track master's degree program for non-nursing college graduates helped boost enrollments at the University of Miami in 2004. "Our greatest need right now is for state subsidies to fund scholarships for our nursing students," said Dr. Nilda Peragallo, dean of School of Nursing. "States need to step up and provide more financial aid to nursing students attending private institutions, especially when public institutions are rejecting qualified applicants due to a lack of resources."

The impressive enrollment increase at Arizona State University (ASU) is attributed to the school's plan to grow its baccalaureate nursing program on three regional campuses and in partnership with the Mayo Clinic as well as the move to shorten degree completion times by switching to a year-round format. "The college designed an expansion plan that would capitalize on our locations and geographically distribute baccalaureate program graduates throughout the state," said Dr. Karen Sousa, interim dean at ASU's College of Nursing. "We addressed the time to complete the four-semester nursing major by utilizing the calendar year and creating a summer semester to enable students to complete their studies in 16 months rather than 24 months." When asked about future growth, Dr. Sousa explained that the high demand for clinical placements from all nursing programs "is limiting access to these learning centers and presents a barrier."

Institutions that have increased the nursing student population face new challenges to further expansion. At Johns Hopkins University in Baltimore, the nursing school's physical limitations present the largest obstacle to addressing the nursing shortage. "Among the serious barriers we face are the very walls of our building," said dean Martha N. Hill. "We need space … space for more students, space for more faculty, space for more programs and space for staff to support our faculty and programs. Our campaign to expand our building is underway, but in the meantime, we are doubling up in both classrooms and offices."

In Texas, Dramatic Growth Funds were designated in the Nursing Shortage Reduction Act of 2001 to support increased enrollments in community colleges, general academic universities, and health science center schools of nursing. On average, health science centers in the state showed the largest increase in enrollments with a 27 percent increase, while community colleges and academic campuses increased enrollments by about 23 and 7 percent, respectively.

“We increased enrollments by almost a third from 200 to about 300 undergraduate student admissions a year,” said Dr. Robin D. Froman, dean of the University of Texas Health Science Center at San Antonio School of Nursing. “Unfortunately, we only received 30 percent of the funding anticipated from the Nursing Shortage Reduction Act while the community colleges and academic campuses received 100 percent of the expected funding. Though we demonstrated the ability to increase capacity, we cannot, sustain increased enrollments without the financial resources to hire faculty for adequate instructional support for students.”

The nursing program at the University of Florida turns away 3 or more students for every space available in the school's upper division baccalaureate courses. Given this internal competition, many freshmen and sophomore students are now changing majors in an effort to complete a degree program in four years. "Many bright new college students are not even trying to get into nursing because they have heard that admission into the upper division courses is so competitive," said Dr. Kathleen Ann Long, dean of the University of Florida's College of Nursing. "Without more faculty and clinical placement sites, nursing schools will not be able to graduate enough students to sustain a strong nursing workforce."