The United States faces a chronic shortage of nurses, but there’s no shortage of people interested or qualified to get into the field. What’s going on?
A lack of space and faculty is hampering opportunity for these budding medical professionals and efforts are afoot to maintain the shortage by blocking new competition in nursing education.
According to the Bureau of Labor Statistics, a person can become a nurse by pursuing either a four-year Bachelor’s degree in nursing (BSN), a two-year associate’s degree in nursing (ADAN), or a three-year hospital-based diploma from an approved nursing program. Any of these degrees or certificates typically qualifies a person for an entry-level position. In 2010, however, the Institute for Medicine, a quasi-government organization that makes policy prescriptions, recommended that 80 percent of nurses hold a bachelor’s degree by 2020, a significant jump from the level of 50 percent at the time.
In order to reach those goals hospitals and healthcare providers have been scrambling to fill their ranks with nurses holding bachelors or pushing those on staff with associates degrees and certificates to upgrade their educations. The effort apparently is working as the number of BSN graduates is exceeding associate-degree holders, but it is causing headaches as well.
A national push for more nurses to carry bachelor’s degrees makes it increasingly difficult for those who have associates to get hired or to get ahead. The push for increased certification, says nothing about their actual ability to do the work of nursing. Furthermore, people from low-income communities and communities of color are hurt in a field that traditionally has been a good career path since it didn’t require the costs of a full college education.
Those who want bachelor’s degree have a problem because of the lack of faculty, classroom space, clinical sites, and budget constraints in baccalaureate and graduate programs at four-year institutions. Some 68,938 qualified people applied for a bachelor’s and graduate nursing program in 2014, according to the American Association of Colleges and Nurses.
Four-year colleges are the only institutions currently able to grant bachelor’s degrees but since they can’t manage the strain of rising student populations and teacher shortages, expanding bachelor’s programs at community colleges could be a solution.
Community colleges are local and could provide working students the flexibility to study part-time. Such a shift would present new competition to four-year colleges and some claim that new programs would place more pressure on demand for scarce nursing instructors.
A turf war is now being waged between four-year colleges on one side and community colleges on the other. On the sidelines, prospective nurses sit idly by waiting for an opportunity just to learn.
Sadly, this is an example of cronyism. Colleges can’t raise tuition by as much if there is competition. Community colleges may offer the same education at a lower cost to students and with greater flexibility than four-year schools provide. Competition would reduce the number of nursing applicants getting turned away and graduate more qualified healthcare professionals at a time when the aging Baby Boomer generation will place increasing demands on our healthcare system.
Legislative reform efforts at the state level face tough opposition, meanwhile. After most of the four-year California State University campuses challenged a bill to allow community colleges to offer some bachelor’s degrees, the final bill passed in 2014 allows them to offer some bachelor’s degrees in subjects like mortuary sciences, but not nursing.
North Carolina is feeling the effects of its nurse shortage, but even early discussions to study the feasibility of expanding baccalaureate degrees to community college have been put on ice.
Instead of protecting the interests of four year colleges, we need more and stronger efforts to expand opportunity.