At a time when many Americans are in desperate need of a job, the field of nursing will soon be in desperate need of Americans.
The economic downturn of the past few years has temporarily eased the nation's shortage of nurses, but university nursing schools say they are struggling to keep up with what is expected to be soaring demand and chronic shortfalls in years to come.
Employment services routinely list nursing as one of the hot hiring professions of the next decade, but supply never seems to catch up with demand - even as the national unemployment rate tops 9 percent.
The need for more nurses in the coming years stems mainly from an aging baby boomer population as well as a generation of aging nurses who will retire. Although the nursing shortage of the early 21st century has been helped temporarily by the economy, many are predicting a shortage in the next several years.
"I look at it like a double helix. When the economy is up, the nursing supply goes down. And when the economy tanks, the supply goes back up," said Karen Haller, vice president of nursing at Johns Hopkins Hospital. "What we're seeing right now is an aging of the workforce. Many nurses in their 50s are going to be retiring soon. ... There is a silver tsunami of retirements coming. You can't delay retirement forever."
Most labor shortages tend to be self-correcting - workers flock to jobs as wages rise.
The problem, however, is not a lack of Americans who want to be nurses. It's finding the schools that can teach them.
"There's definitely a lot of people interested in nursing," said Robert Rosseter, spokesman for the American Association of Colleges of Nursing.
"The number of students who met all the requirements but weren't admitted was over 67,000 students last year [in U.S. nursing programs]," he said. "People do want in, but there just aren't enough seats."
The No. 1 reason why qualified students are turned away from nursing programs: a lack of faculty.
While the number of applicants to undergraduate nursing programs is climbing, the number of students accepted remains low. At the University of Minnesota at Twin Cities, 64 of 324 total applicants were admitted in 2011. The numbers are also low at the University of Washington at Seattle, which admitted 95 out of 455 total applicants, and the University of Pittsburgh, which admitted 120 students out of 1,050 total applicants in 2010. All three schools have highly ranked nursing programs.
Ethan Nowaczyk, a student from UM-Twin Cities, said he feels he was wrongly denied admission into the nursing program last spring.
"This is the thing I want to do. I want to help people. I feel like I'm definitely qualified but I wasn't accepted, and that's a lot of people's problem," Mr. Nowaczyk said. "I have good grades. But the school only has so many spots. It's just frustrating that they have a shortage, but I want to do this and I can't."
Kristen Swanson, dean of the School of Nursing at the University of North Carolina at Chapel Hill, said a lack of funding is to blame. UNC reduced its undergraduate program by 25 percent this year because of cuts in state funding.
Ms. Swanson said the resulting faculty layoffs meant that the school simply was unable to accept more applicants.
"The bottom line is, it's not like we could get by with less faculty teaching the same number of students. We still always have to have [a certain] ratio in the clinical settings. We can have a large number of students in the big lectures, but that's only a portion of nursing education. And that's where I have clinical faculty that I've had to let go in order to sustain my budget, and once I let them go I have to reduce my number of students," Ms. Swanson said.
"I felt I could decrease the quantity of students, but I would not compromise the quality of our education program," Ms. Swanson added. UNC-Chapel Hill's nursing program accepted 258 out of 551 "qualified" applicants in 2011.
Joanne Spetz, an associate professor at the University of California at San Francisco and a specialist in health economics, said she feared that the lull in the nursing shortage could produce a false sense of security among policymakers and legislators.
"My worry is that because of our current economic conditions, the legislature will say, 'Oh, we're done with the shortage and we're going to pull all this money back out of nursing programs.' Then we've lost all our progress."
She added, "If we don't take our eyes off the ball, then the shortage may not resume with the kind of ferocity that it had before. But if we do allow the current economic situation to influence our decisions, then we're going to be in a position where the shortage will come back really strong."
UNC's Ms. Swanson stressed the importance of funding more nurses to go for higher education and giving nursing school faculty members competitive wages. She also said raising wages would not be helpful in this situation because nurses already get paid a "decent amount."
"Nurses already get paid an amount that reflects the important work they do, and getting people to want to be nurses is not the problem. Plenty of people still want to be nurses," Ms. Swanson said.
Ms. Haller of Johns Hopkins said the shortage will have disastrous effects without more trained nurses.
"When we don't have enough nurses, we close beds. There's less access to health care for the public. We can't put a patient in a hospital bed if we don't have the nurses to take care of him," Ms. Haller said. "[That will] not be a good situation for the public to be in."
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