In the world of nursing, consistent rates of students graduating from nursing programs, becoming licensed, and successfully entering the workforce are critical to the long-term viability of the nursing profession and the healthcare system itself. As the true lifeblood of healthcare delivery, nurses are central to patient care, from long-term and public health to acute care and home health. In that regard, nursing education is a pipeline to the future.nursing-education-pipeline-to-the-future

Nursing School Capacity

In May 2023, the American Association of Colleges of Nursing (AACN) released data showing that student enrollment in entry-level baccalaureate nursing programs

decreased by 1.4% in 2022, the first decrease in 20 years. Overall, 844 colleges and universities offer a BSN education, and many turned away thousands of qualified candidates due to a lack of clinical training sites and faculty. In 2022, 66,261 candidates were rejected, and in 2021 applications by 76,140 candidates were turned down.

Alongside these disappointing numbers in the entry-level BSN category, the AACN identified other factors: 

  • Enrollment in RN to BSN bridge programs has been declining over the last 4 years.
  • Masters programs have seen a 9.4% decrease since 2021.
  • Nursing PhD program enrollment shrank 4.1% from 2021 to 2022.
  • DNP program enrollment is at a virtual standstill.

When it comes to nursing school capacity, theres plenty of evidence that something isnt right. This statement from an October 2021 article by National Public Radio says a great deal about one major hurdle: One of the biggest bottlenecks in the system is long-standing: There are not enough people who teach nursing. Educators in the field must have advanced degrees yet typically earn about half that of a nurse working the hospital floor.”  

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Beckers Hospital Review reported in August 2023 that the California Hospital Association and the Service Employees International Union (SEIU) have teamed up to introduce a bill that would hold community colleges accountable for reserving 15% of enrollment slots for healthcare workers looking to advance their education and move into higher-paying career tracks like nursing. Whether this bill can make it through Congress and become law is unknown.

The U.S. Department of Labor has issued $78 million in grants to expand nursing school enrollment in 17 states. The state of Maryland has awarded its nursing program grants to boost schools and address the long-standing and worrisome nursing shortage. New Mexico is also expanding its nursing school capacity through support for increased enrollment.

Meanwhile, schools like the University of Florida and the University of Hawaii are addressing capacity in their unique ways.

Generating Interest in the Profession

While legislation, grants, and expanding nursing school capacity are all valuable strategies to increase the nursing workforce, we can also keep more grassroots efforts in our sights.

In families from many different backgrounds, a multigenerational tradition of service in the nursing profession is often the norm. Aunts, mothers, fathers, siblings, and others can profoundly influence younger generations career choices. When the value of being a nurse is communicated from generation to generation, a familial line of nurses can extend over many decades as additional family members join the profession.

As nurses, speaking proudly of the profession and our work can generate interest in those considering their options. While twenty-first-century nursing and healthcare have enormous challenges, we can also tell the story of how nursing provides endless opportunities and flexibility. Of course, there is the potential to travel and see other parts of the country and see ones education through to a terminal degree such as a PhD or DNP.

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In communicating about the possibilities to be found in nursing, we can point out that, contrary to what the public and the media might think, not all nurses work in the hospital. There are expanding opportunities in the pharmaceutical, biotech, and medical device industries; public health; informatics; nurse entrepreneurship; medical writing; legal nurse consulting; nurse coaching; research; and many other fascinating areas. In the interest of our professions growth, we paint an expansive picture for those who think of nursing as solely hospital based.

Pipeline to the Future

Whether a new graduate nurse eventually becomes an operating room nurse, a biotech research nurse, or a self-employed legal nurse consultant, the nursing school remains the pipeline through which that individual must pass to realize their dream. No matter how one persons professional journey unfolds, it all begins with admission to an accredited nursing program, successfully graduating and passing the NCLEX®, and then receiving a license to practice. The nursing school is the funnel for future nurses of every stripe and interest.

When nursing school capacity is hobbled, our profession and society suffer. Decreased graduation rates translate to a shrinking nursing workforce, staffing shortages, nurses working under stress, and the potential for compromised patient safety and outcomes. Burned-out nurses are more likely to leave the profession and less likely to encourage younger generations to pursue the same career path.

Addressing decreased nursing school capacity is paramount, and we can use our collective genius to find solutions, whether through grants, legislation, and public relations or the direct recruitment of faculty through the offer of increased salaries and improved work conditions.

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We must use every available means to secure the flow of fresh talent through the pipeline to the future. Our society and the lives of those within it depend on the quality and quantity of the nursing workforce, and its our responsibility to see that the pipeline remains filled with the talented nurses of tomorrow.

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Keith Carlson
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