An exodus of nurses from the profession, a shortage of educators, and limitations in clinical placements are creating a pipeline shortage that won’t be ending anytime soon.

It’s the trifecta of factors – retirements, pandemic after-effects, and an aging population that needs more care – the main reasons why the backbone of America’s healthcare – nursing - is experiencing a critical shortage.

School of Nursing dean Ken White, who is also the President of the American Academy of Nursing, offered his expertise and insight to CBS News last week about possible approaches to helping stop the tide of fewer entrants and more exits in the nursing pipeline.

“We were expecting exits from baby boom nurses throughout this decade,” said White. “But what we’ve experienced since the pandemic is a greater rate of attrition of nurses who are newly deployed in nursing just one or two years into their nursing career.”

The numbers making up the crisis are startling. While the U.S. Bureau of Labor Statistics projects more than 275,000 additional nurses are needed by 2030, nursing schools turned away more than 90,000 qualified applications last year because they didn’t have enough educators or clinical placement sites, according to the American Association of Colleges of Nursing.

“We have a turnover problem,” said White, who is halfway through his two-year presidency of the Academy. “To add more nurses is only part of the equation; we need to make sure we learn more about how we can support nurses, value and respect their contributions, and make sure that they’re in a safe and supportive culture.”

White points to a changing mindset among today’s early career nurses as a factor; if they don’t feel respected and supported in their first year or two, they’ll leave. They may leave for another position that pays more or has more support to offer or worse, they may leave nursing altogether.

“They don’t have the same commitment that our baby boom nurses had to work in one place for their entire career. For them to leave, that only exacerbates the problem. So, we need to understand what nurses need to feel valued and respected in order to give the very best care for their patients.”

woman in scrubs examines a pregnant manikin
More than 90,000 qualified nursing applicants were turned away last year because nursing schools didn’t have enough educators or clinical placement sites; here IHP student Meghan Mundy learns maternity delivery in the simulation lab.

Possible Approaches

White says fixing the nursing shortage is a complicated issue, but there are a few things to be considered.

“One is financial incentives. Loan repayment. Loan remission, scholarships in return for work commitment once they graduate,” says White, who began as School of Nursing dean in July of 2021. “It’s difficult to give up employment for one or two years to go back to school to be a nurse and pay very high tuitions in many cases. I think we need to ease that financial burden.

“Another challenge we have is there are so many people who want to be nurses, but we just don’t have enough slots in school for them.”

Applicants are being turned away for two reasons: 1) there’s a shortage of nurse educators across the country and 2) nursing programs have difficulty in finding clinical instructors and experiential learning opportunities. If you can’t guarantee nursing students will learn in a hospital or community setting, there’s no sense in admitting them because they won’t receive the hands-on experience they need to graduate and provide patient care.

White says incentivizing nurse educators is a necessity, especially given that the salary nurses can earn working at the hospital jumped during the pandemic.

“Nursing educators can oftentimes make more money as a staff nurse than they can being a nurse educator. We need to right-size that to make sure our nurse educators are rewarded for the great work they do.”

Uncle Sam may be another solution. The Department of Labor recently announced an $80 million program aimed at schools and clinical partners attracting more diverse nursing students, and incentivizing hospitals to take on students in a clinical setting.

"The program’s $80 million is a great start but I do think we need much more than that,” said White. “We need policymakers and private funders to take a very close look at what needs to be done to fund or reimburse hospitals and health systems for nursing education.

“We need more nurses of color, we need more men in nursing, we need more people with disabilities in nursing. We need nurses taking care of our patients who looks like they do. It’s so important to establish trust in the patient-provider relationship.”

While the shortage won’t be eased overnight, White points to why he and others are committed to this profession.

“Yes, nursing is hard, but the rewards are great. To be able to touch the life of another human in a point of need or in a time of suffering is an amazing reward.”

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