Doctoring up the nursing profession: several factors are contributing to the national nursing shortage, but initiatives, perceptions and college programs can nurture industry's growth

Black Issues in Higher Education, Nov 18, 2004 by Crystal L. Keels

For all the baby boomers who've embraced and adopted healthier lifestyles, including proper diet and exercise, there may be an even more compelling reason. If you get sick or become hospitalized, you may not have the critically needed services of a well-trained nurse.

It's been widely reported that there is a nursing shortage in the United States, and it is expected to grow worse as the population increases and ages and new medical procedures are developed. Hospitals, nursing homes, adult-care facilities and home-care services will suffer increasingly, industry experts say, as the current trend seems likely to continue.

The U.S. Department of Health and Human Services (DHHS) projects a 29 percent shortage in registered nurses by 2020, compared to 2002, when the shortage was measured at 6 percent. The American Association of Colleges of Nursing (AACN) predicts that by 2020, 44 states and the District of Columbia will be affected by the dearth of registered nurses. And Trendwatch, a publication of the American Hospital Association, reported in 2001 that nursing career opportunities comprised 75 percent of national hospital vacancies.

But does the nationwide nursing shortage reflect what's going on in colleges of nursing across the country? And how is the higher education community responding to this challenge?

RECRUITMENT AND RETENTION

According to reports issued by organizations including the U.S. Department of Health and Human Services, the American Association of Colleges of Nursing and the Health Resources and Services Administration, there are a number of factors such as lack of adequate funding, long hours and unfavorable working conditions contributing to the nursing shortage that arguably threatens the quality of national health care.

There are several other well-documented reasons for the growing scarcity. In spite of recent increases in the number of nursing students matriculating at the undergraduate level, enrollments fall short of both the current and the projected gap in the number of available caregivers. Additionally, many practicing nurses are now reaching retirement age.

"(A previous) decline in enrollment has resulted in a decline in the educational pipeline," says Lisa Fuller, program coordinator/advisor at the Wayne State University College of Nursing in Detroit.

To complicate matters even further, there are fewer people to educate would-be nurses, especially as nurse educators also move closer to retirement. In addition, nurses with Ph.D.s, who are qualified to teach, are difficult to find. As a result, qualified nursing school applicants are often turned away, and for those who make it through a bachelor of science in nursing (BSN) program, teaching in the academy may not necessarily be the goal.

"A lot of nurses are not interested in teaching," says Dr. Rosie Calvin, professor of nursing, principal investigator and director of the Jackson Heart TRAIN (Training for Research Awareness in Nursing) program in the School of Nursing at the University of Mississippi Medical Center in Jackson. "They can make more money doing things other than teaching. Not many are interested, or feel they can do it."

"It," in this case, is the pursuit of the doctoral degree that is required for nurse educators at the postsecondary level.

"You have to be in the market before you are in the market," says Dr. Clinton Bristow Jr., president of Alcorn State University in Mississippi, about recruiting doctorally prepared nurses. "You can't start looking in November for January. You've got to start a year or so in advance and do national searches," he explains.

Nursing schools are now taking deliberate steps to address the complexities of the nursing shortage with an array of initiatives designed to attract more students at both the undergraduate and graduate levels, particularly those from underrepresented groups.

Historically, African Americans, as part of the underrepresented population, were not flocking in great numbers to become nurses, says Dr. Cornelia P. Porter, dean and professor in the School of Nursing at Florida A&M University. Porter says looking at the issue from a social psychological framework, nursing was not a field that African Americans were encouraged to pursue because of the perception that the profession perpetuated the type of servitude into which Blacks--particularly Black women--had historically been forced. Even now, Porter points out, the percentage of African American nurses in the United States is small, accounting for 4.8 percent of all registered nurses, according to the March 2002 National Sample Survey of Registered Nurses. (Data from 2004 are currently under analysis.) Alcorn's Bristow offers similar sentiments about the history of African Americans in the nursing profession, but adds that contemporary notions of the nursing profession have shifted to the point that many African Americans--male and female--now perceive the profession as a means for upward mobility.

And many educational programs see this and other underrepresented segments of the population as important resources for the future of the nursing profession.