Though enrollments rise at U.S. nursing colleges and universities, increase is insufficient to meet the demand for new nurses: Labor department projects the need for 1 million new and replacement nurses by 2010

Nevada RNformation, Feb 2003

According to the results of the annual survey released today by the American Association of Colleges of Nursing (AACN), enrollments in entry-level baccalaureate programs in nursing increased by 8 percent in fall 2002 over last year. This increase comes at a time when the need for nurses with baccalaureate and graduate degrees is expanding in the U.S. health care system. Though this increase signals a shift in enrollment trends, the number of students in the educational pipeline is still insufficient to meet the projected demand for a million new nurses over the next 10 years.

AACN findings are based on responses from a total of 578 (84.8 percent) of the nation's nursing schools with baccalaureate- and graduate-degree programs that were surveyed in fall 2002. The survey found that total enrollment in all nursing programs leading to the baccalaureate degree was 116,099, up from 106,557 in 2001. By comparison, the total enrollment in 1995, the year enrollments began to dip, was 127,683 for all baccalaureate nursing programs.

Enrollment trends are determined by comparing data from the same schools reporting in both 2001 and 2002. Data show that nursing school enrollments are up in all regions of the United States with the greatest increase realized in the North Atlantic states where enrollments in entry-level baccalaureate programs rose by 10.7 percent. Looking at enrollment levels in other regions, schools in the South were up by 6.7 percent, and schools in the Midwest and West were up by 8.0 percent.

"Schools across the country have done an excellent job in responding to the nursing shortage and getting the word out about career opportunities in the nursing," said AACN President Kathleen Ann Long, PhD, RNCS, FAAN. "We are encouraged by the upswing in enrollments, but understand that we have a long way to go before we come close to meeting the projected demand for nurses into the foreseeable future."

Though enrollments are up at the majority of nursing schools, slightly more than 30 percent of schools with baccalaureate or higher degrees in nursing reported no change or declines in enrollments this year resulting in unfilled seats. Almost 40 percent of schools with increased enrollments attracted only 20 or fewer new students this year.

Though entry-level baccalaureate programs saw increases this year, programs that enable registered nurses (RN) prepared with a diploma or associate's degree to earn a bachelor's degree and enhance their skills continue to register declining enrollments. From 2001 to 2002, enrollments in RN-to-baccalaureate programs declined 2.1 percent, continuing the downward trend that began in 1999. The survey also found that enrollments in master's degree programs in nursing rose 3.5 percent with a total population of 33,976 students now enrolled in programs nationwide.

Enrollments Rise Despite Many Challenges

Nursing schools across the country are struggling to find creative ways to expand student capacity despite many obstacles. A shortage of nursing faculty, funding cuts, inadequate facilities, competition for students, and a lack of clinical placement opportunities are hampering efforts to attract and retain more students. To overcome these challenges, schools are forming partnerships with clinical agencies to support mutual needs, lobbying for continued state and federal monies, retooling marketing strategies, and stepping up efforts to expand diversity and recruit new populations into nursing.

To strengthen these efforts, some states including Texas, Pennsylvania, and Florida have passed new legislation to provide more funding for nursing schools to expand their programs and accommodate more students. Faculty shortages are being addressed to a limited degree through partnerships between schools and health care facilities that allow their personnel to serve as teachers and provide clinical support. Schools are also reaching out to career changers and those impacted by the economic downturn with accelerated baccalaureate programs that offer the fastest route to becoming a registered nurse for those already holding a degree in another field. (See the Enrollment Success Stories and Challenges to Future Growth section below.)

Student Enrollments and the Nursing Shortage

"Though enrollments are moving in the right direction, we are far from satisfying the demand for nursing care in this country," explained AACN's Executive Director Geraldine "Polly" Bednash, PhD, RN, FAAN. "The shortage is having a devastating effect right now on our health care system's ability to provide safe patient care, and much more must be done to dramatically expand student capacity at our nation's nursing colleges and universities." The most recent projections from the U.S. Bureau of Labor Statistics indicate that one million new and replacement nurses will be needed by the year 2010.

In 2002, many national reports attempted to quantify the nursing shortage and explain the. threat this problem poses to health care delivery. According to a report released by the Health Resources and Services Administration within the U.S. Department of Health and Human Services in July 2002, the number of states with a shortage of registered nurses is expected to grow from 30 states in 2000 to 44 states in 2002. Surveys and studies published this year in the New England Journal of Medicine, Journal of the American Medical Association, and by the Joint Commission of Accreditation of Healthcare Organizations all confirm that the shortage of registered nurses is impacting the delivery of health care in the U.S and negatively affecting patient outcomes. The shortage is expected to intensify over the next decade as baby boomers age and a large percentage of the current nursing workforce retires.