​Nurses are a critical part of health care and make up a large section of the health profession, including the senior living sector. According to the World Health Statistics Report, there are approximately 3.9 million nurses in the U.S. and it is estimated that 1.2 million additional nurses will be needed by 2020. According to the American Nurses Association (ANA), a national organization representing 4 million nurses in all 50 states and U.S. territories, there will be more registered nurse (RN) jobs available through 2022 than any other profession in this country. 

However, many of those positions will remain vacant. It’s no secret that the U.S. is facing a serious nursing shortage. Many senior living communities are already experiencing it in the form of fierce competition when communities adding nursing staff. Such competition is especially present with during vacancies of nurse leader positions.

Turning Away Nursing Students

According to the American Association Colleges of Nursing Report on 2018-2019 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs in 2018. Going back a decade, nursing schools have annually rejected around 30,000 applicants who met admissions requirements.  

Why is this happening? While there is a large and growing number of nursing students, there is a lack of instructors to educate them. In order to teach nursing, one must first become at a minimum a registered nurse (RN) with several years of work experience. Most nurse educators complete a Master's degree in nursing education, although a doctorate is required to teach at many universities. These requirements, plus the fact that a nurse practitioner can earn $97,000 compared to an average salary of $78,575 for a nursing school assistant professor, according to the American Association of Nurse Practitioners, add to the nursing shortage.

Dropouts and More

Other factors contribute to the nurse shortage. Nursing school is rigorous considering the coursework, reading for homework, and clinical work. For some, it is more challenging than expected, especially when it comes to the clinical work. It is one thing to study course materials and another when having to interact and provide hands-on care for patients. The reality of what nursing entails can dismay some students, causing them to dropout. 

Another factor has to do with the demographics of the current workforce. The nursing workforce is aging just like the population they serve. Currently, the U.S. has the highest number of Americans over the age of 65 than any other time in history. Baby boomers are retiring to the tune of 10,000 per day, and this number includes nurses. 

As the population ages, the need for health services increases. Today, the older population is living longer and consequently, requires more health care and nursing services. Nurses are stretched to the max since the supply of nurses no longer meets the demand.

Nurses can experience burnout. Burnout is categorized as physical, mental and emotional exhaustion, according to National Nurses United. Disengagement often follows. Burnout can also lead to dulled emotions and detachment, which can negatively affect patients. What is causing burnout? Long shifts, overextension due to the nursing shortage, high-stress environments, and coping with illness and death are some factors.

Legislatures Taking Action

Recently, the author had an opportunity to speak with a professor at a nursing school who has 25 years of nursing experience in a clinical environment, five years of experience as a nurse educator in a clinical environment, and five years of experience as an educator in an academic environment. This professor stated that there is a push in many states for legislatures to address the nursing shortage immediately. In one state in particular, Arizona, recently passed two bills in this category, S1524 and S1354.

Bill S1524 calls for a working group to problem solve the nursing shortage. The bills seeks to bring together representatives via from all universities and colleges with a nursing program, members of healthcare organizations, and the Department of Health Services in order to establish a long-term plan and pilot program to address the nursing shortage. 

Bill 1354 provides $10 million to the Arizona Department of Health Services to create a grant program for assistance to universities and community colleges for registered nursing and advanced practice nursing programs. The bill also calls for assistance to health care institutions to develop and operate programs using retired physicians and nurses to provide guidance to new graduates of medical and nursing programs.

Recommendations for Schools

How can schools attract the best nursing instructors? According to the professor, some suggestions mentioned were attracting more nursing instructors with a salary comparable to that of a nurse in a clinical setting, attracting new educators by paying for their advanced education degree required, and adding more simulated clinical experiences since booking real hospital settings has become very competitive. In a typical hospital setting, there could four or five schools coming in on one day to perform clinicals, and the space is at a premium. 

However, expanding class size is not the answer. “When class sizes increase, we can’t give each nursing student the individual attention they need to be the best at their profession which is ultimately, providing top notch patient care,” says the professor. 

The Case of Florida

While the nursing shortage is being felt across the U.S., some states are hurting more than others. Florida anticipates that there will be nearly 114,000 openings for registered nurses from 2018 through 2023. The Florida Department of Economic Opportunity lists nearly 3900 of those openings within Manatee and Sarasota counties alone. 

The nursing crisis was brought to the attention of Florida policymakers. In Feb. 2019, technical schools lobbied Florida state legislators to allow Florida technical schools and centers to provide transition programs. Students who complete the licensed nursing program would be able to continue their education. The move would create more opportunities for students to take the state exam and become registered nurses. As a result of their lobbying, Florida House Bill 381​ was introduced and filed.

Unfortunately, the bill did not make it out of its respective committees and will not pass this year to become law. Even though the bill did not advance in 2019, it may resurface in 2020.

Julie Rupenski is the Founder, President & CEO of MedBest. She has gained national recognition for providing top talent solutions exclusively for the senior living industry. Julie is a seasoned recruiter at filling c-suite, vice president, regional, and property level positions. She has an in-depth knowledge of the senior living industry since she previously worked in operations for both senior housing and senior living. Julie earned her degree in Gerontology at the University of South Florida, Tampa, Fla. She can be reached at jrupenski@medbest.com or 727-526-1294.