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From Lack of Resources, Not Lack of Students, Cause Nurse Shortage

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Lack of Resources, Not Lack of Students, Cause Nurse Shortage

By Kottapurath Kunjumoideen MD

Lack of Resources, Not Lack of Students, Cause Nurse Shortage
A prominent Houston nursing educator long held the view that that America's nursing shortage cannot be blamed on people not wanting to become nurses, but rather on insufficient space and resources to train all those who want to become nurses. There is now more evidence to support this view from a survey conducted by American Association of Colleges of Nursing (AACN). Dearth of resources combined with ever-shrinking pool of people willing and able to turn down higher-paying nursing jobs to become educators, is the actual cause of the problem.

"Texas nursing schools turned away 4,200 qualified applicants last year because they lacked the faculty, equipment and space with which to educate them," said Patricia L. Starck, D.S.N., dean of The University of Texas School of Nursing at Houston. "Our school alone had to turn away 10 applicants for every one we accepted, because of limited resources.".

The preliminary data from recently release AACN survey shows that enrollment in entry-level baccalaureate nursing programs increased by 13 percent from 2004 to 2005. But this has to be taken in the context that nursing colleges and universities were forced to deny entry to 32,617 qualified applications in 2005, a dramatic increase from the 3,600 turned away in 2002.

The federal government is projecting a shortfall of one million registered nurses by the year 2012. According to research conducted at Vanderbilt University, enrollment in nursing programs would have to increase by at least 40 percent annually to replace those nurses expected to leave the workforce through retirement. The full report is available online at

Texas is far below the national average of the nurse-to-population ratio, currently 782 nurses per 100,000 people. In Texas, the ratio is 609 nurses per 100,000 people. By some estimates, Texas will need 138,000 additional nurses in the next seven to 10 years.

Widespread media coverage of the critical need for qualified nurses and Johnson and Johnson's $20 million, multi-year campaign to attract more people to the nursing field have triggered a boom in the number of applicants to nursing programs.

In 2000, the UT School of Nursing at Houston had 411 applicants for 120 slots. Over the last five years, the school's applicant pool has increased 247 percent, resulting in a large number of qualified, motivated aspiring nurses unable to get into school.

Admissions officials at the school, ranked in the top 10 percent of all nursing schools in the country, have had an particularly difficult time turning people away. Even though its entrance requirements are extremely high - including a 3.7 grade point average in prior college classes, letters of recommendation, extensive science prerequisites, and in-person interviews - the school still had to deny entry this year to over 1,200 people who met all of the requirements.

"It's frustrating," said Starck. "We are trying new things to increase the number of students we can educate, including an accelerated nursing program, using hospital nurses as on-the-job educators, and a number of other programs, but there is only so much we can do. We've increased the number of bachelor of nursing degree students we graduate by 56 percent over the last five years, but there's still a critical nursing shortage. Without an increase in state funding, we won't be able to solve this problem. Add in the fact that we can't pay faculty members as much as the private sector can, and we are really stuck," she said.

Last year, new nursing school graduates in the Houston area earned, on average, $44,000 in their first job. Nationwide, the average annual nursing salary reported in 2004 is $54,574, up about 10 percent from the prior year.

The UT School of Nursing shares the 800-acre Texas Medical Center campus with two other nursing schools - the Prairie View AandM University College of Nursing and the College of Nursing of Texas Woman's University - both of which are constructing new buildings.

In autumn 2004, the UT nursing school opened its $57 million School of Nursing and Student Community Center. Experienced nursing educators like Starck, however, know that more than expanded physical space is needed to educate future nurses.

"Every $150,000 spent annually on a faculty member and their classes allows us to train 10 more students," said Starck, who has been dean of the UT School of Nursing at Houston since 1984. "We know how much it costs to train a student, and increased state funding would be an economic investment in educating Texans for jobs that are ready and waiting.".

Daniel Stoneking, now in his second year of nursing school, knows only too well how difficult it is to enroll in a top-ranked program. After completing two years of core requirements at Texas A and M University, Stoneking applied to the UT School of Nursing at Houston, specifically because it is so highly ranked. His grades were excellent, he had glowing letters of recommendation, and he did well in his personal interview. So Stoneking was stunned to find out that he had been wait-listed for the school.

"I honestly didn't know what to think," he said. "I had wanted to be a nurse for years, and being wait-listed shocked me. I soon found out I was actually lucky - other friends of mine were outright rejected, even though we were all qualified. I stuck with it, calling the school for updates and basically just being persistent. Luckily, just before school started, a space opened up and I was next on the list. The school called me immediately, and two weeks later I started nursing school.".

The prospect of motivated, qualified, caring students like Stoneking not becoming nurses because there is nowhere for them to go to learn is particularly troubling to Starck. "It takes a special person to be a good nurse," she said. "And the fact that every year, thousands of these smart and caring people are prevented from reaching their dream through no fault of their own is very frustrating.".


Did you know?
Preliminary data from a new survey by the American Association of Colleges of Nursing (AACN) supports the view of a prominent Houston nursing educator that America's nursing shortage cannot be blamed on a lack of people wanting to become nurses. Insufficient space and resources to train all of those qualified to become nurses, along with an ever-shrinking pool of people willing and able to turn down higher-paying nursing jobs to become educators, is the actual cause of the problem. Lack of Resources, Not Lack of Students, Cause Nurse Shortage

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