March 2001

Nationwide Nursing Shortage at Crisis Level

The current nursing shortage poses a major threat to the quality of health care throughout the nation — especially in Arkansas.

A recent survey conducted by the Arkansas Hospital Association found 53 hospitals reporting 750 budgeted unfilled registered nursing vacancies, with 1,500 registered nurses needed immediately.

“At the present time, the R.N. vacancy rate at University Hospital is 16 percent with 88 unfilled vacancies,” says Linda C. Hodges, Ed.D., R.N., dean, UAMS College of Nursing. “Each component of the state's health-care system is caught in the throes of a nursing shortage that grows worse each day, limiting access and quality of care.”

Dr. Hodges recently testified before the U.S. Senate Health, Education, Labor and Pensions Committee, in Washington, D.C., and the Arkansas Joint Committee on Education about the reasons for the shortage as a national trend. “Enrollment and graduation rates have markedly declined, nursing faculty shortages are escalating, educational resources are declining, clinical sites for student placement have decreased, and fewer R.N.s are available to mentor students and new graduates. At the same time, the current nursing staff is aging along with the rest of the baby boomer generation. Retirements are increasing, and the demand for highly educated R.N.s continues to exceed supply.”

The declining enrollment in nursing education can be attributed to a number of factors. According to Hodges, the image of nursing has changed over the past decade, “from a field that offered many opportunities and high job security to one that holds great uncertainty with sometimes dangerous working conditions.” She also says that today's college students view nursing's beginning salaries as low compared to other professions. Along with limited financial aid, that causes many people to choose other fields of study. These are areas of concern, says Hodges, that need immediate attention if we expect to reverse this alarming trend.

The problem does not stop at low recruitment and declining graduation rates. According to Hodges, we are also facing a critical need for nursing faculty. “In many instances, more qualified nursing applicants are available than the numbers of faculty and educational resources to support them. For example, in Arkansas, in 1999, there were 153 qualified applicants who were not admitted to the state's registered nursing programs due to insufficient numbers of qualified faculty, inadequate physical facilities and nursing learning labs, and budgetary funding.”

Teacher shortages are caused by a number of factors, including aging of faculty, low salaries, increased workload, and inadequate numbers of master's and doctoral graduates to fill vacant and new faculty positions. The average age of Arkansas nursing faculty in all levels of basic registered nursing education is 47, and the average age of doctoral faculty is 53. In the year 2000, five of the state's 57 doctoral faculty members retired. And, says Hodges, with the baby boomers comprising the bulk of nurse educators, “the number of retirements can be expected to reach alarming proportions by the end of the decade.”

How bad is it? During the past year, 28 of Arkansas' 273 full-time and 63 part-time nursing faculty resigned, most citing low salary and increased work demands as primary reasons. Currently 13 faculty positions are vacant in the state. Nearly 17 percent of the full-time and 54 percent of the part-time faculty lack a master's degree, the minimum requirement for national accreditation. With only 47 doctoral faculty, the state is at risk of losing accreditation. A large number of faculty will be retiring in the next five years, leaving even fewer teachers to prepare nursing workforces for the future.

Something must be done, and we can't wait much longer to do it, says Hodges. “The faculty situation in our state is really becoming desperate. We need to put in place a program by which we can educate more nurses at the master's and doctorate levels to take positions in our schools of nursing; we must do something about faculty salaries to make them competitive with the private sector and other universities across the country; and we need to increase the number of faculty who are from culturally and ethnically diverse backgrounds.”

Efforts are being made to make state and federal lawmakers aware of the situation; hence, the trip to Washington (and our own state capitol) by Hodges. The situation, she says, is critical and the crisis is very real. “Everywhere in the nation, this problem is becoming acute. There are just not enough nurses. With the least educated nursing workforce and one of the lowest ratios of R.N.s per capita in the nation, Arkansas is facing a major dilemma.”

08/28/01