Annual AACN Study Shows Baccalaureate Enrollment at Nursing Schools Nearly Doubled from Last Report
Lisette Hilton

Enrollments in entry-level nursing baccalaureate programs increased by 15.9% in fall 2003, according to a preliminary report released December 2003 by the American Association of Colleges of Nursing (AACN).

That's encouraging news when you consider that last year's increase in baccalaureate enrollments was 8.1%, following a 3.7% increase in 2000 to 2001. Prior to the last three years of enrollment increases, nursing schools nationwide experienced a six-year period of enrollment declines that saw the student population shrink from 127,683 in 1995 to 103,999 in 2000.

Still, the increase is not enough to address the current RN shortage, which is expected to intensify during the next 10 years. In a report published in the November/December 2003 issue of Health Affairs, Peter I. Buerhaus, RN, PhD, FAAN, and his colleagues found that "because the number of young RNs has decreased so dramatically over the past two decades, enrollments of young people in nursing programs would have to increase at least 40% annually to replace those expected to leave the workforce through retirement." (For more information, see "New Study Shows RN Shortage Temporarily Easing - But Long-Term Outlook Remains Serious.")

AACN President Kathleen Ann Long, APRN, PhD, FAAN, vows that AACN will continue to work with federal legislators and stakeholders to fund programs that expand student capacity at the baccalaureate and higher degree levels.

Loud, Clear Messages

Geraldine (Polly) Bednash, RN, PhD, FAAN, AACN executive director, says the report tells nursing students that they're not alone in choosing a nursing career. "The world is getting the message that a nursing career is an exciting option for the future and that they've made the right choice," she says.

And student nurses need not worry about finding a job because while enrollments are up many more nurses are needed in the pipeline to meet the public's healthcare demands, she says.

Challenges to Meeting the Demands

Part of the challenge to greater enrollment increases will be to have more faculty members available for schools. According to AACN 2003 data, there is an 8.6% vacancy rate among nursing faculty. "The primary reason for the shortage of faculty is that the whole world wants nurses with graduate degrees. This is very important for student nurses, to look at this and understand that the baccalaureate is the first step to a long and productive and financially rewarding career. There are lots of opportunities when you get a graduate degree to do clinical practice or serve as a faculty member," says Bednash. "There is an enormous need for nurses with doctoral degrees. Less than 1% of all nurses in this country have a doctoral degree."

The lack of faculty is not the only problem. In some instances, public institutions don't have the funds to hire the faculty. Hospitals and healthcare systems are stepping in to fill that void. Robert Riney, senior vice president and chief administrative officer, Henry Ford Health Systems, Detroit, MI, says that employers are providing faculty and sometimes funding positions at schools for nurse faculty. Riney, the 2003 president of the American Society for Healthcare Human Resources Administration (ASHHRA), says, "I think all organizations have to strongly consider sponsoring faculty and actually funding in some cases the faculty in our academic programs. It is still far cheaper than the cost of bed closures and other things that result from a nursing shortage."

Trend Toward Higher Educated Entry Level RNs

Bednash says that the report also sends a clear message that nurses are getting the message that they should enter their careers with baccalaureate training. This comes on the heels of research by Linda H. Aiken, RN, PhD, FAAN, and colleagues, published in the September 24, 2003, Journal of the American Medical Association. The Aiken study shows that a better-educated hospital workforce positively impacts patient outcomes.

Final Report Due Out by January

These are AACN's preliminary findings about nursing education. The final full report, due out in early January 2004, will showcase data on graduate education and doctoral programs in nursing. AACN does not follow associate degree education, according to Bednash.

Lisette Hilton is a freelance healthcare reporter, specializing in covering local, national, and worldwide news for nurses, pharmacists, physicians, and other allied health professionals.