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Nursing Shortage Worsened by Teacher Shortage

The math doesn’t add up. At a time when registered nurses are in more demand than ever, nursing schools in Indiana can’t accept all the student applicants because of a shortage of instructors, classrooms and clinical training sites.

In nearly 30 years in the field, Pat McQuade has seen health care become increasingly complex. “Nursing is like medicine, law and engineering—they are rigorous disciplines,” McQuade said, requiring highly skilled instruction in chemistry, biology, the mechanics of equipment, and math to calculate drug dosages.

As a nursing coordinator for a Lutheran parish in South Bend, McQuade deals mostly with older people who need health care and wellness services, and she predicts a growing need for well-trained nurses as the population ages. But the education system isn’t keeping pace with demand.

Indiana currently has 2,000 nursing vacancies, yet the state’s nursing schools turn away 2,500 qualified applicants each year. Nationally, those numbers equal about 116,000 nursing vacancies and 50,000 students who must wait or seek other opportunities.

Among them is Jana Cole, 25, of Indianapolis. Cole worked as an office assistant in a doctor’s office during her teens and was encouraged to pursue a nursing career. At Indiana University-Purdue University Indianapolis, she thought she was on track—she’d completed her basic coursework, boasting a 3.7 GPA.

And yet she was turned down by IUPUI’s School of Nursing. She was shocked, until she learned that only one member of her small study group was admitted.

“You’d think with a 3.7 you could get into any program, especially after people have been telling you there is such a demand [for nurses],” Cole said. She has set aside nursing for now and works as member services coordinator for a national fraternity.

Marion Broome, dean of the Indiana University School of Nursing, said the school increased its student capacity by 30 percent in 2007, but it is hard to retain an aging workforce of instructors. Why? Compensation is part of the problem. Pay is typically better in medical practice than in teaching. An Indiana nurse with a master’s degree can expect to make $70,000 to $100,000, Broome said, whereas an instructor with a doctorate will start around $65,000. Given that, it becomes difficult to justify returning to school for the advanced degree necessary to become an instructor.

Sen. Evan Bayh, D, has proposed that the federal government help repay loans for nurses who get advanced degrees and commit to teaching for four years. Master’s graduates could receive up to $40,000, and those with doctorates up to $80,000.

Broome points out that the average age of an Indiana nursing instructor is 56. By 2015, 37 percent of the state’s nursing faculty is projected to reach retirement age.

“What we’re seeing is that the nurse faculty population is reaching retirement more rapidly than the general nurse workforce,” said Donna L. Boland, president of the Indiana Nursing Workforce Development Coalition.

Coupled with that is the sheer increase in health care facilities over the last decade.

“We now have specialty hospitals, orthopedics, heart hospitals, cancer hospitals. Most hospitals have gone from semiprivate to private rooms,” Broome said. “All those put an extraordinary demand on the number of nurses you need.” At the same time, not enough facilities are willing to provide hands-on training that nursing students need.

Clyde Hall, AARP Indiana state president, said, “Health reform puts a premium on access and affordability. Growing our nursing workforce has got to be a part of that.”

Christopher M. Lloyd is a freelance reporter based in Indianapolis.

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