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Despite rise in students, nursing
shortage remains

By Diane E. Lewis, Globe Staff, 1/26/03

Prompted by the economic downturn and a desire for more meaningful careers, high school graduates and midcareer professionals are applying to nursing schools in growing numbers, but the increases still aren't enough to meet the nation's need for nurse specialists.

At the Nursing Programs at Simmons College, enrollment of nursing students 23 and older doubled this school year, rising from 45 to 90.

At the William F. Connell School of Nursing at Boston College, 200 applications poured into the admissions department for a master's entry program, up from 100 last year.

At the College of Nursing and Health Sciences at the University of Massachusetts, Boston, nursing enrollments in the entry-level baccalaureate program increased to 121 in the fall of 2002, up from 107 the year before. The nursing program received 565 applications last year compared to 408 in 2001.

''We see a trend upward,'' said Robert Rosseter, spokesman for the American Association of Colleges of Nursing (AACN). ''At a time when some people are being laid off, nursing is attractive. People see nursing as a secure field. They know the projections are showing a steady growth in the profession over the next decade.''

In a recent survey, the association found enrollment in entry-level nursing programs that offer bachelor of science degrees increased more than 8 percent to 116,099 in the 2002-2003 school year, up from 106,557 last year. Enrollments in master's degree programs were up 3.5 percent this school year, rising to 33,976 students nationwide.

''The fact that the nursing shortage has gotten a great deal of publicity is one of the reasons for this,'' said Marion Winfrey, associate dean of the College of Nursing and Health Sciences at UMass Boston. ''Also, the economy has forced people out of certain jobs, and UMass tends to cater to adults who want a career change. We tend to get the more mature adult population, people who are 25 and older.''

Union contracts stipulating pay increases and improved working conditions at hospitals have also attracted applicants to Massachusetts nursing schools, say specialists. At Brigham & Women's Hospital in Boston, full-time nurses at top scale will be earning $100,000 per year by 2004 under the terms of a new contract. The agreement raises salaries by 17 to 22 percent based on years of service, making nurses at Brigham & Women's among the highest paid in the state, according to the Massachusetts Nurses Association.

Paradoxically, the hike in applications and enrollments is coming while hospitals are still clamoring for more nurses, but many training programs do not have the space - or the faculty - to meet their needs. Barbara Hazard Munro, dean of nursing at Boston College, said the master's entry nursing program has room for only 32 students, but it received more than six times as many applications for this school year. The program awards a master's degree in a nursing specialty to professionals from other fields who successfully complete 18 months of study, she said.

Despite such interest, the federal government forecasts that by 2020 close to 3 million nurses will be needed, but only 2 million will be available. In all, 44 states will have nursing shortages by that time, including Massachusetts.

In response, some hospitals and colleges are creating partnerships to increase the number of nurses in critical care, intensive care, and medical surgical units, specialties where demand is greatest. At Beverly Hospital, nursing officials forged a partnership in 2001 with educators at North Shore Community College and other institutions in the region and began pairing new nursing graduates with seasoned nurses in critical care who act as mentors.

Called the Critical Care Career Program, the initiative is akin to an apprenticeship in the hospital's 14-bed critical care unit. Nursing mentors, called preceptors, help new recruits set goals that allow them to progress from basic to more advanced skills over eight weeks. Once they have completed the program, the new recruits sign a contract to work full time for 18 months in the critical care unit at Beverly Hospital.

That appealed to Stacey Twomey, 27, of Lynn. A former nurse's aide at a North Shore nursing home, she said she always wanted to attend to the seriously ill. After becoming a licensed practical nurse she enrolled at North Shore Community College. She received board certification as a registered nurse and was paired with a nurse mentor at Beverly Hospital last year. Twomey works a 40-hour shift at the hospital and says she wouldn't have it any other way. She credits the program with providing an entree to critical care.

''I wanted to work in an intensive care unit but. . .I would have been expected to work on a regular medical surgical floor first before I'd be allowed into the critical care unit,'' said Twomey. ''But with the program, you can come in without having all of that experience. I was happy to see the hospital bring people in with some experience and let them absorb all the knowledge that nurses who have been here for 20 years already have.''

The program is the brainchild of Maria Lustenberger, clinical care nurse manager at Beverly Hospital. ''Stacey was our first new grad,'' she said. ''Five people have gotten into the program so far, including a woman who had not been a nurse in 10 years.''

Lustenberger said that as part of the program the new nurses attended a weekly class offered by the North Shore Critical Care Consortium, a coalition of hospitals. Educators from the hospitals teach the class. The new nurses also worked in the unit when not in class.

This spring, Beverly Hospital and Addison Gilbert Hospital in Gloucester will team up to offer a six-week program to help nurses who have been away from nursing reenter the profession. The Nurse Reentry Pathway program will combine classroom instruction with hands-on clinical experience.

Meanwhile, the University of Massachusetts in Amherst has partnered with two local hospitals, Baystate Medical Center in Springfield and Cooley Dickinson Hospital in Northampton, to provide funding to hire additional nursing faculty to work with new students. The partnership enabled UMass Amherst to hire two full-time instructors and one part-time instructor, said AACN.

A partnership between Simmons College and Boston Medical Center gives students credit toward a bachelor's or master's degree in nursing for working in the medical center's operating room as a scrub nurse or as a first assistant nurse, noted Judy A. Beal, associate dean of nursing programs at Simmons College.

Rosseter noted that colleges are also creating more programs that target men and women seeking a career change. ''There are 72 additional accelerated nursing programs that are in the planning stages across the country,'' he said. ''They take students who have a degree in another field and help them complete nursing requirements in 12 to 18 months.''

Beal agreed. ''I'm seeing students who went into other careers and are not satisfied,'' she said. ''One woman said she was often at the World Trade Center on business, but she woke up after Sept. 11 and asked herself, 'If I had died, would I have died happy?' ''

A few days later, the woman asked the nursing school at Simmons to send an application, said Beal.

Diane E. Lewis can be reached at dlewis@globe.com.

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