A prescription for more nurses
THE CLAMPDOWN at the nursing program at Massachusetts Bay Community College, where state officials suspended new enrollees last week, may have been warranted. But it comes at a bad time. The state is facing a dire shortage of nurses and nursing faculty.
Mass. Bay and the state are working out a resolution to allegations of grade tampering and poor leadership leveled by the state Board of Registration in Nursing. But the underlying national shortage will remain. A 2002 report from the US Department of Health and Human Services projects that by 2020, there will be a national shortage of 808,000 nurses -- with more than 25,000 vacancies in Massachusetts.
At Mass. Bay, the nursing program has struggled to hire faculty and staff. Faculty blame an internal reorganization. Now, in response to the nursing board, the school plans to hire four faculty members. To do so, the college will work with a search firm and local hospitals and look among its part-time faculty.
But even after it cleans house, Mass. Bay will face dispiriting facts. Colleges can't match the salaries that nurses can earn in clinical and corporate settings. Lacking professors, colleges turn away qualified students. Mass. Bay says it only admits a third of its applicants. There's also a huge need for colleges to build new labs to train students.
Even if colleges could expand their capacity, there would still be fierce competition among students to get clinical training spots at hospitals and other healthcare settings. These organizations also need to increase their training capacity.
To address these logjams in Massachusetts, a group of nurses, hospitals, and state higher education officials has formed the Public Higher Education Initiative in Nursing and Allied Health Education.
The initiative is studying salary and training issues, and it is backing innovations such as expanding clinical training by using simulation technology: computer-assisted mannequins that nursing students can practice on. This isn't a replacement for treating live patients. But simulations can expose students to dire medical events and let them learn -- and make mistakes -- without causing harm. The initiative is also looking at how curriculums should change to train nurses to handle demanding modern workloads, everything from learning the latest medical facts to working with technology to providing compassionate patient care.
The larger challenge is to take these and other efforts, weave them into a comprehensive policy, and bring them up to scale. This work must be done on many fronts with a substantially increased and coordinated investment of public and private funds.
To have excellent healthcare, the nation needs new innovations to train more nurses. 