Nursing Workforce Shortages Collide with Lack of Nurse Educators

• Some nursing programs tout record enrollment, as others turn students away, adding yet another layer to the workforce shortages landscape in the industry.
• The issue meets at the intersection of the nurse educator and nursing workforce shortages, as seen in the latest American Association of College Nursing’s enrollment survey.
• The survey found that sustaining enrollment “continues to be a challenge,” but schools have committed to expanding their programs to meet demand.

As some nursing school programs tout record enrollment, others are turning students away, adding yet another layer to the industry’s workforce pipeline concerns and worker shortage. 

The issue meets at the intersection of the nurse educator and nursing workforce shortages, as evidenced by the American Association of College Nursing’s (AACN) 2023-2024 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing survey.

Conducted annually among nursing schools nationwide, the data highlights the state of the education landscape. The most recent survey, released in April, found that sustaining enrollment “continues to be a challenge.” Despite that, schools have committed to expanding their programs to meet demand, according to Dr. Deborah Trautman, AACN president and chief executive officer. 

Record Enrollment?

The first years of the COVID-19 pandemic brought an uptick in interest in the nursing profession, and some programs still credit that period for their enrollment gains. The Allegheny (PA) Health Network West Penn School of Nursing is among those, having reported a more than 50% enrollment increase in the past year, according to WPXI. 

“I think there was a much bigger interest in healthcare and understanding healthcare and wellness after the pandemic,” Amy Stoker, AHN Schools of Nursing Director, told WPXI. “Lots of people started to explore nursing as a profession.”

However, AACN’s 2023 enrollment data revealed a decline in admissions to entry-level baccalaureate programs for the first time in two decades.

Admissions dropped 1.4%, from 2021 to 2022, but AACN noted that a one-year decline doesn’t necessarily signal a trend. Eleven colleges and universities were added to the organization’s survey since last year’s report, and BSN enrollment increased by 0.3% from 2022 to 2023. Still — overall enrollment is lower than the “all-time high” achieved in 2021.

Thomas Edison State University’s W. Cary Edwards School of Nursing and Health Professions also reported “record enrollment,” according to a May 2024 report in the Trentonian.

“The size of the incoming cohort reflects the role institutions like ours play in addressing the nursing shortage and meeting the increasingly complex health care demands of our communities,” said Merodie A. Hancock, Ph.D., president of TESU.

The University of Connecticut’s School of Nursing received 3,800 applications for the 2028 cohort — at 32% increase from the previous year — and expects to enroll its “largest class for the 2024 academic year.”

And while Georgia technical colleges saw a 15% enrollment increase in fall 2023 for associate degree nursing programs, Central Georgia Technical College President Ivan Allen told GovTech that finding nursing instructors has been difficult. 

Turning Students Away

Several programs also have skewed application-to-faculty ratios, causing qualified students to be turned away.

Central Florida colleges are among those unable to keep up with the quantity of nursing school admissions, even with increased faculty and new facilities. This results in programs not accepting candidates because of “lack of capacity.”

Nancy Gasper, dean of nursing at Seminole State College of Florida, told the RV Times that the “lack of faculty” also has played a role.

“It’s hard for nurses to leave the bedside and take a hit to their compensation to become educators,” Gasper said. “So I think there needs to also be a relook at those scales to see if there’s a way to level the compensation playing field.”

In the Midwest, Hawkeye Community College (Waterloo, Iowa) has a waitlist for its program, and struggles to get students into area hospitals for clinical rotations, according to Omaha WOWT. Troy Moran, dean of health sciences, told the NBC affiliate that in their area alone, multiple programs compete for space at a select number of hospitals — on top of issues with recruiting faculty.

“The competitiveness of the market, right, what nurses are earning out in the industry,” Moran said. “We really cannot get that close to what they’re doing so they have to have a passion to want to teach.”

Struggling to get into public programs, some students opt for the higher cost of a private education just to enter the field, according to a December 2023 Cal Matters report.

“Private nursing schools are teaching more students each year, filling in the gaps as California hospitals face increasing staffing shortages and public, four-year universities struggle to grow,” Cal Matters reported. “According to the California Board of Registered Nursing, in 2021 nearly 64,300 students applied for just 16,600 spots in associate, bachelor’s, and master’s degree nursing programs. About 55% of those spots were at private institutions.” 

Overall Trend

Enrollment dropped in both 2023 and 2024 for RN-to-BSN programs, according to AACN data 

“Last year, enrollment in RN-to-BSN programs decreased by 16.9% or 19,871 students,” AACN stated in 2023. “This downward trend follows an enrollment surge in RN-to-BSN programs, which saw a rapid increase from 30,684 students in 2002 to 139,587 enrolled students in 2018. Today, fewer than 100,000 students (98,734) are enrolled in these programs.”

Enrollments decreased across programs, yet “thousands of qualified students were turned away from four-year colleges and universities” in 2023.

“The primary barriers to accepting all qualified students at nursing schools continue to be insufficient clinical placement sites, faculty, preceptors, and classroom space, as well as budget cuts,” AACN stated.

The possible trend continued in the 2024 report, with AACN identifying the same contributing factors. 

The Bottom Line

While media coverage shows nursing programs both touting record enrollment and turning away qualified applicants, the situation isn’t black and white. Some programs have been able to expand, adding facilities and educators, but still don’t have the capacity to admit enough students to push down the workforce shortage. This is, in part, because educational institutions are contending with a faculty shortage. Annual survey data shows that fewer than 100,000 students are currently enrolled in RN to BSN programs. 

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