Long before the 7 p.m. ovations rang out across the United States amid the stresses of COVID-19, America admired its health care workers.
For 17 consecutive years and counting, nursing has topped Gallup’s poll of most trusted professions. But it took a pandemic for many to gain a deeper appreciation and respect for the contributions that our nurses provide to a community’s health and wellness.
No one said the work is easy; few feel the demands and threats of COVID-19 more than nurses on the front lines across the nation. But even before the pandemic, enrollment in nursing degree programs was not growing fast enough to meet the projected demand for nurses overall. A 2017 report from the U.S. Department of Health and Human Services forecasts that Texas alone will be short nearly 16,000 nurses by 2030, the second largest deficit in the nation behind California. The Texas Center for Nursing Workforce Studies projects an even larger deficit of registered nurses in Texas by 2030.
A key bottleneck is nursing programs that often receive more qualified applicants than they have the resources to accept; these resources often include salaries to hire faculty and limits to the availability of clinical rotations for students.
One reason for the shortage of nurses is the accelerating rate of retirements as baby boomers age. To combat this, we need more flexible nursing programs that allow us to produce larger numbers of highly qualified nurses and help RNs enhance their skills and meet emerging health care crises using the latest evidence-based information. Rigorous online programs are a proven complement to nursing programs, increasing access for working students.
At the same time, there have been calls to increase the overall education level of nurses. Although almost 60% of new RNs still enter practice with less than a bachelor’s degree, according to a 2018 national survey of RNs conducted by the Health Resources and Services Administration, a decade of research continues to show that more highly educated nurses improve patient outcomes, including lower hospital mortality.
In October 2010, the Institute of Medicine released its landmark report on “The Future of Nursing,” which called for increasing the number of college-prepared nurses in the workforce to 80% and doubling the population of nurses with doctoral degrees by 2020. Subsequent reports have found the U.S. has fallen well short of that goal — 56% with bachelor’s degrees in 2017 — and set 2029 as the new goal for 80%.
Now more than ever, hospitals and health systems must take active roles in assuring an adequate supply of highly qualified, competent and confident nurses to deliver the quality of care that our patients have come to expect. However, we cannot resolve these challenges alone. Through experience, we know it takes innovative partnerships between employers and academic institutions to produce an adequate supply of qualified professionals able to respond to a rapidly changing health care environment.
That is why we at UT Southwestern Medical Center are partnering with the University of Texas at Arlington’s College of Nursing and Health Innovation, which through its online nursing program has greatly expanded the capacity to bring more nurses into the profession and add efficient methods for advancing the education of our practicing nurses. Thousands of nurses have completed their education through the UTA program, which — based on both annual graduates and enrollments — is the largest public nursing program of its kind in the country.
Online nursing programs, which are already growing faster than face-to-face programs nationwide and in Texas, allow institutions to meet time-pressed and place-bound students where they are. This is especially critical to nurses with two-year degrees who are already working in hospitals, who cannot easily pick up and attend four-year institutions in person.
Online programs also provide quality courses and preparation to a larger pool of people. Online bachelor of science in nursing degree programs often meet the needs of working nurses and nurses who reside at a distance from a program, facilitating increased access to nursing education. These programs allow individuals the opportunity of becoming BSN-prepared registered nurses wherever they reside. These online programs are often more affordable for students.
Without a doubt, nursing professionals require certain hands-on experiences to acquire essential competencies. Working with UTA, we have created educational programs that use technology while providing access to essential clinical experiences at UT Southwestern hospital settings that are key to meeting health care’s current and future challenges.
Across the country, we have seen the consequences of attempting to respond to COVID-19 with a nationwide nursing shortage: overworked nurses, overburdened hospitals, an inability to respond effectively to health care threats old and new, and, ultimately, worse health outcomes.
The people of Texas deserve better.
By engaging with academic nursing programs, we can expand our capacity to produce highly qualified nurses with bachelor’s degrees, enhance our ability to provide life-long learning for practicing nurses, and maximize our response to rapidly changing health care needs, whether that is today’s pandemic or the new urgencies tomorrow will surely bring.
Susan Hernandez is the health system chief nurse executive at UT Southwestern Medical Center.
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