Nursing schools must do everything to accommodate rising demand, interest in the field

By Charnelle Lee, Western New Mexico University Undergraduate Nursing Programs Coordinator, New Mexico Nursing Education Consortium Nurse Educator Endowment Award Winner

Intensive care units throughout New Mexico are operating beyond capacity. Hundred-day hospital stays are almost commonplace now but were unheard of before 2020. Nurses, aging along with our U.S. population, are retiring. As demand for healthcare services mounts, the shortage of registered nurses worsens.

The COVID-19 pandemic has exacerbated the nursing shortage by increasing the number of patients entering the healthcare system and skewing the patient-to-nurse ratio toward dicey territory.

Nursing staff shortage can lead to errors and higher morbidity and mortality rates. Longer, more taxing shifts also lead to nurse burn-out and turnover, which interrupts the continuity of care with similarly dismal consequences for patients. It's a cycle that can only be broken by adding more nurses.

Nationwide, we'll need roughly 1.2 million new nurses by 2030, and New Mexico, which tallies just over 11 nurses per 1,000 residents, will require up to 3,700 more to avoid a catastrophic breakdown in healthcare services statewide.

Rural areas are facing an even more critical need. Only 16% of nurses live in rural areas. And given that the 46 million Americans living in such communities tend to be older and have more chronic conditions, frontier residents are the ones experiencing the effects of a lack of access to care. While efforts are being made to bridge the gap, much still needs to be done in the way of training and recruiting talent.

The American Association of Colleges of Nursing found that enrollment in nursing programs has increased despite worry that the pandemic might repel would-be healthcare workers. In fact, the number of students pursing bachelor's degrees in nursing grew by nearly 6%, an encouraging figure since bachelor's prepared nurses are linked to better patient outcomes. However, the interest in nursing school was not matched by the capacity of our nation's nursing programs; colleges and universities were still refusing thousands of qualified applicants.

The obvious solution then is to expand both the capacity of and frequency of training programs. Taking that a step further, colleges and universities should also provide options that work better for nontraditional students who are working other jobs and raising families while earning their degrees. And, to solve the problem where it lies, rural institutions particularly need to open their doors wider.

Nurse training programs are usually located in metro areas, drawing students from rural communities not only for school but potentially the rest of their careers, according to the National Rural Health Association. And students in large, urban nursing programs are only minimally exposed to rural healthcare topics in the classroom or clinicals. They graduate feeling ill-equipped to work in such environments.

Smaller nurse education programs and those in rural areas will play a key role in ensuring the health of their neighbors. Nursing programs can increase admission to twice a year instead of annually, expand clinical opportunities to weekends and night shifts, and offer part-time options for aspiring nurses who need more flexibility. Colleges and universities can combat the parallel shortage of nursing faculty by offering the market rate and continuing to employ technology that helps offset the limited availability of clinical sites. Simulation is being implemented successfully in most nursing programs, which recognize that, although patient exposure is necessary, incorporating high-fidelity simulation is a proven method of covering the gap between nursing theory and bedside nursing.

While there are no shortcuts to training competent nurses ready to enter today's healthcare environment, enhancing access to nursing programs is the next best solution. Training every qualified applicant who wants to join the next generation of nurses should be the goal of all New Mexico universities.