AEGiS-WSJ: Enrollment in Nursing Rises, But Crisis in Field May Linger

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Enrollment in Nursing Rises, But Crisis in Field May Linger

Wall Street Journal - May 26, 2003
Kris Maher, Staff Reporter of The Wall Street Journal

The number of students entering nursing, a profession that has been facing a drastic shortage for nearly a decade, is finally on the rise. But the crisis is far from over, and recent events have only added uncertainty to the profession's recovery.

The total U.S. student-nursing population rose 3.7% in 2001 and 8% in 2002, according to the American Association of Colleges of Nursing, which represents more than 570 nursing schools. But the current figures are still 10,000 students shy of the roughly 128,000 enrolled in 1995, when enrollments began to fall. Moreover, with a large number of practicing nurses leaving the field, the enrollment level is not nearly high enough to meet the one million new and replacement nurses that will be needed by 2010, as estimated by the Bureau of Labor Statistics.

Many in medicine fear that over that span, prospective nurses will be discouraged by such rising threats as bioterrorism and severe acute respiratory syndrome. Earlier this month, 150 anxious medical workers in Taiwan resigned, fearing unsafe working conditions, after several doctors and nurses died from the contagious new respiratory ailment.

Experts say those threats haven't yet scared away students in the U.S., primarily because no major SARS outbreaks or bioterror disasters have affected U.S. health-care workers. Such cases "haven't generated the six o'clock news story," says James Bentley, senior vice president for strategic policy planning for the American Hospital Association, a Chicago group that represents close to 5,000 hospitals and health-care organizations. Mr. Bentley argues that even if such incidents did occur, they might not turn away nurses; instead they "can really bring out the heroic side as well," he says, citing the waves of people drawn to firefighting after the Sept. 11, 2001, terrorist attacks.

The dearth of openings in many other professions could also make nursing more attractive to college students as well as career changers.

Right now, the profession is stuck in a vicious cycle, with many current and former nurses maintaining that the biggest reason people are leaving the field, ironically, is the problems caused by chronic understaffing.

"The infectious diseases that we're exposed to are not what tips the balance," says Pat Greenberg, executive director of the Nurse Alliance of New York State/1199 Service Employees International Union, which represents 27,000 nurses in New York state. "No, I really think that it's the nursing work conditions that are driving nurses out of the profession."

Many registered nurses start out earning between $35,000 and $40,000 a year.

Indeed, the job has gotten more stressful over the past two decades. Hospital staffs grew much leaner during the 1990s. With managed-care companies monitoring admittances, hospitals are also more selective about who they admit, which means the average patient in a hospital is sicker today than he was a decade ago. Nurses have far more to do with far less support, and many have left stressful emergency rooms, operating rooms and intensive care units.

For a sense of what SARS and other diseases could bring to the nursing profession, some medical professionals look to the rise of the AIDS epidemic in 1980s. At the time, many worried that nurses would fear working with infectious patients who carried the virus that causes AIDS. But the number of nurses actually grew.

According to Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, the increase in nurses was due to the resources hospitals poured into the problem, as much as to the altruistic goals of many who became nurses. "Hospitals made some very good accommodations to really improve working conditions for nurses," she says.

She is less optimistic that the situation would repeat today. "Given how burned out all of our nurses here are, having SARS here could be a big disaster," says Ms. Aiken. Still, she says, recalling how hospitals responded to AIDS, "One can only hope that some of these new concerns would have the same effect."

Write to Kris Maher at kris.maher@wsj.com

030526
WJ030514

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Elton John AIDS Foundation UK, the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .