Nursing Students From All Backgrounds Need More Support
COMMENTARY

Nurses are critically important for the health and well-being of our country. They’ve worked tirelessly and bravely in unimaginable circumstances throughout the COVID-19 pandemic. However, the pandemic only served to highlight the challenges that face the current and future nursing workforce. The United States is facing a historic nursing shortage, which will get worse without swift and decisive action.
In my over three decades as a nurse — clinician, faculty, and academic administrator — I’ve seen firsthand the importance of nurturing the next generation of nurses. The pandemic has challenged our already fragile pipeline of new nurses. Higher education, including nursing education, took hard hits during the pandemic, the consequences of which are yet to be seen. Many nursing programs are struggling with limited capacity to expand enrollment, meaning qualified students can’t get accepted.
Last year alone, nearly 92,000 qualified applications were turned away from U.S. baccalaureate and graduate nursing programs because these institutions didn’t have the capacity to accept and educate more students. With a faculty shortage that’s left 8% of nursing school faculty positions vacant, the problem is only getting worse. No qualified person who wants to dedicate their career to nursing should be turned away — especially during a severe workforce shortage.
Moreover, the cost of nursing education is extremely high — more than 1,300% higher in 2021 than in 1978 — creating financial barriers for many prospective students. Such barriers will accelerate as the economic fallout from the pandemic continues. Inflation is reaching a 40-year high; people are finding it difficult to provide for their families. I work with students who are experiencing homelessness and food insecurity. Faced with these economic difficulties, many individuals from diverse backgrounds are prevented from pursuing careers in nursing even when the opportunity is available to them. We must make nursing school more accessible and affordable for all students.
Furthermore, 46% of nursing programs cite the lack of clinical placements for hands-on learning with patients as the primary reason for turning away qualified applicants. Clinical experience is critical for practice-readiness, yet the lack of clinical training opportunities in hospitals and other health care settings has been exacerbated by pandemic-related restrictions. Simulation is a research-supported strategy to replace up to 50% of required clinical hours while maintaining learning outcomes. Current studies are underway to determine the impact of screen-based and virtual reality simulation on learning outcomes among nursing students. Additionally, many nursing programs are also leveraging innovative partnerships with health care organizations to increase access to clinical placements. Increased collaboration between nursing programs and practice will be critical to ensure nursing students are prepared to enter the workforce.
Nursing programs must find solutions to address access and equity. This begins with admission criteria. Programs should broaden their acceptance criteria to give students from all backgrounds the opportunity for a nursing career. We need to extend more support to students. Research has found that mentoring programs have been successful in increasing the diversity of the nursing workforce. Proactive advising programs can provide students with mentorship not just through their course work, but in their personal lives, too.
Acknowledging that academic success is as much a function of social and economic stability as it is aptitude and commitment is crucial to ensuring that appropriate services are available to struggling students. We also need to increase the resources available for student success. For example, leveraging educational technology can have a profound impact on student success. I found that partnership with ATI Nursing Education, a leading provider of education technology solutions, has equipped faculty with a comprehensive data-driven suite of technologies that engage students in problem solving that not only prepare them for success on the NCLEX licensing exam, but also for the realties and complexities of the practice environment. By filling these gaps, we can ensure a more accessible and equitable nursing pipeline.
While this may sound like a daunting task, I know faculty and academic leaders have the ability and commitment to evolve our nursing education programs to meet the needs of the ever-evolving system in which their students will practice. I urge the entire nursing community to advocate for innovative, equitable ways to help more students succeed.
F. Patrick Robinson, PhD, RN, ACRN, CNE, ANEF, FAAN is the President of Research College of Nursing, Kansas City, MO.