Baltimore Sun: "RN applicants shut out"

March 17, 2004 -- Today the Baltimore Sun ran an article by Sandy Alexander about Maryland community college associate degree nursing programs that have been turning away as many as three quarters of their applicants, despite the critical nursing shortage, because of limited resources. The piece makes some valuable points about problems in nursing education and includes helpful profiles of current students. However, its unquestioning embrace of the idea that educational requirements must be streamlined in order to produce new nurses as fast as possible leaves no room for discussion of how to address the problems that have actually led to the shortage, such as short-staffing and the lack of workplace empowerment. The piece also seems to suggest that anyone willing to make some effort can and should be a nurse, an approach that we doubt would have been taken in an article about the training of physicians.

The story describes current efforts by Maryland community colleges to increase their capacity to train nurses, such as through accelerated programs and starting more than one program each year. One official notes that her school's planned spring admissions date would (as the article puts it) "allow students who did not succeed in the first trimester to start over right away." The piece also explains that one of the main challenges the community colleges face is a lack of faculty. State law reportedly requires that nursing instructors have at least a master's degree, and according to the president of the National Organization for Associate Degree Nursing, nursing instructor salaries "can't compete" with those of nurse practitioners. Another problem the schools face is getting adequate access to clinical training facilities, as hospitals are now being stretched by a variety of factors. The story reports that most nurses "eligible" for the Maryland RN exams have associates degrees, and cites a community college nursing director for the idea that community colleges attract students who want a "faster," "more economical" or "more local" education option. The article briefly discusses one bachelor's degree nursing program, noting that the associate dean for academic affairs at the state's largest nursing school reported an astonishing 400% increase in applicants in the last year and that she attributed the "rush" to the overall economy and awareness of the nursing shortage. This dean is quoted as saying that her school, "as well as the community colleges, will be turning away qualified applicants."

The story also includes brief profiles of three community college nursing students. One is a 51-year-old former insurance claims adjuster whose desire to be a nurse was "cemented" after her son was killed by a drunken driver, and who recently started class after having been "turned away from packed nursing programs" twice. Another is a 24-year-old originally from Afghanistan who hopes to eventually earn a masters degree and return to Afghanistan to care for people there. And the last is a 42-year-old former administrative assistant who plans to eventually pursue a bachelor's degree. The inclusion of these profiles shows that nursing is an increasingly popular choice for persons from a variety of backgrounds, including those looking for a new career later in life, though it might have been helpful to profile one male student.

The apparent increase in interest in nursing is certainly encouraging, though as the article rightly notes, much of that may be due to the current economy. The piece also suggests that nursing schools are turning away "qualified applicants," and that is an issue that merits close attention. The faculty shortage is a very serious problem. However, overall the piece seems to embrace the idea that new nurses must be trained as fast as possible by clearing away educational obstacles such as competitive admissions and existing program duration requirements. The article does not question the school official who seems eager to re-enroll immediately students who fail. And though a few parts of the piece do suggest that training is rigorous--it ends with a nursing program director asserting that schools would "never want to err on the side of not having the quality" because nurses are responsible for "incredible" things--most of the story seems to suggest that anyone who is willing to put forth an effort can become a nurse.

A more balanced piece might have discussed how the push to streamline educational requirements relates to the ongoing controversy within nursing over minimum requirements, their potential effects and whether (despite the assurances noted above) anyone is concerned about a potential reduction in educational quality that could affect care. It might also have addressed the factors that have actually led to the current shortage, such as short-staffing and the overall lack of respect and resources for practicing nurses and nursing professors. The low pay of instructors is mentioned, but there is no suggestion that one way to increase capacity might be to pay them more, even if that could be difficult in the current budget climate. The piece might have explored whether a headlong rush to turn out new nurses in the ways discussed will do much to address the long-term problems of the shortage or the public health crisis it presents. If the underlying problems in nursing are not addressed, we fear that the new grads are likely to end up in the same situation as their predecessors.

See Sandy Alexander's article "RN applicants shut out" in the March 17, 2004 edition of the Baltimore Sun.

Feel free to contact the author Sandy Alexander with your comments, or write a letter to the editor of the Baltimore Sun.