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A new survey suggests that nursing might be missing its golden opportunity to replenish the nursing workforce with bright, baccalaureate-trained young people who are willing and able to join its ranks.

According to 2004 data from the American Association of Colleges of Nursing (AACN), while enrollment in entry-level bachelor programs in nursing increased by 10.6% over 2003, U.S. nursing schools denied 26,340 qualified applications. In 2003, nursing schools turned away 15,944 qualified applicants from entry-level baccalaureate nursing programs, according to the AACN.

Nursing faculty shortages, a diminishing pool of clinical sites, and lack of government and other funding resources are among the roadblocks, nursing school administrators say.

“Deans and faculty have been creative at trying to expand the number of people that they can bring into the programs,” says AACN Executive Director Geraldine “Polly” Bednash, RN, PhD, FAAN. “But it’s clear that they’re reaching their maximum capacity to expand.”

While some students are opting to take prerequisites and other courses as they wait to reapply in nursing schools, others are abandoning the career choice, Bednash says.

Rise in interest

Many nursing schools have expanded in recent years, but not enough to meet the growing demand.

Graduations from entry-level baccalaureate nursing programs were up sharply in 2004, with a 14% increase over 2003. The recent rise in graduations follows a 4.3% increase in 2003 and 3.2% increase in 2002 — that’s following six straight years of graduation declines, according to the AACN.

The story at Florida Atlantic University’s Christine E. Lynn College of Nursing in Boca Raton is much the same: increasing enrollments and an inability to accommodate all the qualified students who apply.

“In the past 10 years, we’ve had 100-plus more applicants than we could accept,” says the school’s dean, Anne Boykin, RN, PhD. “This year, we turned away about 200 qualified applicants.”

Faculty shortfall

It’s a vicious cycle for deans trying to expand faculty rosters. There aren’t enough master’s- and doctorate-trained faculty to go around, and many of those who are qualified have significantly higher-paying jobs from which to choose.

In a July survey, the AACN reported a national nurse faculty vacancy rate of 8.1%, translating to about 2.9 faculty vacancies per school. More than half of those were faculty positions requiring a doctoral degree.

The situation might get worse: The average age of full-time nurse faculty members is 51.5 years and that of doctorally prepared faculty is 53.5, according to the AACN.

Universities and colleges are strapped when it comes to what they can pay to lure faculty. And government and state resources for expanding nursing school faculty and programs have been inconsistent, according to the AACN.

Boykin calls the faculty hiring situation “horrible” and “frightening.”

“Until we can support more persons to become faculty and encourage them and reward them for being faculty in nursing programs, this trend is not going to reverse itself,” she says. “We just can’t take more students without more faculty.”

Some baccalaureate programs had been banking on government and other funds that only partially materialized.

“We increased enrollments by almost a third from 200 to about 300 undergraduate student admissions a year,” Robin Froman, RN, PhD, FAAN, dean of the University of Texas Health Science Center at San Antonio School of Nursing, tells the AACN in a Dec. 15 press release. “Unfortunately, we only received 30% of the funding anticipated from the Nursing Shortage Reduction Act, while the community colleges and academic campuses received 100% of the expected funding. Though we demonstrated the ability to increase capacity, we cannot sustain increased enrollments without the financial resources to hire faculty for adequate instructional support for students.”

Private universities are facing similar challenges. According to Nancy Hoffart, RN, PhD, dean and professor at the School of Nursing, Northeastern University, Boston, the school, which admits between 85 and 90 freshmen, had close to 800 applications in 2004.

“My slots are limited by faculty — just as in every other institution,” Hoffart says. “We’re struggling the most right now for part-time faculty. We use a lot of part-time faculty to teach in the clinical setting.”