Momentum Builds to Solve
Nursing Shortage

By John Leighty
April 25, 2005

A push to solve the state’s nursing shortages got a high-profile boost in mid-April when Gov. Arnold Schwarzenegger put forward a $90 million five-year plan aimed at closing a nursing gap which could hit critical mass by 2010.

The governor focused on one course of action that state officials, hospitals, and nursing organizations strongly agree is a top priority — finding ways to increase the educational capacity for educating new RNs to fill vacancies.

Deloras Jones, RN, MSN, executive director of the California Institute for Nursing & Health Care, said the $90 million — $18 million a year for five years — is federal workforce investment dollars over which the governor has discretionary control. While the federal funds can’t be used for infrastructure such as building more classrooms, they will help with programs to increase nursing faculty and forge joint ventures with the hospital industry, she says.

“I think what will emerge are partnerships — foundations and hospitals working with colleges to develop innovative sustaining solutions to educational capacity.” Jones adds that state nursing schools are turning away about 40% of qualified applicants because of faculty shortages and a lack of classroom space and training facilities.

Jayne Cohen, RN, PhD, director of the San Jose State School of Nursing, says she views the governor’s use of workforce investment funds as “seed money” that needs to be expanded upon.

“I’m encouraged to hear that the state is finally acknowledging it has to put funding into nursing,” says Cohen. “Every dollar helps — financial resources are needed to educate nurses.”

Moore Foundation

However, she says her department got its biggest boost from a $5.5 million grant from the Gordon and Betty Moore Foundation to create a bachelor of science “boot camp” and a graduate nursing education program.

The grant money will allow honors students to participate in an accelerated, 18-month program culminating in a bachelor’s in nursing degree, beginning with a group of 30 students in summer 2005. Over the next five years, about 90 students will receive a bachelor’s in nursing through the program, says Cohen.

“In perspective, the Moore Foundation is pumping $110 million over two years into nursing programs in five San Francisco Bay Area counties,” she says. “The governor is putting $90 million over five years to cover the entire state.”

Jones says the nonprofit, bipartisan California Institute for Nursing & Health Care has developed a master plan to tackle the state’s nursing crisis that focuses on five key components: education, nurse practice, recruitment, diversity, and work environment.

This month, the Institute identified many successful partnerships to increase capacity of current nursing programs between nursing schools and the health care industry that she said could be replicated throughout the state. Included were these programs:

l ‑Southern California Regional Collaborative: A partnership between five colleges and seven hospitals that will add 100 additional nursing students each year to the region. One innovation: classes via teleconferencing.

• Sacramento City College/Sutter Health: Sutter is donating $15 million over five years for programs to increase nursing grads.
• Fresno City College Paradigm Program: Regional hospitals supply and sponsor students for a contract education program that will graduate basic RN students in four semesters and LVNs in two semesters.
• San Francisco State/Cañada College: Fast-track baccalaureate degree program that will add 40 new nursing students a year for the next 10 years.
• Long Beach Memorial/Cal State Long Beach: An innovative partnership for sponsoring nurses to meet local needs.

California Nurse Education Initiative

Under Schwarzenegger’s California Nurse Education Initiative, the state will provide $18 million a year for the next five years to fund nurse education, primarily in partnership with California Community Colleges and the private sector. His five-point program will seek to expand capacity by encouraging partnerships between providers and schools, including some state universities, to educate nurses, recruiting additional nurse educators, and creating nursing academies at high schools and colleges.

“The money for our initiative will allow us to expand nurse education at our colleges, recruit former nurses to help teach in our nursing schools, and create statewide on-the-job nursing training programs and much, much more,” said Schwarzenegger on his weekly radio address in mid-April.

Schwarzenegger said the hospital industry reports a shortage of about 14,000 registered nurses in the state, a 12-15% vacancy rate, which was one reason he issued an executive order freezing further implementation of California’s landmark nurse staffing ratios law Jan. 1. While his freezing of lowering med-surg nurse-to-patient ratios from 1:6 to 1:5 was overturned in a court challenge by the California Nurses Association, (CNA), the governor has filed an appeal that is pending.

CNA President Deborah Burger challenged hospital shortage figures, saying Kaiser Permanente facilities and many others have successfully met the ratios. She also contends that the ratios law has increased workplace and patient safety, a key factor in nurse satisfaction.

Politics aside, Jones says the need for more nurses is very real as the baby boom generation begins hitting retirement age in 2010, putting additional strain on healthcare resources.

“We need to be worried about the nursing shortage we have looming in front of us, but I’m optimistic we can do something to mitigate its severe impact,” says Jones.

The five-year public/private initiative proposed by Gov. Schwarzenegger would:

1. Provide $90 million to expand and increase nurse education opportunities.
2. Support partnerships between nursing schools and health facilities to build more educational programs
3. Recruit more qualified instructors.
4. Develop new avenues to nursing careers with high school and college nursing academies and apprenticeships.
5. Seek additional funds for nurse education from federal and other funding sources.

John Leighty is a freelance writer for Nursweek.