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For Yorker, who has four faculty positions unfilled in San Francisco, low salaries are the "single greatest barrier" to getting nurses into the workforce. "We can't compete with the marketplace to attract credentialed faculty," she said. "Nurses in the Bay Area are the highest paid in the country because of the cost of living. However, our faculty salaries are national and state norm. We are at a serious disadvantage."

San Francisco State was hit with a $30.2 million budget cut this year. The amount represents almost 21 percent of the school's general fund budget. That trickled down to a $76,000 shortfall for the School of Nursing. According to one administrator, the School of Nursing took less of the pinch because "nursing is the best-funded discipline on campus."

With some creative budgeting, the school did not cut any faculty or enrollment. But students and staff felt the crunch. "Every day we're confronted with the fact that the existing staff is totally overworked," said Carolyn Foley, 34, a student in the RN/MSN program. "They are teaching extra classes or have accepted a ton of students. They don't have time."

Foley, along with a dozen other students in the RN/MSN track, were forced to delay taking elective classes for their advanced practice certification. For Foley, this means she will finish up units next fall, while working full time as a nurse. "I'm not sure I'm going to sleep," she said. "It's a bummer."

Foley's classmate Staci Smith will have to delay graduation by a semester to fulfill her elective requirements.

"It doesn't help the nursing shortage when there are people out there who are willing to work, but can't get out of school," said Smith, 34. "They do the best they can with limited resources. But the whole nursing education process is frustrating."

New blood needed

By 2020, there will be a shortage of 434,000 nurses in the United States. Today, more than 100,000 nursing positions are vacant, according to a Web site sponsored by Johnson & Johnson.

Almost every hospital has nursing jobs open, and the clamor is only going to get worse. In Collin County, Texas-which grew 86.2 percent between 1990 and 2000-expanding hospitals will need 1,000 nurses to staff the new facilities, according to a recent article in the Dallas Morning News.

UTHSC-Houston's Starck said she had just read a state report on the nursing shortage in Arkansas that echoed her own experience.

"Arkansas needs 1,925 nurses, and they are producing 683," Starck said. "They need 1,200 more nurses graduated per year. Every school is in the same boat. We have the jobs waiting in hospitals, we've got the labor force willing to fill the jobs. What we don't have is the means of educating them."

Overall enrollment in entry-level baccalaureate nursing programs increased this year by almost 17 percent. But the good news is tempered by the increase falling far short of the projected need to reverse the shortage: Enrollments of young people in nursing programs would have to increase at least 40 percent annually to replace those expected to leave the workforce through retirement, according to the American Association of Colleges of Nursing.

"Over the next 10 to 15 years, I think 50 percent of the faculty are going to be retiring," Job said. "It's going to be a huge crunch. For those of us in education and hospitals, it's a very scary thing."

With the average age for an RN at 46 years, the nursing workforce is quickly heading for retirement.

The nursing faculty workforce-with an average age of 51 years-will get there even faster: The percentage of RNs who are in education already has dropped dramatically, from 3.7 percent of the workforce in 1980 to 2.1 percent of the workforce in 2000, according to the National Sample Survey of Registered Nurses.

Positive partnerships

Idaho, for example, has only one MSN program in the state. And the number of graduates from the program doesn't meet the academic need. So Job, like many nursing program administrators, bolstered her program by reaching out to the local health care industry. The two big hospitals in Boise, St. Luke's Regional Medical Center and Saint Alphonsus Regional Medical Center, committed to providing multiyear funding to support faculty salaries.

"We want the university to have enough faculty to up the student enrollment to have enough nurses coming down the pipeline," said Randall Hudspeth, MS, APRN, Saint Alphonsus director of professional practice. Industry partnerships are a key component-both in keeping nursing programs afloat and in stemming the nursing shortage.