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Maurcena Wells, 64, assists in sewing a patient's head after a post-craniotomy at Albuquerque (N.M.) Regional Medical Center. "I plan to keep working as long as I can," Wells said, "because I do need the income. I still want to take trips and do some things to the house...I have to keep working."

The recession that ended last year turned out to be a dark cloud with a silver lining for nursing. On the upside, the downturn in the economy highlighted the demand for RNs and the seeming insatiable nursing shortage.

With an almost ironclad guarantee of employment, the recession-aided by marketing campaigns-swelled nursing school enrollment. Second-degree programs that speed professionals from other industries into nursing especially flourished.

Also on the upside, RNs didn't experience the layoffs that crippled manufacturing industries, and their salaries continued to advance through the recession that consumed 2002.

On the downside, however, nurses may have to cope for years with the effects of a weak and uncertain economy. In the extreme, some RNs have come to realize that they must continue working instead of savoring retirement. Staffing also remains an issue, with heavier workloads for lighter staffs, which is also a product of the recession.

"Historically, in periods of economic recession, nursing sees an influx of new applicants. It offers young men and women job security at a time when people in a variety of other industries are losing jobs," said Judith Shindul-Rothschild, Ph.D., MSN, RN, of the William F. Connell School of Nursing at Boston College.

All Nursing Schools , an Internet resource representing 170 nursing schools, experienced a 93 percent increase in visitors to its Web site-to about 4.8 million-and a 95 percent jump in inquiries to schools in the year ending Sept. 30, said Mike Mathieu, president and founder of site owner All Star Directories.

"Second-degree students in particular, helped along by the weak economy, are turning to nursing as a career," Mathieu said. Inquiries do not translate one-for-one into students, but 37 percent of the information requests for bachelor's degree programs came from nontraditional students, he said.

In a survey of 578 nursing schools, or about 85 percent of four-year degree programs in the United States, the American Association of Colleges of Nursing reported that overall enrollment in undergraduate programs was up more than 16 percent in the fall of 2003.

Boston College reflects the yin-yang of recession and nursing. The college admits only its top applicants, regardless of their field of study.

"From one year to the next, we don't know who we're going to get," Shindul-Rothschild said. Yet the nursing freshman class is up 53 percent, to 80 students, "the biggest jump ever. We're thrilled," she said, adding that nursing is attracting "very competitive applicants" who just as easily could choose to be in education, arts and sciences, social work or business, and who have the underpinnings to be future nursing leaders.

Top of the pops

Shindul-Rothschild attributes the rush to nursing to two things: recession and an awakened interest in service professions in the aftermath of Sept. 11, which contributed to the economic downturn.

Nowhere is the increasing interest in nursing school more evident than at Vanderbilt University in Nashville, Tenn. Enrollment is a record 264 students for this academic year, with a waiting list of more than 35 academically qualified students. Vanderbiltthree-semester "bridge" program for students with other degrees surged to 148 students from 124.

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