HD26 - Study of Nursing Education in Virginia

Executive Summary:
The stability of Virginia's health care system is dependent on an adequate supply of appropriately educated and skilled nurses. Nurses are the largest single group of health care providers. Virginia, along with the entire nation, stands on the threshold of what is forecasted to be a nursing shortage so great that that the public's health will be threatened. House Joint Resolution (HJR) 664 of the 2001 Session of the General Assembly directed a study of education programs for registered nurses and licensed practical nurses in Virginia to determine whether the capacity of Virginia's RN and LPN nursing education programs needs to be increased to meet future demands.

Fundamental shifts are occurring in Virginia that increase the need for nurses at a time when the supply is declining. An aging population, changes in the delivery of health care that require more nurses, an aging nursing population and the decrease in applicants to nursing programs have led to a shortage unlike past shortages. Interest in nursing has been declining. Educational Institutions are facing unprecedented numbers of faculty retirements.

Past nursing shortages have followed recurring cycles. Permanent solutions to past shortages have not been achieved. A critical shortage of nurses has begun. A permanent solution to the nursing shortage is needed. The solution must include changes in working conditions as well as increasing the supply of nurses. Improving working conditions is and primarily the responsibility of health care organizations. Increasing the supply of nurses is the responsibility of the Commonwealth.

The nursing shortage affects every sector of health care and nursing education. This report focuses primarily on entry level nursing education programs and the recruitment of new nurses. However, nurses with advanced education are also needed but the need is not as critical as the need for new nurses.

Virginia has experienced slow growth in the numbers of RNs and LPNs throughout the 1990s. In 2001, the first decline in the number of LPNs occurred. Past growth of the nursing population has been due to the infusions of newly educated nurses and by nurses who move into Virginia. Demand for nurses continues to rise and overall enrollment in nursing programs has declined. By 2020, Virginia will experience a 30 percent deficit in the number of nurses needed by health care facilities. Growth in the supply of nurses cannot be maintained without an increase in nursing program enrollments.

Nursing education programs in Virginia are spread across the Commonwealth and increasing enrollment in existing programs provides the most effective and fastest means of increasing the supply of nurses. A statewide recruitment plan is needed to assure that potential students are aware of the opportunities in nursing, the educational program options and the scholarship and loan repayment programs.

Expansion of nursing programs, as a phased process, will provide for an immediate increase in nursing graduates, as a first step, and the development of a long-term plan for sustained program growth. Scholarship and loan repayment funds must be increased to make nursing education more accessible. Large numbers of faculty will retire during the next ten years as education programs are expanding. New faculty must be educated and emphasis placed on preparing masters and doctoral students for faculty positions. Faculty workload is heavy and salaries are low and these issues must be addressed if the necessary faculty is to be recruited.

Virginia has to address the shortage now or suffer the consequences of inadequate staffing, limited access to health care and the potential of increased errors and adverse outcomes in health care settings. Failure to take action will exacerbate the problem. A coordinated public/private response is needed to reduce the negative impact on the health of Virginians.