High number of nursing students; Concerns about shortages remain

According to recently released data from the American Association of Colleges of Nursing (AACN), student enrollment in undergraduate nursing programs increased by 3.3% in 2021. The increase follows a rise by 5.6% in 2020 and keeps alive a more than 20-year streak of continuous enrollment growth, according to the organization, which conducts the student enrollment survey each year.


Cynthia McCurren, PhD, RN, Dean and Professor of Nursing at the University of Michigan-Flint, and Chair of the AACN Board of Trustees, said Medscape Medical News that the results are “great news given concerns about nursing shortages”.

These encouraging numbers alone, however, may not be enough to allay growing concerns about nursing shortages – especially as factors such as the COVID-19 pandemic, clinician burnout, a hand The aging workforce and the RaDonda Vaught case threaten to transform current and future nurses. away from the job.

Additionally, the AACN 2021 survey, based on responses collected from 964 nursing schools across the country, also revealed results that do not bode well for healthcare organizations looking to address the demand for nurses in their ranks in the future.

Decrease in the pool of professors

Perhaps most concerning, enrollment in doctoral nursing programs has continued to decline, with a 0.7% drop from 2020 to 2021, which comes on top of a 0.9% drop from 2019 to 2020. Since enrollment in doctoral programs began to decline in 2013, enrollment has declined by 13%, from 5,145 students in 2013 to 4,476 students in 2021.

This, in turn, could make it difficult for nursing schools to employ the faculty needed to meet the demand for nursing education. Indeed, 91,938 qualified applicants (not applicants) were not accepted into nursing schools nationwide in 2021.



Dr. Cynthia McCurren

“Although nursing schools have been successful in increasing enrollment over the past two decades, expanding programs even further can be a challenge given the shortage of clinical learning sites, faculty and preceptors, and other resource constraints,” McCurren said. “We know that the current faculty vacancy rate has climbed to 8% – the highest rate since 2013 – and that the vast majority of vacancies are for professors with PhDs.”

McCurren added that the AACN is working with stakeholders to advocate for new resources and funding to expand doctoral programs and welcome anyone seeking a research-based doctorate.

Lawmakers in several states are also responding to the call for help by passing bills to expand nursing schools. For example, a new Indiana law removes growth limits for 2- and 4-year nursing programs, allows nursing schools to replace some required clinical hours with simulation hours, and allows 2-year programs to hire more part-time teachers.

A Kentucky bill lifts limits on program growth and relaxes credential requirements for faculty in nursing schools.

Editing quality issues

The 2021 survey also showed that for the third year in a row, the number of students in bachelor’s degree programs – commonly known as RN to BSN programs – fell, with 12,579 fewer students enrolled. last year (a decrease of 9.6%). This downward trend, which raises quality concerns, reverses a surge in enrollment that occurred between 2002 and 2018, when the number of nursing students rose from 30,684 to 139,587, an increase of 355 %.

“The Institute of Medicine has called for at least 80% of RNs to be prepared for the baccalaureate, although the latest data shows that only 65% ​​of the RN population is educated at this level or above. Research has shown that more educated RNs are linked to lower patient mortality rates, fewer errors, better coordination of care, and other positive outcomes.Thus, a shortage of baccalaureate-educated nurses can impact overall quality care,” McCurren warned.

McCurren noted that the AACN continues to study enrollment in nursing schools and support initiatives that could help meet nursing staffing needs in the industry, but also noted that stakeholders need to take collaboration current challenges, such as burnout.

“The nursing profession as a whole – both clinical and academic settings – has prioritized the well-being of nurses to directly address some of the issues related to nurse burnout and stress.” McCurren concluded. “Nursing schools are striving to increase their capacity, but the places where our graduates work must also adapt if we are to maintain a healthy nursing workforce.”

John McCormack is a freelance writer based in Riverside, Illinois covering health care information technology, policy, and clinical care issues.