New Mexico’s intensive care units are operating beyond capacity. Hundred-day hospital stays are almost commonplace today, but were unheard of before 2020. Nurses, aging with our American population, are retiring. As the demand for health care services increases, the shortage of registered nurses is getting worse.
The COVID-19 pandemic has exacerbated the nursing shortage by increasing the number of patients entering the healthcare system and skewing the patient-nurse ratio into risky territory.
A nursing shortage can lead to errors and higher rates of morbidity and mortality. Longer and more taxing shifts also lead to burnout and turnover of nursing staff, interrupting continuity of care with equally disastrous consequences for patients. It’s a cycle that can only be broken by adding more nurses.
Nationally, we will need about 1.2 million new nurses by 2030, and New Mexico, which has just over 11 nurses per 1,000 people, will need up to 3. 700 more to prevent a catastrophic breakdown of health services across the state.
Rural areas face an even more critical need. Only 16% of nurses live in rural areas. And given that the 46 million Americans living in these communities tend to be older and have more chronic conditions, border residents are the ones bearing the brunt of a lack of access to care. While efforts are being made to bridge the gap, there is still much to be done in terms of training and recruiting talent.
The American Association of Colleges of Nursing has found enrollment in nursing programs has increased despite fears the pandemic will push away future healthcare workers. In fact, the number of students pursuing bachelor’s degrees in nursing has increased by almost 6%, an encouraging number since nurses with a bachelor’s degree are linked to better patient outcomes. However, interest in nursing school has not been matched by the capacity of our country’s nursing programs; colleges and universities were still turning away thousands of qualified applicants.
The obvious solution then is to increase both the capacity and the frequency of training programs. Going one step further, colleges and universities should also provide options that work better for non-traditional students who take on other jobs and raise families while earning their degrees. And, to solve the problem where it is, rural institutions especially need to open their doors more widely.
According to the National Rural Health Association, nurse education programs are typically located in metropolitan areas, attracting students from rural communities not just for school, but potentially for the rest of their careers. And students in large urban nursing programs have little exposure to rural health care topics in the classroom or clinic. They graduate feeling ill-equipped to work in such environments.
Small nurse training programs and those in rural areas will play a key role in ensuring the health of their neighbours. Nursing programs can increase admission to twice a year instead of once a year, expand clinical opportunities to weekends and night shifts, and offer part-time options to aspiring nurses who have need more flexibility. Colleges and universities can combat the parallel shortage of nursing faculty by offering the market rate and continuing to use technology that helps offset the limited availability of clinical sites. Simulation is successfully implemented in most nursing programs, which recognize that although patient exposure is necessary, incorporating high-fidelity simulation is a proven method of bridging the gap between nursing theory and bedside nursing.
While there is no shortcut to producing competent nurses ready to enter today’s healthcare environment, improving access to nursing programs is the best way to go. Educating every qualified candidate who wants to join the next generation of nurses should be the goal of all universities in New Mexico.
Charnelle Lee is a recipient of the New Mexico Nursing Education Consortium Nurse Educator Endowment Award.