In 2007, warning of a nurse shortage in Michigan and long admission waiting lists for nursing schools, then- Gov. Jennifer Granholm proclaimed: “Something's wrong with this picture and we are going to fix it.”
Well, not exactly.
Six years and millions of dollars later, there are renewed warnings of impending nursing shortages. Hiring bottlenecks persist at the very nursing schools that could turn out more nurses. An aging nursing faculty is poised to leave more teaching vacancies as they retire.
And as more baby-boom nurses also leave work this decade, experts foresee trouble ahead.
“We have an aging nursing work force and our nursing faculty is even older,” said Carole Stacy, director of the Michigan Center for Nursing, a program of the Michigan Health Council.
While Stacy said that some schools have worked through their waiting lists, she said others still have lists “several years long.”
At the moment, however, Stacy believes there are enough nurses in Michigan to meet demand. In her view, job postings in hospitals and elsewhere that are going unfilled are often due to specific credential requirements, as opposed to a general shortage of qualified candidates.
But with thousands of Michigan nurses in their 50s and 60s, that soon could change.
1 in 3 RNs approaching retirement age
“What I am hearing now with the economy getting better, is that nurses who put off retiring are saying they are going to retire. In about two years, we are going to see shortages.”
A 2010 survey by the Center for Nursing underscores her concern. It found that more than a third of registered nurses were age 55 or older and 43 percent of licensed practical nurses were 55 or older. At the time, there were nearly 160,000 nurses licensed by the state of Michigan.
Nursing faculty have a similar profile, one reflected not only in Michigan but across the country.
A national survey of 2010-2011 nursing programs country found the average age of master's degree-prepared nurse professors to be nearly 58 and associate professors 56. In 2011, the Center for Nursing reported that 41 percent of full-time nursing faculty were 56 or older.
According to the American Association of Colleges of Nursing, U.S. nursing schools turned away some 75,000 qualified applicants from baccalaureate and graduate nursing programs in 2011 because of insufficient faculty, clinical sites, classroom space, clinical teachers and budget constraints. About two-thirds of nursing schools that responded to its survey cited faculty shortages as a reason for not accepting qualified candidates into baccalaureate programs.
Demand for nurses will grow
At the same time, numerous forecasts project a rising need for nurses just as baby-boom nurses retire over the coming years. According to the Bureau of Labor Statistics, the number of needed nurses will grow from 2.74 million in 2010 to 3.45 million in 2020. That reflects the inescapable fact that America is aging and that older people require more health care.
The number of those 65 and older is projected to rise from 40 million in 2010 to 55 million in 2020 and 72 million in 2030. In 2008, people 65 and older comprised 13 percent of the population, but accounted for 35 percent of hospital discharges, according to a federal report.
The predicted demand would seem to dictate comparable growth in capacity at nursing schools. But experts say the barrier to hiring remains much the same as when Granholm launched the Michigan Nursing Corps, an initiative to train more nurses:
In 2008, the Michigan departments of Labor and Economic Growth and Community Health awarded $1.5 million in grants to six Michigan nursing schools and four hospital partners, the beginning of the Michigan Nursing Corps. That was expanded to total spending of $7.3 million through 2011. It added 93 clinical faculty through partnerships and 86 master's degree and doctorate teachers.
But faculty salaries continue to lag what a nurse can make in the field, impeding future hiring.
A clinical nurse with experience can earn upwards of $80,000 at a Michigan hospital. The salary for a clinical nursing faculty position at a four-year program – which typically requires a master's degree – might be $20,000 or more less.
A $20,000 pay cut to teach?
“Pay is really the big issue,” said Debra Nault, director of nursing practice for the Michigan Nurses Association. “The pay is not really what you can earn in a hospital.”
Nault recalled that she earned about $80,000 a year as a clinical nurse specialist at Sparrow Hospital in Lansing, when she contemplated taking a full-time nursing faculty position.
“It was like a $25,000 pay cut,” she said.
On top of that, potential clinical nursing faculty candidates typically need to foot the expense of a master's degree in order to qualify for the position.
“You really have to be motivated to be in that academic world,” Nault said.
At Grand Valley State University's Kirkhof College of Nursing, Dean Cynthia McCurren feels fortunate to have most of her open faculty positions filled at the moment. But she said the salary gap between teaching positions and nursing practice remains a problem.
“It's a pretty big discrepancy. It can be a $20,000- or $30,000-a-year difference.”
At Grand Rapids Community College, the wait list for its RN program is 3.5 to 4 years. And it has been that length for several years, according to Michelle Richter, GRCC’s nursing school director.
Richter said it is a particular problem to attract part-time adjunct faculty teachers – who need a master's degree to be hired – given the compensation the school can offer.
“They are starting at such a low salary,” she said.
Richter said the school is further limited in the number of nurses it can turn out by the Michigan Board of Nursing, which authorizes the number of student “seats” its program can offer.
Jeanette Klemczak, who formerly served as chief nurse executive for the Michigan Department of Community Health, credits the Michigan Nursing Corps with steps in the right direction. She is now health care talent director for the Michigan Workforce Development Agency.
But Klemczak said considerable challenges remain.
She noted that the state projects a 21 percent rise in demand for registered nurses and 20 percent for licensed practical nurses by 2018. That's without accounting for the effects of the federal Affordable Care Act – which is expected to add more insured patients – and the proposed expansion of Medicaid, which could add 350,000 more insured individuals.
“This is like the quiet before the storm,” she said.