Florida nursing schools need more funding, faculty to prevent 59,100 nurse shortfall: report

Florida nursing schools need more funding, faculty to prevent 59,100 nurse shortfall: report
·6 min read

Florida could face a shortfall of 59,100 nurses by 2035, according to a projection using data from before the pandemic.

Commissioned by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida, the report found that Florida’s aging population and expected growth will worsen the already-existing demand for new nurses.

The report, done by market analysis group IHS Markit, says the issue could partially be caused by a shortage of nursing school graduates: A 2018-19 survey by the Florida Center for Nursing found that many nursing programs didn’t have the resources or funds to expand, and couldn’t find enough faculty or clinical sites even when they could.

“A strong health care workforce and capacity in the education system to graduate needed nurses over the coming years are critical,” said Mary C. Mayhew, president and CEO of Florida Hospital Association.

Yet as hospitals try to fill thousands of vacant positions, Florida’s nursing students pass the required nurse licensure exam at one of the lowest rates of any state. Many well-regarded programs with higher pass rates for the test, called the National Council Licensure Examination (NCLEX), regularly turn away qualified applicants because their programs don’t have enough resources to expand.

During the 2018-19 academic year, 182 of Florida’s pre-licensure registered nurse programs received nearly 8,000 more qualified applicants than total seats available for new students, according to the Florida Center for Nursing.

“Every single year ... we have more applicants than seats. And that’s been our biggest challenge,” said James Henningsen, president of the College of Central Florida.

Henningsen estimates that the school rejected 40-60 qualified applicants during the most recent admission cycle. The University of Central Florida rejected over 200 qualified applicants to its Bachelor of Science in Nursing program for the 2020-21 year, said Mary Lou Sole, dean of UCF College of Nursing. Seminole State College of Florida rejected almost 200 applicants to its nursing program in Fall 2021, said Nancy Gasper, dean of nursing.

These public schools not only had exam pass rates from 85% to 100% in 2019 but also offer more affordable options than the for-profit schools throughout the state.

“If they want to get into nursing, they know the wages are good, they’re going to go to a for-profit if they have capacity, and pay five times as much and end up with all the student loan debt,” Henningsen said.

Each of the three public schools said more state funding could help them further grow their programs by building more physical space, converting existing space into nursing facilities, or hiring more faculty. Many have gotten funding from the state to grow or build new facilities, but still say they need more.

Florida allocated $1.3 billion in state operating funds for Florida colleges for the 2021-22 budget, a $64.5 million increase. The state allocated $2.8 billion for its universities, a $130 million increase, according to budget highlights. Florida’s colleges and universities also received about $2.1 billion in federal pandemic relief funds.

Florida allocates less funding per student to support general operations of higher education than the national average, according to a 2018 study by the State Higher Education Executive Officers Association.

Further complicating the issue is that even though there are more qualified applicants than spots, programs enroll fewer students than seats. The Florida Center for Nursing found that in 2019 there were about 6,400 empty slots statewide. About one out of three nursing schools actually said they did not get enough qualified applicants to fill all their seats.

“Seats left vacant may relate to other capacity concerns other than the total number of seats available,” the report states.

It’s also hard to find nursing faculty and place students at clinical sites, said Michael Vitale, vice president of academic affairs at Lake-Sumter State College. He said the college’s nursing program hasn’t had to turn away qualified applicants recently, though it struggled with the issue a few years ago.

“The real, ultimate limiting factor is finding nurses that want to teach, to leave the nursing profession ... and become a faculty member,” Vitale said.

The Florida College System Council of Presidents, a group of presidents from the Florida College System’s 28 institutions, hopes to get more funding to grow nursing and other health care programs in the 2022 legislative session, said Angela Garcia Falconetti, president of Polk State College and group chair.

However, growing the nursing profession in Florida will not simply be solved by increasing opportunities for would-be nurses to get their degrees, said Michelle Mahon, assistant director of nursing practice at National Nurses United, a union of registered nurses.

“It’s very important to remember the commissioner of this report is the hospital association themselves,” she said. “They’re focusing on education, and rightfully so, however, just filling a pipeline, we will continue to be in this problem. ... There is a hole in the pipeline that is ... glossed over by the report.”

Her opinion is that the report prioritizes education to shift focus from actions the hospitals could take to improving working conditions and keep more nurses in the state.

One example, she said, comes when the report notes that Florida nurses are paid significantly less than the national average, but does not propose paying nurses more as a solution to the shortage. National Nurses United is advocating for minimum staffing ratios and workplace violence prevention standards, among other policies to increase nurse retention and safety.

Mahon also thinks the report wrongly assumes that the surge of nurses who quit or relocated during COVID-19 will be temporary.

“They optimistically view this as a short-term problem,” she said. “However, we do expect there to be a massive sequela on nurses’ mental health as a result of the conditions they’ve had to face in this pandemic ... and they were preventable by the hospitals.”

She also notes that the new report contradicts a widely distributed 2017 study by the Health Resources and Services Administration (HRSA), which predicted Florida would actually have an “oversupply” of 53,700 full-time registered nurses by 2030. This Florida Hospital Association report suggests there will be a shortage of over 31,000 RNs by that point.

Both HRSA and IHS Markit representatives said the differences can be attributed to updated data, different datasets, and different definitions of a full-time equivalent nurse.

Spokesperson Peter Sinclair said HRSA intends to publish its own set of updated nursing workforce projection numbers this year.

Leslie Postal contributed to this reporting.

ccatherman@orlandosentinel.com

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