Reasons for Shortage are Complicated and Longstanding

"The reasons are complicated," Freeman explains, beginning with decisions made in the 1950s to downgrade nursing schools and create "associate" degree programs available at local two-year community colleges. Nursing education was no longer hospital-based with a Bachelor of Science in Nursing (BSN) no longer mandatory.


"All those (hospital) programs were closed," Freeman says. "Nurses with four-year degrees felt they were no longer treated as professionals. Of course, those two-year nurse associates earned less. Today, we are paying for being so short-sighted."

A nursing shortage is a lot like the weather: everybody talks about it, but nobody seems to know what to do about it. The ANA's own in-house magazine, in March of 1998, ran a detailed article titled: New Nursing Shortage Hits: Causes Complex. Any alarms raised about quality care clashed with the shortage of cash, however. That same year, the ANA noted that California, for example, in 1998, waived nurses licensing requirements during its flu epidemic." Then Governor Pete Wilson called it an "emergency care crisis."

"After the failure of the Clinton Health Care plan in 1993," Peterson notes, "managed care was thought to be a solution - and it wasn't."

As Chaos Builds, Nursing Professions Try to Respond

"By 2000, it was a fairly chaotic time," Peterson says, and it was time for the ANA to respond. In 2001, the ANA joined with other autonomous nursing organizations such as the AACN, AONE, and NLN, in issuing a joint report: Strategies to Reverse the New Nursing Shortage, which focused on leadership for education, practice and research.

"We invested more heavily in nursing education by creating scholarships," Peterson noted. "And we shifted our focus towards creating new teachers of nurses as nursing faculty got older."

The nursing professions initiative has had success. "We now have a wait list of about 100,000 people who want to train as nurses. The problem is we don't have the faculty."

Indeed, by 2004, many men and women decided to choose nursing as a new or second career. Health Affairs Journal reports that larger numbers of people in their late twenties and early thirties are entering the profession, far older and from different segments of the potential workforce than in the past.

Recruiting Success Clashes with Statehouse Cutbacks

At the same time, however, cash-strapped state governments began cutting back on college funding as they faced their own budget short-falls.

"We have the students but lack the capacity - the brick and mortar buildings and the labs do not stretch far enough," she says.

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