RALEIGH (April 6, 2023) – There’s no shortage of people who want to be nurses. But there is a shortage of people to turn them into nurses – and as a result, a shortage of nurses in North Carolina.
The budget proposal the state House approved today tries to address that shortage by providing millions for the state’s community colleges and universities to expand nursing programs and hire nursing instructors.
“We know there’s been a shortage of nursing instructors around the state,” said House Speaker Tim Moore. “And so that’s gonna allow the community colleges to catch up and make sure that we have those folks working.”
Even before the coronavirus pandemic, North Carolina faced a shortage of nurses. Prior to the pandemic, NC Nursecast, developed by the Cecil G. Sheps Center at UNC-Chapel Hill, predicted a shortage of 12,500 registered nurses and 5,000 licensed practical nurses across the state by 2033.1
HIGHER ED WORKS focused on that shortage in a 2021 series called “Help Wanted: Nurses.”
The series revealed how the main reason for the state’s nurse shortage is a shortage of instructors – because a nurse can make more money being a nurse than she can teaching how to nurse.
Wake Technical Community College President Scott Ralls explains the shortage in this video:
“When you can make more to do the job than you can to teach people how to do the job, and that gap grows, then you’re in trouble,” Ralls says.
“When that differential is like this,” he says, spreading his hands apart, “then we’re in trouble. And we’re in trouble.”
State legislators asked last year for a study of how the state could increase the number of nursing graduates from public institutions by 50%.
THE STUDY FOUND the state’s community colleges and universities graduated a total of 4,212 nurses in 2021. To increase that number to 6,318, the study’s first recommendation was to address the shortage of nursing faculty at both community colleges and universities.
It cited one example of a community college within an hour’s drive of multiple hospitals in two major health-care systems. Faculty at the college make $31.88-35.76 an hour, while nurses at the hospitals make $37.80-40.29 an hour – a difference of $4,000 to $17,500 a year.
For universities, there is also a shortage of master’s and doctoral degree holders, the study found, so increasing instructors will also require investments in graduate nursing programs.
Nursing faculty at community colleges are required to take courses in adult teaching and learning, and some are required to have graduate degrees, the study said. But potential instructors see little value in paying for additional education for a job that pays less than they already make.
As a result, from 2018-22, the study found, UNC System schools were only able to admit two-thirds of qualified students. And from 2019-21, the state’s community colleges could only admit 58% of qualified applicants.
“Robust resource allocation aimed at both reducing attrition of enrolled nursing students and increasing the ability of the Systems to admit qualified applicants into nursing programs would reduce the timeline to reach 6,300 graduates significantly, to perhaps 2028 or 2029 in the judgment of some nursing leaders,” the study concluded.2
TO ADDRESS A GENERAL SHORTAGE of health-care workers across the state, the House budget – which still must go to the state Senate – would put:
- An additional $40 million over the next two years into expansion of courses in health-care fields at NC community colleges. It remains to be seen how many of those funds would go toward nursing instruction, however.
- Another $20 million over two years specifically into support for nursing programs at community colleges. And $2 million over two years specifically into Surry Community College to hire eight nursing instructors under an agreement with Northern Regional Hospital.3
- $40 million over two years into expansion of courses in health-care fields across the UNC System. Again, it remains to be seen how many of those funds would be devoted to nursing.
- $15 million over two years into expansion of primary-care programs, including nursing, at East Carolina University.
- $15 million over two years into health-care programs at UNC Pembroke to meet regional workforce demands. Robeson County consistently ranks as the least-healthy county in the state.
- $21 million over two years into health-care fields at the state’s private colleges and universities, including $1 million for High Point University and $500,000 for nursing at the University of Mount Olive.
In addition, the House budget makes additional allocations beyond staff raises for community college and university officials to help recruit and retain faculty and staff in hard-to-fill positions.4
1 https://ncnursecast.unc.edu/key-findings/.
2 https://www.northcarolina.edu/apps/bog/doc.php?id=67169&code=bog, pp. 15-28.
3 https://webservices.ncleg.gov/ViewNewsFile/71/HB259_CommRpt_2ndEdit_2023_04_03, p. B10.
4 https://webservices.ncleg.gov/ViewNewsFile/71/HB259_CommRpt_2ndEdit_2023_04_03, B35-B56.
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