Why You Should be Concerned About the Future of Nursing

Prior to Hurricane Irma hitting landfall in Florida, Governor Rick Scott of Florida pleaded for 1,000 volunteer nurses to help at special needs shelters. In any catastrophe, nurses are critical in assuring the health of the public is maintained.

Nurses are not only essential in emergencies, but they are essential to the overall health and welfare of the United States. Employment of registered nurses is projected to grow 16 percent from 2014 to 2024. Much of the demand for health care services will increase because of the aging population.

Nursing Workforce Development programs, perhaps more familiarly known as Title VIII (Public Health Service Act [142 U.S.C. 296 et seq.]), are the cornerstone of sustaining a robust nursing workforce, qualified to meet our nation’s increasing health care needs. The following is an overview of the Title VIII Nursing Workforce Development programs:

• Advanced Education Nursing Grants: Provide funds to help schools of nursing, academic health centers, and other nonprofit entities improve the education and practice of nurse practitioners, nurse midwives, nurse anesthetists, nurse educators, nurse administrators, public health nurses, and clinical nurse specialists.

• Workforce Diversity Grants: Increase disadvantaged students’ access to nursing education

• Nurse Education and Retention Grants: Strengthen nursing education programs at schools of nursing, academic health centers, nurse-managed health centers, and other health care facilities that provide nursing education.

• Nurse Faculty Loan Program: Provide for partial loan forgiveness, up to 85 percent, for students who agree to teach full-time at an accredited school of nursing.

• Nurse Loan Repayment and Scholarship Programs: Provide for the cancellation of up to 85 percent of educational loans for nursing students who agree to practice in a designated nursing shortage area for at least three years.

The President's FY 2018 Budget Proposal calls for a decrease in funding of Title VIII Nursing Workforce Development programs. The administration has proposed to eliminate $403 million in health professions and nursing training programs, which they claim, lack evidence that they significantly improve the Nation’s health workforce.

In an effort to grasp the full impact that elimination of funds would have on the future of the nursing profession, I reached out to Dr. Deborah Trautman, President and CEO of the American Association of Colleges of Nursing (AACN), which is the national voice for university and four-year college education programs in nursing. Her response to my questions follow:

Can you briefly discuss the history of Title VIII Nursing Workforce Development programs?

Dr. Trautman: The Title VIII Nursing Workforce Development programs were signed into law by President Lyndon B. Johnson under the Nurse Training Act of 1964. For over 50 years, these programs have provided a consistent source of support for our students, faculty, and institutions. The programs bolster the educational pipeline of Registered Nurses, Advanced Practice Registered Nurses, nurse faculty, and students. They have been in existence for this long because of their proven success. As trends in the nursing workforce and within our patient populations have changed throughout the years, the programs have evolved to make sure they are meeting their mission, which is to ensure access to care for all communities, particularly rural and underserved communities.

The recent budget proposal cites that the Nursing Workforce Development Programs “lack evidence that they significantly improve the Nation’s health workforce.Can you cite evidence demonstrating how the Nursing Workforce Development Programs have been instrumental in improving the nursing workforce?

Dr. Trautman: It is unfortunate and discouraging to see this claim when this clearly is not the case. Last year alone, the programs supported over 61,000 students and practicing nurses. Recipients of Title VIII, including AACN member schools, have created powerful returns on investment by putting the dollars to work in ways that address critical needs within their institutions and communities. For example, the James Madison University School of Nursing in the Shenandoah Valley of Virginia, which encompasses several rural and medically-underserved regions, was able to open a Nurse Practitioner program through Title VIII funding, which has since graduated 140 nurse practitioners to provide primary care to underserved and rural areas throughout the Commonwealth. At Saint Louis University School of Nursing in Missouri, Title VIII funds have enabled the school to recruit, retain, and graduate more students from disadvantaged backgrounds and individuals underrepresented in the nursing profession. Many of the recipients of the funding have shared that they would not have been able to attend or complete nursing school if it were not for Title VIII. Some students were the first in their families to attend college. So, you can see that there is definitely a tremendous impact across the pipeline, from student education through care delivery.

Why should the public be concerned about a reduction in Nursing Workforce Development Programs? What direct impact will it have on the consumers of health care?

Dr. Trautman: A reduction in funding for Title VIII may impact access to essential nursing services, which are critical to sustaining the health of the nation. Our population is aging as the baby boomers are coming to retirement age and people are living longer and more active lives. We have seen an increase in chronic diseases such as diabetes, hypertension, and heart disease, just to name a few. Both of these developments are accelerating the demand for care. One of the goals for these Nursing Workforce Development Programs is to provide health care for people who are geographically isolated and economically or medically vulnerable. There are currently rural and underserved communities in the United States that have only nurses and advanced practice registered nurses as their health care provider and without these professionals, they would have to drive hours to seek care. Health care consumers need highly educated nurses to meet the increasing care needs of our population. This is why the public should be concerned. Governor Rick Scott was right to ask for volunteer nurses because nurses are educated and prepared to support their communities utilizing all available resources. They do this work every day, and they do it well!

How can health care consumers ensure that these programs continue to receive funding?

Dr. Trautman: To start, legislators need to hear more about how nurses are making an impact on the health of their communities. Nearly everyone has either been cared for, or has had a loved one cared for by a nurse. Realizing how embedded that nurses are in the community, and then understanding the gravity of their absence if they were no longer there to offer their services, is exactly the reason why we need to ensure that Title VIII programs continue to flourish. Title VIII provides a direct lifeline in deploying nurses where they are needed most. There is legislation in the House of Representatives and Senate that would help ensure the programs are sustained- the Nursing Workforce Reauthorization Act of 2017. This legislation would reauthorize, or renew, their ability to receive federal funding through Fiscal Year 2022 and modernizes the programs to align with current trends in health care. Telling your federal legislators to cosponsor this bill is a vital step.

Dr. Ruth Tarantine is currently dean of nursing for Colorado Technical University. With over 25 years of nursing experience, she holds a master’s degree in nursing from the University of Pittsburgh, and a doctorate of nursing practice from Chatham University.

The views or opinions expressed by me in this blog are my own and not those of my employer.

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