If you talk to hospital, home health, or clinic leaders anywhere in the country right now, you’ll hear the same concern: we don’t have enough nurses. What’s worse, the education pipeline that’s supposed to replenish and grow the workforce isn’t keeping up with the demand in our healthcare sector.
I see that reality every day in my role as Chief Nursing Officer at ATI Nursing Education/Ascend Learning. Recruiting and retaining nurses is increasingly difficult, and supporting career advancement is a key part of changing that. Many students today aspire to become nurse practitioners, clinical specialists, and other advanced practice providers. Some will even go on to become desperately needed educators training the next generation of nurses.
We must do everything we can to support these students and make their dreams and aspirations come true. That’s why changes to federal student borrowing just finalized by the U.S. Department of Education are very worrisome for anyone concerned about the future of healthcare.
The department changed the limits on federal student loans for graduate programs. Under the new rule, students pursuing certain “professional” degrees—such as medicine—could borrow up to $50,000 a year. But many other graduate healthcare programs would be capped at $20,500 annually, with a lifetime limit of $100,000. That includes Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), and master’s and doctoral programs in Nursing Education.
For students who want to advance their careers, federal loans have long helped bridge the gap to pay for schooling costs. Many graduate nursing programs may run well over $30,000 a year, although tuition varies widely. Now that federal loan options are more limited, some students will decide the math doesn’t work and be forced to abandon their dreams.
When fewer students pursue advanced nursing degrees, our country loses out in at least two important ways. First, we should expect fewer advanced practice nurses, such as nurse practitioners, who expand access to care in rural and medically underserved communities where physician shortages are hitting hard.
Second, an important story that’s largely being overlooked in the conversation about these loan caps is the impact they will have on faculty and the nursing education pipeline. Advanced nursing degrees are not just the pathways into vital roles that our healthcare system increasingly depends on. They are also prerequisites for most faculty positions to train future nurses at a time when 7.2% of faculty seats nationwide sit vacant – and a large majority of those positions (80.9%) require or prefer a doctoral degree.
The reality of becoming a nurse educator is already a difficult decision to make for many nurses practicing in the clinical setting, but their passion and dedication to the profession drive them. Data shows that the median salary for a master’s-prepared professor in schools of nursing is roughly $35,000 less per year when compared to the median salary across advanced practice registered nurse roles. The new lower loan caps will only compound this significant salary pressure and may make the financial disincentive too large for some nurses to transition to academia.
The faculty shortage has long-term impacts on our nursing workforce. Across the country, nursing schools routinely turn away qualified applicants because they simply don’t have enough faculty to teach them. Just last year, over 80,000 qualified applications were turned away from baccalaureate and graduate nursing programs due to capacity constraints. The Department of Education’s new policy makes it harder to pursue advanced degrees, meaning the bottleneck will only tighten, and the number of new nurses entering the workforce will decline.
Advanced healthcare programs are, by any reasonable definition, professional education. They prepare students to enter licensed professions and require training well beyond a bachelor’s degree. Treating them differently from other professionals ignores the essential role these careers play in a well-functioning healthcare system – a view widely held by hundreds of organizations across the nursing community, such as the American Association of Colleges of Nursing, the American Nurses Association, and over 150 members of Congress.
Bottom line – the United States needs more nurses. We need more licensed practical nursing and registered nursing students. We need more nurse practitioners caring for patients in rural communities that struggle with physician shortages. We need more nurse anesthetists supporting surgical care. And, importantly, for all these roles, we need more nurse educators who can train the nursing students who will join the healthcare workforce of tomorrow.
Decisions made in Washington about education financing shape the future of the healthcare workforce. That’s why I’m disappointed with the Department of Education’s decision to limit student loan opportunities for advanced nursing programs. Now, Congress must step in to ensure that students pursuing these careers still have access to the financing they need.
If fewer nurses can take that next step in their training, patients and entire communities will eventually feel the impact. I urge Congress to consider solutions such as S.4568, the Nursing is a Professional Degree Act, H.R. 6739, the Clarity in Professional Degree Act, and H.R. 6718, the Professional Student Degree Act, all of which would make certain advanced health degrees eligible for the higher “professional degree” federal student loan limits. Congress needs to act to protect the nursing workforce pipeline.
