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More educators could stem Iowa’s nursing crisis
Though reforming the U.S. health care system will likely produce controversial answers to a long list of complicated questions, one proposed solution to the nation’s worsening nurse shortage is alluringly simple.
Each year, nursing schools turn away thousands of qualified applicants for lack of the instructors and resources to accommodate them. If only schools could admit more students, the looming nursing crisis might be reversed.
“If I can put it in anatomical terms, there’s not enough red blood cells flowing through the blood stream. We need to make more red blood cells,” said Dr. Rita A. Frantz, professor and dean at the University of Iowa’s College of Nursing. “It’s not that we don’t have the students. We definitely have the applicant pool — way more than we can accommodate. And this isn’t a problem unique to our school. It’s happening throughout the country.”
U.S. Rep. Tom Latham (R-Ames), who has been an active participant in policy discussions related to nursing for years, thinks the federal government can help give schools like Frantz’s the resources they need to attract more nurse educators. Together with U.S. Rep. Tammy Baldwin, a Wisconsin Democrat, Latham introduced a bill that would establish a federal student loan repayment program for nurses who agree to teach full-time at an accredited school of nursing.
Programs already exist to help nursing school graduates pay student loans, but none specifically target prospective instructors. In 2004, Iowa began a new Nursing Education Loan Repayment Program that took aim at alleviating the shortage of nurse educators and registered nurses (RNs), especially those who work in long-term care facilities or in rural communities. The program, administered by the Iowa College Student Aid Commission, does not eliminate required payments to student loans, but supplements the payments. Depending on the nurse’s chosen place of employment, the supplements can range from $5,000 to $20,000, spread over a four-year commitment.
The bill proposed by Baldwin and Latham would specifically target individuals who are interested in pursuing advanced degrees to become nurse educators.
Frantz is all for it. “It gives individuals an option of working off their loan by being a faculty member,” she explained. “If the legislation passes as it is currently written, these educators could work off as much as 80 percent of their total loan debt — which is just amazing.”
Among other benefits, the bill might do a better job keeping nursing school graduates in Iowa than efforts targeted at other types of nurses. Students who hope to become nursing instructors “have family and other ties to the state that will keep them here, which is not necessarily the case with our undergraduate students,” Frantz said.
A few interest groups have already come out in support of the Latham-Baldwin bill. Dr. Polly Bednash, executive director of the American Association of Colleges of Nursing, applauded it.
“A significant barrier to addressing the nurse faculty shortage is enticing nurses with advanced degrees to pursue careers in academia when salaries in the practice setting are much higher,” Bednash said. “One way to compensate for these lower salaries and attract younger nurses into teaching roles is to relieve their educational debt.”
The Service Employees International Union, which counts 80,000 nurses among its 2 million members nationwide, has also endorsed the measure.
When free market incentives go wrong, government help may be needed
Recognizing that its own nursing instructors were growing older and that few replacements were coming in to fill the void, the University of Iowa launched a multi-faceted program in 2007 that shifted more emphasis toward the preparation of new nursing instructors.
The program has achieved some success. Forty-five students are expected to graduate at the end of this summer with an advanced degree that will have prepared them to teach in Iowa’s community college system. An additional 70 students were admitted to that program this spring and are scheduled to graduate next summer.
Despite the university’s efforts to train more nurse educators, once students graduate with advanced degrees, it is often in their financial interests to work in clinical practice instead. The average annual salary for nurse educators is about 20 percent less than nurses with higher degrees can earn in clinical practice. (This despite the fact that nurse salaries are low industry-wide.)
Latham and Baldwin hope their bill will correct the disparity, making it less of a sacrifice to teach.
“I believe this would go a long way toward addressing the nursing shortage,” Latham said. “There are plenty of qualified applicants who want to become nurses that are shut out each year.”
Latham says he is not opposed to the bill being grouped into a larger health care reform package. He understands that either way it would require a new appropriation, but he says the cost is necessary to avert a health care disaster.
“Nurses really are the face of health care,” he said. “If left unaddressed, this shortage is going to undermine access and quality of care in Iowa and throughout the nation.”