Ingrams June 2023

Waiting for Reinforcements

Drop in nursing-school enrollments has hospital executives prepping for a more competitive talent landscape ahead.

by Dennis Boone

For more than a decade, hospital ex ecutives have been ringing alarm bells about a looming shortage in the phy sician ranks as the first wave of Baby Boom-age doctors wrapped up their ca reers. For the past 3½ years, those same executives have lamented the thinning of the nursing ranks as pandemic-relat ed stresses prompted nurses to abandon their careers en masse. Now, from the other end of the health- care talent pipeline, a new threat: While U.S. medical-school enrollments of phy- sicians have increased significantly in recent years, up 5.8 percent since 2018, nursing numbers have broken the oppo site direction—hard. That’s the case as well in Missouri and Kansas. Across three dozen nurs ing schools in the two-state region, en rollment fell from 22,268 in the fall of

nurse-practitioner program director for Maryville University of St. Louis, by far the two-state region’s largest nursing school. “This is one of the major reasons why nationwide enrollment in nursing programs has returned to the ‘norm’ or typical levels,” Elbe said. Furthermore, she said, some nurses opted to transi tion to travel nursing due to the finan cial advantages and higher salaries as sociated with it, and “as a result, many nurses postponed their plans of pursu ing a nurse-practitioner education.” As enrollment has dropped at the University of Missouri-Kansas City, “we have been evaluating that, and continue to,” said Casey Bauer of the School of Nursing and Health Scienc es. “It is a cluster of variables.” Among them, she said, were high er numbers of high school students

2021 to 19,339 a year later—a drop of 2,929 students, or nearly 13.2 percent. In a single year. Worse, those num bers are down from 25,355 as recently as 2019, pushing the total decline over one four-year cohort to 23.5 percent. Nursing school officials say the drop has left current levels closer to histori cal norms. But health authorities have been concerned for years that histori cal norms weren’t going to be enough. The aging cohort of Baby Boomers— the largest generation in U.S. history when they started showing up—will require significantly higher numbers well into the future. “In 2020, when the COVID-19 pan demic hit, many nurses were either laid off or experienced increased burnout, leading them to leave the nursing pro fession altogether,” said Mykale Elbe,

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June 2023

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