Several senior UD nursing students were chatting at a CHNS open house and career fair in April, when the subject turned to their plans after graduation.

"All my roommates and my friends who aren't nurses are having a really hard time finding jobs," Liz Lantieri, CHNS 2002, commented. "They envy me because I've had my job lined up since January."

"I've had mine since December," said Natasha Gilkey, CHNS 2002.

The others in the group nodded. They, too, said they had jobs ready and waiting for them, most in their first choice of location and specialty.

But, experts say, what's good news for nursing students is bad news for American health care--a serious and worsening shortage of working nurses that is leaving hospitals, long-term-care facilities and community health agencies struggling to hire and retain qualified staff.

A recent survey of registered nurses, conducted by the U.S. Department of Health and Human Services, contains some statistics that show the extent of the problem, including:

• Labor analysts project that, if current trends continue, the nation will face a shortage of a half-million nurses by 2020;
  
  
• At any given time, 13 percent of nursing vacancies are unfilled, and the percentage is even higher in some types of facilities, such as nursing homes;
  
  
• The average age of nurses is about 45, with only 10 percent younger than 30; and
  
  
• Of 2.7 million nurses in the United States today, nearly one in five isn't actively practicing.

Another recent study has found that these numbers translate directly to concerns about patient care. The study, published in May in the New England Journal of Medicine, found that hospitals with higher ratios of registered nurses to patients resulted in patients requiring shorter stays and suffering fewer serious complications such as infections, internal bleeding and even death.

The shortage, which experts say is nationwide but varies somewhat in different regions of the country, clearly is affecting Delaware.

"We're short 500 registered nurses in hospitals and hospital-based nursing homes in the state," says Joseph M. Letnaunchyn, president of the Delaware Health Care Association and a member of the CHNS Visiting Committee. "The Delaware Health Care Commission completed a study this spring that found we have an aging nursing work force, declining numbers of people seeking nursing careers and an aging population that's going to require more health care in coming years."

The Visiting Committee is a group of health-care professionals from the community that meets regularly to support the College on health-care issues. This year, the committee has made the shortage of health-care professionals its top priority.

For CHNS, the nursing labor shortage has been a mix of good and bad news. As demand for nurses--and, therefore, salaries, job security and such perks as signing bonuses--grows, more students are becoming interested in the field. In UD's Department of Nursing, both applications from prospective students and job-placement rates for graduates have soared.

"Although other baccalaureate nursing programs around the country saw a decline in admissions over several years, ours was very fleeting--we had a dip one year, and then we went back up again," Mary Ann Miller, former acting department chairperson, says. "But, this year, our requests for admission have really skyrocketed. It gives the University a wonderful, high-quality pool to choose from."

For the fall 2002 semester, 393 prospective nursing students applied for admission to UD, up from 254 who applied for fall 2001. The University can't immediately expand its freshman nursing class size significantly, Miller says, because the number of faculty members and the available clinical locations for students to have hands-on experience is limited.

"We can comfortably accommodate a freshman class of 100-110, but at 120 we would be stretched to about our limit," Miller says. She notes that there also are students in the accelerated program designed for students who have another bachelor's degree and are returning to school to earn their bachelor's degree in nursing. By senior year, when those students are added to the regular undergraduate class, a freshman class of 100 could become a graduating class of 130-140.

"We're starting to think about creative ways to address the need for more clinical experiences, because there's a lot of competition among nursing programs for those spots," Miller says. "We're thinking of trying some creative scheduling, such as making use of weekends."

Another pressing issue for the College is the need for nursing faculty to accommodate future students. "We need to address the lack of Ph.D. nurse educators, especially because our faculty is aging, which is part of a national trend," CHNS Dean Betty Paulanka says. "We're talking to some hospitals about possible joint appointments or exchanges of faculty and staff."

"Even if we admitted hundreds of new students, we aren't going to have the faculty to teach them, and that's an issue we're grappling with," Miller says. "The median age of nursing faculty [at UD and nationally] is about 51, so they won't necessarily be retiring in three years, but a lot of them will be retiring in 10 years."

Meanwhile, the labor shortage has benefited new graduates, with many hospitals paying signing bonuses to new hires and some addressing the problem of retaining nurses by paying an annual bonus over the first three years that a new nurse stays on the job.

"The recruiters have been relentless this year, especially those from the Philadelphia area," Miller says. "Our graduates have a wonderful reputation, and they're certainly in demand."

--Ann Manser, AS '73, CHEP '73