Can Nursing Schools Keep Pace With Skyrocketing NP Demand?

Nursing schools are trying to keep pace with the continued popularity of the nurse practitioner (NP) specialty despite faculty and clinical site shortages. A fresh influx of government funding aims to help schools overcome those barriers, offering incentives to nursing students to pursue advanced practice and nurse educator roles while easing the nursing pipeline bottleneck.

The US Department of Health and Human Services (HHS) recently announced awards of more than $100 million to expand the nursing workforce. More than half of the funds will help train advanced practice nurses.

The federal funding announcement comes after the Bureau of Labor Statistics reported that the nurse practitioner occupation continues to be the fastest-growing occupation in the US. It is expected to increase by 46% by 2031 with 112,000 additional positions.

Nearly $35 million will bolster the Advanced Nursing Education Workforce (ANEW) Program, which will help 56 nursing programs develop clinical partnerships for advanced practice registered nurses (APRNs) specializing in primary care, mental health, substance abuse disorders, and maternal health.

An additional $30 million will support residency and fellowship training programs for advanced practice nurses in primary care. To offset a shortage of nursing school educators, $26.5 million will fund the Nurse Faculty Loan Program, which helps 88 nursing programs provide low-interest loans to those pursuing faculty positions. In some cases, loan cancellations of up to 85% will be offered.

Nursing programs have some flexibility to increase enrollment to meet the demand, said Joan Stanley, NP, FAAN, FAANP, chief academic officer for the American Association of Colleges of Nursing (AACN).

Last year, master’s level NP programs had close to 11,000 unfilled admissions slots, she said. Despite the open spots, nursing schools turned away 10,000 qualified applicants from master’s and doctoral nursing programs ― including nearly 2500 NP program applicants ― because of the shortage of faculty and clinical space, AACN reported.

Stanley said government funding may help schools that are already at or near capacity to move beyond the budget and faculty constraints and expand their admissions.

For example, nursing schools at the University of Tennessee and Michigan’s Grand Valley State University received ANEW grants this year and will use the money to expand academic and clinical partnerships to train APRN students who plan to work with rural and underserved communities. Between the two schools, among almost five dozen HHS funding recipients, this round of funding will help nearly 60 Doctor of Nursing Practice (DNP) students.

In 2019, Grand Valley State used HHS grants to train 20 DNP students who eventually worked in rural and underserved communities.

Nine Maryland nursing programs, including Johns Hopkins University and the University of Maryland, Baltimore, will use state grants to help launch a PhD in nursing education program, develop clinical opportunities for NP students, and build an existing nurse educator certificate program.

Despite ongoing debates between doctors and advanced practice providers over scope creep, NPs in primary care help offset physician shortages and care for an aging population, particularly in rural areas. NPs represent 1 in 4 primary care providers in rural practices, according to the American Association of Nurse Practitioners. Stanley predicts that the demand for NPs in rural areas will continue to grow.

NPs perform some duties that are similar to those of physicians, but for less money ― a draw for health systems trying to reduce costs and provide affordable care, according to Deb Nevins, chief strategy officer for Point of Care Network, a networking organization for NPs and physician assistants.

NPs can prescribe independently in 27 states and the District of Columbia. Many NPs manage their own patient panels without physician supervision, Nevins said, adding that she expects more states will pursue broader scopes of practice for APRNs.

On a federal level, the Improving Care and Access to Nurses Act, currently in the US Senate, could remove even more APRN practice barriers. If passed, the bill could drive greater demand for NPs with schools again seeking ways to expand enrollment.

Steph Weber is a Midwest-based freelance journalist specializing in healthcare and law.

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