By Susan Levine
Washington Post Staff Writer
Tuesday, November 6, 2007
With Maryland facing a shortage of 10,000 nurses in less than a decade, a coalition of hospital leaders and nursing educators proposed yesterday spending $59 million to expand state training programs and avert a looming health-care catastrophe.
The plan would allow an additional 1,800 first-year students to be admitted to nursing school annually starting in 2009, nearly double current numbers. Supporters expect much interest in those seats. Maryland's 25 nursing programs, where enrollment has climbed almost 50 percent since 2001, routinely reject qualified applicants because they do not have enough instructors.
Without a reversal, nursing vacancies in hospitals could rise to 18 percent by 2016, the leaders warn. Nursing homes would also have many unfilled positions. The problem, though affecting all communities, would be most acute in Montgomery and Prince George's counties and the Baltimore area.
"That's a train wreck," said Cal Pierson, president of the Maryland Hospital Association, who foresees a decrease in beds as well as diverted ambulances and postponed surgeries.
Worries in Maryland parallel concerns nationally. Not only nurses but medical technicians, therapists and counselors could be in scarce supply as an aging population places increased demands on the health-care system.
Only days ago, the U.S. Senate passed a bill that would give as many as 61,000 foreign nurses and physical therapists the right to enter the country with green cards. And states are taking their own measures. An alliance of government and private-sector officials in Northern Virginia is pursuing a 14-step strategy that includes industry endowing nursing faculty chairs. Virginia Gov. Timothy M. Kaine (D) recently announced a scholarship program to encourage master's and doctoral nursing students to teach at state colleges and universities after they graduate.
Maryland has loosened requirements that all faculty members have advanced nursing degrees, and some hospitals have lent staff nurses to serve as adjunct professors. The coalition is calling for more significant action. It points to the number of open nursing positions in the state's 54 hospitals. After decreasing for two years, vacancies are almost back to a 2001 high of 15.6 percent.
Yet the solution proposed yesterday comes as lawmakers grapple with a projected state budget deficit of at least $1.5 billion. That grim scenario will jeopardize the backing of legislators and Gov. Martin O'Malley (D), who as a candidate proposed using scholarships to attract more students to the field.
The plan's designers counter that its cost would be short-lived, especially compared with its long-term benefit.
"Ending the nursing shortage is crucial to the public health," said Janet D. Allan, dean of the University of Maryland's nursing school.
Their remedy would combine about $39 million in state funds with more than $19 million in business or nonprofit investment to pay for several hundred additional faculty members, higher faculty salaries, and additional classrooms and clinical sites.
The expansion would start paying for itself by the third year with money the hospitals would save by not having to hire temporary nurses at contract agencies' premium prices. Hospitals have pledged their support for the long haul, Pierson said. "The one thing we're missing is the seed money," he said.