In born in 1946 was around 20 percent more

In Wisconsin and across the
country, one of the greatest challenges facing our health care system is the shortage of registered nurses.  While
many people assume that this problem may not be a weighty subject, this issue could soon cause
detrimental effects on our state and the nation.  While
colleges and the government are trying to find the root of the problem, we must analyze the numerous factors that
have pushed us into the current situation we are in.  Although
characteristics such as the aging generation of baby boomers, health care legislation,
college acceptance rates, and even retirements have driven us to the state we
are in, there is a larger problem that has impacted the shortage.  Within this paper, I will be further
discussing this bigger issue as well as the small factors that have affected
the shortage and the larger problem of the shortage that our state is
facing.  With this information, I hope to
increase the knowledge that common people know about the nursing issue and
address the best solution to this problem.

            To
begin addressing this problem, we must go to where one of the leading factors
first began. As a response to WWII ending, eager young adults who yearned to
start families made the birth rate swell. The total number of babies born in
1946 was around 20 percent more than the amount in 1945. The increased birth
rate ceased around 20 years later in 1964. 
This boom of babies was the beginning of the “baby boomer” generation. As
of today, this generation makes up almost 40 percent of our nation’s
population. In addition to making up almost half of our population, the “baby
boomers” are already in their 60s and needing additional health care.  According to the United States Census
Bureau, the number of baby boomers turning 65 each day is around 10,000, which
will continue until around 2030.  In
addition to this, the American Hospital Association (AHA) has predicted that by
2030 more than 60 percent of baby boomers will be suffering from chronic
conditions, 25 percent will be living with diabetes, 33 percent will be obese,
and nearly 50 percent will be suffering from arthritis. With this anticipated large increase of individuals needing hospital or
clinic treatment, the need for the number of health care workers, including
nurses, will rise.

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            Another factor that is increasing
the need for health care workers is the Affordable Care Act, or ACA, which was
passed in 2010.  According to USA Today, the boomer generation
was said to gain the most from this health care act which drastically changed
our health care system. Before the Affordable Care Act, the boomer generation
often times would pay higher health costs, around five to seven times higher
than younger Americans. This became a big problem if their former employees did
not offer retiree health benefits. There would also be the occurrence of health
insurance companies denying coverage to people who had pre-existing
conditions.  With the ACA being passed,
it gave older Americans the access to health care without the limitations
stated before. The Affordable Care Act prevented insurers from denying coverage
to individuals who already had pre-existing conditions and it limits the age
rating so that a Boomer could only pay three times as much as younger
generations. Although with the Affordable Care Act, it now authorizes
states to develop a system of coordinated care through a health home. The
health home facilitates access and coordinate health services through home
health care.
These different health cares include primary care,
behavioral care, and community-based care for recipients with a chronic
condition. With
this better health care system, not only has the life expectancy rate
increased, but the number of health care workers has increased simultaneously.

            While the life expectancy rate may
be increasing, the state will soon be seeing a large number of individuals
retiring throughout numerous occupations. 
Beginning in the early 1970s, a
larger number of female baby boomers declared nursing as their profession.  By the 1990s, baby boomer registered nurses
(RN) made up around two-thirds of the nation’s RN workforce, totaling around
one million nurses. The number of RNs peaked at 1.26 million in 2008, but since
then, the baby boomer nursing generation began retiring in large numbers.  According to Health Affairs, since 2012,
around 60,000 nurses were exiting the work force each year.   In about
a decade, more than 70,000 RNs will be retiring annually. The heavy retirement
of one million RNs from the workforce between now and 2030 will leave the
health care field in a massive deficit.

            With
the increasing number of baby-boomer nurses retiring, the quality of patient care
could in turn decrease as new and less experienced nurses enter the nursing
profession.  With most of our older
generation nurses retiring, not only are they leaving jobs open, but they are
also taking decades of experience with them. I am not suggesting the new nurses
are not capable of providing care, but the older nurses have more experience
and knowledge when it comes to managing difficult situations with patients.
With the patients care at risk, we must address this situation happening in our
state more than ever and begin to find solutions.

            To begin addressing the problem of
the nursing shortage, we must look at what colleges around the state are
doing.  Around our local four-year
colleges, the nursing departments are beginning to feel the stress from the
state to help aid
in the number of nurses going into the field. Linda Young, the Dean of the
College of Nursing and Health Science at the University of Wisconsin-Eau Claire
comments on the problem the state is facing. 
She says:

The numbers are not looking good,
as we look to the future, we’re going to face an even more dramatic nursing
shortage than we are now, so we need to prepare for that.

Although colleges
like the University of Eau Claire are feeling the pressure, they continue to turn away half of
their qualified applicants due to the limited number of faculty the program
has.  Even our state’s biggest university, the University of Wisconsin-Madison,
has a very limited number of applicants accepted each semester.  Through an interview with Dr. Lisa Bratzke,
the Honors Program Coordinator and an Assistant Nursing Professor at the
University of Wisconsin-Madison, she states, “The shortage will become worse
with time.”

            We
continue to see a trend throughout the universities in Wisconsin in which their
acceptance rates are failing to keep up with the number of students
applying.  In 2012-2013, 50% to 80% of
qualified undergraduate students who applied to nursing programs at either
UW-Madison, UW-Eau Claire, UW-Milwaukee, or UW-Oshkosh were denied admission.  While these applicants were all well
qualified to be admitted to these programs, the were ultimately denied because of the lack of faculty members to teach
them. 
It is evident that the nursing shortage is not a direct cause of the
lack of students going for nursing, but rather the amount of faculty who can teach
them.  While these four nursing
programs are struggling with faculty members, the state itself is trying to
encourage current nurses to return to school and earn a higher degree.

            In
2013, a $3.2 million fund called the Nurses for Wisconsin initiative, was given
to four UW system schools to increase the number of nursing instructors. This
money will offer fellowships and loan forgiveness to help nurses return to
school, earn advanced degrees, and become nursing instructors. These four
schools, which include Madison, Eau-Claire, Milwaukee, and Oshkosh, are still
struggling with the challenge of increasing enrollment with a decreasing number
of instructors. The Nurses for Wisconsin
initiative, which lasted until 2015, was meant to accomplish numerous goals.  Firstly, it would provide fellowships, which
is financial support, to nurses enrolling in doctoral programs at the four
previously listed schools.  The
pre-doctoral fellowship will also support students pursuing either a PhD or Doctor of Nursing Practice (DNP) degree.
With this fellowship, individuals
will receive paid tuition and fees, as well as a salary in exchange for a
three-year commitment to any of the four listed UW nursing schools. Lastly, the
four schools are offering loan forgiveness as a way to encourage faculty with a
PhD or Doctor of Nursing Practice degree
to educate. This program will repay up to $50,000 of student loan debt for
new employees. Up until its end in 2015, this money was a huge step to help the
state rebuild and enhance the nursing programs these colleges offer. 

            In
addition to the Nurses for Wisconsin initiative fund, numerous hospitals around
the state give tuition funds to nurses going back to school to earn a higher
degree.  While this helps give current
nurses the push to go back to school, the new Republican tax legislation would make
this more difficult.  One of the biggest losses
is that grad students who get tuition waivers will now have to pay income tax
on the waiver. This includes graduate nursing students who are receiving
tuition waivers while working with the staff. After an interview with Dr.
Catherine Kennedy, Graduate Admissions Coordinator at the University of
Wisconsin- Eau Claire, she says:

Although
we do not do the tuition waiver, we do offer work with the graduate
faculty.  In addition to this, I do know
many individuals use the HRSA Loan Repayment which allows licensed registered
nurses to receive loans to help pay for graduate programs.

While all these
programs were a jump in the right direction, the process of reinventing similar
programs may take some time. To further address this problem, we need creative
strategies to help repair these programs and the state.

            While the nursing shortage problem
is Wisconsin continues, we are faced with the question: How do we get more
nurses? After numerous years of
volunteering and working in the Marshfield Clinic Hospital, I have seen the
effects of the shortage directly on the community and patients.  Through my experience as a Certified Nursing
Assistant (CNA), I have had a first-hand encounter with the deficit of nurses
in hospitals.  With this nursing shortage becoming more prominent, the RNs are
pressured to not only take numerous extra shifts, but also take shifts that can
last over sixteen hours. These long shifts not only endanger the patients, but
also the nurses working.  These incidents
caused by the lack of staff give me the motivation to reconsider a solution for
the nursing programs and the state.

            While the Nurses for Wisconsin initiative gave Wisconsin the jump start
it needed, it should have not ended in
2015.  Since this fund has ended, there has not been another initiative to
address this problem.  Nevertheless,
other states and universities have begun working with AACN, the American
Association of Colleges of Nursing, to help improve access to graduate programs
that lead to positions as professors in colleges.  To begin addressing this problem again, the universities
need additional funding to help influence current registered nurses to return
to school.  In addition to this, many
associations like the American Nurses Association and the AACN, have urged Congress
to improve Nursing Workforce Development programs. The Public Health Service
Act, which is the primary source of federal aid for nursing education programs,
needs to increase the amount of aid available. 
According to the University of Notre Dame:

The ANA
and AACN believe that it can help alleviate the financial burden of training
new nurses, including nurse educators.

One of the
top solutions to this problem is increasing the funding the state is receiving
for nursing programs. While this may not happen, there are numerous other
smaller and more manageable solutions that are possible for not only the state,
but also for universities like Eau Claire.

            While focusing on current registered nurses
will greatly aid to the deficit of nurses, focusing on current high schoolers
could also help the number of individuals considering the field of nursing.
While we would still need more individuals to teach these students, it might
create a higher supply and demand influence on the state.  In
most public high schools, surrounding colleges will give presentations to
attend their school.  We need nursing programs,
to also start these presentations to influence high schoolers to consider
nursing as a profession. In addition
to this, colleges should also begin pushing current nursing students into the
education side of nursing.  This
could be done by either providing beginning level programs to give experience to
undergraduate nursing students, or by giving additional information about further
education for nursing.

            Another solution local colleges could pursue
is forming strategic partnerships to help increase their programs capacity for
students.  The University of Wisconsin-Eau
Claire began forming a partnership with the Marshfield Clinic to increase the
number of applicants accepted.  This
additional program at the Marshfield site has allowed around twelve more
applicants to be accepted into a nursing program.  This partnership between the clinic and the
university is what other colleges
should begin.  This would not only
increase the number of applicants being accepted into nursing programs, but
also would increase the number of locations in which you could earn a four year
nursing degree.  Additional colleges like
the University of Minnesota have begun private partnerships with the VA Health
Care system in hopes to expand enrollment in the school’s BSN program.  These examples of small expansion could
ultimately save the nursing programs in the state.  Although they accept fewer amounts of
applicants, they also require a smaller number of faculty to sustain the
program.

            While these smaller solutions may help the
nursing shortage in our state, we ultimately need to focus solely on the
faculty in these programs. The main issue, while still affected by baby boomer
age, is the shortage of faculty in these schools. Each year, massive
numbers of qualified applicants are turned away because of the lack of
professors.  While influencing teenagers
in high school and undergraduate nursing majors may begin to solve the lack of
nurses, the first step to repairing the nursing system is acquiring more
professors who are able to teach these students.

 To begin fixing the shortage, we need to begin
influencing and encouraging current nurses in the health care field to return
to school and earn the licenses they need to educate. Programs such as the Nurses for Wisconsin initiative is what the state
and universities need to be contributing towards the solution.  These types of programs provide financial aid
to nurses who are seeking the opportunity to go back to school and earn a
higher degree. Without these nurses who even have a small interest in
returning to school, we will fail to rebuild the program and the problem in our
state will persist. Robin Beeman, Assistant Dean for the Eau Claire nursing
program in Marshfield even says, “The shortage of faculty qualified to teach is
becoming more of the issue.”

Without these nurses and
professors, the nursing shortage in Wisconsin will become even worse.  The number of nurses Wisconsin universities are
outputting is not nearly enough to sustain the amount of elderly people we will
soon be caring for in the near future. While
the grants, new facilities, and even higher acceptance rates could fix the
current shortage, our state needs to start looking at what we currently have.  Although
the previously stated smaller solutions would be very useful, the issue of this
detrimental nurse shortage will fail to be solved without the current nurses we
have.  The solution to the nursing
shortage Wisconsin is now experiencing, is the nurses themselves.