Nursing programs feel financial pinch
By Jennifer Hiller
Advertiser Education Writer
At a time when Hawai'i is facing a critical nursing shortage, the state's universities are having trouble getting students through their programs and into the work force.
The School of Nursing and Dental Hygiene at the University of Hawai'i-Manoa has a waiting list three times longer than the number of students it can accept following nine years of budget cuts. And with the state's financial crisis, it faces the potential of another 5 percent budget cut.
Hawai'i Pacific University's nursing program has a different problem. Although it is graduating nursing students at a steady rate, the school is worried that its program is producing so many graduates that clinical hospitals — with their own nursing shortage — cannot accommodate all for training.
The national nursing shortage is hitting Hawai'i in other ways as well.
In another decade, if trends continue, experts say, Hawai'i will begin to experience a net loss of nurses, with as many as half of the current 9,000 working RNs reaching an age when they'll retire or ease out of the work force.
It's a problem that extends to the universities as the schools try to keep a full slate of faculty members who are also nearing retirement.
"You are losing nurses across the board," said John Stepulis, assistant dean of nursing at HPU. "That includes faculty."
Roseanne Harrigan, dean of the School of Nursing and Dental Hygiene, and other deans at UH have been asked to come up with scenarios for 5, 10 and 15 percent budget cuts.
"I've had a budget cut every year since I've been here," Harrigan said. "For the past three years it's been 4 percent each year. If I get even a 5 percent hit I have to close programs and lose support staff."
Because nursing programs must retain a maximum of a 10-to-1 student-faculty ratio in clinical settings to remain accredited, Harrigan said, meeting the nursing shortage is not simply a matter of cramming more students into the classes.
"I have to maintain health and safety standards," she said. "I can't cut corners."
HPU, the state's largest nursing program, has about 700 students and has been able to take care of all applicants, Stepulis said. It graduates 150 students each year.
"We have a policy: If a student is qualified, they are not turned away," he said. "We don't have waiting lists."
But the school is concerned about the ability of local hospitals — already short on nurses — to accept an increasing number of students in their clinical facilities.
"We are held back by attracting faculty and by how many students the clinical facilities can handle in the community," Stepulis said. "They are very stressed out as it is."
Health-care providers in Hawai'i are scrambling to maintain a full staff of registered nurses.
For now, the popular remedy is to supplement the supply of 9,000 working nurses by recruiting highly skilled RNs who accept short-term contracts for the chance to work and travel. Recruiters say Hawai'i is an obvious draw, and virtually all Island hospitals rely to some degree on traveling nurses, especially for hard-to-fill, high-skill jobs.
Applications and enrollment into nursing programs at UH and HPU have been steady because students are aware of the high demand for nurses. But Harrigan worries that could change. Hawai'i generally lags behind the Mainland by about two years in trends, and nursing schools nationwide are dealing with a critical drop in enrollment, she said.
"They're not drawing the same numbers they used to," said Sharon Stephanie Monet, director of education and practice at the Hawai'i Nurses Association. "They got used to having academically talented women basically forced to choose from three professions: teaching, nursing and social work. People have a lot of other professions open to them now."
UH accepts 40 new students to its program each semester. There are already 90 applications for next semester's spots, Harrigan said.
Harrigan is asking that her college be spared further budget cuts so she won't have to cut staff or accept fewer students. She is also seeking partnerships with local hospitals: this fall The Queen's Medical Center gave a grant for 10 additional students in the nursing program. But the students could not be accepted into the program because of a lack of space.
The Hawai'i Nurses Association plans to go the Legislature in January and ask for more money to raise the salaries of nursing faculty, scholarships for nursing students, and the development of a Center on Nursing that would track the state's nursing population, workplace issues and trends, Monet said.
Stepulis said HPU is considering building more nursing labs to fit more students — but that there are problems in the industry that need to be addressed to help with the shortage.
"We can double this program in a couple of years, but you need buildings, you need people," he said. "We have to take measures to make nursing more interesting. We have to be culturally diverse. It's still thought of as a Caucasian woman's profession."
Reach Jennifer Hiller at jhiller@honoluluadvertiser.com or 525-8084.
