April 2, 2008
The Honorable Edward Kennedy
Health, Education, Labor and Pensions Committee
Washington, DC 20510
The Honorable Michael Enzi
Health, Education, Labor and Pensions Committee
Washington, DC 20510
Dear Chairman Kennedy and Ranking Member Enzi:
On behalf of the undersigned organizations, we urge you and the members of the Senate Health, Education, Labor and Pensions (HELP) Committee, to include the following nursing language during the House and Senate reauthorization of the Higher Education Act. It is our belief that the language below, which was included in the College Opportunity and Affordability Act (H.R. 4137), will help to alleviate the severe nursing and nurse faculty shortage facing our country.
The Nurse Faculty Pilot Project, offered as Section 777 in H.R. 4137, awards pilot project grants for partnerships between an accredited school of nursing and a hospital or other health facility. This program would provide scholarships and fund release time for qualified nurse employees so that those employees can earn a salary while obtaining an advanced degree in nursing. These nurses will then become faculty at an accredited school of nursing.
The language contained in the Nurse Faculty Pilot Project would help schools of nursing to address the severe shortage of nurse faculty, but at the same time, allow nurses to continue working in hospitals or healthcare facilities. The American Academy of Nursing, American Association of Colleges of Nursing, American Nurses Association, American Organization of Nurse Executives, National Organization of Nurse Practitioner Faculties, Oncology Nursing Society, and United American Nurses supported this language when it was originally introduced as The Nurse Faculty Higher Education Act (H.R. 2384) by Reps. Carolyn McCarthy, LPN (D-NY) and Charles Boustany (R-LA).
According to the American Association of Colleges of Nursings (AACN) 2007-2008 annual survey, 40,285 qualified applicants were turned away from baccalaureate and graduate programs in academic year 2007. The top reason cited by schools of nursing for not accepting all applicants into entry-level baccalaureate programs was insufficient faculty (71.4%). Further, a report released by AACN in July 2007 found that a total of 767 faculty vacancies were identified at nursing schools with baccalaureate and/or graduate programs across the country. Besides the vacancies, schools cited the need to create an additional 43 faculty positions to accommodate student demand.
The nursing community also encourages you and the Senate HELP Committee to include Section 428K(b)(2) and 428K(h)(7) of H.R. 4137, which would expand loan forgiveness at an accredited school of nursing. This language originated from the Teacher Nurse Support Act (H.R. 2621), which was introduced by Reps. McCarthy and Jon Porter (R-NV) and was supported by the American Association of Colleges of Nursing, American Organization of Nurse Executives, and Oncology Nursing Society.
A recent AACN (2008) study found that graduate nursing students are typically left with an educational debt between $60,000 and $100,000 at the end of their studies. Given the high cost of advanced nursing education, nurses holding these degrees are less likely to accept faculty positions. Higher compensation in clinical and private-sector settings is luring current and potential nurse educators away from teaching. According to the 2006 salary survey by The Nurse Practitioner, the average salary of a master's prepared nurse practitioner is $72,480. By contrast, AACN recently reported that master's prepared faculty earned an annual average salary of $64,011. Federal support is desperately needed for these future faculty members. Moreover, federal loan forgiveness must also be expanded to support the nurses who will provide expert care to patients across the country.
Finally, the undersigned nursing organizations urge the Members of the Senate HELP Committee to include the Nursing School Capacity language under Part R, Section 817 of H.R. 4137. This language, offered by Reps. Rush Holt (D-NJ) and Peter Welch (D-VT), requests that the Institute of Medicine (IOM) study the constraints encountered by schools of nursing in admitting and graduating the number of registered nurses necessary to ensure patient safety. This language has been supported by the American Association of Colleges of Nursing and American Nurses Association.
As mentioned above, the nursing educational system is struggling to increase capacity due, in part, to a nurse faculty shortage. However, other factors play a role in the ability to increase the number of students in nursing programs. Schools responding to the 2007-2008 AACN annual survey also pointed to insufficient clinical sites, classroom space, clinical preceptors, and budget constraints as obstacles.
The barriers faced by schools of nursing in attempting to increase enrollment and graduations are vastly complex and warrant further investigation. This language would facilitate the discussion of these constraints and help explore solutions to barriers that are preventing potential students from entering the nursing profession. Furthermore, recommendations made by the IOM will serve as a valuable resource for policy-makers as well as the health and education systems.
We, the undersigned nursing organizations, would like to thank you and the members of the Senate HELP Committee and the House Education and Labor (E&L) Committee for including the Additional Capacity for RN Students or Graduate-level Nursing Students program in both S. 1642 (Part D, Section 826) and in H.R. 4137 (Part F, Section 776). This language, which will significantly benefit nursing schools, faculty, and students across the country, was supported by the American Academy of Nursing, American Association of Colleges of Nursing, American Nephrology Nurses' Association, American Nurses Association, American Organization of Nurse Executives, Association of Womens Health, Obstetric and Neonatal Nurses, Emergency Nurses Association, and the National League for Nursing.
Additionally, we commend both the Senate HELP Committee and the House E&L Committee for expanding the language under the Graduate Assistance in Areas of National Need program. This new language ensures that a further investigation will be conducted concerning what new professions should be considered Areas of National Need. We firmly believe that this language will include graduate prepared nurses.
We greatly appreciate your consideration of this request, and we look forward to working with you and your staff.
American Association of Colleges of Nursing
American Nephrology Nurses Association
American Nurses Association
American Organization of Nurse Executives
Association of Rehabilitation Nurses
Association of Women's Health, Obstetric and Neonatal Nurses
Oncology Nursing Society
Senator Christopher Dodd
Senator Tom Harkin
Senator Barbara Mikulski
Senator Jeff Bingaman
Senator Patty Murray
Senator Jack Reed
Senator Hillary Rodham Clinton
Senator Barack Obama
Senator Bernard Sanders
Senator Sherrod Brown
Senator Judd Gregg
Senator Lamar Alexander
Senator Richard Burr
Senator Johnny Isakson
Senator Lisa Murkowski
Senator Orrin Hatch
Senator Pat Roberts
Senator Wayne Allard
Senator Tom Coburn