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Webster's RX: A cash infusion for the health of nursing

This article first appeared in the St. Louis Beacon, March 25, 2009 - With a faltering economy making tuition increasingly unaffordable, many college students face the prospect of having to cut back on classes to defer costs. This may not be necessary for some nursing students at Webster University, which announced last week its plan to distribute roughly $100,000 in scholarship and stipend money to current students.

The $262,000 earmark, secured by U.S. Rep. Russ Carnahan, D-St. Louis, also will go toward buying updated classroom and lab equipment and supporting students who are training to be specialists in health-care leadership and anesthesia.

Most of Webster's nursing students work at day jobs and take classes part-time in the evening. Carolyn Corley, director of foundation and government relations at Webster, said she's hoping that the grant not only will allow students to stay on track to graduate but enable some to reach the finish line earlier.

In a time of economic uncertainty, some wonder what the job market will look like for students who can afford to finish their degree programs in the coming months. Nevertheless, keeping students moving through the pipeline is among the concerns of people working and teaching in the nursing field.

"The more students we can get through in a timely manner with scholarship assistance, the more slots open up for new students," Corley said.

Graduating as many nurses as possible has been important in recent years because of a shortage of nurses in some areas. Webster administrators are also concerned about a longer-term problem facing the field: the graying of nursing faculty. One in five nurse educators plans to retire within three to five years, according to the National League of Nursing, a membership group that includes nursing faculty.

More than 70 percent of the nursing schools responding to a 2007 survey from the American Association of Colleges of Nursing said faculty shortages were among the reasons they couldn't accept qualified applicants into their programs. Because nursing schools stick to strict student-to-faculty ratios, a shortage of educators could make it impossible to educate more students.

To address this concern, the scholarship piece of Webster's grant is intended specifically for master's students in the university's program that prepares people to teach in schools of nursing.

FILLED TO THE BRINK

At Webster, the nursing programs are not oversubscribed. There's enough space to accommodate qualified applicants, program directors say. But many nursing schools are at capacity with extensive waiting lists. According to the American Association of Colleges of Nursing survey, U.S. nursing schools turned away 40,285 qualified applicants to baccalaureate and graduate nursing programs in 2007 due to a lack of clinical sites and budget constraints, as well as a dearth of faculty.

Community colleges are often unable to keep up with student demand. St. Louis Community College, which offers an associate degree in nursing (one of several routes to becoming a registered nurse), admits about 240 students each academic year. More than double that number apply to the program, and many students who are on the waiting list are qualified, said Karen Mayes, director of nursing education at SLCC.

Roughly half of the college's graduates finish the program in three years, while the other half finish in two. Many of the students are already on financial aid, and Mayes said additional resources would help more students finish the program in less time.

"Anything we can do to get students through more quickly is helpful," she said. "Life intervenes with our students, and the extra dollars would likely mean they wouldn't have to work quite as much."

TUITION REIMBURSEMENTS IN JEOPARDY?

Aside from scholarships, many students who are already registered nurses and seeking an additional degree rely on their employers to help pay for their education. Jenny Broeder, who coordinates the master's in nursing program at Webster,  said she's concerned about employers who are dropping -- or cutting back on -- tuition reimbursements because of the economy.

"I have students at my door saying, 'I don't have enough money for next semester'," said Broeder.

Some Saint Louis University nursing students have the entire cost of their tuition (or close to it) funded by employers. Teri Murray, dean of SLU's nursing school, said she's heard that some hospitals are re-evaluating reimbursements.

"That would put a hardship on students in all post-licensure programs," Murray said. "It would definitely alter the student's ability to progress through the program."

One of the major regional employers of nurses, Barnes-Jewish Hospital, hasn't cut any tuition reimbursement, according to Shawn Ray, the hospital's chief retention officer. Scholarships are still available for nurses who want to return to school, she said.

Murray said financial challenges also face students in the school's one-year accelerated nursing program, which is for students who have a non-nursing bachelor's degree and have completed the requisite math and science classes. Because these students already have a degree, they routinely don't qualify for outside financial assistance. Students in the program often are awarded scholarships through the university.

FACING THE JOB MARKET

Inside the region's nursing schools, administrators are watching the job market closely. Murray, the SLU dean, said common wisdom has long been that nursing is a "recession-proof" career. Her message to students: The jobs are still there, but you might have to look longer or broaden your search of hospitals.

Mayes, the SLCC director, said with the economy down, she wouldn't be surprised to see this year's graduates have a tougher time finding work. Factors that could work against the students include nurses who once planned to retire now staying on longer than usual, or those who had left the field coming back to work part time.

Barnes-Jewish Hospital, which continues to add more nurses to its payroll, has fewer nursing openings (roughly 50) than at this time a year ago (about 150), according to Ray. One reason is that the hospital is seeing a decrease in the number of nurses leaving. "People are afraid to make a move when they see wage freezing and benefit cutbacks out there," she said. Barnes is doing neither, Ray said.

Increased nursing retention rates explain a slowdown in hiring at St. John's Mercy Health Care, said Tracey Moffatt, the hospital's executive vice president for clinical performance and chief nurse executive.

Barnes-Jewish is also seeing nurses who had left wanting to return part-time because of the sour economy.

More people are applying for nursing jobs than ever before, Ray said. Many of the applicants are experienced, but not necessarily in high-demand areas such as the operating room and intensive-care unit.

Moffatt said St. John's often gives a first look at nursing students from the area's schools who have already spent time working at the facility. And she's bullish about the prospects for all students.

"There will always be a need for more nurses, because the aging population here will increase demand," Moffatt said. "As our nurses retire, we're going to need replacements."