The American Association of Colleges of Nursing (AACN) released preliminary survey data that show that enrollment in entry-level baccalaureate nursing programs increased by 4.98 percent from 2006 to 2007. Though this marks the seventh consecutive year of enrollment growth, the rate at which nursing schools have been able to increase student capacity has declined sharply since 2003 when enrollment was up by 16.6 percent. While this increase represents a positive trend, AACN is concerned that more than 30,000 qualified applicants were turned away from baccalaureate nursing programs last year due primarily to an intensifying shortage of nurse faculty.

"In an environment of diminishing faculty and financial resources, nursing schools nationwide must be commended once again for managing to expand student capacity in professional nursing programs," said AACN President Jeanette Lancaster. "Still, with the nation facing a nursing shortage into the foreseeable future, more must be done to ensure that all qualified individuals looking to enter the field are accommodated in baccalaureate and graduate nursing programs."

By the year 2020, the Health Resources and Services Administration (HRSA) projects that more than one million new Registered Nurses (RNs) will be needed in the U.S. healthcare system to meet the demand for nursing care. HRSA projects that nursing schools must increase the number of graduates by 90 percent in order to adequately address the nursing shortage. With preliminary data showing a 7.4 percent increase in graduations from baccalaureate nursing programs this year, schools are falling far short of meeting this target.

Trends in Nursing School Enrollments

AACN's annual survey is the most reliable source for actual (versus projected) data on enrollment and graduations reported by the nation's baccalaureate- and graduate-degree programs in nursing. This year's 4.98 percent enrollment increase is based on data supplied by the same 427 schools reporting in both 2006 and 2007. This is the seventh consecutive year of enrollment gains with 7.6, 9.6, 14.1, 16.6, 8.1, and 3.7 percent increases in 2006, 2005, 2004, 2003, 2002, and 2001, respectively. Prior to the seven-year upswing, baccalaureate nursing programs experienced six years of declining enrollments from 1995 through 2000. For a graphic depicting enrollment changes in baccalaureate nursing programs from 1994-2007, see here.

The AACN survey also found that the number of graduates from entry-level baccalaureate programs increased by 7.4 percent from 2006 to 2007. The rise in graduations follows 18.4, 13.4, 14.0, 4.3 and 3.2 percent increases in the number of graduates in 2006, 2005, 2004, 2003 and 2002, respectively. This upward trend was preceded by a six-year period of graduation declines from 1996 through 2001.

Qualified Students Turned Away Despite Nursing Shortage

Though interest in nursing careers remains strong, many individuals seeking to enter the profession cannot be accommodated in nursing programs due to faculty and resource constraints. Preliminary AACN data show that 30,709 qualified applications were turned away from entry-level baccalaureate nursing programs in 2007. The number of qualified applicants denied admission each year remains high with 38,415; 37,514; 29,425; 15,944; and 3,600 students turned away in 2006, 2005, 2004, 2003 and 2002, respectively. AACN expects this number to rise even higher when final data on qualified applicants turned away in 2007 is available in March 2008. The primary barriers to accepting all qualified students at nursing colleges and universities continue to be insufficient faculty, clinical placement sites, and classroom space. For a graphic showing the number of qualified applicants turned away from baccalaureate nursing programs over the past six years, see here.

"A successful solution to the shortage of RNs and nurse faculty will require a collaborative effort on the part of the nursing profession, the health care system, the federal government, businesses, and all stakeholders," added Dr. Lancaster. "Together, we must remove barriers to pursuing a nursing education, provide incentives for nurses to advance their education, facilitate careers in academic nursing, and create practice environments that encourage professional practice and respect educational achievement."

To help address the shortage of nursing faculty, AACN is leveraging its resources to secure federal funding for professional nursing programs, offer regional faculty development conferences, administer minority faculty recruitment scholarship programs, collect annual data on faculty vacancy rates, identify strategies to address the shortage, and focus media attention on this important issue. For more detail on the nurse faculty shortage and AACN's response, see here..

Interest Runs High in Professional Nursing Careers

Given the demands of today's health care system, the greatest need in the nursing workforce is for nurses prepared at the baccalaureate- and graduate- degree levels. With the government calling for baccalaureate preparation for at least two thirds of the nursing workforce, the evidence clearly shows that higher levels of nursing education are linked with lower patient mortality rates, fewer errors, and greater job satisfaction among RNs. The American Organization of Nurse Executives (AONE), the national voice for nurse leaders in the practice arena, also calls for baccalaureate preparation for all RNs in the future. The growing complexity of patient care and the increase in patient acuity require that RNs have the best entry-level preparation available.

Advocating for less than a baccalaureate degree in nursing has contributed greatly to the current shortage of nurse educators. Data from the federal Division of Nursing clearly show that graduates of baccalaureate-degree programs in nursing are four times more likely than graduates of associate degree programs to pursue a doctoral or master's degree, which is needed to teach in all types of nursing programs.

"To stabilize the nursing workforce, the federal government and other stakeholders must focus on increasing nursing school enrollments at the baccalaureate level," said Dr. Lancaster. "Besides adding to the RN workforce, graduates of baccalaureate nursing programs are much more likely to pursue graduate education and achieve the credentials needed to serve as nurse educators."

AACN and other authorities believe that education has a strong impact on a nurse's ability to practice, and that patients deserve the best educated nursing workforce possible. A growing body of research from Dr. Linda Aiken and others shows a strong connection between baccalaureate education and lower mortality rates. The nursing shortage cannot be used as a reason for denying patients the best care possible, especially when almost 800 programs exist to move entry-level nurses to the baccalaureate and graduate levels. For more details on the programs available to create a more highly qualified nursing workforce, including online options, see here.

About the AACN Survey

Now in its 27th year, AACN's Annual Survey of Institutions with Baccalaureate and Higher Degree Nursing Programs is conducted by the association's Data and Research Center. Information from the survey forms the basis for the nation's premier database on trends in enrollments and graduations, student and faculty demographics, and faculty and deans' salaries. AACN data reflect actual counts reported in fall 2007 by nursing schools, not projections or estimates based on past reporting.

The annual AACN survey is a collaborative effort with data on nurse practitioner programs collected jointly with the National Organization of Nurse Practitioner Faculties and data on clinical nurse specialist programs collected with the National Association of Clinical Nurse Specialists. Complete survey results are compiled in three separate reports, which will be available in March 2008:

- 2007-2008 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing
- 2007-2008 Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs in Nursing
- 2007-2008 Salaries of Deans in Baccalaureate and Graduate Programs in Nursing

More information about the upcoming data reports will be posted soon on the AACN Web site .

The American Association of Colleges of Nursing (AACN) is the national voice for university and four-year college education programs in nursing. Representing more than 600 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice.

American Association of Colleges of Nursing