$390M for nurses: How hospitals, colleges are tackling the shortage

With 94 percent of hospitals of health executives reporting their shortage of nurses as "critical," the industry is plugging hundreds of millions of dollars into reversing the trend.

How 12 health systems, colleges and universities are working to solve the nursing shortage:

  • Arizona State University (Tempe) — $5,475,660

The Department of Labor will divvy up $78 million in grant funds for the next five years among 25 organizations to bolster a stronger nurse workforce pipeline. Arizona State University was one of the winners of what sources told Becker's was a highly competitive grant application process. 

The university bookmarked the $5.4 million it won to offer 140 people in its nurse education professional track with free tuition and support services. 

  • Atlantic Health System (Morristown, N.J.) — $2,785,263

With nearly $2.8 million from the Department of Labor, Atlantic Health System will launch a new program called the Pathway to Ensuring Access and Clinical Excellence in Nursing. It will create more than 2,700 nursing jobs by "institut[ing] professional pathways for registered nurses in acute care and critical care specialties" and creating "clinical pathways for nursing assistants," according to a news release. 

The new program will feature monthly nurse assistant bootcamps with "didactic training and preceptor-supported orientation on a patient care unit," said Trish O'Keefe, PhD, RN, senior vice president and chief nurse executive of Atlantic Health System and president of Morristown Medical Center. 

Suja Mathew, MD, executive vice president and chief clinical officer of AHS, said the PEACE program will be a "powerful tool" to fix the "unsustainable shortage of nurses" that is projected to grow for the next 10 years. 

  • HCA Healthcare (Nashville, Tenn.) — $336,000,000

HCA Healthcare earmarked $336 million in May for new nursing education programs. The system budgeted $200 million to open new campuses for its Galen College of Nursing, which it obtained in 2020, according to a spokesperson. To date, it has announced 14 campuses nationwide and most are already open since Galen joined HCA.

The remaining $136 million will fully fund its new Centers for Clinical Advancement. HCA has invested $46 million to open 12 clinical advancement centers since 2019, and another $90 million is committed to opening 20 more over the next three years, the spokesperson said. 

  • Massachusetts General Hospital Institute of Health Professions (Charlestown) —  $5,885,354

With $5.9 million, the Massachusetts General Hospital Institute of Health Professions was the second-largest winner of the Department of Labor's grant funds. The first was the Regents of the University of California in Davis, which was awarded $5,999,908. 

"The max you could request was $6 million, so we felt like we should think big," Ken R. White, PhD, RN, dean of the nursing school at MGH Institute of Health Professions, said. 

With the grant, the institute plans to pay 224 students' tuition, fees and wraparound services — such as childcare and employing a part-time academic success coach. Eligible students will be among those entering the school for an Master of Science in Leadership in Nursing Education, a post-master's certificate in nursing education or a continuing professional development certified academic clinical nurse educator preparation course. 

The shortage of nurse educators sprung from a chain of reactions, Dr. White said. During the COVID-19 pandemic, Baby Boomer nurses opted in for early retirement or became sick and died. Next, there was an influx in high acuity cases, and newer nurses weren't prepared for the intensive care patients needed. 

Then, hospitals employed contract travel nurses to fill the workforce gaps — and paid them more than incumbent nurses, leading to the latter to advocate for higher pay. Systems raised hourly rates but didn't increase wages for clinical nursing instructors working at the bedside. 

"Because the salaries went up because the need was so great, all they needed to do was work an extra shift or two, and they could almost make as much money as they were making taking a group of four nursing students on the unit," Dr. White said. 

The grant money will refresh the incentives for nurses to become teachers, he said.

  • Montana State University Billings — $1,948,894

The City College at Montana State University Billings will accept more students into its registered nurse and licensed practical nurse programs, thanks to nearly $2 million from the Department of Labor. Every year, it will accept 22 LPN students, which is up from 15, and 56 RN students, up from 40. 

The university said in a news release its Nurse Expansion Grant Program will focus on supporting rural healthcare workforces. 

  • Palomar Health (Escondido, Calif.) — $100,000

In April, Palomar backed an initiative with $100,000 to incentivize current and new nurses to pledge to work at the system for at least three years. Palomar leaders told Becker's the $100,000 will help reduce contract labor spend, which, for the two-hospital system, was projected to be more than $15 million this year. 

By confirming employment for three years, President and CEO Diane Hansen said the 2024 fiscal year's budget should see less costs for turnover expenses, orientation costs and traveler nurses. At the peak of fiscal year 2023, Palomar had 320 travelers, and by early fall, that figure will be at 45. 

"We had to reimagine the way we recruited nurses," Mel Russell, MSN, RN, chief nurse executive of Palomar Health, said. "We just had to do it." 

As of mid-June, 880 internal nurses at Palomar, or more than 70 percent of its nursing workforce, signed the three-year agreement. 

  • Riverside Community College District and the Riverside City College (Calif.) — $2,681,768

Riverside plans to secure more apprenticeships in its nursing school with the Department of Labor funds. Every year, the five-year grant will sponsor 10 more vocational nurse apprenticeships, 80 more registered nurses and 60 more dual enrollment placements for certified nursing assistants, according to the nursing school's Dean Tammy Vant Hul, PhD, RN.

The money will also be allocated to a remediation specialist, a veteran outreach coordinator, and individual costs including books, supplies and licensure expenses.

"Once they have their experience, we're going to bring them back as assistants to help the pipeline of faculty," Dr. Vant Hul said. "We're trying to hit all sides here. By increasing the number of registered nurses, we're increasing the pipeline to faculty as well."

  • Thomas Edison State University (Trenton, N.J.) — $2,761,271

The New Jersey school plans to divide its Department of Labor grant funds into two pools: About $1.7 million will be for 125 scholarships, and $1 million will develop a master's in psychiatric mental health nursing and a preceptor certificate program, and pay the salary of one person to coordinate the two new programs.

The scholarships will be among students seeking a BSN, a master's in psychiatric mental health nursing or a preceptor certificate, according to Cynthia Baum, PhD, provost and senior vice president for academic affairs. 

  • Sanford Health (Sioux Falls, S.D.) — $2,954,400

With nearly $3 million from the Department of Labor, Sanford will "improve first-year retention for new nurses and increase the number of nurses in the registered nurse career pathway in North Dakota, South Dakota, Minnesota and Iowa by expanding paid internship programs" and providing tuition support, according to a news release. 

The grant will create 875 paid nurse internships over the next four years, according to a spokesperson. 

The grant will also fund some faculty positions for an accelerated BSN second degree program it will launch with Fargo-based North Dakota State University.

  • University of Houston College of Nursing — $20,000,000

The University of Houston will create three endowed professorships and fund scholarships with the $20 million alumni gift it received in May, according to a news release.

"Additional endowments funded by the gift will bolster research, nursing education and clinical learning, scholarships, graduate student fellowships, adjunct faculty support and marketing and communications for the [school]," the release said.

  • University of Jamestown (N.D.) — $2,329,543

About half of the $2.3 million the North Dakota school received from the Department of Labor will develop two programs — a Master of Science in Nursing and an Associate of Science in Nursing — and more instructional space and equipment. The other 50 percent is earmarked for curriculum development, student success services and outreach, according to a spokesperson.

  • University of Maryland School of Nursing (Baltimore) — $7,000,000

A $7 million gift will pay for 218 scholarships: 116 BSN students, 42 MSN students and 60 people in the school's teaching in nursing and health professions certificate are eligible for the new scholarships.

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