What the nursing degree scheme means for staffing shortages

Staffing shortages are already top of mind for hospital and health system leaders. Now, a nursing degree scheme adds a new layer to the issue, Dani Bowie, DNP, RN, who has expertise related to staffing models, told Becker's.

Dr. Bowie, vice president of clinical strategy and transformation for San Francisco-based healthcare labor marketplace company Trusted Health, said situations like what has unfolded in Florida require health systems to collaborate with state licensing boards when reviewing their existing nursing staff to ensure education degrees are valid and not associated with a fraudulent school.

"It's actually a lot of administrative work to go back and understand where those nurses are working today, and how many there are and the impact on the current workforce situation," said Dr. Bowie, who previously served as vice president of nursing workforce development for Cincinnati-based Bon Secours Mercy Health. 

Dr. Bowie spoke with Becker's Feb. 7 about the matter as investigations continue into a coordinated scheme that involved selling more than 7,600 fraudulent diplomas and transcripts from three now-shuttered Florida nursing schools. Some states have already taken disciplinary action against nurses who allegedly purchased fraudulent degree documents, which allowed them to sit for the National Council Licensure Examination without completing the required coursework or training.

The scheme comes amid healthcare workforce shortages across the U.S., which are a key focus for hospital and health system leaders.

"Top of mind for many health systems is the current state of the workforce, and how to keep the workforce healthy, meaning [addressing] burnout and well-being and ensuring that the workforce stays engaged and wants to continue to work," said Dr. Bowie, who also previously served as system director of clinical resource management for Portland, Ore.-based Legacy Health. "And then there's a lot of literature out there in regards to what the workforce will look like in the future." 

She specifically referenced estimates and analysis from a McKinsey report published May 11, 2022, which projected a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025.

As hospitals and health systems continue to face the realities of such shortages, nursing schools are producing new graduates. Student enrollment in entry-level baccalaureate nursing programs climbed by 3.3 percent in 2021, according to data released April 5, 2022, by the American Association of Colleges of Nursing. But the data also showed that a total of 91,938 qualified applications were not accepted at U.S. nursing schools in 2021, and that total included 76,140 turned away from entry-level baccalaureate nursing programs.

And now, with the recent nursing degree scheme, states, which have their own nursing boards, are conducting their investigations to see how many nurses involved in the scheme went on to secure employment at U.S. healthcare facilities.

"These nurses are practicing. And so [what is] the scope? How many nurses are involved in this? And then [what is] the impact on the health systems and the places that they're employed?" said Dr. Bowie.

"Because with it goes knowledge. They're most likely experienced nurses. So there's something to be said about the complexity gap or the knowledge that's lost when a nurse whose experienced leaves the profession. And so it's also health systems preparing for the complexity gap of losing experienced nurses, whether through this [scheme] or through the up and coming retirement of the baby boomers, and making sure that we do have enough schools in place to educate and continue to produce highly trained, qualified nurses who do have the right academic and educational rigor to do the work."

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