January 24, 2005
Steve West has driven his ambulance to the hospital and waited four hours in the emergency department, unable to unload his patient from the gurney because there weren’t enough nurses to staff available beds.
Such experiences convinced West, a part-time emergency medical technician, to leave his full-time profession in public relations and become a nurse.
But after more than two years of classes that have qualified him for the nursing program with the Maricopa Community College District, the Gilbert resident is waiting again, this time for a place in the classroom.
"I’m putting everything on hold to wait this out," said West, 37. "Unfortunately, demand for nurses now is significantly higher than the ability to graduate nurses. We need to do something to open up that gap a little bit."
The Arizona Hospital and Healthcare Association, an industry group representing the state’s hospitals, is taking a bold step this legislative session by pushing a proposed bill, Arizona’s Partnership for Nursing Education, requesting $20 million from the state over five years to alleviate the nursing shortage.
The allocation would combine with another $20 million the association is seeking at the federal level for a five-year demonstration program to fund new and existing nursing faculties at the state’s universities and community colleges, said Laurie Lange, vice president of public affairs for the association.
Lange said Sen. Carolyn Allen, R-Scottsdale, chairwoman of the Senate Health Committee, has agreed to sponsor the bill. Several attempts last week to reach Allen for comment on the proposed bill were unsuccessful.
"It’s very critical that the Legislature pass this legislation now," said Lange. "It’s a big problem when you have a nursing shortage and you don’t have enough room for students in nursing programs. That’s a big concern and we need to do something about that."
The price tag, however, may be too steep this legislative session, when state lawmakers will be grappling with a halfbillion dollar deficit and costly predicaments such as the enrollment surge in the Arizona Health Care Cost Containment System, said Rep. Russell Pearce, R-Mesa, chairman of the house appropriations committee.
"We’ve got some major challenges. Now is the time to put our house in order," said Pearce. "It’s just not a time to spend more money."
Meanwhile, the nursing shortage has reached a tipping point, according to health care authorities. To serve an exploding population, hospitals are being built or expanded in the Valley at a record pace without the certainty that there will be enough local nurses to staff them. The reason: Arizona’s nursing schools simply can’t produce enough graduates to meet demand.
Last year, 971 qualified applicants for nursing programs at universities and community colleges statewide were denied enrollment in the semester for which they applied, said Pamela Randolph, nurse practice consultant for education at the Arizona State Board of Nursing.
The backup has nursing authorities worried about what health care facilities will do, and what aspiring nursing students will do as they wait for a place in the classroom.
"It’s overwhelming. I wish we could place them all," said Pat Harris, director of health care education at the Maricopa Community College District. "How long will they wait before they decide, ‘Well, maybe I’ll do something else with my life?’ "
CALL FOR HELP
The problem, nursing school leaders said, is there’s not enough faculty or space in which to teach nursing students. Advocates turned to the legislature for help.
In 2002, lawmakers passed SB1260, which called for the doubling of enrollment capacity in nursing programs by 2007. Leaders in the nursing community were to submit a plan for meeting that goal to the governor, seek financial help from private industry, then return to the legislature for funding.
Since the bill’s passage, a task force has submitted its plan to boost nursing program enrollment to Gov. Janet Napolitano, and the state’s universities and community colleges have received millions of dollars from hospitals to add nursing students. Still, the new hospital partnerships with nursing schools will not be enough to double capacity, said Harris.
"We’re at the point where it’s difficult for us to go forward without some support, whether it’s public or private," she said. "We’ve sort of done the low-hanging fruit and now we’re getting to the middle of the tree."
Obtaining funding from the state this year, however, will be difficult, lobbyists said.
Besides a state budget shortfall, Arizona’s Partnership for Nursing Education will face competing interests, including efforts to bring a medical school to downtown Phoenix. Last year’s announcements of plans for a medical school ignited a buzz about the school’s ability to spur economic development, alleviate a physician shortage and create synergies with the Translational Genomics Institute and other scientific research.
The Arizona Board of Regents has a lobbyist, Jaime Molera, whose main task is working with state government on a medical school. In her State of the State address, Napolitano announced that she put $7 million in her proposed budget to start the medical school’s first class.
"The recent attention on the medical school has kind of taken front page, if you will, and put the nursing shortage on the back page," said Marjorie Isenberg, dean of the University of Arizona College of Nursing. "But (the nursing shortage) still exists. It’s still a reality."
Lobbyists for UA and Arizona State University said they requested additional funding last year that benefitted their nursing programs, and a similar request is being made this year. But getting a major financial boost for nursing, when the universities are struggling just to cover costs, is unlikely, they said.
"To ask for a lot of money when we don’t think we’re going to get it is not a good way to go," said Greg Fahey, UA vice president for government relations.
Lange, however, said the hospital association will be able to make a convincing case for more money.
The question now is whether the Legislature will follow through on its goal to double enrollment, said Isenberg.
West is hoping his wait for a spot in the MCCD’s nursing program doesn’t drag on too long.
"I have friends who have waited two, three semesters to get in," he said. "What do you do with your life?"
Nursing applicants turned away
Many qualified students are rejected from nursing programs at Arizona’s universities and community colleges. Schools reported the following numbers of applications denied for the spring 2005 semester:
Maricopa Community College District
Arizona State University
University of Arizona
*Includes regular and accelerated nursing programs
SOURCE: ASU, UA, Maricopa TRIBUNE Community Colleges