31 Days, 31 Ways: State Cuts Nursing Education Funding

Throughout the month of August, The Texas Tribune is featuring 31 ways Texans' lives will change come Sept. 1, the date most bills passed by the Legislature — including the dramatically reduced budget — take effect. Check out our story calendar here. 

Day 29: The state has dramatically reduced support for nursing education, meaning Texas will continue to face a critical shortage of registered nurses.

There is already a major shortage of registered nurses in Texas. It's not going to get any better, because lawmakers have dramatically slashed nursing education funding for the next two years.

According to state health officials, the demand for full-time practitioners exceeds availability by 22,000 and — left unremedied — is on track to reach 70,000 by 2020. The shortage is due to a number of factors, including aging nurses and more acute patients in a fast-growing state. And it's not that people don't want to break into the profession. There simply aren't enough nursing schools or faculty in Texas. In 2010 alone, more than 11,200 qualified applicants were turned away.

Clair Jordan, the executive director of the Texas Nurses Association, says she is concerned that waiting list will continue to balloon. The 2011 legislative session marked a significant departure from lawmakers’ previous efforts to invest in nursing education. A coalition that includes TNA, the Texas Hospital Association, the Texas Association of Business and chambers of commerce statewide has worked for years to lobby for more state support for nursing education. Since 2001, Texas has initiated aggressive efforts to produce more nurses by funding the so-called “Dramatic Growth Funds.” Within a decade, Jordan says, investment has increased the number of professional nursing graduates from 7,ooo to 14,000.

Watch the Tribune’s interview with Jordan below. She discusses how the Legislature’s 36 percent cut to that critical nursing education program may curtail the progress advocates have fought so hard to achieve, and why the quality of patient care may ultimately be at risk.

According to the Texas Higher Education Coordinating Board, the Legislature eliminated three funding streams:

• Financial aid funding for professional nursing students ($1.8 million), affecting 870 students for each year of the next biennium
• Financial aid for vocational nursing students ($91,266), affecting 310 students over the course of the next two years
• The Texas Hospital-Based Nursing Education Partnership Grants Program ($4.75 million), which had provided “innovative” instruction to students by fostering relationships between hospitals and colleges to enroll more students and to produce more graduates in professional nursing

The biggest blow to nursing education, though, will likely be seen with the state’s decision to reduce the Professional Nursing Shortage Reduction Program (commonly referred to as the "Dramatic Growth Funds") by 36 percent, or $17 million. THECB said the program aimed to increase graduation rates among registered nurses, and to increase the number of graduates from master’s and doctoral programs who can go on to serve in faculty positions.

“The budget reduction will slow down the progress the state has made in recent years in terms of producing nursing graduates, a critical shortage profession. There is a set student/faculty ratio that must be maintained and this program is designed to enable institutions to hire additional faculty or supplement faculty salaries to help keep them in the classroom,” THECB said in a statement sent to the Tribune.

During the session, efforts to lobby lawmakers to preserve the funding or generate revenue failed.

State Rep. Donna Howard, D-Austin, a former practitioner, told the Tribune she is deeply concerned not only about the impact of the nursing shortage, but about whether the state will have enough qualified providers to care for a sicker patient population in a fast-changing hospital environment.

“Having fewer RNs will make it necessary to employ those with less training and clinical experience,” Howard wrote in an email to the Tribune. “We’ve already seen this happen to some extent in our public schools where RNs have been replaced with (licensed vocational nurses) or even office personnel. Decreases in the dollars necessary to increase and adequately prepare our nursing workforce will mean less access to competent care, exactly the opposite direction we should be going.”

Web resources:

Texas Nursing Workforce Shortage Coalition's website

Texas Nurses Association's nursing education page.

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