The Virginia Hospital & Healthcare Association (VHHA) works with state and federal leaders to identify funding necessary to achieve the goal of increasing the number of Virginia nursing program graduates by two percent each year. As this effort continues, Virginia Department of Health Professions (DHP) statistics can help inform this work. Data show that in 2016, the most recent year for which numbers are available, 15,846 applications were sent to nursing programs in Virginia (see Figure 1 below). But only 10,561 (67 percent) of applicants were qualified for acceptance. Nursing schools accepted 7,373 (70 percent) of that group, which left 3,188 (30 percent) of qualified students without a program slot, and thus waiting for a chance in the next academic semester. Among the fortunate 70 percent, 6,062 students (82 percent) actually enrolled in nursing programs. In the final analysis, just 38 percent of those who applied to nursing programs were successfully enrolled. As part of its data collection efforts, DHP gathers information about wait-listed students.1 Twenty-five of the 72 registered nurse programs that provided responses to the DHP survey cited lack of clinical space as a reason for turning away students. In Virginia, students must complete 500 hours of patient care work – experience often derived through rotations in Virginia general acute care hospitals. While many nursing schools employ simulation labs to prepare students for patient work, state law stipulates that only 25 percent of the 500-hour requirement may be satisfied through simulation. In the survey, 26 programs (36 percent) cited “inability to expand effective program capacity” (meaning a program has the maximum number of students that can be accommodated based on available faculty, resources, and instructional standards) as a reason for turning away qualified students. These findings indicate that enhanced funding may help boost enrollment in nurse training programs, though it does not guarantee an outcome. It is the experience of VHHA, for instance, that while scholarships may improve enrollment, providing a scholarship doesn’t guarantee recipients will graduate. Of course, issues related to nursing school enrollment and completion are complex. For example, focusing exclusively on enrollment trends overlooks the fact that attrition rates range from 12 percent to 23 percent.2 Expanding clinical time could help about one-third of the nursing programs in Virginia. But that requires planning and work flow adjustments by clinical site administrators, staff, and educators. Increasing enrollment and completion requires a long-term strategy that includes additional faculty, which has budgetary implications for nursing programs. State law stipulates a 1-to-10 faculty-to-student ratio in order to have students in a clinical area; a 1-to-18 ratio is considered appropriate national standard in institutes of higher education.3 Efforts to increasing nurse graduates in Virginia will require local, state, and federal collaboration that likely will take several years to bear fruit and necessitate an evaluation of the unique issues affecting nursing schools in distinctive regions of Virginia. (9/7)
1 Department of Health Professions Healthcare Workforce Data Center, Virginia’s Nursing Education Programs: 2016-2017 Academic Year. March 2018.
2 Department of Health Professions Healthcare Workforce Data Center, Virginia’s Nursing Education Programs: 2016-2017 Academic Year. March 2018.
Figure 1. Summary of Applicants and Their Success at Enrolling in Nursing Program 2016-2017