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Thousands of Would-be Nurses Denied Affordable Training Options

November 13, 2006 at 2:41 PM EDT
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RAY SUAREZ: Now, the difficulties of educating new nurses. The NewsHour’s special correspondent for education, John Merrow, has that story.

ABBY ADVINCULA, Potential Nursing Student: Hi, can I take your order?

JOHN MERROW, Special Correspondent for Education: When Abby Advincula first came to San Diego from the Philippines, the best she could get was a job at McDonalds. But after six years, she wants more.

ABBY ADVINCULA: It stresses you out. Sometimes you’re just like, “I don’t want to go to work anymore.” I don’t want to be an assistant manager. I want to be a nurse.

JOHN MERROW: To become a nurse, Abby planned to attend a community college, affordable, open places where anyone, regardless of wealth or background, can get an education. More than half of all nurses come from community colleges.

Abby Advincula thought she was in the right place at the right time. California’s hospitals need nurses, and she’s fully qualified. But San Diego City College put her on the waiting list.

ABBY ADVINCULA: They just told me, like, “Oh, you have to wait four to six semesters.” I’m just frustrated. It’s just like delaying my dreams three years. You’ve been thinking, “I could have been a nurse, you know? And what am I still doing here?”

The high cost of teaching nursing

JOHN MERROW: All across the country, thousands of would-be nurses wait-listed at community colleges are asking the same question: "What am I doing here?" U.S. hospitals are desperate. Even though they're importing nurses from overseas, they still have 118,000 vacant positions. California alone needs 14,000 nurses right now.

DEBBIE BERG, Director of Nursing, San Diego City College: Registered nurses at the bedside are the most effective health care providers, and right now we're in a crisis, and we're not able to provide that.

JOHN MERROW: Debbie Berg is director of nursing at San Diego City College.

DEBBIE BERG: What's at stake is the health care of the people of our country.

JOHN MERROW: One reason for the bottleneck: teaching nursing is expensive.

NURSE: Barbara, I have your last med. I'm going to turn on the light here.

JOHN MERROW: It costs three times more to train a nurse than it does to educate a typical community college student. But the California legislature does not take the cost difference into account.

TERRY BURGESS, President, San Diego City College: The state pays us for what I like to refer to as "butts in seats." It's that we're paid literally by the contact hours, and we're all reimbursed at the same rate.

JOHN MERROW: Terry Burgess is president of San Diego City College.

TERRY BURGESS: I could have a psychology lecture with 100 or 150 students in it and one professor or I could have a nursing clinical with 10 students and one professor, and the state reimburses me the same rate for whether it's the nursing student in that setting or whether it's a psychology student in another setting.

NANCY SHULOCK, California State University: It's all about getting students in the seats, through the official count, which is about the fourth week of the term. And that's what they have to do to survive.

JOHN MERROW: According to Nancy Shulock, a California college expert, seat count is critical. In California, community colleges compete with the K-12 system for state money.

NANCY SHULOCK: In recent years, there's been a lot of focus on improving funding levels for K through 12. So you can't do both because of the way we've set things up in the state. You can't increase K-12 and increase community colleges, because they're fighting for shares of one defined pie.

JOHN MERROW: For every student enrolled in kindergarten through 12th grade, the state chips in about $7,000. Community colleges get only $4,500 per student. By contrast, the University of California gets four times as much, about $19,000 per student.

Old equipment, faculty woes

JOHN MERROW:  For community colleges, which educate nearly half of all the undergraduates in the country, this means run-down classrooms, dated facilities, reduced services, and a reliance on low-paid, part-time faculty. In nursing, where small classes are required by law and labs and equipment are expensive, the pinch is particularly painful.

MALINDA WHITNEY, Nursing Student: A lot of our stuff is antiquated.

JOHN MERROW: Malinda Whitney is a first-year nursing student.

MALINDA WHITNEY: There's not a lot of models that we can work on. A lot of us are sharing things, and we're practicing on ourselves. And, OK, yes, that's OK in some instances, but you don't have the equipment to use, so I think that definitely that's something that's lacking.

JOHN MERROW: The limitations become clear when student nurses begin their clinical rotations in hospitals.

MALINDA WHITNEY: You're having to get your teacher having to get the nurse to kind of explain to you, "OK, well, how do I use this machine because I've never used it? I kind of know and I can maybe figure it out, but I have a patient's life on my hands, so it's not like I can sit here and be trying to figure out this, you know, at the bedside."

JOHN MERROW: Under-funding also makes it hard to find nursing faculty. At the beginning of this school year, one out of every 12 nursing faculty positions nationwide was unfilled. Pam Kersey-McCandless teaches nursing at San Diego City College.

PAM KERSEY-MCCANDLESS, Nursing Professor, San Diego City College: People go to school for a long time to receive a master's degree. And teaching, they would make less than they would working at a hospital.

JOHN MERROW: A lot less. A nurse with a master's degree can make as much as $100,000 a year in a hospital. Teaching nursing at a community college pays about half that.

DEBBIE BERG: We've had a position open for over six months, and we can't even get any applicants. So there's not enough faculty right now. But within 15 years, there's not going to be any.

DAVE RYNDERS, Nursing Student: My first semester, I couldn't get any kind of pre-reqs at all. I talked to a lot of people that are just taking one or two classes. They need three; they can only get one. A lot of people don't make it in.

The future of nursing

JOHN MERROW: After 20 years as a carpenter, an injury forced Dave Rynders to switch careers. He, too, chose nursing, expecting his studies to be quick.

DAVE RYNDERS: My two-year nursing education is going to take me about six years to complete, with all my pre-reqs, and then my waiting period, and then finally the accelerated two-year nursing program. It's kind of ridiculous.

JOHN MERROW: Recently, California made an effort to shorten the wait, providing money to expand some nursing programs.

TERRY BURGESS: And we're part of a consortium of colleges here in the San Diego region which did receive some funding to help to add some nursing slots, but it's really quite modest. I think we added 15 nursing slots to a class of about 100 or so.

JOHN MERROW: Fifteen more nurses will not solve the problem. As baby boomers get older, demand will only increase. Ten years from now, the United States will need at least a million more nurses, yet thousands are left waiting.

DAVE RYNDERS: Eventually, I'll see all the legislators, me or someone like me will see these legislators in my hospital. And then I can tell them what I think, as they're receiving low-level care because they didn't fund the programs.

RAY SUAREZ: Since John Merrow filed that story, San Diego City College has announced plans to expand its nursing facilities, and Dave Rynders remains on the waiting list for admission.