What’s behind the nursing shortage

To the Editor:

At the National League for Nursing and the NLN Foundation, we applaud The Chronicle of Philanthropy for spotlighting an oft-neglected sector of grant and foundation support with your cover story on the nursing profession (“Coming to the Aid of Nurses,” February 21).

However, while Nicole Wallace’s article is right on the money in reporting that, due to severe faculty shortages, schools of nursing were forced to turn away tens of thousands of applicants, unfortunately the data she cites understate the problem: The data do not cover associate-degree and diploma programs, which accounted for 56 percent of enrollments in basic registered-nurse programs in 2006.

According to our statistics, which include applications to, as well as enrollment and graduation rates in, all types of nursing programs, not just those offering baccalaureate degrees and higher, 88,000 qualified applications — or one out of every three submitted to nursing-education programs this year — were rejected due to lack of capacity.

Perhaps equally troubling in the current climate, the league’s soon-to-be released annual survey of nursing schools reveals that applications to pre-licensure RN programs dipped a notable 8.7 percent in 2006 from their peak the previous year. The difficulty of gaining entry to nursing school is a suspected cause of this disturbing fact.

Beverly L. Malone
Chief Executive
National League for Nursing
New York

To the Editor:

In addition to the excellent work being supported by foundations in response to the nursing shortage in the United States, this issue has a powerful international dimension — namely, the impact of overseas recruiting of nurses on the health systems of their countries of origin.

This is a complex issue: how to address brain drain in source countries in a way that takes into account shortcomings of in-country health systems and does not block developing-country health workers from exercising their right to emigrate.

One response, which we support through our grant making, is to develop voluntary codes of conduct for nursing recruiters that, at the very least, can help diminish unfair treatment of foreign nurses in the United States.

In conjunction with sustained attention to source-country health systems, the codes of conduct may help mitigate what is for some countries an unsustainable one-way exodus of trained health-care professionals to the United States. Importantly, the codes will provide models and incentives for recruiting companies and hospitals to “give back” to source countries, and to arrange innovative twinning arrangements between hospitals to promote training and exchange of health personnel.

Jonathan F. Fanton
President
John D. and Catherine T. MacArthur Foundation
Chicago

To the Editor:

I work in health-care philanthropy and was overjoyed to see an article directly related to my field.

However, I was extremely disappointed in the cover photo.

This image is supposed to depict the nursing industry. Being very close to the nursing industry and working with many hospitals, at least in California, your picture looks nothing like our nursing population, which is predominantly Asian and Hispanic.

Further investigation into the article itself and the images found within its pages reveals that you later chose more realistic depictions of today’s nursing industry (nurses of color, foreign nurses, etc.). Why aren’t they on the cover?

This photo is a rather archaic perception of today’s nursing industry and better fits the picture of nursing in the United States in the 1950s, or a suburban modeling shoot.

Furthermore, the photo does not do much to encourage diversity, even among persons of European descent, as each participant in the photo (even the dummy patient) is white, with the same blonde hair.

In the future, please acknowledge the reality of the situation and make more appropriate choices in descriptive images.

Tiffany Cantrell
Grants Administrator
Barlow Respiratory Hospital Foundation
Los Angeles

Editor’s note: Ms. Cantrell’s letter was one of several complaints about the cover image. As we noted on our table-of-contents page, it was a picture of nursing students and an instructor at a Duke Foundation-financed program mentioned in the article. That and all the other photographs accompanying the package of articles were of people mentioned in the text; none were of models selected to depict nurses.