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On the Rise

The BRN school report shows more nurses graduating from California nursing programs.

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MAKING THE GRADE: Ethan Alesi, BSN, FNP, RN, checks a patient during his clinical training at Samuel Merritt University School of Nursing. Alesi is a 2002 SMU graduate. courtesy Samuel Merritt University

Since 2001, the number of nursing programs in California has increased from 97 to 138, housed in the state's 125 nursing schools. California nursing schools' graduation numbers have risen annually, from 5,178 in 2000-01 to 10,570 in academic year 2008-09. In that time, nearly 65,000 nurses have graduated.

Data Driven

That is the bottom line from this year's annual School Report from the Board of Registered Nursing. The school report is commissioned by the BRN's education advisory committee, then reported by the Center for the Health Professions at the University of California, San Francisco.

The report is filled with information on the numbers of new students enrolled (13,988 in 2008-09) in the number of available slots (12,812 for the same time period) and the number of students applying for slots (22,523). For 2008-09, a total of 25,285 students are enrolled in nursing schools; 29,691 are listed as pre-nursing students. For academic year 2008-09, more than 61 percent of applicants for nursing school in California did not get accepted. Joanne Spetz, PhD, investigator on the report, noted the number of applications is likely greater than the number of individuals applying for admission because potential students often apply to more than one program to better their chances for admission.

"The number of admission slots has risen every year since 2001," Spetz said. "Many programs are over-enrolled, and some schools have two or three admission cycles. Some programs may take a few extra students, or backfill empty slots, or could include LVN to RN students. The key thing is in early 2000, these programs were not operating at full capacity, and now they are. The number of qualified applicants still far outstrips the number of slots."

Joanne Spetz, PhD
Program Growth

Because of the large number of recent nursing graduates unable to find work due to the effects of the economy on the nursing workforce, some of the "soft money" used to fund some slots in nursing schools is being pulled back. Spetz cautioned programs dependent on this "soft money" may begin to feel the pinch and may decrease enrollment to match funding. Many programs will be lucky to stay stable in the challenging budget environment.

"We expect more people will be looking at nursing," she said. "And we expect admission rates to be tight. Nearly a quarter of admission slots are based on grants. We know demand is going to go up despite the current economic conditions. There's a concern that legislators will see new graduates having trouble finding work, decree the shortage is over and pull the plug on funding."

The biggest increase was seen in entry level master's (ELM) degree programs, nearly doubling from nine in 2004-05 to 16 in 2008-09. In that time, the number of students admitted to ELM programs has more than doubled, going from 876 students admitted in 2004-05 to 2,184 in 2008-09. The greatest growth has come in private programs, which Spetz said tend to be a little more entrepreneurial and nimble.

"There are more people looking at nursing as a second career," Spetz said. "ELM programs draw people who want to be NPs, clinical nurse specialists or administrative supervisors.

By the Numbers

More than 10,500 students completed their nursing degree in 2008-09. There are still more than there times as many ADN graduates (7,119) as BSN graduates (2,788), although the gap is narrowing. Spetz noted the state needs to graduate between 10,000 and 12,000 nurses a year to meet the challenge of the nursing shortage.

While the retention rate (75.2 percent in 2008-09) has risen gradually over the past decade, the attrition rate had remained fairly constant. It decreased this year from 16 percent the past 3 years to 14.7 percent in the latest survey. Of 10,630 students expected to finish their programs in 2008-09, 7,990 actually graduated. An additional 1,078 are still enrolled, but 1,562 dropped out. Attrition rates are higher in ADN programs, running nearly twice the BSN rate and three times the ELM rate. Attrition is also higher in public schools than in private schools.

The use of simulation centers continues to increase. Nearly 90 percent (111) of nursing schools use simulation in some form for part of the clinical requirements for students; 85 of those plan to expand. An additional 11 schools planned to add simulation to the curriculum for 2009-10.

"The majority of schools that increased their simulation use did so because they received grants," Spetz said. "Most use sim centers to standardize clinical experiences, to check clinical competencies, to provide clinical experience not available in a clinical setting and to make up for clinicals no longer available in hospitals."

That lack of clinical sites is a big problem, Spetz added.

"The lack of pinch points, like pediatrics, is a big challenge," she said. "Schools can usually find med/surg placements, but specialty care is a problem."

Faculty is another issue.

"We still expect a number of faculty retirements," Spetz continued. "These programs all will not be able to maintain or expand enrollments without more faculty."

Regional Focus

The report also breaks out information on a regional basis for nine of the 10 regions in the state. The nine regions include Northern California, the Northern Sacramento Valley, Greater Sacramento, the Bay Area, the San Joaquin Valley, the Central Coast, Southern California I (Los Angeles and Ventura counties), Southern California II (Orange, Riverside and San Bernardino counties) and the Southern Border Region. The Central Sierra does not have any nursing education programs and was not included in the analyses.

Southern California I and the 10-county Bay Area are home to 70 of the 125 schools of nursing in the state. Applications for these schools continue to be more than can be accommodated: 55 percent of those applying to the 40 schools in Southern California I are turned down, while 62 percent of those applying to the 30 schools in the Bay Area don't get in. More than 80 percent of the state's new nursing graduates come from these two regions: 2,319 in the Bay Area and 3,151 in Los Angeles/Ventura counties.

The complete school report plus regional breakdowns is available on the BRN website.

Candy Goulette is regional editor for ADVANCE.

Articles Archives

Of course we need help to get placed! I grad in May 2010 with 3.5 GPA, Dept honors, Sigma Theta Tau, BLS and ACLS certifications and have not even had one interview. All I keep getting are postcards saying there are no open positions for some with my "qualifications" meaning an inexperienced new grad. Only 50% of my colleagues have found work. One of my colleagues has her nursing license sitting in her bedroom drawer (as do I) and is working as an aide as that is all she could get. I know others who are working as waitresses. I myself am looking to get back into secretarial work but it has all been outsourced. I wrote a letter to NLN who responded stating I could always "teach nursing" which I cannot because I dont have a masters and which will also not solve the huge problem of oversupply. NLN also suggested that I pick up and move to South Dakota where they thought there was still hiring or to a "more rural area" I already live in a rural area, bumping into deer and moose all the time. I would love to work on an Indian Reservation in S.D. but per govt website I am too old (> age 44). I have tried everything: prisons, per diem (there are positions but they are waiting for the State to fund them and the State is broke). Nursing homes: either they are not hiring, want LPN and not RN re: cheaper or dont want new grads as they now want one year Med Surg and one year Acute Care. I would love research but all the postings I have found require at least 3 years experience. I paid for my tuition out of a trust fund for which I get lifetime income which has now been permanently reduced due to the shenanigans of my school not telling us til our last semester how much it costs to train a new nurse, starting at about $22,000 per nurse. This was not told us by the department but in an off-handed way by one of our professors but it must have been important as she put the number on our first exam. Had I known this, I would not have continued and I am sure the department was aware of. Figuring it out, they made on my graduating class - over the entire lifespan of their 4 year education, 6 million dollars (this is a private school). It is unconscionable and should not be allowed. Schools should be limited as to how many can be graduated from nursing school for the foreseeable future. But, as of now, all nursing schools that I know of are running at full enrollment with a one year waiting list for students to get in. I have talked to many students who are either in wait list mode or in 1st year and I have yet to talk to any who are aware of the employment situation. When you are in school, you are fixated on passing and getting enough sleep. It never enters your mind that you might be getting duped by the system.

Marie October 31, 2010
Poughkeepsie, NY

Are we having trouble placing all the new grads? How are we helping them get experience for jobs who require it?

Laura RomeroJune 24, 2010


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