Student demand for nursing degrees far outstrips supply in Arkansas, with more than 1,100 qualified applicants denied entrance to nursing programs in the 12-month period ending June 30, 2013, according to the most recent statistics available from the Arkansas State Board of Nursing.
Enrollment in pre-nursing at the University of Arkansas at Fayetteville -- one of the state's largest nursing bachelor's degree programs -- has grown in recent years at a rate far higher than overall enrollment. The number of pre-nursing students has more than doubled since the fall of 2008, rising from 373 to 842 last fall.
Aspiring nurses generally apply in their sophomore years for entrance to UA's nursing school. But only 100 students gained admission of about 270 who applied at the end of the 2013 fall semester, said Lee Ann Looney, an academic counselor for UA's pre-nursing program. Students may also apply the next spring in hopes of securing one of another 100 admission slots.
Applicants face a high rejection rate even though the school doubled its admissions in the 2011-12 school year.
"The increase was in response to the high number of applications we received and the need for more nurses in the community," said Pegge Bell, director of UA's Eleanor Mann School of Nursing.
Qualified students may not make the cut, she acknowledged. In data submitted to the State Nursing Board, UA reported that 89 otherwise qualified applicants were denied admission in the 12-month period ending June 30, 2013.
The limits
Bell said enrollment must be aligned with the availability of sometimes scare clinical placements for students, where the students learn in health care settings.
"We can't be a puppy mill and take in 500 students and don't have anywhere to put them," Bell said.
Other nursing educators in Northwest Arkansas meet regularly to discuss the availability of such clinical placements -- which may not be available for some types of care.
"Many of us are relying on simulations for specialties like pediatrics and obstetrics," Bell said.
Sue Tedford, executive director of the State Nursing Board, called the lack of clinical slots "the biggest impediment" to expanding nursing school slots statewide, though the board reports that overall student enrollment in registered nurse programs increased statewide, from 5,178 in 2010 to 6,794 in 2012.
The board approves all nursing programs and has requirements for the ratio of instructors to students -- another issue for nursing schools. Also, Tedford said, qualified instructors may choose jobs in health care rather than at universities.
"If I get my master's degree, I can go make twice as much money in a practice setting as in education," Tedford said. The board since 2010 has offered scholarships in hopes of training more nursing educators, she said.
John Brown University in Siloam Springs announced plans last year to award a bachelor's degree in nursing.
"Historically, there's always been a larger pipeline than there is actually spots," said Ellen Odell, JBU's director of nursing. The university expects to admit 40 or fewer students yearly into its nursing school, which will require a separate application, like UA's nursing school.
Nationally, the American Association of Colleges of Nursing found in a fall 2013 survey that 57,944 qualified applications were denied admission to baccalaureate programs for the 2013-14 school year.
In Arkansas -- looking at associate and bachelor's degree programs -- the number of qualified applicants denied has tripled recently, increasing from 336 in the 12-month period ending June 30, 2009, to 1,143 in fiscal 2013.
The numbers are likely skewed a bit because students are encouraged to apply to multiple programs. For those seeking only bachelor's degrees, 356 qualified applicants were turned away in fiscal 2013 compared with 459 a year earlier.
Making the grade
Alexandra Irvin, 22, was one of the students hoping to land a spot in UA's nursing school when she applied in 2012.
"I was fairly confident," said Irvin. "I was still a little nervous because physiology was difficult, and I was afraid a little slip up in that class would have gotten my GPA knocked a little bit down."
Irvin was admitted and now is president of the Student Nurses Association on campus. She said she knew others who were initially denied admission but reapplied and were accepted. Another student she knew transferred to a different nursing program, she said.
She described mixed feelings about the competitive process.
"There are people who have been turned away who could be a wonderful nurse, and I really believe that," Irvin said.
However, she said students who struggled with certain academic subjects might not be a good fit for the intense work required in the program.
With more students applying, Bell said, the standards have risen for acceptance to the nursing program.
"In the last five years, the GPA has improved from the previous five years. We didn't have as many applications, but now that we do, yes, the GPAs are higher," Bell said.
The nursing school requires a minimum 3.0 grade-point average for all applicants, as well as certain prerequisite science courses.
Previously, admissions reviewers ranked all applicants according to grade-point average. But beginning with the class enrolling this fall, the UA implemented a new admissions formula "not just relying on GPA any longer," Looney said.
Under the new system, applicants are reviewed on a 100-point system. As part of the system, for example, students receive four points for each A grade earned in a first attempt at required science courses and two points for each B.
"If you're good in science, then you'll probably be good in nursing," Bell said.
But the new system also awards four points for each science course taken at UA, as well as bonus points for completing at least 50 percent of prerequesite courses at UA -- including nonscience classes like English.
"What we're trying to do is advantage those students who come here as freshmen," Bell said, adding that the number of transfer admissions likely will go down under the new process.
High demand field
Of the UA pre-nursing students denied admission to UA's nursing school, it's not known how many transfer to other schools.
Looney said she knows many who choose another health-related major, like kinesiology.
The university early on makes students aware of the competitiveness within the nursing program, she said.
"Through freshman orientation, the adviser works with them, telling them what the admission rate is," Looney said.
Looney said job availability and good salaries make nursing a desirable field for students. Registered nurses on average make between $32,800 and $56,920 in Arkansas, according to the latest data from the federal Bureau of Labor Statistics.
Tedford, with the state board, said new graduates may be having more trouble finding jobs than about five years ago, but there is a push within the health care industry to hire more nurses with bachelor's degrees.
For Irvin, whose mother is a nurse, nursing came after a stint as a pre-veterinary student.
There were also thoughts of medical school. But, "to me, it seems like [doctors] don't have a lot of free time, and also don't deal as closely with the patients as nurses do," she said.
Despite any short-term difficulties for recent graduates finding work in Arkansas, nursing remains a growth field. One national projection described demand for registered nurses as increasing by 19 percent from 2012-22, with an estimated 3.2 million jobs that will need to be filled.
"It's sad we have this many qualified people, and we can't educate them," Tedford said.
NW News on 07/27/2014