Q: Is there a shortage of advanced practice registered nurses, or will there be in the future?
A: APRNs—specifically nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives—play critical roles in the U.S. health care delivery system by providing primary, preventative and specialty care in acute and ambulatory care settings.
With the passage of health care reform legislation last year and the move to adopt new models of care delivery, roles for APRNs are expanding and the demand for their services is rising. Further, the Institute of Medicine’s landmark report on the future of nursing calls for allowing all nurses to practice to the full extent of their education, training and licensure, which would require the removal of APRN scope-of-practice barriers in some states. As restrictions are lifted and new practice opportunities open up, APRNs are well prepared and positioned to meet the growing demand for primary care and related services.
Q: Is there a faculty shortage of APRN educators?
A: A significant faculty shortage in the United States has hindered growth in the nursing workforce, including the production of APRNs. According to AACN’s annual survey, U.S. nursing schools turned away more than 11,000 qualified applicants from graduate nursing programs in 2010, primarily due to an insufficient number of faculty.
The large majority of these applicants were interested in completing APRN programs. Further, AACN reported a national faculty vacancy rate of 6.9 percent in 2010, with more than 92 percent of these vacancies either requiring or preferring a doctoral degree—a typical requirement for faculty teaching in APRN programs.
Q: In other words, do APRNs face the same kind of situation as nurses in general? If so, how does it compare?
A: Like RNs, APRNs are expected to be in high demand into the foreseeable future. Though the current economic downturn has impacted typical employment trends in nursing, all analysts agree that when the economy recovers, usual retirement and work patterns will resume and a nursing shortage is likely to result. Though steps can be taken to more quickly increase the number of RNs needed through accelerated and degree completion programs (i.e. LPN to RN programs, accelerated BSN and MSN programs), the same is not true of APRNs. Since APRNs require graduate level preparation, which increasingly means a doctoral degree, steps must be taken now to ensure that the pipeline into these programs is robust and adequate to meet the nation’s future health care needs.
Q: Are there enough APRNs in the education pipeline?
A: Interest in APRN programs is very strong with today’s student interested in the array of practice opportunities open to nurses providing care at the highest level. Though student demand is robust, many nursing programs must turn away qualified applicants due to a shortage of faculty, too few clinical training sites, and budget cuts. AACN will continue to advocate for more funding at the federal, state and local levels to assist schools looking to expand the pipeline of APRN students.
Q: Does the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, address APRN education?
A: The Institute of Medicine report calls for nurses to take a leadership role in shaping how care is delivered, and APRNs are well prepared to rise to this challenge. The report also calls for doubling the number of nurses with doctoral degrees, which is fast becoming the preferred route to APRN preparation.
Q: Finally, what are the latest data available on APRN education programs?
A: According to AACN’s 2010 annual survey of nursing schools, here are the latest data available on the number of APRN programs by role and enrollment in those programs:
- Nurse Practitioner: 339 programs with 38,877 students enrolled
- Clinical Nurse Specialist: 178 programs with 3,424 students enrolled
- Certified Registered Nurse Anesthetist: 63 programs with 3,690 students enrolled
- Certified Nurse Midwives: 39 programs with 1,168 students enrolled