State Budget Cuts Take Toll on Nurse Education, Research and Practice Programs

    • July 30, 2010

Greer Glazer is running a lean nurse training machine—and it’s about to get even leaner thanks to another round of budget cuts enacted by the Massachusetts Legislature.

As dean of the College of Nursing and Health Sciences at the University of Massachusetts Boston, Glazer—a former Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow (2001–2004)—is expecting a 6 percent cut to the nursing department’s budget this fiscal year, which began in Massachusetts and in most other states on July 1.

She’s cutting all remaining budgetary fat—photocopying expenses, travel budgets, academic journal subscriptions—to balance the budget. And she’s making some more painful cuts too. Next year, students will see shrinking scholarship funds and expanding class sizes.

Still, Glazer feels fortunate: She has raised enough outside money that she will be able to spare more essential items—like faculty, staff and students—from the budget axe this year. And she even plans to hire more faculty this fall to accommodate increasing enrollment, a blessing her peers at many other nursing schools will not have.

“Students will have fewer professional resources and less individualized attention this year,” she says, “but they will still get the kind of quality education they need to thrive as students and future professionals.”

The University of Massachusetts Boston is not alone. Legislators in states across the country have cut publicly funded programs to offset steep declines in revenues this year. And nursing departments—which can be costly to run thanks to expensive equipment and relatively low teacher-to-student ratios—have not escaped the budget axe.

Nursing departments in states including Arizona, California, Connecticut, Georgia, Kansas, Michigan, Nevada, Oregon, Pennsylvania, Tennessee and Washington state have been threatened by proposed budget cuts to public colleges and universities, according to a survey of recent news stories. Some cuts have been averted; others have been delayed or are still pending.

To cope with the cuts, nursing school officials have taken a number of steps, including implementing hiring freezes; capping or cutting student enrollment; suspending or ending certain nursing degree programs; consolidating and moving nursing programs; and raising the cost of tuition. Some programs have faced closure.

The cuts are taking a serious toll on faculty, staff and students—and threaten to undermine care for patients, according to Patricia Butterfield, Ph.D., R.N., F.A.A.N., dean of the Washington State University College of Nursing.

Faculty and staff there face salary freezes and severe restrictions on travel, and students are taking on additional jobs to afford tuition, she said. “That diminishes the time they have to study, to reflect, and to become the type of clinician we want them to become.”

State Budget Cuts Undermine Nurse Services in a Variety of Settings

Nurses and patients in other settings are reeling from the cuts too.

In New York City, for example, school nurses are slated to be eliminated from about 145 public schools. Less severe proposals to eliminate school nurse positions have surfaced in places such as Weymouth, Mass., Paterson, N.J., and Pearland, Texas.

And in Massachusetts, a nursing workforce initiative that aims to address a shortage of nurses and nurse educators will not receive the full amount of funding that was authorized. “While it is hard to reach our goals with such a small pot of money, we appreciate that many agencies and programs are being even more negatively impacted in these difficult budget times,” said Maureen Sroczynski, R.N., M.S., chief nursing consultant for the Massachusetts Department of Higher Education Nursing Initiative, which aims to curb shortages of nurses and nurse educators.

The cuts to nursing education programs and related initiatives are particularly painful because they are coming at a time when the need for nursing services will increase dramatically, with health reform implementation bringing more people into the system, the population aging and more people facing chronic conditions, according to Brenda Cleary, Ph.D., R.N., F.A.A.N., director of the Center to Champion Nursing in America. The center is a consumer-driven initiative of RWJF, AARP and the AARP Foundation that is working to increase the nation’s capacity to educate and retain nurses who are prepared and empowered to positively impact health care access, quality and costs. “We not only will need more nurses, but more graduate prepared nurses trained to provide chronic care management, care coordination and primary care,” Cleary said.

The demand for nurses has eased in some parts of the country because working nurses are picking up more hours or putting off retirement to compensate for lost income from laid-off spouses or shrinking retirement accounts in the wake of the nation’s economic woes. And some retired nurses are returning to work.

But there still are not nearly enough nurses to meet the long-term demand, Cleary added. “State budget cuts to nursing schools mean that the supply of nurses will plunge as demand for their services skyrockets,” she said.

Without the resources to hire new faculty, nursing schools will be forced to turn away even more qualified applicants than they already are—precisely the opposite of what needs to happen to curb a looming shortage of nurses. “Ultimately, patients will have less access to nurses at a time when they need it most,” Cleary warned.

Experts don’t foresee an immediate solution to the problem. Fiscal problems are expected to continue to plague states in the near future, so more gut-wrenching budget decisions lie ahead. “Our legislative outlook for the next year is extremely dim,” Washington State’s Butterfield said. “I had hoped to see the light at the end of the tunnel by now, but it’s still far away.”