IT IS URGENT that nurse leaders refocus their attention and creativity on reinvigorating the growth trajectory of our prelicensure nursing pipeline. Recent studies1,2 have identified a significant drop in the total nursing workforce (total registered nurse [RN] full-time equivalents), and retirements are looming for the largest age cohort of practicing nurses. Hospital-based RN staff nurse vacancy rates have increased to the unprecedented level of 17% in 2022, which is likely to further accelerate the annual RN turnover rate, which now exceeds 27%.3 Nursing employment growth projections by the Bureau of Labor Statistics are inadequate to meet the demand for frontline caregivers. Current enrollment and graduation rates as reported by AACN are woefully insufficient to meet the needs of the health care industry. Most recent faculty vacancy rates are more than 8%. In summary, our health system is in crisis due to an insufficient supply of RNs and requires the immediate attention of nurse leaders.4-6

It is time for both health system nurse executives and schools of nursing deans to revisit past approaches that have proven insufficient to ensure meaningful growth in our nursing workforce, commensurate with market demands. In addition to federal funding sources, health care providers need to invest significantly to help fund local prelicensure nursing programs, specifically directing those funds to capacity increases and faculty resources. They also need to look within their own workforce for future bedside caregivers. Nurse leaders should encourage boards of nursing to remove unreasonable limitations on the use of simulation so that schools can optimize its use in the academic setting. Faculty shortages can be mitigated by fully utilizing and integrating hospital-based nursing educators with formalized faculty roles through joint appointments and collaborative relationships. Most health systems have a wealth of educated and talented educators who supplement faculty and provide student oversight. Both schools and practice leaders need to work to improve the NCLEX pass rates of graduating students.

While the DNP enrollment increase (2002-2021) as reported by AACN is commendable, we have failed to provide sufficient growth in our entry-level baccalaureate nursing program enrollment. In the short run, health systems need to focus their energy and support on building the prelicensure pipeline, even within their own workforce. Nurse leaders need to challenge each other to find creative ways to expand enrollments and alleviate the strain that has been placed on our bedside nursing staff. Every community of nurse leaders should consider this an essential part of their job.

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