BARRY WILLIAMS /Special

Fran Kamp, RN, MSN, helps first year nursing students Nana Nakasone, left, and Shannon Moon, right, with taking a blood pressure on Sim Man at the Georgia Baptist College of Nursing at Mercer University.

"Our classrooms are bursting at the seams. I've got students coming out of my ears, and we still need faculty," said Christina Horne, Ph.D., RN, director of the undergraduate program at the WellStar School of Nursing at Kennesaw State University.

She could just as easily be describing the atmosphere at any other Georgia nursing school. To address the problem, Horne is taking on another duty, as member of the new Board of Regents task force on nursing education.

"I'm glad to be on it," she said. "It's one thing to write a report about the shortage problem. Now someone needs to do the things that will make a difference in solving this complex issue — the things that will help us educate and recruit more nursing faculty and increase clinical training sites. We need to walk the talk."

Believing that more people are aware of the urgent shortages of nurses and other health care workers, she said, "I see a lot of things happening for the positive."

In June, the Board of Regents Task Force on Health Professions Education published its final report. The bottom line: Georgia faces critical shortages of health care professionals in the next decade that will decrease access to care, increase costs and negatively impact the state's residents and economy.

According to the report, Georgia is the ninth-most-populous state; but on a per capita basis, the state ranks 39th in physician supply; 47th or lower in the supply of psychologists, social workers and dietitians; and 42nd or lower in the supply of physical therapists and registered nurses.

In fact, in no category of health professionals does Georgia's supply meet its needs. Hospitals and nursing homes are already reporting vacancy rates as high as 15 percent for nurses and therapy professionals, according to the Georgia Hospital Association.

"Both nationally and within Georgia, there is a broadening awareness of the seriousness of the health care work force shortages and what might happen in 10 to 15 years if we don't make substantive changes," said Dr. Daniel W. Rahn, president of the Medical College of Georgia, who led the task force. "Since everything is connected in health care, we need to have a strategic alignment of everyone involved. We must work collaboratively to create the necessary strategies."

Taking a systemwide approach, Chancellor Erroll B. Davis Jr. appointed Rahn to the newly created position of senior vice chancellor for health and medical programs in July. Davis also aligned his 2008 budget requests to reflect urgent health care priorities, requesting $37.2 million for the University of Georgia's College of Pharmacy, $5 million to design a school of dentistry building at MCG and $42.5 million for a long-needed health sciences building at Kennesaw State.

The University System is the largest educator of health care professionals in the state, with more than 5,000 students enrolled in 35 institutions. "The new task force will address nursing first, because that is the area of greatest need," Rahn said.

Georgia is predicted to need almost 20,000 additional nurses by 2012, yet had to turn away more than 4,000 qualified nursing applicants in 2005 because there was no one to teach them and nowhere to train them.

Because the shortage of nursing faculty is the primary limitation to programs accepting more students, the task force will be looking at salary enhancements, teaching incentives and programs to increase the number of nurse educators in the state. More scholarships and service-cancelable loans to help nurses earn higher degrees will also be on the table.

Also on the task force will be members from the Georgia Department of Adult and Technical Education and members from the Georgia Board of Nursing. Rahn believes that Georgia can achieve greater educational capacity when schools share needs and resources, rather than one institution trying to do it alone.

In 2004-05, the University System of Georgia and the Georgia Department of Adult and Technical Education graduated 1,891 candidates eligible for the RN exam. The task force will be charged with increasing that number to 2,300 by next July and aiming for 3,000 to 3,500 graduates per year in the future.

Hospitals need help

In August, the Georgia Hospital Association took a broader approach to addressing members' staffing vacancies.

"A few years ago, the Legislature formed a Health Care Workforce Policy Advisory Committee to address shortages, but it lost its funding, so we decided to expand our work force council," said Karen Waters, vice president of professional services at GHA. "Patient demand is growing in hospitals at the same time that nursing and allied health professionals are aging and nearing retirement. We have to see an increase in the number of younger professionals into the pipeline."

In August, GHA convened a Georgia Nursing Educational Invitational Summit. Almost 50 representatives from the Board of Nursing, nursing schools, the University System of Georgia, the Georgia Department of Adult and Technical Education, the Georgia Department of Labor, the state Department of Education, the governor's office and the Georgia Student Finance Commission attended.

"We asked them to lay personal issues at the door and focus on what's needed for Georgia. Representatives each spoke for about five minutes, followed by lots of discussion," Waters said. "The group came up with about 30 different strategies, and now we're going back to the participants to have them prioritize them and identify who can take the lead for implementing each one."

Multiple solutions needed

Besides faculty and funding shortages, another major concern is how to increase the number of clinical training sites for nursing students.

"Finding placement for 426 students is a challenge, when the ratio is six students to one instructor and you're competing with other nursing programs," said Susan Gunby, RN, Ph.D., dean of Georgia Baptist College of Nursing of Mercer University. "We're all stepping over each other, using different shifts and placing people on weekends in order to get the job done."

Many solutions are needed, because this is a multifaceted problem, Gunby said. Compounding the nursing shortage are an aging nursing and faculty work force, the lack of adequate classroom and lab space on campuses, fewer nurses choosing to teach because of lower salaries in faculty jobs and nurses leaving the field because of stressful working conditions. Even the acuity level and obesity of patients are affecting nursing staff.

"This is unlike anything I've ever seen in 38 years in nursing," Gunby said.

Fortunately, Georgia's nursing schools and hospitals have already begun to find creative ways to expand their programs and increase enrollments. Partnerships with hospital systems to fund equipment and nursing scholarships; accelerated BSN and MSN programs to graduate nurses faster; LPN-to-RN bridge programs to train higher-qualified practitioners; re-entry programs to lure nonpracticing nurses back to the work force; and the use of distance learning to extend education into underserved areas are ways in which Georgia institutions are trying to increase the flow of nurses into the system.

"Many other states have recognized the nursing shortage but not done what Georgia has done," said Barbara

Woodring, Ed.D., RN, CPN, who recently became director of Georgia State University's Byrdine F. Lewis School of Nursing. "I see it as a very positive factor that the Board of Regents and others are taking it seriously."