Texas Nursing Shortage Is Second Worst in U.S.

I can recall my mother, a retired RN, talking about the nursing shortage in the 1980s when she worked the afternoon shift on a post-partum unit.

In fact, it seems that the nursing shortage is as old as me. The question is: Will we ever fix the problem?

By 2022, more than 500,000 experienced nurses are expected to retire. To fill the void from retirees, the U.S. Bureau of Labor Statistics projects a need for more than 1 million new nurses.

We break these numbers down further for you. By 2030, Texas is projected to have a deficit of 15,900 nurses.

While several factors fuel the nursing shortage, one of the leading contributors takes root in a generation — the baby boomers.

Retiring baby boomer nurses — combined with baby boomers in the general population with advanced diseases — play a significant role in the shortage, said Tamara Eades, DNP, MSN, RN, coordinator of RN-BSN operations and clinical assistant professor at the University of Texas at Arlington.

“In acute care, home health, rehabs and nursing homes, we have a greater need for nurses because of baby boomers,” said Eades, who is president-elect of the Texas Nurses Association. “In Texas, we have about 420,000 nurses, and the baby boomers born from 1946-1964 make up three-fourths of our working nurses.”

To give it context, Eades said about 10,000 baby boomers turn 65 every day in the U.S.

Another factor contributing to the Texas nursing shortage is there are too few nurse educators to fill faculty positions in colleges and universities, Eades said. This is due to dwindling nurse faculty members because bedside nurses can generally bring home bigger paychecks in acute care.

“The younger generation of nurses does not want to enter in faculty positions because of (lower) salary,” she said.

A call for specialty nurses in Texas

The state’s demand for nurse practitioners (NP) is expected to grow 46.3% — from 13,826 in 2015 to 20,227 by 2030. Approximately 25% of the demand will not be met, according to the Texas Center for Nursing Workforce Studies.

In Texas, demand for certified nurse midwives (CNM) is projected to show an unmet need of 80% by 2030.

Top 5 states hit hardest by the nursing shortage, according to HRSA.

State Projected Nurse Deficit by 2030
California 44,500
Texas 15,900
New Jersey 11,400
South Carolina 10,400
Alaska 5,400

Getting CNAs up to speed

How does an entire profession attract millions of people to it? Give them opportunities they can’t refuse, such as training, increased pay and a job offer with tuition reimbursement.

Project QUEST (Quality Employment Through Skills Training) is a Texas-based workforce program that identifies people with barriers to education for placement in training programs, from computer programming to healthcare.

Lelani Mercado, deputy director with the San Antonio-based program explained how it is helping close the gap in the Texas nursing shortage. “Once (students) complete their training, they have an opportunity to work with an employer as a frontline health worker like a CNA or nursing tech,” she said.

The hope is students take a job as a CNA and then pursue becoming an RN to ease the Texas nursing shortage.

Each training period, or pilot, lasts 12-16 weeks for CNAs or acute care techs.

What’s unique is the program pays participants to learn. This is an attractive offer considering some candidates come from the fast food industry, said Mercado, which typically offers lower wages and less attractive career training opportunities.

“They are getting paid in a hospital setting while learning applications they will be using, like taking blood pressure and vital signs,” Mercado said. “And they have exposure to patients, so they know what it means to triage a patient.”

Job placements are taking place upon program completion. “The last class had 10 people in the cohort,” she said. “Seven moved into positions. And 100% were offered a position — but only seven took jobs — and six are still working there 18 months later.”

Dana Brandt, director of HR strategy with CHRISTUS Santa Rosa Health System in the San Antonio metropolitan area, gives QUEST a thumbs up.

“It has given participants a foothold in the healthcare arena to then be able to further their education and go on to a higher level of professionalism,” she said.

Novel ways to fix the Texas nursing shortage

Brandt and Eades offer a few suggestions they think would help ease the current Texas nursing shortage:

  1. Create more nursing programs in Texas and other states.
  2. Develop “visiting professor instructor programs” where nurses dedicate time as guest speakers at colleges. This includes higher-level nurses guest lecturing to take some of the burden off of nursing schools.
  3. Expand space for student learning by building state-of-the art clinical simulation labs.
  4. Find more funding, including more grant opportunities.