Nursing is the backbone of healthcare in the United States and across the world. Nurses have always exemplified the meaning of “essential worker,” long before the COVID-19 pandemic drove the point home.

COVID-19 focused our attention on the essential nature of nurses and the challenges facing the future of nursing, especially in Texas. The crushing weight of the health crisis fell hardest on nurses. And nurses are in short supply.

But the lessons of the pandemic also present an unprecedented opportunity for dedicated nurses, healthcare organizations, and nursing colleges to help shape the future of healthcare.

The Nursing Shortage

Nurses make up the largest segment of the healthcare sector. The Bureau of Labor Statistics projects 7 percent job growth through the rest of the decade, from 3 million nurses in 2019 to 3.3 million in 2029.

After accounting for retirement and nurses exiting the field, BLS data suggests 175,900 job openings each year. In other words, there are plenty of nursing jobs available and will be for the foreseeable future, but not enough trained nurses to fill them.

Why is this?

Over a decade ago, the Institute of Medicine published its landmark research, The Future of Nursing: Leading Change, Advancing Health. The report cautioned of a nursing workforce capacity shortfall throughout the United States. Two pressure points push the ongoing nursing shortage.

At one end of the equation, healthcare demand steadily increases with the aging Baby Boomer generation. Nursing schools, on the other hand, struggle to expand their capacity to meet the swelling demand. Therefore, many traditional nursing programs don’t have the resources to accommodate all qualified applicants.

According to the American Association of Colleges of Nursing, the nursing gap is forecast to spread across the country through 2030, given the status quo.

While country-wide, the nursing shortage will hit the hardest in the south and west.

The key to “bridging the gap,” says the Institute of Medicine in its report, is through “expanding nursing capacity.”

The research calls for increasing to 80 percent the number of baccalaureate-prepared nurses in the workforce and doubling the number of nurses with doctoral degrees. Before the pandemic, only 64.2 percent of the nursing workforce held a bachelor’s degree, falling well short of that recommendation.

The Nursing Shortage in Texas

Texas reflects these national trends. There are too few nurses stretched across too many patients. Recent data published in the NurseJournal shows Texas with among the lowest per capita nurse-to-population ratio in the country, with 9.62 nurses per 1000 residents.

In 2019, a Texas Governmental Public Health Nurse Staffing Study reported that “high vacancy and turnover rates can lead to negative outcomes that can affect the quality of care” by increasing workload and stress levels of existing staff. Then, in 2020, COVID-19 came calling. The challenges already in place exploded into a crisis.

Nurses in Texas and across the country faced unprecedented challenges and expectations. As the pandemic spiraled out of control, everyone looked to nurses for frontline care.

Nursing is the Linchpin to Quality Healthcare

While the pandemic emphasizes the nursing shortage in Texas and elsewhere, it also underscores the critical role nurses play in the healthcare system — now and into the future. According to the Future of Nursing report, “The nursing profession has the potential to affect wide-reaching changes in the health care system.”

The “regular proximity to patients and scientific understanding of care processes” gives nurses “a unique ability to act as partners with other health professionals.” When fully utilized, this partnership can “lead in the improvement and redesign of the health care system and its many practice environments.”

Crucially, addressing their needs and concerns, such as nursing burnout and self-care, should inform staffing and care delivery decisions.

The more policy reflects nurses as the linchpin to quality healthcare, the closer we are to bridging the nursing gap.

Houston Christian University Filling the Nursing Gap

As we’ve discussed, the nursing shortage is not necessarily for lack of people motivated to become nurses.

Traditional location-based nursing programs simply do not have the resources to accept all the qualified applications received. Working nurses ready to pursue their bachelor’s degree are often in no position to attend a ground-based program. A bottleneck in nurse training is the consequence. The solution is a new model for nursing education. An article in The Dallas Morning News speaks to this solution:

“Online nursing programs, which are already growing faster than face-to-face programs nationwide and in Texas, allow institutions to meet time-pressed and place-bound students where they are,” says author Susan Hernandez. “This is especially critical for nurses with two-year degrees who are already working in hospitals, who cannot easily pick up and attend four-year institutions in person.”

Houston Christian University epitomizes Hernandez’s point. HCU’s online RN to BSN program is designed to meet the need outlined in The Future of Nursing report of increasing baccalaureate-trained nurses.

The 100 percent online program allows working registered nurses the flexibility to earn a BSN degree while maintaining their professional life. Houston Christian University aligns with the recommendations presented by the Insitute of Medicine in the Future of Nursing.

Flexible and industry-aligned, HCU is a model for meeting the challenges of our most essential workers. Training qualified, dedicated nurses allows each to meet the potential of their capabilities and turn the tide of the nursing shortage.