Minnesota nursing schools team up to confront severe shortage

Minnesota nursing schools are banding together to recruit more students and address a shortage that is poised to leave hospitals and clinics severely understaffed in the next few years.

The University of Minnesota and Minnesota State on Tuesday announced the debut of the Coalition for Nursing Excellence and Equity and its ambitious goal of making nursing education more successful and innovative without increasing cost or reducing access.

"Continuing to do what we've been doing won't address the current nursing shortage or the even greater one our state is facing in the very near future," said Connie White Delaney, dean of the University of Minnesota School of Nursing.

Key goals include recruiting more people into nursing — particularly minority members who work in a variety of lower-wage medical jobs but struggle to move up — and improving virtual and live instruction so students aren't inadequately prepared for their eventual jobs.

The shortage has been on the horizon for decades — with nurses in the massive baby boom generation not only retiring but reaching ages at which they need more medical care themselves. It was exacerbated by the pandemic, which increased stress and burnout and drove even more nurses from the profession prematurely.

Twin Cities hospitals already are reporting increased reliance on high-cost temporary staffing agencies this year, resulting in multimillion-dollar deficits. Even with 50 nursing schools in Minnesota, the current training pipeline won't produce enough graduates to address the state's estimated need for 25,000 new registered nurses per year by the end of this decade, Delaney said.

"We aren't keeping up," she said, calling the situation "the most dire nursing shortage at least in decades."

The shortage has a way of compounding its own problems, said Valerie DeFor, executive director of the Minnesota State HealthForce Center of Excellence, a group of medical providers and academic institutions supporting the new coalition.

Even if the state could fill its schools with more students, the current shortage of nurses has resulted in too few becoming nurse educators to train them. And when short-staffed hospitals don't have enough nurses to handle additional duties beyond direct patient care, they cut the number of slots for hands-on student training, she said.

"This (shortage), I don't see a cycle out of it without change, without an intervention," DeFor said.

The coalition's goal is to boost instruction at every school in the state and increase the pool of registered nurses as well as licensed practical nurses. The U operates a nursing school in Minneapolis along with a satellite campus in Rochester, while Minnesota State has a large nursing school in Mankato and programs spread across 30 other institutions. Private schools such as St. Catherine University operate nursing programs as well.

Nursing schools have already responded with alternative training programs beyond the traditional four-year track. Students with other college degrees started their first hands-on lessons Monday at the U, which will turn them out as registered nurses with master's degrees in 16 months.

Ruqiya Warsame knew she was being a little slow and deliberate Monday, when an instructor watched her prepare insulin solution to inject into a practice dummy. The 26-year-old graduated from the U in 2018 with the intent to work in public health but felt a draw to nursing when she was at a clinic and saw how Somali patients benefitted from caregivers with the same racial and ethnic background.

"Sometimes just seeing someone that looks like them and can speak their language and can understand the complexities of their culture can help in their whole healing and well-being," said Warsame, who hopes to practice nursing in a hospital neurological intensive care unit.

An underrepresentation of minorities in nursing is contributing to the broader shortage. The disparity is frustrating because minority members make up a greater share of nursing aides and lower-level health care workers who should be on career tracks to move up, said Jennifer Eccles, senior system director of nursing excellence for Minnesota State.

The coalition will seek to address any racial, systemic or financial barriers that keep minority caregivers from pursuing nursing. More federal grants are available to nursing students, for example, if they commit after graduation to rural work or other shortage areas, Eccles said.

"This is a time to serve the underserved and the underrepresented and the underestimated," she said.

Another coalition goal is to raise nursing education so that it simulates the conditions students will experience. The pandemic hastened use of virtual classes and simulations, but nurses reported that they were left underprepared for real-life stress in hospitals and clinics.

The U received a grant to experiment with heightened use of virtual reality, both on 2-D screens and with 3-D goggles, to create lifelike simulations. Instead of just practicing placements of urinary catheters in patients, VR simulations can make students decide first whether the catheters are necessary.

"Students are fairly protected. For safety reasons, we don't just throw them out there," said Cynthia Bradley, the U nursing school's director of simulation. "Anything we can do in VR to help them understand what the expectations are and the demands, then they're more prepared when they actually get there."

One advantage of the coalition could be creating a single VR program that works for all Minnesota nursing schools, an efficiency that could lower the technology's cost, she added.

Mallory Willett looked more self-assured than some classmates Monday as she practiced her insulin draw — the benefit of having worked with needles and in a non-nursing clinical role at a reproductive health center in St. Paul. The 25-year-old hopes to work in a hospital emergency room and that her classes and clinical rotations will prepare her to handle the job's stress.

"That is something I am really taking seriously," she said, "because I'm not doing all this — going through all this education and everything — to be burned out and leave the field altogether. I want to be in this for the long haul."