Dr. William Osler, one of the founders of Johns Hopkins Hospital and a pioneer in medical education and history said, “The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest.” Now, though, we have nurses on strike for safer working conditions and greater compensation, and educators decrying federal action to withdraw graduate nursing education from the category of “professional.”
The members of a profession are highly educated, with specialized knowledge, may be required to pass state-approved licensure exams, and pledge to certain ideals. In the case of nursing, the pledge is to patient welfare, compassion and trust, building knowledge in the field, lifelong learning, teamwork, professional integrity, an ethical code, skillful care, and humanity. Like other professions, nursing requires prolonged learning and licensure.
So imagine the surprise to nurses, nurse educators, nurse researchers, nurse executives, hospital administrators and others when the U.S. Department of Education declared that an advanced degree in nursing did not qualify for federal student aid. Yet advanced education is one of the pathways for advancement in nursing, and many employers require a master’s degree.
In response to critical reactions to its decree, the department said it did not mean that nursing is not a profession, just that advanced nursing education at the master’s and doctoral levels did not qualify for federal student loans. In addition to reducing the amount students can borrow under the Graduate PLUS program, which previously allowed up to the full cost of a program, the government has cut in half the amount that students in nursing and social work, among others disciplines, can borrow for advanced education.
No such limits have been proposed for medicine, dentistry, pharmacy, veterinary medicine, optometry, osteopathic medicine, podiatry, chiropractic, theology, law or clinical psychology. Architects, physical therapists, social workers, computer scientists and accountants, however, join nursing in losing their professional status.
The Education Department is trying to limit access to government-backed loans for graduate degrees because, it says, the availability of loans encourages universities to raise tuition even in fields that have limited employment opportunities and low compensation. That is certainly not the case in nursing. Others support the department, arguing that there is a strong correlation between extended graduate study for women and our low rate of childbearing.
According to public reports, there are approximately 57,000 registered nurses on Long Island, with an average age of 46. In New York City and the Downstate region, there is a critical shortage of certain categories of nursing, with “disaster emergencies” declared in Manhattan, the Bronx and Nassau County. In upstate New York, over 93 percent of hospitals report extreme difficulty in recruiting RNs, and 97 percent struggle with retention. Hospitals and nursing homes have the most difficulty recruiting and retaining RNs.
Long Island is fortunate to have universities that offer baccalaureate and higher nursing programs, including Adelphi, Farmingdale, Hofstra, LIU, Molloy, NYIT, St. Joseph’s and Stony Brook. Yet even with these resources, shortages remain. With the new federal guidelines, those shortages will likely persist, while retention rates drop.
I have seen the profession of nursing from four distinct vantage points. As assistant commissioner of Higher Education in Indiana in the 1970s, I was involved in a national study of nursing supply and demand commissioned by the National Governor’s Association. In the 1980s I initiated a nursing program at Ramapo College of New Jersey, in partnership with the University of Medicine and Dentistry of New Jersey, which did not offer nursing.
In the 2000s I led the rebuilding of Adelphi’s historic nursing program, which had been neglected by a previous administration. We built new, state-of-the-art nursing labs and teaching spaces, with the help of leaders at Winthrop and Northwell hospitals.
From these experiences, I learned a great deal about nursing education and practice. They are professionals at every level of education.
More than 150 Republicans and Democrats in the U.S. House of Representatives have authored a bill, the Professional Student Degree Act, that would include graduate nursing education in the category of professional degree, and give graduate nursing students access to the federal student-aid programs for which they were eligible just last year. Let’s hope that wisdom prevails in Congress, with hearty encouragement from grateful patients.
Robert A. Scott is president emeritus of Adelphi University and the author of “How University Boards Work.”
