Nursing Dean to Congress: President's Proposed Budget Cuts Would Worsen Nation's Nursing Shortage

March 19, 2008
March 19, 2008 – On March 13, University of Virginia School of Nursing Dean Jeanette Lancaster testified before the U.S. House of Representatives' Subcommittee on Labor, Health and Human Services, Education and Related Agencies to advocate for support of nursing education in the upcoming federal budget. Lancaster, the Sadie Heath Cabaniss Professor of Nursing, is president of the American Association of Colleges of Nursing.

Speaking on behalf of the AACN, she presented the organization's budgetary funding priorities, which include seeking $200 million for the Nursing Workforce Development Programs authorized under Title VIII of the Public Health Service Act.

Lancaster cited the decade-long shortage of registered nurses that is already affecting health care delivery in the United States and explained the necessity of acting immediately to prevent even worse ramifications as aging baby boomers increasingly impact the nation's health care system. More than 1.2 million new and replacement nurses will be needed by 2014, but the supply of nurses is not growing at a pace to meet those needs.

The Health Resources and Services Administration projects that nursing schools will need to increase the number of their graduates by 90 percent to adequately address the shortage.  Yet a shortage of nursing faculty led nursing schools across the country to turn away more than 40,000 qualified applicants last year.

The U.Va. School of Nursing received 404 applications for only 57 spaces in the fall 2008 semester; for the past three years, the school has been able to accept only 14 to 15 percent of applicants.

Title VIII programs, the largest source of federal funding for nursing education, are a proven solution to past nursing shortages and are viewed as a potentially significant help for the current problem. However, while expressing gratitude for the subcommittee's past support for Title VIII programs, Lancaster sounded the alarm about two major concerns with current and proposed funding.

The Nurse Faculty Loan Program, dedicated to educating future nursing faculty, provides cancellation of up to 85 percent of their educational loans for those who agree to teach in a school of nursing. It is, however, seriously underfunded at one of the lowest levels of all Title VIII programs ($7.86 million).

In addition, Lancaster expressed great concerned that President Bush's FY 2009 budget proposal has marked for elimination Advanced Education Nursing grants that support programs to prepare graduate-level nurses to be primary care providers and nurse educators. In FY 2007, this program supported 16,000 students; eliminating it would be a major setback in overcoming both the nursing faculty shortage and the nursing shortage, especially in rural and underserved areas of the country. Indeed, Lancaster has personally seen the benefit of this program, noting in her testimony, "I am a product of Title VIII funding for my master's degree in psychiatric mental health nursing."

According to Lancaster, the committee asked almost no questions of any of those who testified. The chair did explain to each how much the president's proposed budget would cut their programs and Lancaster explained that such a drastic cut "would nearly redline the support for nursing faculty and nurse practitioners, both of which are so key to our health care system." She framed her deep concern by adapting the words of U.Va. founder Thomas Jefferson, who wrote, "Without health no pleasure can be tasted by man," adding that "without faculty there is no capacity to educate nurses. With all the pending faculty retirements in nursing education, the issue will not be one of increasing enrollments, but the struggle to sustain enrollment at current levels."

The American Association of Colleges of Nursing is the national voice for America's baccalaureate- and higher-degree nursing education programs. AACN's educational, research, governmental advocacy, data collection, publications and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate education, research and practice in nursing — the nation's largest health care profession.

The University of Virginia School of Nursing stands among the top 5 percent in the nation, ranked 19th by US News & World Report; two of its graduate programs are currently listed in the U.S. News Top Ten. With a vigorous research program that includes studies in rural health care and disparities, oncology, gerontology, complementary therapies and nursing history, the school has implemented new programs and strategies to address the national nursing shortage and the concurrent need for more highly educated nurses to deliver increasingly complex health care.  For information about the U.Va. School of Nursing and its programs, visit