Amid a statewide nursing shortage, hundreds of qualified applicants for nursing degrees are not being admitted to programs in Mississippi because the colleges can't meet the demand.
Community colleges face the most severe admissions limitations. At East Central Community College in Decatur, for example, 485 qualified applicants submitted bids for this fall's associate's degree class, and the school accepted 72.
Itawamba Community College received 850 applications and accepted 150, and at Northwest Mississippi Community College in Senatobia, 456 applied with 156 admissions.
Some four-year institutions in the state are turning away nearly half their applicant pool, as well.
In one case, the University of Mississippi Medical Center's bachelor's degree in nursing drew 350 applications for this fall's class of 140 slots.
Mirrored throughout the country, this multi-faceted problem is one that some say will likely worsen as current nursing faculty members reach retirement age and prospective teachers put further education on hold to support themselves in a depressed economy.
The funding for and recruiting of faculty is the biggest barrier to accepting more students, program directors in the state say.
Pat Waltman, associate dean for academic affairs and accreditation at UMC's School of Nursing, said enrollment in the school's programs is increasing but not quickly enough.
"There are just not a sufficient number of qualified nurses out there," she said, explaining that nursing educators must have at least a master's degree in nursing to teach undergraduate courses and a doctorate to teach at the master's level.
Waltman said in order to create more nursing faculty, those with associate degrees, the minimum level of education needed to work as a licensed practical nurse or a registered nurse, must continue their training – a financial and time commitment that many working nurses can't make.
"In Mississippi, we have about twice as many graduates from associate degree nursing as from baccalaureate or higher degree programs, and only about 15 percent continue with their education to earn the bachelor's degree," Waltman said. "Only about 5 percent of those go on to earn a master's or doctorate degree."
Bridge programs available throughout the state are popular.
They offer a short, online option for a registered nurse to earn a bachelor's or, eventually, a master's. Nurses can often complete them while working.
But recruiting highly educated nurses into teaching is just as challenging, as the salary of a nursing educator is not competitive with salaries for practicing nurses.
"When they can go into private practice or work in the private sector and make anywhere from $30,000 to $50,000 to $60,000 more dollars a year, teaching's not very lucrative," said Debra Spring, assistant dean of nursing at Hinds Community College. "You have to really find the right person who is looking for the benefits of teaching."
Hinds admits two classes per year in its associate programs, drawing 220 applications for 155 spots this fall. Its licensed practical nurse to registered nurse bridge program, though, has a two-year waiting list.
"The rewards are in preparing the next generation," Spring said. "I always felt like I was impacting more patients through teaching because for every person I teach, many patients would be impacted by their care."
Lizabeth Carlson, dean of the nursing school at Delta State University, echoes that pride. She took a $40,000 pay cut when she began teaching.
In 2006 and 2007, the Legislature funded a salary increase of more than $12,000 over two years for nursing faculty at community colleges and public universities to address the shortage. It helped with recruitment and retention, said Janette McCrory, director of nursing education for the College Board.
But the shortage persists.
Money remains the issue for DSU, where Carlson said enrollment has tripled in the past five years but the nursing programs demonstrate greater potential.
For its baccalaureate class this fall, 52 students applied for 39 spots, and for the master's, 56 applied for 32.
"The main barrier is that we don't have the funding to hire more faculty," Carlson said.
Ellen Williams, dean of nursing at Northwest Mississippi Community College in Senatobia, said the availability of hospitals and other care facilities for hands-on training keeps her class sizes smaller than she'd want them.
"We compete with other nursing schools in the area for clinical sites, particularly in the Memphis area, and it is sometimes difficult to find placement for our students," Williams said.
Mississippi University for Women faces the same difficulty, particularly when students are looking to specialize.
"We take as many students as we can in order to provide the clinical experiences, but areas like (obstetrics) and pediatrics are difficult to place," said Sheila Adams, dean of nursing and speech language pathology.
At MUW, about 100 students enroll in associate degree nursing, another 65 begin on the baccalaureate level, 285 enter the online bridge program, and about 45 more pursue a master's. The exact numbers of applicants for the recent admission cycle were not available, but Adams said MUW accepts more than it turns away.
Adams said the clinical shortage is augmented with patient simulators, including a child model and a mother model that actually delivers a model baby.
Two other factors can restrict programs from growing – actual classroom and laboratory space.
At the University of Southern Mississippi, Director of Nursing Katherine Nugent said she can't wait for a new building in the works for its College of Health.
"A barrier is the capacity of the physical building that we're in, and the age of the building in being able to stay up to date with cutting-edge technology," she said.
The bachelor of nursing program at USM enrolls a class twice a year.
For this fall, 92 of the126 who applied were admitted.
The new building, for which construction will probably start in the fall of 2014, will allow more admissions.
"It is the No. 1 priority for the university right now," she said.