Clinical Nursing Support, $4.3 Million
Each year, California’s demand for nurses exceeds the number of students who are prepared to enter
the nursing workforce. By 2010, over 47,000 additional nurses will be needed to serve California’s
population. Currently, California’s institutions of higher education graduate only approximately
6,000 nurses annually. To meet state demand, California higher education will need to graduate
15,000 nurses annually—250 percent of the current number of nursing graduates. Faced with this
extraordinary demand, however, only a fraction of prospective students seeking admission to CSU
clinical nursing programs can be accommodated due to the limited numbers of qualified faculty,
facilities, and clinical placement opportunities in health care facilities. The CSU is already the major
source of new nurses in the state and is eager to increase the number of students it prepares for
careers in nursing, but to do so will require significantly greater state support.
The severity of the nursing shortage in California means that the state will have to rely on a variety of
programs to increase the availability of nurses; those programs include recruitment outside the state
and partnerships with private health care institutions. But, there is broad consensus in the health
care industry that the core of the solution depends on increasing the capacity of the state to attract,
educate, and train new nurses. The Board of Registered Nurses, the National League for Nursing, the
California Nursing Association, every major health care provider, and higher education leaders are all
in agreement, and on the record, identifying the critical need to increase the production of nurses.
There is no disagreement on this fundamental need; there is only a lack of resources to address the
growing problem. This support budget request represents a down payment to address the critical
nursing shortage in the state.
Under the terms of the Higher Education Compact, the CSU is expected to serve 2.5 percent more
students annually. It could be assumed that the CSU should be able to expand its nursing programs
within its annual enrollment growth allocation. Unfortunately, it is not that simple. The CSU receives
marginal cost funding for every new student it serves. That marginal cost is based on a mixture of
course offerings, some more expensive than the average, some less. Nursing programs, however, are
unique in many respects, one of which is the extent to which they are more expensive than other
“average” programs offered at the university. Nursing programs are more than twice as costly to
offer compared to “average” programs.
There are several factors that contribute to the higher cost of nursing programs. First, there is a
severe shortage of Ph.D. trained nursing faculty. This shortage drives up the cost of nursing faculty.
In addition, nursing classes, especially at the clinical level, are required to be much smaller than the
average class. The student-to-faculty ratio (SFR) in nursing programs is 10.5:1 compared to the actual
average for the university that is more than twice that number. In addition to these major cost drivers,
expensive and specialized equipment used in nursing programs adds to the cost of these programs.
The higher cost of nursing programs means that campuses cannot simply expand their capacity to
educate nurses within marginal cost allocations. Instead, substantially expanding nursing programs
will require substantial funding enhancements.