While the reasons vary, one thing is clear: If the trend holds, every hospital will face a serious shortage in the next five years. But getting into nursing school is a challenge for many prospective nurses.
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Training in a state-of-the-art simulation lab helps prepare nursing students like Lorelie Espa for the real-life situations they'll face in the hospital.
It's demanding and grueling work, but Espa doesn't mind. She's just grateful to be in a nursing program.
"I have been put on so many waitlists to become a nurse and I've been taking, like, prerequisites everywhere just to kill time," she said.
It took five years for Espa to get into a nursing program. Since 2017, on average, the California Board of Registered Nursing School Survey finds only about 29% of qualified applicants were enrolled in nursing programs statewide, and 71% were turned away.
At private, for profit institutions, the acceptance rate was 52% during this period. At public schools, it was 20%.
"We do see waitlists, especially in the community college programs," said Joanne Spetz, Ph.D., a health economist at UC San Francisco who studies healthcare workforce trends.
"We are hearing consistently in the surveys that we do that schools have had an increase in their faculty vacancies," she said.
Yet, in past 10 years, West Coast University says it has more than doubled its annual enrollment at its Anaheim, Ontario and North Hollywood locations.
From 1,500 in 2013 to now about 3,300 new students per year. But according to the State Board of Registered Nursing, this explosive growth occurred without their oversight.
"This one absolutely just almost made my head explode," said Tricia Wynne with California Board of Registered Nursing.
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At an education and licensing committee meeting held Oct. 5, the nursing board expressed how far West Coast administrators stepped out of bounds.
"They increase their student enrollment by 1,800 students without going through the process. It was just really surprising to me," said Wynne.
West Coast University sued the California Nursing Board, challenging their authority to oversee enrollment increases but lost.
"We had grown so much without the clarity that they had the authority and power. That's what they were saying. So it seemed a little, to me, nonsensical," said Chiarina Piazza, Ph.D., the Dean of the Nursing Program at West Coast University.
Eyewitness News repeatedly reached out to the California Board of Registered Nursing, but they declined to comment.
Now, following the legal fight, West Coast administrators are now worried the board will curtail its growth and possibly rollback enrollment, affecting the pipeline of new nurses.
"In general, around 10 or 11,000 newly licensed nurses a year pretty much gets you the number of replacements you need to fill the shoes of retiring baby boomers," said Spetz.
That number of graduating nurses also needs to pass the National Council Licensure Examination or NCLEX. During the pandemic, enrollments and pass rates at all nursing schools dipped at the same time the number of retiring nurses rose. But despite other dire predictions, Spetz said the impact to our state will be short lived.
"The latest data show that the graduations have recovered, and if that continues, then we are on track to kind of fill the shortage that we see right now, in a few years," Spetz said.
However, she added the issue can't be solved simply by graduating more nurses.
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"We are pretty much graduating the right number, but not necessarily in the right places, and we know that employers are having a hard time onboarding them, because of all the stresses that have come from the retirements and resignations of older nurses," she said.
Spetz said areas with large programs such as those in Orange County, Los Angeles and San Francisco could even see a surplus of nurses potentially forcing new graduates like Espa to seek jobs elsewhere.
"If they graduate, they move to Fresno and Bakersfield, great, but if they want to stay in Orange County, some of them might have trouble finding jobs," she said.
West Coast's tuition is about $150,000, more than double what some students might pay for the same degree at a public school.
Piazza adds that 70% of their students identify as persons of color. Experts point out that a culturally-diverse nursing workforce is an asset for hospitals with diverse patient populations.
As an immigrant from the Philippines, Espa said she had a tough time tapping into the educational system, but going to a private school brought her closer to her goal.
"I feel like I can see myself, you know, being a nurse, closer than being on a waitlist," she said.
The Board of Registered Nursing is expected to make a decision about West Coast University's enrollment practices on Thursday, Nov. 16.