Data from the Texas Department of State Health Services shows the nursing shortage is particularly bad in the Gulf Coast region, which includes Harris and Galveston counties.
Jack Frazee, director of government affairs and general counsel for the Texas Nurses Association, which aims to advance the profession across the state, said there is a shortage of about 27,000 nurses statewide. It’s expected to grow to 57,000 by 2032, he said.
“Obviously, the trend line is going in the wrong direction,” he said.
The registered nurse turnover rate in the Gulf Coast region in 2022 was nearly 30%, and the vacancy rate of registered nurses was almost 16%—the highest in both areas since 2014. For licensed vocational nurses, the vacancy rate in the Gulf Coast region was 41.8%, said Pamela Lauer, manager for the Texas Center for Nursing Workforce Studies, in an email.
Local college officials said the problem is not necessarily a lack of students interested in nursing but a shortage of teachers willing and able to educate them. Research shows an average of 10,000 applications to nursing education programs are denied annually due to a lack of space, Frazee said.
The number of qualified applicants to nursing education programs in the Gulf Coast region dipped by 3.5% in 2022 for the first time since 2014, according to state department data. The number of nursing graduates in the region also dipped 5.7%.
Meanwhile, legislators tried to address the problem through bills in the 88th Texas Legislature.Lack of teachers
The University of Houston-Clear Lake at Pearland has a program that allows registered nurses to obtain their Bachelor of Science in nursing, opening career advancement opportunities. The program started in 2014, and there’s been a growing interest in it, said Karen Alexander, director of nursing and associate professor at the university.
UHCL’s program offers students the ability to attend classes online or in person to cater to their needs. The university is now considering making a graduate program, Alexander said.
“The real shortage is the shortage of nurse educators, actually,” she said. “You can’t put nurses out there to work if you don’t have educators to educate them.”
San Jacinto Community College in Pasadena also has a nursing programs with several levels of education. The college has a vocational nursing program, which grants certifications to students within one year; a program that trains licensed vocational nurses to become registered nurses within 1 1/2 years; a two-year program for licensed nursing degrees; and a program that trains registered nurses to get their bachelor’s degree, which was created when the COVID-19 pandemic began in 2020, said Veronica Jammer, department chair for San Jacinto’s Bachelor of Science in nursing program.
“The intent is to meet people wherever they are,” she said of the numerous programs.
Jammer said San Jac is seeing a decline in graduates to some extent. Limited faculty affects how many students the college’s nursing programs can enroll, she said.
Also contributing to the problem is pay disparities, Alexander said. Nurses generally make more money practicing than they do teaching. Additionally, the barriers to become a nursing instructor are high, so few become teachers, Alexander said.
Alexander, who has a PhD, said her salary would be twice as high if she worked in a corporate setting.
“You really have to do this because you love this,” she said.
Jammer said San Jacinto College is aware of the problem and keeps salaries as competitive as possible. But education entities cannot compete neck-and-neck with the health care industry, she said.
Lauer said Texas nursing schools are generally increasing the number of nurses they graduate each year. However, more barriers—such as a lack of clinical space to train nursing students and recruiting nurse educators—must be addressed to increase the number of graduates even more, she said.
“The education pipeline is absolutely critical to meeting demand for nurses, but closing the demand gap will likely require interventions in other areas, too,” she said.
Aging workforce, population
Another factor pushing the nursing shortage is an aging workforce and population.
People live longer than they did decades ago, which means there’s an increased demand for medical care, including from nurses. Additionally, many nurses—and nurse educators—are 56 or older and will soon leave the workforce, Alexander said.
“We’re gonna see a mass retirement,” she said.
In 2000, 13.4% of Harris County nurses and 12.7% of Galveston County nurses were age 56 or older. As of 2019, those percentages had grown to 23.8% and 27.1%, respectively, according to state department data.
During the height of COVID-19, Frazee said he met a nurse in her 60s who worked 100 hours in a week, Frazee said.
“People were working really long hours,” he said. “It has been very traumatic for nurses.”
Lauer said age is a big factor in the problem.
“The growing and aging population is a big driver for increased demand for nurses, and that demand is projected to grow at a much higher rate than the supply of nurses,” she said.
Jammer also said an aging workforce is a problem. At the height of COVID-19, nurses, some of which were older, worked 12 to 16 hours a day with ill patients.
“That just put a bad taste in some of the nurses’ mouths,” she said.Legislative efforts
Bills were considered in the 88th Texas Legislature, which ended May 29, to address the nursing shortage.
Adjusted for inflation, the last time legislators considered such a high amount of spending on the nursing shortage problem was 2011. This session marked the largest amount of funding—about $80 million—for nursing education and related bills the state has considered, Frazee said.
However, many bills did not pass the House and Senate by the end of the session, including Senate Bill 1700—also known as the Healthcare Expanded & Accessed Locally Act. The bill would have removed regulations to allow nurse practitioners to provide care to areas with nursing shortages.
One that did pass was SB 25, which supports nursing students with scholarships, nurses and nurse faculty with loan repayment help, and nursing education programs with grants. Gov. Greg Abbott signed the bill into law, effectively immediately, on June 18.
Well over 20 legislators authored the bill, including Sen. Mayes Middleton, R-Galveston.
“Nurses are front-line health care workers, and we must innovate to encourage students to enter nursing,” Middleton said in an email to Community Impact. “This field is critical to expanding access to health care and helping lower costs.”
