Yes on Prop B Helps Grow Pipeline of Nurses in Missouri

Karen Cox.jpgBy Karen Cox, Ph.D., RN, FAAN; Board Chair, Health Care Foundation of Greater Kansas City

By now, most people know that Prop B addresses Missouri’s health, smoking and school funding problems through a 73-cent tax increase on cigarettes and an increase in the tax on other tobacco products.

This increase in Missouri’s lowest-in-the-nation tobacco tax would provide $283 million annually in new revenue and is a proven way to decrease smoking rates and prevent Missouri kids from ever starting to smoke.

But there is another benefit that Missourians will receive with the passing of this ballot initiative. Prop B will provide additional funding needed to improve the health care workforce.

For the past few decades there has been a nursing workforce shortage crisis. Just as the crisis was reaching its height, our country was faced with a recession. As the recession started to accelerate, registered nurses who had eyed retirement found themselves facing an unsure future. Spouses and partners lost jobs, and the value of nest eggs plummeted, causing many to postpone their planned retirements.

This impact of the recession on the nursing workforce has created a false sense of security in the nursing field, specifically as it relates to lower turnover and increased retention. Nurses continue to be wary as the economy slowly edges toward recovery. This amalgamation of events has many in health care leadership claiming the nursing shortage is officially over.

Not so fast. This pattern of nurses working past retirement cannot be sustained, and here are the numbers:

  • In an article in the Journal of Nursing Administration, it was stated that 33 percent of RNs are 50 years old and over—the baby boomers.
  • The American Association of Colleges of Nursing (AACN) reports that half of RNs indicate their desire to retire within 15 to 20 years.
  • The pipeline for new nurses continues to be clogged by an aging nurse faculty that also is poised to retire. According to the AACN, the average age of nursing faculty with master's and doctorate’s degrees is roughly 60 and 56 years old, respectively. AACN also found that nearly 55,000 qualified applicants were not accepted into schools of nursing because of shortages of faculty, adequate clinical sites and other resources.
  • Compared to the baby boomers who are leaving the workforce, there are nine million fewer Generation Xers, those born between 1965 and 1984, that have entered the workforce.

The shortfall of nursing professionals has been estimated by the Bureau of Health Professions to be close to one million. This number was calculated before passage of health care reform. As we continue to implement the ACA, we enter uncharted waters of reform with a tsunami of anticipated newly insured patients now having access to healthcare goods and services at the precise time when these retirements will start to accelerate. According to the Institute of Medicine's The Future of Nursing, the passage of health care reform will bring in an additional 32 million people as newly insured.

Thirty percent of the revenue (approximately $84 million) generated from Prop B would go to Missouri’s colleges and universities to support educational opportunities for tomorrow’s workforce and our future caregivers. On November 6, we have the power to reduce smoking in Missouri and to provide new funding for our public schools, colleges and universities.

As a nurse leader and as someone who cares deeply about the health of our children, I urge voters in Missouri to help save lives and invest in our children’s future by voting yes on Prop B.


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