Watching nurses take care of his grandfather at a hospital left an indelible impression on David Mulhall when he was younger.
Their interaction with patients “made me want to do it,” said Mulhall, 22, of Louisville.
So he enrolled in the University of Louisville School of Nursing, where he graduated in May and has accepted a nursing job at University Hospital.
Mulhall is part of a growing number of people accepted into the UofL nursing school in an era when other schools around the country and state are having to turn away many qualified applicants for various reasons — from an insufficient number of faculty to budgetary constraints.
For people who want to become nurses, said Ruth Staten, an associate dean for academic programs and associate professor at the University of Louisville School of Nursing, “We’re working, really, as hard as we can to make sure that students have that opportunity and that the workforce is being fed, as much as we can, the number of nurses that they need in the workforce.”
Interest in the nursing profession is high, partly because of a strong demand for nurses at a time when the country is grappling with a nursing shortage and an aging population that needs care. The nursing workforce also is aging, leading to retirements and a dearth of people to serve as educators.
“We’re faced with more demand and we’re faced with a lot of retirements inside the nursing profession,” said Mark Vogt, chief executive of Galen College of Nursing, which has a campus in Louisville.
Vogt said Galen, which has several different routes to entering nursing, has been keeping up with demand from students who want to enroll there.
But, in general, U.S. nursing schools turned away more than 64,000 qualified applicants from baccalaureate and graduate nursing programs in 2016, according to the American Association of Colleges of Nursing.
UofL, on the other hand, is in building mode. The school has gone from admitting about 70 students per semester into its four-year undergraduate nursing program in the 2013-14 academic year to about 100 per semester currently. Out of 230 qualified applicants, 200 were admitted in 2017-18.
Some of the steps UofL has taken to keep its enrollment growing have included expanding classrooms to accommodate more students and hiring part-time faculty to instruct students.
“We have really great part-time clinical faculty and we use a lot of them,” Staten said. Some of them probably worked the day before and are taking the students to clinical agencies and giving them “really rich clinical experiences.”
The school also has been making good use of manikin-based simulations that give students a feel for what it’s like when a patient goes through a medical situation, such as a heart attack or stroke, Staten said.
The sophisticated manikins’ “vital signs start changing and their lab values start changing,” she said. “Their blood pressure is going up. All those things. The students learn how to detect the changes and talk to the patient and figure out what’s going on, and then to read the signs, to see them and then take the appropriate action.”
The University of Kentucky College of Nursing also makes use of simulations. It has classrooms set up like hospitals, and there are patient simulators (the manikins) that represent patients of various ages, said Dr. Kristin Ashford, an associate dean in the UK College of Nursing.
“We are trying to think about creative ways to provide that clinical experience that may not be in a hospital to help increase our Kentucky nursing workforce,” Ashford said.
Nationally, schools have had to turn away qualified applicants because of an insufficient number of faculty, clinical sites, classroom space and clinical preceptors as well as budgetary issues, according to the American Association of Colleges of Nursing.
The University of Kentucky College of Nursing typically has a waiting list of 50 to 100 qualified applicants for its four-year undergraduate program, Ashford said.
“Historically speaking, we’ve had several years in which we’ve had a significant number of students that meet eligibility for our nursing program, however, (they) may not be accepted because we can only accept a set number of students,” Ashford said. “At UK, that is right around 220 students at the undergraduate level we admit each year.”
Some students go on to reapply to UK and get in, Ashford said, but it’s not unusual for the Lexington university to refer students to other schools, such as Western Kentucky University or Berea College.
“We certainly want them to be successful becoming a nurse, so we will explore other options with them,” such as attending another institution, Ashford said.
Staten made similar comments, noting that “if a person really, really wants to be a nurse, then they should go after their passion where they can find it.”
UofL’s 270 pre-licensure students include those in the Louisville Bachelor of Science in nursing program, a Master’s Entry into Professional Nursing second-degree program, and a BSN program in Owensboro that has helped to fill the need for baccalaureate-trained nurses in that part of the state.
Nurses are in high demand for a number of reasons, including a shortage of nurses fueled by “the aging of (the) current workforce and baby boomers retiring and more people getting older and needing care,” Staten said.
Furthermore, “it’s a good job” with a lot of meaning and a steady income, she said.
A UofL student, Ivone Adamenou, 21, said she’s seeking to become a registered nurse because she wants to be of help to people. Adamenou came to the United States seven years ago from her homeland in Africa and will graduate with her bachelor’s of science in nursing degree in December.
“Most opportunities in Togo are limited because of politics,” she said. Coming here “gave me an opportunity to do something to make a difference in people’s life.”
Although Mulhall’s experience with his grandfather influenced his decision to pursue nursing, he also had practical reasons.
“Good salary and the job security is definitely a part of it,” he said, noting that local facilities were very interested in recruiting him and other nursing students.
“When I was interviewing and when my friends were interviewing, it was pretty apparent that unless there was a huge red flag with something that you would be able to find a job,” Mulhall said.
Vogt said society needs more “great caregivers.”
“Whether they go to Bellarmine, UofL, Spalding, Galen or wherever they go, it’s trying to find that person who is passionate about helping people,” he said.
The nursing workforce is aging, just as the general population is, and patients tend to be sicker these days, which makes them more complicated to care for, he said.
Galen has classes year-round and many different pathways for people to get their nursing education, including a three-year baccalaureate degree, a 12-month LPN program and a two-year associate degree.
The college sometimes serves as an alternative for students who’ve gotten placed on waiting lists at other schools or who have degrees in other professions.
There is tremendous interest from people wanting to become nurses, and it’s not just the 18- to 21-year-old typical college student, Vogt said.
“Most of our students have a degree in something else or have been to school somewhere else and decided that nursing is a better fit for them,” he said.