Desperately Needed: More Nurses. So What's the Role of Philanthropy?


Whatever happens to the Affordable Care Act, much of the talk about the country's healthcare will remain focused on the persistent challenges around access to medical care and its affordability. But wait, there's less: It turns out we're fast running out of the largest segment of health professionals who provide medical care—specifically, nurses.

This is not a sudden development, but things are getting worse: As Rebecca Grant wrote last year in the Atlantic:

The U.S. has been dealing with a nursing deficit of varying degrees for decades, but today—due to an aging population, the rising incidence of chronic disease, an aging nursing workforce, and the limited capacity of nursing schools—this shortage is on the cusp of becoming a crisis, one with worrying implications for patients and health-care providers alike.

Hundreds of thousands of nursing jobs could go unfilled in future years, with grave implications for patient care. What's also troubling about this problem, even heartbreaking, is that well-paying nursing jobs are now likely to be unfilled even as too many Americans languish in dead-end careers in industries like retail and restaurants. This is a classic case where there's lots of room for creative win-win solutions. And because the nursing shortage is a problem that neither government nor the private sector is solving fast enough, this a prime place for philanthropy to step in. 

Which brings us to the news of a recent $1.5 million grant from the Harold Alfond Foundation to Saint Joseph's College, in Maine, to be used to educate new nurses to address that state's critical shortage. According to Alfond, nearly three-fourths of Maine nurses are nearing retirement age, and there are insufficient numbers of students and new nurses in the pipeline. Maine is one of the states most considered at risk for future nursing shortages. As well, this is a place where young people desperately need promising new career opportunities. 

In short, the Alfond Foundation's focus on nursing makes a whole lot of sense. 

We've written about Alfond before, reporting on its effort to address another problem that plagues both Maine and the nation as a whole: the inability of many families to afford college. 

RelatedA Funder's Interesting New Effort to Help Families Save for College

Alfond's big new nursing grant will support the creation of a new academic center to get more nurses into the state's workforce. The Alfond grant will help Saint Joseph's expand its training simulation labs, among other measures.

Helping one school ramp up capacity is certainly prudent planning and a wise use of philanthropic resources, but it can't do the job on its own. Even in Maine, the country's ninth least-populated state, there are 14 institutions where students can earn nursing degrees of one sort or another.

The rising demand for nursing in Maine and elsewhere, it's worth noting, isn't just from hospitals. It's also from nursing homes and home healthcare agencies. Meanwhile, in another trend, the scope of medical procedures that nurses perform is increasing—especially in places where doctors are in short supply. Any way you slice it, nurses are becoming ever more important to the functioning of our healthcare system. 

Still, nursing doesn't receive as much attention from foundations as you might think. Nurses have long been a specific focus of the Gordon and Betty Moore Foundation, although its work in this area has lately evolved. Meanwhile, the Robert Wood Johnson Foundation has worked to expand the roles of nurses as part of its broader "culture of health" efforts in the U.S. But RWJF's work in the nursing space is more about empowering nurses to be agents of change than tackling the vast looming shortages of nursing that are coming at us fast. Other funders make grants in the nursing space, but it's not a large pool overall. 


Given the lack of major foundation attention, the role of local higher institutions—and the donors that support them—is all important in addressing the nursing crisis. This shortage is the kind of thing that happens when higher and professional education institutions don't have the resources to train the next generation of workers, or when it becomes unaffordable. We run out of the skilled professionals we need, like trained medical professionals. The nurse shortage is a wake-up call dressed in scrubs to remind us of the need to expand the capacity of higher and professional education, while reining in tuition and other costs connected to those degrees.

Donors may not be able to exert much influence over cost, but they can certainly step in—as the Alfond Foundation has—to help get more students through school. Obviously, too, government needs to do much more here. Unless we expand the nursing pipeline, and fast, bad things are going to happen. 

There are a lot of important causes in healthcare to address, both within philanthropy and beyond. Some, like heart disease and diabetes, affect a lot of people and thus are important. Some affect only a few people and are still important, especially if it's you or your kid. The education and supply of nurses is one that affects everyone, and this is an area where we need all hands on deck right now.