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Florida Nursing Schools Cut Budgets

Monday September 8, 2008
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At the same time Florida faces a nursing shortage that could cripple the healthcare system in coming years, the flagging economy has resulted in decreased tax revenues, leading the state legislature to ask public universities to slash budgets. "It doesn't bode well," says Divina Grossman, RN, PhD, dean of the College of Nursing and Health Sciences at Florida International University in Miami. "This is a time when we should begin increasing our capacity."

The Florida Center for Nursing, in its report "Forecasting Supply, Demand, and Shortage of RNs and LPNs in Florida, 2007–2020," predicts that if no additional effort is made to alleviate the shortage, it will grow from about 11,000 vacant full-time RN positions in 2007 to more than 52,000 vacant positions by 2020, a potential crisis for healthcare delivery.

Even if Florida nursing schools graduate 15% more new nurses and experienced nurses delay their retirements by an average of two years, the state still faces a shortage over the next 15 years, the report says. With budget cuts, however, some state nursing schools will reduce, not increase, admissions.

Affected schools are taking different individual approaches to weathering the crunch, with some cutting expenditures across the board and others devising more strategic survival plans.

The Breakdown

The University of South Florida in Tampa cut $35.6 million across the school system. USF's total budget was $1.8 billion from all sources, including $517 million in state funding.

The College of Nursing sliced $1 million from its budget by not admitting a summer cohort and limiting enrollment in undergraduate and master's programs, says Patricia Burns, RN, PhD, FAAN, senior associate vice president of USF Health and dean of the USF College of Nursing.

Campuswide, USF will cut 500 positions, the majority unfilled. Nursing will eliminate vacant positions but not lay off any faculty. However, if the legislature demands further cuts, Burns says she will "have to look at faculty layoffs and decreasing the size of the undergraduate program."

Florida Atlantic University in Boca Raton pared $9.6 million from its operating budget, now at $521.8 million, 1.7% less than last year. The university cut 134 positions, including 34 that were filled.

The provost allocated different decreases for the various colleges. The Christine E. Lynn College of Nursing trimmed 5.5% off its budget, equating to several hundred thousand dollars, says Anne Boykin, RN, PhD, dean of the college. It will phase out the traditional BSN program at FAU's Port St. Lucie campus, eliminating the program after the current year, and, starting this fall, the Boca Raton campus will accept 60 undergraduate students, rather than 100, in its traditional and accelerated BSN programs. It will admit master's degree students only once per year. The college did not lay off faculty.

"It was a very painful process we went through," Boykin says. "We are doing the best we can."

Florida Gulf Coast University in Fort Myers shaved its budget by 1.5%, about $2.2 million, according to the Naples News. The College of Health Professions suspended admission to the RN-to-BSN program. Students already enrolled will be able to complete their studies.

"I tried to think about what is the greatest need for the people of Southwest Florida and what is the access to education for students," says Marianne Rogers, RN, EdD, director of the program. Since other RN-to-BSN programs exist, that was the program to go. "Although I would have liked to hold on to everything, I couldn't and still deliver education at a quality level."

The University of Florida in Gainesville lost $47 million in state funding, 6% of its budget. The College of Nursing faced a reduction of $510,000, and like Florida Gulf Coast, it will eliminate its RN-to-BSN program. It also will close the biobehavioral research center and reduce service at the Archer Family Health Clinic. The nursing program will eliminate three part-time clinical faculty positions.

The University of Central Florida in Orlando reduced its budget by $11.4 million, about 4% for the coming year. That is on top of a $33.1 million decrease in the 2007–08 budget. The university applied the cuts evenly to each college, according to UCF spokesman Grant Heston. The College of Nursing started 2007–08 with a $5.5 million budget and began 2008–09 with a $4.99 million budget.

FIU was forced to remove $32 million from its budget. The College of Nursing & Health Sciences received a $1.3 million reduction. FIU strategically trimmed based on the university's priorities and took a longer-term approach, expecting the weak economy to continue in the coming year.

"They didn't want to cut all in the same way," Grossman says. "They thought if they did it across the board, all the programs would be equally on life support and impact everybody adversely vs. strategically.

"We used four criteria in reviewing every program prior to making the decision on budget cuts," Grossman says. That included academic excellence; research productivity and the number of PhD graduates, which the college is trying to increase; community impact; and financial sustainability. Some programs receive significant support from external sources, which would be lost if the program was eliminated. For instance the nurse anesthetist program receives funding for half of the faculty salaries from the Miami Beach Anesthesiology Associates, and the speech and language program operates with a grant from Miami-Dade County Public Schools.

Consequently, the college will phase out the bachelor's in health science and health information management programs and the post-professional athletic training track. Grossman is considering decreasing the size of the traditional nursing class from 140 to 100, but that decision had not been made as of press time. FIU admits 236 undergraduate nursing students annually, including 96 in its foreign-physician-to-BSN program.

"It seems we're not being very proactive," Grossman adds. "I'm not seeing at the state or federal level a big push to try to increase capacity. I don't see the funding that is needed to make it happen. It's a public health crisis in the making."

The legislature did not fund the SUCCEED Florida workforce education grant program, established in 2005 to support training for high-growth, high-demand, high-pay occupations. The grants funded programs on a one-year basis. Barry University in Miami and Orlando had received money the first two years for a PhD program and last year for undergraduate education. It had admitted 36 PhD students and has secured funding to get them through.

Debra Anscombe Wood, RN, is a Nursing Spectrum contributing writer.

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