National Defense Authorization Act for Fiscal Year 2008--Resumed

Floor Speech

NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2008--Resumed -- (Senate - September 17, 2007)

BREAK IN TRANSCRIPT

ADMENDMENT NO. 2268

Mr. DURBIN. Mr. President, we are engaged in one of the longest conflicts in American history, and the need for qualified nurses in military medical facilities is increasing. Tragic stories of injured veterans returning from war and heart-wrenching images on television remind us that the military needs qualified nurses. Unfortunately, the military faces the same difficulty recruiting and retaining nurses that civilian medical facilities are facing.

Neither the Army nor the Air Force has met nurse recruitment goals since the 1990s. In 2004, the Navy Nurse Corps fell 32 percent below its recruitment target, while the Air Force missed its nurse recruitment target by 30 percent. At a Senate appropriations hearing earlier this year, Nurse Corps leaders pointed to a serious shortage of military nurses. The Army, Navy, and Air Force each have a 10-percent shortage of nurses, with shortages reaching nearly 40 percent in some critical specialties.

Civilian hospitals face similar challenges. According to the American College of Healthcare Executives, 72 percent of hospitals experienced a nursing shortage in 2004. The shortage is growing. The U.S. Department of Health and Human Services, HHS, found that in 2000 this country was 110,000 nurses short of the number, both civilian and military, necessary to adequately provide quality health care. By 2005, the shortage had doubled to 219,000. By 2020, we will be more than 1 million nurses short of what we need for quality health care. This will create a problem for military health care as well as the Nation at large.

To avoid the vast shortage HHS is projecting, we have to improve the number of nurses graduating and entering the workforce each year. If we only were to replace the nurses who are retiring, we would need to increase student enrollment at nursing schools by 40 percent. But the baseline demand for nurses, however, continues to rise, while the supply falls. If we increased the number of graduates from nursing school by 90 percent by 2020, we would still fall short of the number needed for quality care.

One of the major factors contributing to the nursing shortage is the shortage of teachers at schools of nursing. Last year, nursing colleges across the Nation denied admission to over 40,000 qualified applicants because there were not enough faculty members to teach the students. Last year, approximately 2,000 qualified student applicants were rejected from Illinois nursing schools because there were not enough teachers.

And the shortage does not discriminate between rural or urban areas, city or countryside, large or small schools. For example, in 2006, the University of Illinois at Chicago, consistently recognized as one of the top ten nursing programs in the United States, was sixth in total NIH research and research training dollars, and in 2004, it was ranked eighth out of 142 schools of nursing by U.S. News & World Report. However, despite the nationwide prestige, the school turned away more than 500 qualified applicants last year. Northern Illinois University, a smaller school in DeKalb, IL, was forced to reject 233 qualified applicants as a result of a shortage of teachers and financial resources.

The American Association of Colleges of Nursing surveyed more than 400 schools of nursing last year. Seventy-one percent of the schools reported vacancies on their faculty. An additional 15 percent said they were fully staffed but still needed more faculty to handle the number of students who want to be trained.

Statistics paint a bleak picture for the availability of nursing faculty now and into the future. The median age of a doctorally prepared nursing faculty member is 52 years old. The average age of retirement for faculty at schools of nursing is 62.5 years. It is expected that 200 to 300 doctorally prepared faculty will be eligible for retirement each year from 2005 through 2012 , drastically reducing the number of available faculty--even though more than 1 million replacement nurses will be needed. The military recruits nurses from the same source as doctors and hospitals: civilian nursing schools. Unless we address the lack of faculty, the shortage of nurses will only worsen.

In 1994, the Department of Defense established a program called Troops to Teachers, which serves the dual purpose of helping relieve the shortages of math, science, and special education teachers in high-poverty schools while assisting military personnel in making successful transitions to second careers in teaching. As of January 2004, more than 6,000 former soldiers have been hired as teachers through the Troops to Teachers Program, and an additional 6,700 are now qualified teachers and looking for placements.

My amendment will set up a pilot program called Troops to Nurse Teachers to make it easier for military nurses, retiring nurses, or those leaving the military to pursue a career teaching the future nurse workforce. I am proud to have the support of my colleagues: Senators Inouye, Inhofe, Obama, Menendez, Biden, Mikulski, Dole, Reed, Lieberman, and Collins. I thank the leadership of the Senate Armed Services Committee, Chairman Levin, Senator Warner, for their support and willingness to accept the amendment.

The Troops to Nurse Teachers Program seeks to address the nursing shortage in the different branches of the military while tapping into the existing wealth of knowledge and expertise of military nurses to help address the nationwide shortage of nurses.

The goals of the Troops to Nurse Teachers program are two fold. First, the program intends to increase the number of nurse faculty members so nursing schools can expand enrollment and alleviate the ongoing shortage both in the civilian and military sectors. Second, the Troops to Nurse Teachers Program is meant to help military personnel make successful transitions to second careers in teaching, similar to Troops to Teachers. The program would achieve these goals by offering incentives to nurses transi-Ðtioning from the military to become full-time nurse faculty members, while providing the military a new recruitment tool and advertising agent.

The Troops to Nurse Teachers Program will provide transitional assistance for servicemembers who already hold a master's or Ph.D. in nursing or a related field and are qualified to teach. Eligible service members can receive career placement assistance, transitional stipends, and educational training from accredited schools of nursing to expedite their transition. Troops to Nurse Teachers will also establish a pilot scholarship program for officers of the Armed Forces who have been involved in nursing during their military service to help them obtain the education needed to become nurse educators. Tuition, stipends, and financing for other educational expenses would be provided. Recipients of scholarships must commit to teaching at an accredited school of nursing for 3 years in exchange for the educational support they receive.

In addition, the Troops to Nurse Teachers Program will provide active military nurses the opportunity to complete a 2-year tour of duty at a civilian nursing school to train the next generation of nurses. In exchange, the nurse officer will commit to additional time in the military or the College of Nursing will provide scholarships for nursing students that commit to enlisting in the military.

We have the support of over 20 nursing organizations, including the following: American Association of Colleges of Nursing, American Organization of Nurse Executives, American Nurses Association, Academy of Medical-Surgical Nurses, American Academy of Ambulatory Care Nursing, American College of Nurse Practitioners, American Association of Nurse Anesthetists, American Health Care Association, American Society of PeriAnesthesia Nurses, Association of Women's Health, Obstetric, and Neonatal Nurses, American Association of Occupational Health Nurses, Inc., American Radiological Nurses Association, Association of Perioperative Registered Nurses, Emergency Nurses Association, National Black Nurses Association, National Council of State Boards of Nursing, National Gerontological Nursing Association, National League for Nursing, National Nursing Centers Consortium, National Organization of Nurse Practitioner Faculties, Oncology Nursing Society, Society of Urologic Nurses & Associates.

In addition, the Office of the Secretary of Defense, both Personnel and Recruitment and Health Affairs, are in support of the amendment. We have also worked hard to secure the support and incorporate important feedback from the Nurse Corps of the Departments of the Army, Navy, and Air Force.

We must increase the number of teachers preparing tomorrow's nursing workforce. With the aging of the baby boom generation and the long-term needs of our growing number of wounded veterans, the military and civilian health care systems will need qualified nurses more than ever. The Troops to Nurse Teachers Program will help to alleviate the shortage of nurse faculty and ultimately help make more nurses available for both civilian and military medical facilities.

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