When evaluating nursing school enrollment, students and educators can generally be satisfied with the current status while being mindful of specific concerns.
In April, the American Association of Colleges of Nursing (AACN) released data revealing that enrollment in programs designed to prepare entry-level registered nurses held steady, up 0.3% compared with the previous survey. However, fewer students are entering baccalaureate degree-completion, master’s, and PhD programs.
Each year, AACN surveys nursing schools offering baccalaureate and higher degrees nationally. Conducted in fall 2023, AACN’s latest annual survey, “2023-2024 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing,” contains data reported by 975 nursing schools.
RN to BSN
While the number of students in RN-to-BSN programs decreased significantly for the fifth straight year, that decline needs to be put into context, notes Jean Giddens, PhD, RN, FAAN, ANEF, dean of the University of Kansas School of Nursing and chair of the AACN Board of Directors.
She noted in an interview that in 2002, roughly 30,800 students were enrolled in RN-to-BSN programs. That number skyrocketed to almost 140,000 students enrolled in these programs in 2018-19.
One major factor for that increase was the release in 2010 of the Institute of Medicine’s The Future of Nursing report, notes Giddens. With that landmark report, she notes, there was a national goal to increase the number of baccalaureate-prepared nurses.
In 2010, only 49% of the nursing workforce was prepared at the bachelor’s level. The goal was for 80% of the workforce to have a bachelor’s degree by 2020, she notes.
Following the report, many nurses returned to school to get their bachelor’s degree, “so that triggered a very significant uptick in RN-to-BSN enrollments,” explains Giddens. In 2020, 59% of the nursing workforce was prepared at the bachelor’s level, and now, in 2024, the number is close to 69% baccalaureate prepared, says Giddens.
According to Giddens, another factor for the decline in enrollment in RN-to-BSN programs is that “for the first time, more people are earning their initial degree in a baccalaureate degree. We now have a time where more people are earning their bachelor’s degree at the time of licensure.”
With the current report, conducted in fall 2023, some 89,000 students were enrolled in RN-to-BSN programs, she notes. That’s a decrease of 9.9% compared to the previous survey. “The enrollment is probably balancing back out a bit, reflecting reduced demand,” says Giddens.
DNP Shift
The AACN survey found that enrollment in PhD programs continued to decline, decreasing by 3.1%, while enrollment in DNP programs increased by 2.0%, marking 20 consecutive years of enrollment expansion. Concern about low PhD enrollment, notes Giddens, is far from new, as this has been a topic of discussion for 30 years.
Giddens notes the DNP degree doesn’t compete with the PhD because “it is a different focus from the PhD. It’s a practice doctorate.” These are nurses in clinical practice who are focused on patient care outcomes in a clinical practice environment. The PhD is a research doctorate and prepares nurse scientists, she says.
Giddens says most nurses who enroll in a DNP program fall into one of two categories. The first are nurses with master’s degrees in an advanced practice role who return to school to obtain the DNP degree. The second are bachelor’s-prepared nurses seeking a DNP degree in an advanced practice role or specialty (as opposed to enrolling in a master’s degree program). “What you see here is a big shift in enrollment for the DNP, which is considered the preferred degree for nurses in advanced practice roles.”
“We need to do more to help people understand what a research doctorate is and what kind of careers you can have with a research doctorate,” says Giddens. She points to federal advocacy efforts with AACN and partnerships with organizations such as Jonas Philanthropies.
Faculty Gap
Despite the high demand for nurses, the AACN survey found that thousands of qualified applications were turned away from four-year institutions. In 2023, 65,766 qualified applications (not applicants) were not accepted at nursing schools nationwide, though the students submitting applications may have been accepted and enrolled elsewhere.
Within this total, the AACN survey notes, applications turned away included 55,111 from entry-level baccalaureate, 703 from RN-to-BSN, 5,491 from master’s, 4,225 from DNP, and 236 from PhD nursing programs. Given the persistent shortage of nurse faculty, AACN says it remains concerned that nearly 10,000 applications were turned away from graduate programs, which may further limit the pool of potential nurse educators.
“We are concerned about the lack of sufficient faculty now and for the future,” says Giddens. “There have got to be intentional efforts at the school level as well as the national level.” Efforts to address this, she notes, include more funding for Title VIII Nursing Workforce Development Programs and reintroducing the Future Advancement of Academic Nursing (FAAN) Act.
Maximizing Placements
One method that may help increase enrollment in nursing school involves NursingCAS, a Centralized Application Service for Nursing that provides accredited nursing colleges with an admissions platform to manage application reviews. With this system, notes Giddens, a student can submit one application and direct it to multiple schools.
“If I put in an application through NursingCAS, it will share my application with the schools I’m interested in sharing it with,” explains Giddens. The system allows for “maximizing the potential for placements of students in nursing programs.”
Understanding the Trends
Giddens suggests that placing the survey results within a larger context is key to understanding them. “These enrollment trends don’t make major leaps in one year; rather, they evolve. I wasn’t surprised by any of the results. These are continuing trends.”
Now a freelance writer and editor, he served as a Director at Elsevier, where he was instrumental in the development of major online nursing reference and procedure products. Previously, he served as Editorial Director at Nurses.com, one of the first nursing websites, and was Executive Editor at Nursing magazine, a premier large-circulation journal.
Today, he continues to serve nurses and other clinicians by reporting on developments and trends in healthcare with meaning, context, and insight.
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