Active State-Level Engagement with the Nursing Shortage: A Study of Five Midwestern States

Abstract

This study explores state-level efforts from 1999 through mid-2003 to address the nursing shortage in five midwestern states (Illinois, Iowa, Kansas, Missouri, Nebraska). The authors conducted interviews with 25 representative nurse leaders and others involved with state initiatives; this firsthand perspective provided useful insights on the interplay of various factors within states. For example, taskforce groups appointed to study the shortage were seen to evolve into broad-based and influential nursing coalitions. These coalitions advocated for establishing permanent state nursing centers to collect and analyze nurse workforce data and to improve nurse recruitment, retention, and the nurse practice environment. Expansion of educational programs faced barriers (nurse faculty shortages, limited clinical education sites) that were not readily amenable to solutions, in part because of state funding crises. This study illustrates how strategies are evolving in these states while highlighting the role of collaboration, creativity, and flexibility in solving this critical problem.