[Congressional Record Volume 154, Number 20 (Thursday, February 7, 2008)]
[Extensions of Remarks]
[Pages E152-E153]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   HOLT NURSING SCHOOL CAPACITY AMENDMENT TO COLLEGE OPPORTUNITY AND 
                             AFFORDABILITY

                                 ______
                                 

                           HON. RUSH D. HOLT

                             of new jersey

                    in the house of representatives

                       Thursday, February 7, 2008

  Mr. HOLT. Madam Speaker, nurses are the backbone of our health care 
system. The shortage of nurses throughout our country leaves patients 
unattended, doctors stressed, and nurses exhausted from extra shifts. A 
principle reason for this shortage of nurses is the shortage of nursing 
school faculty. Because of the faculty shortage many schools of nursing 
are turning away good students who would make good nurses.
  I am pleased that my amendment which attaches the Nursing School 
Capacity Act, H.R. 677, to the College Opportunity and Affordability 
Act of 2007 (H.R. 4137) has been accepted in the bill passed in the 
House. I thank Representative Welch and Representative Capps, one of 
the Co-Chairs of the House Nursing Caucus, for cosponsoring this 
amendment with me. H.R. 677, which has 76 cosponsors, directs the 
Institute of Medicine to study the constraints experienced by schools 
of nursing in admitting and graduating enough nurses to meet growing 
needs.
  I appreciate that House Education and Labor Committee Chairman Miller 
accepted our amendment and incorporated it into his Manager's 
Amendment. Today's action shows that Congress understands the 
healthcare crisis facing states like New Jersey.
  The study my amendment directs will explore the constraints that our 
nation's schools of nursing face and propose short and long term 
solutions to address the nursing crisis. I look forward to reviewing 
the study's recommendations and working to implement them before the 
quality of care suffers.
  Over the years, I have heard from many nursing professionals from New 
Jersey about the nursing crisis, particularly the inability of nursing 
schools to meet growing workforce demands. In fact, a study from the 
National League of Nursing states that in 2004, nursing schools were 
forced to turn down 147,000 qualified applicants due to a lack of 
faculty. That is why I first introduced the Nursing School Capacity Act 
three years ago, and why I am excited that it's close to becoming law 
today.
  The American Association of Colleges of Nursing, the American Nurses 
Association, the American Organization of Nurse Executives and the New 
Jersey Hospital Association all endorsed the legislation. I ask 
unanimous consent that their endorsement letters be included in the 
Record.
  We have not solved the nursing crisis with today's action, but we 
have taken a step in better understanding the problem.
                                                 February 4, 2008.
     Hon. Rush Holt,
     House of Representatives,
     Washington, DC.
       Dear Representative Holt: On behalf of the American 
     Association of Colleges of Nursing (AACN) and the American 
     Nurses Association, we would like to thank you for offering 
     the language included in the Nursing School Capacity Act of 
     2007 (H.R. 677) as an amendment to the College Opportunity 
     and Affordability Act of 2007 (H.R. 4137).
       Over the past decade, the inability to increase the supply 
     of nurses has become more apparent as the challenges faced by 
     nursing education programs have intensified. These challenges 
     force schools of nursing to turn away thousands of qualified 
     applicants each year. According to a 2006 AACN report, U.S. 
     nursing schools turned away 42,866 qualified applicants due 
     to an insufficient number of faculty, clinical sites, 
     classroom space, clinical preceptors, and budget constraints. 
     Almost three quarters of the nursing schools responding to 
     AACN's survey pointed to faculty shortages as a primary 
     reason for not accepting all qualified applicants into 
     nursing programs. A Special Survey on Vacant Faculty 
     Positions released by AACN in July 2007, reported a total of 
     767 faculty vacancies (8.8 percent vacancy rate) identified 
     at 329 nursing schools with baccalaureate and/or graduate 
     programs across the country.
       Clearly, the obstacles faced by schools of nursing in 
     attempting to increase enrollment and graduations are vastly 
     complex and warrant further investigation. Your bill will 
     facilitate the discussion of these constraints and help 
     explore solutions to overcome the barriers that are 
     preventing potential students from entering the nursing 
     profession. In addition, your bill calls for recommendations 
     to be made by the Institute of Medicine which will serve as a 
     valuable resource for policy-makers as well as the health, 
     industry, and education systems.
       AACN and ANA sincerely appreciate your willingness to 
     thoroughly investigate the nursing and nurse faculty shortage 
     through the Nursing School Capacity Act.
           Sincerely,
       American Association of Colleges of Nursing.
       American Nurses Association.
                                          American Organization of


                                             Nurse Executives,

                                 Washington, DC, February 4, 2008.
     Hon. Rush Holt,
     House of Representatives,
     Washington, DC.
       Dear Congressman Holt: On behalf of the over 6000 members 
     of the American Organization of Nurse Executives (AONE) 
     representing nurses in all facets of executive practice, we 
     would like to express our strong support for the amendment 
     that you and Representative Welch are prepared to offer to 
     H.R. 4147 the College Opportunity and Affordability Act of 
     2000. The amendment incorporates the language of your bill 
     H.R. 677, the Nursing School Capacity Act into a more 
     comprehensive piece of legislation and would provide the 
     nursing and health care communities with important research 
     into the underlying causes of the nursing shortage.
       The majority of AONE's membership of registered 
     professional nurses are leaders in the day-to-day management 
     and delivery of direct patient care services. In this 
     position, we have been able to see first hand the impacts of 
     the worsening nursing shortage and applaud your efforts to 
     address this critical situation through the provision of 
     study to be conducted by the Institute of Medicine of the 
     National Academy of Sciences. Understanding that the nursing 
     shortage is the result of the convergence of a number of 
     factors, your proposed legislation would identify the 
     constraints encountered by schools of nursing in admitting 
     and graduating the number of registered nurses to ensure 
     patient safety but it would also propose recommendations to 
     alleviate the constraints on a short-term and long-term 
     basis.
       AONE has been in the forefront of attempts to deal with the 
     nursing shortage and welcomes the opportunity to participate 
     in the proposed study as a consultant in partnership with the 
     other relevant organizations named in your legislation. AONE 
     has focused on the work environment and the educational 
     preparation of the nurse of the future. We see our past and 
     current work as integral to the study you have proposed. Your 
     legislation provides a comprehensive approach to identifying 
     and quantifying the factors that have contributed to the 
     shortage such as regulatory barriers, educational 
     preparation, salary and benefit structures, and 
     characteristics of the workplace.
       AONE applauds your efforts and those of Mr. Welch to 
     include this needed legislation as an amendment to H.R. 4147 
     the College Opportunity and Affordability Act of 2007.
           Sincerely,
     Carol A. Watson,
       President.
     Pamela A. Thompson,
       Chief Executive Officer.
                                  ____



                              New Jersey Hospital Association,

                                  Princeton, NJ, February 4, 2008.
     Hon. Rush Holt,
     Longworth House Office Building,
     Washington, DC.
       Dear Congressman Holt: On behalf of our 119 member 
     hospitals and their systems, I am writing to express our 
     strong support for the Holt/Welch Amendment to H.R. 3147, the 
     College Opportunity and Affordability Act of 2007 that would 
     incorporate your bill, H.R. 667, the Nursing School Capacity 
     Act of 2007.
       We have all known for too long that we have an ongoing 
     shortage of nurses in this country, and although we have seen 
     a recent increase in nursing candidates, we cannot keep pace 
     with the demands to educate new nurses. One of the major 
     issues is the inability to expand upon our nursing 
     educational programs in this country. Within the past year 
     125,000 qualified potential nursing students have been placed 
     on waiting lists, and

[[Page E153]]

     almost 2,000 are on waiting lists in New Jersey. These 
     numbers will continue to increase unless we implement sound 
     planning strategies to build a stronger infrastructure for 
     nursing education.
       The issue of faculty supply and demand is very complex and 
     affects every nursing program very differently. It is for 
     this reason that there is a need to conduct a national study 
     of all of these issues so that well formulated 
     recommendations can address the needs of each level of 
     nursing education.
       H.R. 667 will charge the Institute of Medicine of the 
     National Academy of Sciences to undertake this study and 
     identify constraints encountered by schools of nursing in 
     admitting and graduating the number of nurses sufficient to 
     meet the healthcare needs of the United States.
       I commend your leadership on this issue and look forward to 
     working with you in getting this bill signed into law.
           Sincerely,
                                                   Gary S. Carter,
                                                  President & CEO.