How U.S. Budget Cuts Could Affect Nursing Jobs


How U.S. Budget Cuts Could Affect Nursing Jobs

By Debra Wood, RN, contributor

President Trump’s proposed budget for 2018 increases defense spending and funds immigration enforcement and a wall on the southern border with Mexico, while slashing millions of dollars from programs that support nursing education, research and public health. Nursing leaders fear that such cuts could have far-reaching effects on the profession and future nursing jobs.

But first, the budget has to be passed by Congress, offering opportunities for the nursing workforce to speak up and advocate for changes. 

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Meredith Wallace Kazer, PhD, APRN, FAAN, dean and professor at Fairfield University Marion Peckham Egan School of Nursing and Health Studies in Fairfield, Connecticut, went to Washington in late March with the American Association of Colleges of Nursing to explain to senators and representatives the importance of continuing funding for nursing education and research. 

“It’s very frightening,” Kazer said. “It’s just a preliminary budget, so hopefully, there will be changes and additions. We lobbied heavily.”

The budget would reduce funding of the Department of Health and Human Services by $15.1 billion, a 17.9 percent decrease from 2017. That includes eliminating $403 million in health professions and training programs for the nursing workforce, Title VIII funding, citing a lack of “evidence that they significantly improve the nation’s health workforce.” 

Existing research has shown nurses with more education and better staffing improved outcomes, but more data is needed to show that nurse training is able to improve quality of care, said Kazer.

The existing programs have helped thousands pay for their nursing education and training. In 2014-2015, there were 61,202 nursing students who received support from the Title VIII funding, ranging from workforce diversity grants to nursing student loan repayment programs. 

If the budget cuts go through, nursing students who are midway through their educational programs would lose this funding. Some may drop out, Kazer said, and others may need to take out student loans or go to school part-time. 

Suzanne Miyamoto, PhD, RN, FAAN, with the Nursing Community, a coalition of 63 nursing associations, testified in Congress in March 2017. She emphasized that nursing workforce development programs have “helped build the supply and distribution of qualified nurses to meet our nation’s health care needs” for more than 50 years. 

“[This funding] has helped to meet the demand for nurses in the workplace,” Kazer said. 

Employers may have more difficulty filling nursing jobs in the future if more nurses are not trained. The nursing workforce may feel more stressed if new generations of nurses are not available to fill vacancies as older nurses retire. And the nursing faculties will become more stretched, since many of the federal programs support advanced degrees. 

The Trump budget also cuts National Institutes of Health (NIH) funding by $5.8 billion to $25.9 billion. That puts the National Institute of Nursing Research at risk. 

“It’s through programs like this that we are able to investigate better ways to improve patient care,” Kazer said. “We’ve been able to investigate what works and what doesn’t. … Without that funding, our profession could be at a standstill.”

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Reaction to the proposed budget

The American Nurses Association (ANA) released a statement expressing concern that the proposed budget will weaken the nation’s health care system and scientific research. ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, said that the decrease in nurse training “will significantly cripple efforts to effectively recruit, train and educate nurses for practice in rural and medically underserved communities.”

The American Association of Colleges of Nursing released a statement warning decreasing federal dollars by this magnitude will threaten the lives and livelihood of millions of Americans and threaten health care jobs associated with research dollars. 

 National Council of State Boards of Nursing (NCSBN) CEO David Benton, RGN, PhD, FFNF, FRCN, FAAN, said the organization opposes the cuts to nursing workforce programs.

“By not funding the tools that help us comprehend how health care is changing, we will be unable to equip nurses with the necessary skills to care for patients, effectively putting those patients unnecessarily at risk,” Benton said.

The American Public Health Association (APHA) also expressed dismay, saying the budget would devastate vital public health programs and “weaken our nation’s health workforce, which works to assure and improve the health of all of our communities, especially underserved and vulnerable populations.”

While the 2018 budget remains a concern for many in health care, any secondary efforts to repeal the Affordable Care Act (ACA) could also adversely affect nursing jobs and other health care careers. The first repeal-and-replace bill was recently defeated, but discussions about a replacement bill continue to surface. The Commonwealth Fund estimates that 912,000 healthcare jobs would disappear in 2019 if some key provisions of the ACA were to be dismantled. 

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