As Lincoln University's School of Nursing celebrates its 50th anniversary this weekend, the future of the school's curriculum could include study-abroad opportunities and a way for emergency medical technicians to become registered nurses - but expansion is contingent upon addressing building space needs.
LU's nursing school began classes in fall 1969 in Young Hall, according to a "History of Lincoln University School of Nursing." Young Hall is currently home to offices such as the university's president, registrar and campus ID services.
The nursing school briefly relocated to Founders Hall - which now includes the Department of Social and Behavioral Sciences - before finding its current home at Elliff Hall on Dunklin Street.
Ann McSwain, the current dean of the nursing school, said Elliff meets the program's needs for now, but more room would be needed for any expansion.
Linda Bickel, a former LU nursing school department head, said Elliff used to be a lab elementary school for education students to get teaching experience.
McSwain's office is in what used to be the school principal's office, and the old mechanical system that ran the school's bells is still mounted on the wall just outside her door.
"The school of nursing needs more space," Bickel said, especially if it looks into offering graduate programs.
She and McSwain said society is going to need even more nurses - which means more nurses are going to need to be educated at places such as LU.
"We have so many people that are retiring, and that's where the experience is. That's experience you can't get in a textbook. Even if you job shadow that individual, you couldn't absorb all the knowledge that they've gained over the years," McSwain said.
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Need for nurses
The average age of a registered nurse in Missouri in 2017 was 47 years old, according to the Missouri Board of Nursing, which falls under the Missouri Division of Professional Registration.
The state nursing board noted in its 2018 workforce report that "relatively high rates of nurses nearing retirement (aged 55-64) in some counties in the state" were a concern.
Moniteau and Morgan counties are among areas of the state where about 45-65 percent of registered nurses are older than 54, according to the report.
Cole, Callaway, Osage and Boone counties were measured at around 18-27 percent, while about 33-45 percent of registered nurses in Miller County were found to be nearing retirement age.
In terms of geographical distribution, more than 90 percent of the state's registered nurses and advanced practice registered nurses worked in metropolitan counties, as well as more than three-quarters of licensed practical nurses, according to the report.
The report also lists by county how many nurses - LPNs, RNs and APRNs - there were per 10,000 people. Among area counties, the number of nurses per 10,000 people were: Cole, 66.35; Callaway, 23.21; Osage, 15.96; Boone, 85.07; Miller, 14.8; Moniteau, 16.16; and Morgan, 13.78.
Cole, Callaway, Boone, Moniteau and Osage counties were considered by the report to be "metropolitan." Among all such metropolitan counties in the state, St. Louis City had the highest rate, 138.81 nurses per 10,000 people, and McDonald County had the lowest rate, 9.04 nurses per 10,000 people.
Miller and Morgan counties were considered by the report to be rural counties. Among rural counties, Scotland County had the highest rate, 70.04 nurses per 10,000 people, and Ozark County had the lowest rate, 4.99 nurses per 10,000 people.
Missouri's nursing board also noted in 2018 that unemployment among registered nurses and advanced practice registered nurses was low, "indicating that there is a limited supply of RNs and APRNs within the state available to meet the current need."
Nursing shortages also present challenges to nursing schools, in addition to patients.
"Moving forward into the future, we'd like to be able to expand our numbers, to allow more students into the program. We have a lot of qualified applicants in the state of Missouri that are being turned away from nursing schools, because we're really understaffed with qualified faculty. Nursing faculty shortages are a real issue, not just for Lincoln University, but for lots of nursing schools," McSwain said.
The nursing school's BSN program had 82 applicants last year, the 2018-19 year, and 60 were admitted, she said. The two-year associate of applied science in nursing program offered at Fort Leonard Wood had 54 applicants last year, with 36 admitted.
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Demographics of LU's nursing school
The nursing school is LU's biggest school, McSwain said.
The nursing school has 252 undergraduate students in its BSN program, another 97 in the AAS program and four students in the online BSN program for existing RNs - a total of 353 students.
By comparison, the LU School of Business has 287 undergraduate students and the LU School of Education has 112 undergraduate students, according to online records.
In the nursing school, the 252 BSN students are about as diverse as LU is overall: 40 percent black or African American, 47 percent white and 2 percent Hispanic among the BSN students, and 43 percent black or African American, 41 percent white and 2 percent Hispanic for LU overall.
Once a student is accepted into the nursing school, the retention rate is high.
The nursing school's retention rate was 81.4 percent in 2018, compared to 84 percent in 2017 and 78 percent in 2016, McSwain said.
By comparison, LU's overall retention rate in 2016 was 53 percent, and 50 percent in 2017; 2018 data was not yet available on the university's website.
After graduation
Once a student graduates from LU's nursing school, landing a job is assured. McSwain said the job placement rate for the BSN program is 100 percent. The school's nursing students usually have jobs lined up in their third semester, she said.
According to the federal Bureau of Labor Statistics, the job outlook for registered nurses overall between 2018-28 is a 12 percent growth in the number of people employed in the profession - "much faster than the average for all occupations. Growth will occur for a number of reasons, including an increased emphasis on preventive care; growing rates of chronic conditions, such as diabetes and obesity; and demand for health care services from the baby boomer population, as they live longer and more active lives."
A 12 percent growth in registered nurses' employment equates to 371,500 new jobs. That projected growth ranks RNs third in terms of occupations projected to offer the most new jobs between 2018-28 - only behind 881,000 new personal care aides and 640,100 new "combined food preparation and serving workers, including fast food."
The median pay for a registered nurse in 2018 was $71,730 per year, or $34.48 per hour. The median pay last year for a personal care aide was $24,020 per year, and for a food prep and serving worker, $21,250 per year.
Future opportunities
McSwain said most LU nursing students become registered nurses, though other options are available.
"We do have a biology/pre-med option, and then the health and wellness (option) through the Department of Education. Some of those students will go on to be physical therapists and things like that," she said.
EMT certification is not available, she said, but she would like to see in the future a program for existing EMTs to be able to earn a bachelor's degree in nursing.
A four-year bachelor's of science degree in nursing is what the school has offered since 2014. The school also has an online program for existing RNs to earn their bachelor's degree.
McSwain said she'd also like to see opportunities for LU's nursing students to be able to study health care in other countries or other systems, as she said such experiences can provide students with a more global picture that could make them more appreciative of what's available in the United States. The diversity students would encounter could better prepare them to be able to take care of any patient, she added.
There are no current study abroad opportunities, she said. But, she added, "We've talked about it and kind of brainstormed. We do have a couple of individuals who have, whether as faculty or a student themselves. We haven't really narrowed it down to where we would like to go."
She continued, "We have talked about maybe doing some out-of-area community work in Kansas City, St. Louis, places like that, just to see how we would work together and how to kind of troubleshoot the smaller study abroad (program) at home, before taking it on the road."
LU's students are already serving in the local community.
As one example, McSwain said, the nursing school continues to partner to give health screenings and education to school children; St. Martin School was the first such partnership two years ago.
"We've always been involved in the community, in that students are required to do at least two hours of community service every semester, and so if you're admitting 30 students, that's 60 community hours per class," she said.
She said nursing students have helped with Project Homeless Connect, blood drives at churches, the Special Learning Center and Special Olympics.
As at St. Martin School, she said, nursing students have also offered health screenings for children at the Boys & Girls Club of Jefferson City.
"There's usually a lot of people who are reaching out to us, and we have to pick and choose what we can and cannot do. Maybe if we don't get it done this semester, next semester we'll choose to do that," McSwain said. "We try to connect those opportunities with the learning objectives in the classroom so the students feel like they're getting something out of it also."