DESPITE THE HIGH demand for more nurses, students at some California community colleges are finding it difficult to get accepted into nursing programs.
It’s a problem that leaders of the student senate of the California Community Colleges want to confront to eliminate a controversial lottery system that has prevented some students from becoming nurses.
Of the nearly 80 nursing programs offered in the 115 campus community colleges, some use a lottery system to admit applicants. Some students have complained of yearslong waitlists, preventing them from pursuing their major.
“We’re going to have a lot of nurses quit because of COVID, and we’re not going to be able to replace them fast enough,” said Katelyn Bourne, a former member of the student senate and transfer student at Humboldt State. “Why not make a system across the board to get students into nursing? Make it first come, first served.”
In a first-come, first-served system, students would be enrolled as they are accepted into the nursing program.
It’s unclear just how many colleges use a lottery program. A 2019 report on the 77 nursing programs in the community college system found that 47 campuses used a multi-criteria screening process that evaluated for any degrees or certificates they already hold, GPA, volunteer work, interviews, recommendations and life experiences such as being a first-generation student or coming from a low-income background.
The other 30 used first come, first served, a modified random selection, prerequisite courses or random lottery.
It’s up to each campus with a nursing program to decide how they want to admit students, but in a written response from the California Community Colleges Chancellor’s Office, multi-criteria screening appears to be the most effective in decreasing the number of students who leave a program before completion compared with the other methods.
“The colleges using a multi-criteria (process) monitor for adverse impact on diversity, and so far the data shows no adverse impact,” said Rafael Chavez, a spokesman for the chancellor’s office.
But some colleges don’t have the staffing or resources to offer a multi-criteria screening process.
“We use a lottery process because we don’t have the manpower to go through 150 applications and more,” said Roberta Farrar, the director of nursing at Humboldt County’s College of the Redwoods. “We have one person: me.”
Winning the lottery
College of the Redwoods enrolls about 40 students annually into the first year of the program. That means students may spend about a year or two on the program’s waiting list. And the college lacks the funding to open up many more spots. The program uses a computerized lottery to grant admission to the program.
Limited finances, few clinical sites and faculty fatigue have limited the number of students who can participate in nursing despite the demand to enter these programs and the massive shortage California faces for more nurses, Farrar said.
A new report from the University of California San Francisco Health Workforce Research Center on Long-Term Care estimates a shortage of 40,567 full-time registered nurses that is projected to persist until 2026. The report details that many older nurses have left the field and a large number plan on retiring or quitting within the next two years.
The report also found that California is producing fewer nurses.
Community colleges and the state’s universities have had to decrease enrollments, skip new classes of students and reduce class sizes during the pandemic, in part because of the inability to place students in clinical rotations where they receive hands-on training.
“We use a lottery process because we don’t have the manpower to go through 150 applications and more. We have one person: me.”Roberta Farrar, College of the Redwoods director of nursing
“These programs didn’t have the resources to pivot online or to distance within classrooms as private schools can,” said Joanne Spetz, director of UCSF’s Institute for Health Policy Studies and co-author of the report. “Policymakers need to support public nursing education programs to ensure an ongoing pipeline of nurses into the health care system.”
Farrar said a first-come, first-served system wouldn’t work either because the college receives applications from all across the state. Because of the limited number of seats at many campuses, College of the Redwoods receives applications from students who have no intention of moving to Humboldt County or staying in the community to help address the nursing shortage in rural Northern California.
“When I get someone from San Diego with no intent of staying in Humboldt County, that doesn’t help us,” she said.
The lottery system helps students move off the waitlist faster, Farrar said. Accepted students get two deferrals before they are forced to reapply.
“We get applications from out of state, from within the state; people send me (nursing exam) score results and haven’t even applied,” she said. “They’re applying to as many schools as possible to see who will take them first.”
More opportunities, not just more applicants
Bourne, the student helping to write a bill that would end the lottery process at nursing schools, said the student senate doesn’t just want to open the door for more applicants.
“We also want a separate bill to increase funding for nursing programs at community colleges,” she said. That funding would go toward larger class sizes, more incentives to hire nursing instructors and perhaps a way to pay hospitals for more clinical training opportunities.
The chancellor’s office agrees that more funding and resources from the Legislature would help.
Chavez said that help could come by offering hospitals incentives to provide clinical rotations to public community colleges and universities, offering a higher salary to registered nurses as a recruitment tool, and changing regulations that allow for more clinical training time in areas of the hospital that are not delivering direct patient care.