A Call to Action

Federal support for nursing education in the United States has evolved over the past century, often in response to workforce shortages and public health needs. In the early 20th century, nursing education was largely hospital-based with minimal to no federal funding involvement. Training was a loosely organized apprenticeship, often unpaid, and tied to service in hospital wards. During World War II, the Nurse Training Act of 1943 (Bolton Act) became the first major federal investment, funding the US Cadet Nurse Corps to rapidly train nurses for military and civilian service during wartime. In the post-war expansion of hospitals, with growing demands for health care providers, the Nurse Training Act of 1964 was passed, which provided substantial grants and loans to nursing schools for expanding enrollment. The Kennedy and Johnson administrations supported greater government involvement in health care. The Health Professions Education Assistance Act, passed during this period, increased federal investment in nursing education and research to address the shortage of health care providers particularly in rural and inner-city areas. The act also provided funds for construction of new teaching facilities and rehabilitation of existing nursing education facilities. In addition, the 1960s focused on replacing hospital training with university-based nursing programs. From the 1970s onward, federal funding continued through Title VIII of the Public Health Service Act including a focus on graduate education for advanced nursing practice and expanded research training. Current federal funding programs under the Health Resources and Services Administration (HRSA) continue to provide scholarships, loan repayment, and grants to strengthen the nursing workforce. In summary, federal funding has been critical to transforming nursing into the highly educated, professionalized workforce of today. At a recent Department of Education rulemaking session advanced nursing programs were omitted from the definition of “professional degrees. ” Although still recognized as a profession, the proposed rules remove nursing from those professions eligible for higher loan limits. The One Big, Beautiful Bill Act eliminated the Grad PLUS student loan program and amended the list of professional degrees. The change alters access to financial aid for advanced nursing education programs. Under the proposed new law, post-baccalaureate nursing students will be able to borrow a maximum of 100, 000 over a lifetime, whereas “professional students, ” like physicians and dentists, would be able to borrow a maximum of 200, 000. The consequence nurses will have diminished access to advanced nursing education resulting in fewer advanced practice nurses, scientists, and nurse educators. After such a long, historic trajectory of federal funding to support nursing education and workforce development, it is incredulous that the federal government would endanger nurses’ accomplishments and risk the gains achieved through the financial investment of our fellow citizens. Professional nursing organizations, including the National Association of Clinical Nurse Specialists, have launched informational sessions, letter-writing campaigns, and call your legislator initiatives. Now is the time for clinical nurse specialists, and all nurses, to engage in advocacy around this proposed federal change. Answer the call and contact your federal legislators. Advocacy is a core nursing practice competency.