In-state education options for Alaskans interested in nursing have been limited. That’s starting to change.

Second of two stories.

For decades, there were just a few in-state education options for Alaskans considering a career in nursing.

Those options have expanded in recent years — and local health experts say the growth is a hopeful sign for a state that has in the past relied on a transient, non-resident workforce as a fragile fix for a nursing shortage that is predicted to worsen over time.

“There has just not been enough Alaskan nurses to fill all the open positions,” said Marianne Murray, the director of Alaska Pacific University’s nursing program.

But last year, a new, predominantly virtual program started enrolling students from all around the state. Alaska Pacific University this year graduated its second cohort of nursing students. And a local nursing program at Charter College recently launched, too. That’s in addition to an existing nursing program at the University of Alaska Anchorage.

Those recent developments mean that “there’s finally getting to be more availability of access to going into nursing school, which I think has been missing in the past,” Murray said.

More applicants than spots, and more prospective students than teachers

The problem isn’t a lack of interest in the field of nursing.

The directors at Alaska’s nursing schools say that interest in their schools has generally outpaced the slots they have open.

“We have probably three or four times as many applicants as what we have spots for,” said Carla Hagen, director of the University of Alaska Anchorage’s School of Nursing. “There’s more people wanting to enter nursing than we have capacity to teach.”

Similarly, Alaska Pacific University’s program has had about twice as many applicants as spots, said Murray.

“There’s a surplus of students that want to get into the health care field, but we don’t have the actual spots for them,” she said.

[Previously: Alaska has long struggled with a shortage of nurses. The pandemic made it worse.]

One of the reasons the schools have been limited in how much they can expand is a lack of qualified nursing faculty, Hagen and Murray said.

“I would say — and this is true nationally — that there’s truly a nursing faculty shortage,” Hagen said. “One of our biggest challenges is recruiting and retaining qualified nursing faculty.”

To teach nursing, you need at least a master’s degree in nursing, or a Ph.D., Murray said.

“The lack of resources to actually stay in Alaska and get those (degrees), it’s sometimes difficult,” she said.

Still, UAA’s School of Nursing has multiple options for students: an associate, bachelor’s or graduate-level degree in nursing.

An associate degree in nursing is the minimum educational requirement needed to become a registered nurse. A bachelor’s degree in nursing typically takes a few more years of school and is associated with higher-paying jobs.

UAA’s latest nursing cohort included students from Anchorage, Homer, Bethel, Ketchikan, Kodiak, Petersburg, Sitka and Valdez, Hagen said.

APU offers a few degree options, too: one that allows registered nurses with an associate degree to continue their education and get their bachelor’s degree, plus a new program for licensed practical nurses starting up in January of next year in Bethel.

The scope of practice for an LPN is a little less than a registered nurse, and takes less time to receive certification in.

One of the newest schooling options for nurses in Alaska is Nightingale College, a mostly remote school that also offers a bachelor’s program, a licensed practical nurse program and a master’s-level degree in nursing and education.

The school, which is based in Utah and has students across the country, last year began enrolling students from Alaska.

A distance-learning solution

Nightingale College administrators say they view their mostly remote schooling option as part of the solution to Alaska’s nursing shortage.

“There is definitely a shortage here, and our program is looking to solve that,” said Jonathan Tanner, the school’s executive vice president. “We are specifically trying to meet the demand of the local health care partners who tell us they need more nurses.”

Tanner said the the distance-learning aspect of their program allows them to enroll more students than schools with physical classrooms. The school has been offering online courses nationally for a decade and opened up its nursing programs to Alaskans last year, Tanner said.

When the pandemic hit, the school’s experience with remote learning made it a good fit for students who had to pivot to online classes.

Tanner said the school has also developed solutions to address the need for physical, hands-on training in nursing. Nightingale students receive at-home lab kits that include the same materials that would be in a lab or classroom.

Students also undergo virtual simulations that allow them to do things like listen to the sound of a heartbeat or a lung and respond to what they hear.

“All of that can be executed very effectively through virtual simulations,” Tanner said.

All Nightingale students also participate in real-world rotations with local health care facilities, where they have an opportunity to work with patients and doctors, similar to other nursing programs, he said.

[Alaska had a record number of syphilis cases in 2020; this year is on track to hit similar highs]

Snow Yang, 25, who lives in Anchorage, enrolled in Nightingale’s bachelor program for registered nurses last year. She’s a mother of three young children and works a shift at Alaska Regional Hospital three days a week. Nightingale appealed to her because of its flexibility, she said.

“I work the night shift,” she said. “I do the three days on (shift) and four off, so I have four days to split between clinicals, online meetings, homework and exams. And whatever I have left, I try to fit it into time to my kiddos.”

Yang is passionate about nursing — and says she’s happy with the distance learning program, even though it can be challenging sometimes.

“It’s not in person, so if you’re wanting to ask questions and get answers right away, it’s kind of difficult unless you set up a meeting with your professor. And sometimes that can be hard because everybody has different time zones,” she said.

Yang said she’s learned how to manage her time to fit everything in, and is scheduled to graduate with her bachelor’s in nursing next year.

A ‘very promising’ job market

Despite the challenges to becoming a nurse in Alaska, local Alaska health experts say they see a number of positive trends in the world of nursing and nurse education

“I think the job market here is very promising,” Hagen said. One of the regional sites where UAA nursing students complete their practical learning requirements just hired on the majority of their graduates, she said.

At Providence Alaska Medical Center, there are currently a large number of open nursing jobs, said Florian Borowski, the hospital’s chief human resources officer.

At the Alaska Native Medical Center, Dr. Robert Onders, the hospital’s administrator, said that right now, there are many job opportunities for nurses there too — particularly for entry-level positions.

There also appears to be a strong in-state retention rate for local students who study to become nurses in Alaska: About 75% to 80% of UAA graduates picked Alaska as their state to become licensed in, indicating a desire to stay in the state, she said.

That’s an encouraging sign, said Tanner.

“What we’ve seen is that the more you can educate someone in their hometown, the more likely it is that they will stay and continue to benefit the health care systems there locally,” he said.