By Kay Hawes

Like many nurses, Amy Hite spent part of the COVID-19 pandemic sleeping in the basement of her house to avoid exposing her family to the virus she was fighting as a nurse during her waking hours.

“I knew what nurses in the field were going through, because I was living it,” Hite told the Pittsburg State University’s Gorilla Connection. “Situations like those aren’t when you run away from health care — you run to it to help those who need it.”

Hite, who earned her DNP from the University of Kansas School of Nursing in 2011, would be the first to say she was just doing what so many of her colleagues were doing. That’s what nurses do. They run toward the problems others run away from. Along with numerous colleagues throughout the state, Hite continues to run to help those who need it. Hite, EdD(c), DNP, APRN, FNP, professor and director of the Irene Ransom Bradley School of Nursing at Pittsburg State University, serves on the advisory board of the Kansas Nursing Workforce Center.

In the fall of 2023, the KU School of Nursing launched the Kansas Nursing Workforce Center to address multiple crises in the field of nursing. At the completion of its first year, the center released its first report on the state of nursing in Kansas.

Based at the KU School of Nursing, but serving the entire state, the center came out of a series of statewide discussions regarding nursing shortages and workforce issues nationally and across the state.

Like most of the country, Kansas is in the middle of a dire nursing shortage that is projected to get worse before it gets better. The pandemic took a tremendous toll on nurses at all levels, just as Baby Boomers began to retire from the field. And Kansas was one of just a handful of states that hadn’t previously established a nursing workforce center. It needed one.

One source of truth

Those listening sessions, launched first in Topeka and then repeated across the state with stakeholders from all aspects of nursing, offered educators, administrators and employers the opportunity to voice their concerns and prioritize solutions. Hite was involved since day one because she sees tremendous need.

“I think the center is a tremendous opportunity for the state,” Hite said. “It is raising the bar in Kansas to what other states are doing.”

And the biggest request from those stakeholders? One source of truth for all kinds of data about nursing in
the state.

“The number one ask they had for us was to pull together disparate sources of information about the Kansas nursing workforce so that it would be easier for them to make informed decisions,” said Amy Garcia, MSN, RN, DNP, FAAN, interim associate dean for faculty practice and community engagement at KU School of Nursing and a founding director of the Kansas Nursing Workforce Center.

The release in September of 2024 of the center’s report, The State of Nursing in Kansas, reflected that need and also represented the first deliverable for the center.

“The center has done a tremendous amount of work, especially with the report,” Hite said. “Gathering data from all across the state and getting it into one location was an essential first step.”

The report is available without charge. It was compiled using data from 17 different sources, including national and state databases and academic reports. The intent is to update the report in 2025 and then every two years to coincide with the release of new national data from the National Council of State Boards of Nursing.

The report was authored by Garcia and MacArthur, as well as Shin Hye Park, Ph.D., a nurse scientist at KU School of Nursing, and Alexander Alsup, M.S., a data scientist in the Department of Biostatistics and Data Science at the University of Kansas School of Medicine.

Seeking solutions and collaborations

The State of Nursing in Kansas already has made a tremendous impact, according to Kathleen Kottas, BSN, MSN, DNP, dean of workforce training and community education at Barton Community College.

I think the center has been a phenomenal resource, especially the report. We all have ideas and theories and this report actually puts data before us. It gives us a laser pointer to give us focus and direction,” she said.

Brian Pfannenstiel, RN, MSN, director of critical care at Hays Medical Center and immediate past-president of the Kansas Organization of Nurse Leaders, agreed. Pfannenstiel has been a nurse in Hays for 20 years and also has been involved with the Kansas Nursing Workforce Center since its inception. He is excited about the potential for new solutions and new collaborations.

“We now have comprehensive statistics about nursing throughout the state and can use that to drive change in nursing in Kansas,” he said. “We can look at the data and base decisions on that. We didn’t have that six months ago.”

Among the key findings of the report were:

• The population of Kansas is growing more diverse, yet registered nurses in Kansas remain primarily white and female.
• Registered nurses in Kansas are less likely to be actively employed in nursing than the national average. However, 85% of registered nurses and licensed practical nurses in Kansas are actively employed in nursing.
• Nursing shortages are anticipated in the future as 29% of registered nurses and 23% of licensed practical nurses in Kansas are planning to retire within the next five years. And enrollments in nursing education programs are down 39% over the last 10 years.
• Registered nurses in Kansas reported working more hours that the national sample, with 36% typically working more than 40 hours per week.
• A high proportion — 74% — of unemployed registered nurses in Kansas report that taking care of home and family is their primary reason for unemployment, compared with the national sample at 47%.

“We were surprised about the reasons Kansas registered nurses listed for why they are unemployed,” Garcia said, noting that of those nurses who are unemployed, 72% reported that they left nursing to take care of home and family. “This is very different from the national survey. And when we dug deeper, we found that this was consistent for Kansas nurses for nearly 10 years. This needs to be studied further. Could something as simple as childcare or eldercare be deployed to entice nurses back to work?”

Kottas, who has been in health care and education for 40 years and is located in Great Bend, was not surprised by that finding.

“Nurses are just natural caregivers,” she said. “And it makes sense that caring for a family member may take them out of the workforce.”

Kottas sees the day care shortage in her community.

“Day care is so hard to find out here on a good day,” she said, adding that the pandemic caused additional closures. “Access to long-term care for seniors also is hard.”

Kottas said that the Great Bend community, Barton County and several foundations partnered to open a new day care in Great Bend this summer.

“This is another workforce challenge that affects not just nursing and hospitals but entire communities,” she said, noting that it’s helpful that the center’s report was able to identify that challenge through data.

An additional challenge for nursing educators is the shortage of nursing faculty, something that affects educational institutions at all levels throughout the state. Most nurses make competitive salaries, and nurse educators do not.

“It’s not that people don’t want to teach,” Kottas said. “They can’t afford to teach. You interview great candidates and make the offer, then they have to decide if they can take the pay cut to teach. We have to find a way to support nurse educators.”

Pfannenstiel also points to the need to keep nurses
in Kansas.

“We have a lot of nursing students who leave the state upon graduation,” he said. “We need to figure out how to keep them here.”

Pfannenstiel said that it might be helpful to recruit more Kansans or to find ways to convince out-of-state students to stay in Kansas, whether it’s through loan forgiveness or relocation bonuses.

“There are a lot of different ways to approach it,” he said. “We want everybody.”

A career with many different jobs

Kottas also serves on the advisory board for the center, and she is passionate about representing central and western Kansas, where she notes nurses are vital to both the personal health and the economic health
of communities.

“A lot of our nurses are place bound because they may have extended family in the area and own land or perhaps have a spouse with a family business,” she said. “There are places where there is only one doctor for the entire county, but if you choose nursing, you can always have a job, Nursing is one of those wonderful careers where you can change your job but not your career.”

Kottas is excited about the prospect of sharing those opportunities with young people.

“How can we improve the image of nursing in Kansas? And how can we make that image positive and provide a place where young people could see a career for themselves?” she asked.

Pfannenstiel agreed.

“There are so many ways to be a nurse,” he said. “You can be a researcher, you can work with statistics, infection control — there are so many different paths. I never thought I’d be in leadership.”

Pfannenstiel also pointed out that different types of nursing can bring different types of flexible schedules, with jobs that are 8-5, work around kids’ school schedules or just a few days a week.

“I’m excited about explaining all of the different pathways to students,” he said. “We have to be looking at how we get the next generation, whether its high school students or younger students, interested in nursing.”

Tapping into the interests and excitement of students and potential students is on the horizon for the Kansas Nursing Workforce Center.

Barbara MacArthur, M.N., FAAN, director of the Kansas Nursing Workforce Center, said that the center has begun reaching out to prospective students.

“We’re actively seeking input from students and potential students,” she said. “We’re recognizing them as stakeholders.”

Working with Kansas HOSA, a nationally affiliated group for students interested in health care careers, the Kansas Nursing Workforce Center held a focus group in Manhattan with 800 high school students who self-identified as interested in health care.

And while the center will continue to gather data and share information for decision making, its leadership also is looking at ways to further existing collaboration and increase outreach to different audiences.

“We want to continue to reach out and educate audiences about the value and the potential of nursing,” MacArthur said. “It’s clear from the report and our work so far that nurses have a tremendous impact on their communities and a tremendous impact on Kansans.”

And it appears the Kansas Nursing Workforce Center has had a tremendous impact on Kansans as well.