This Is a Crisis 10 Years in the Making

In 2016, I spent time with nursing educators at SUNY Deli in upstate New York, because they were describing the profession with one word “crisis.”

Not hyperbole.
Not politics.
But a warning given with firm and direct seriousness.

Now, nearly a decade later, their warning has morphed into a reality of policy. In November, the Trump administration announced that it would no longer consider Nursing to be a professional degree. What does that mean? It means getting federal financial aid to complete advanced degrees in nursing and other health care professions will become more difficult. It’s all part of the student loan changes made in the One Big Beautiful Bill Act, signed into law on July 4^th 2025. However, the consequences now extend far beyond nursing schools into the basic functioning of hospitals, clinics, rural health systems, and safety-net care across the country.

What’s important to know is, this crisis not sudden. It’s the logical endpoint of years of neglect and of warnings that went largely ignored.

And I have the tape to prove it.

2016: “It’s a Crisis” And It Starts With Educators

In a 2016, I was a reporter for PBS member station WMHT in New York’s Capital Region. My stories aired on their public affairs show New York NOW and I had traveled out to Delhi, NY where the SUNY School of Nursing provided everything from a 2-year pre-license program in applied science to doctorate level degrees of Nurse Practitioner.

At the time, I met then Dean of the School of Nursing, Mary Pat Lewis, who explained, there was looming nursing shortage coming to the US.

“It’s a crisis,” she said plainly.

The issue, Lewis explained, wasn’t about bedside staffing. While that ultimately would likely be impacted, it’s an archaic and reductive way to think of the profession, because the root of the shortage begins with nursing education.

“From an academic perspective, all of our faculty have to be prepared at the master’s level,” Lewis said. “We have accreditation requirements. We have to show evidence.”

And no, nursing education is not informal apprenticeship. To be a nursing educator, you must have advanced degrees, clinical supervision, and credentials. The problem? In 2016, most of the nurses who met those requirements were nearing retirement.

At the same time, Lewis said there’s a structural problem of finances that creates another roadblock to finding qualified educators.

“Nurses can see compensation at a much higher level in practice than they can as a nurse educator.”

In other words: The system financially discourages nurses from becoming the very educators needed to train the next generation.

The Bottleneck Nobody Fixed

By 2016, the numbers were already flashing red.

• One-third of nurses in the US were at least 50 years old

• Nurses with graduate degrees could earn significantly more as practitioners than they could as educators

• Universities were not replacing retiring faculty

• While undergraduate nursing programs were expanding, without enough graduate-level instructors

The result, result is exactly what then Dean Mary Pat Lewis warned of: a bottleneck.

“Too many undergrad students and not enough grad-level educators to help correct this problem.”

Hospitals were already feeling the impact.

At Albany Medical Center, then Chief Nursing Officer Kate Roche explained that students were completing coursework, and then waiting months or years for clinical placements.

“I’ve done my classroom, but I’m literally in a lottery to get those rotations,” Roche said.

Why?

“Because of the number of master’s-prepared or doctoral-prepared clinicians that can be my faculty instructor.”

In 2016, this was still being framed as alarm that would go off.

But the countdown clock was steadily running.

By 2030: Nearly One Million Nurses Short

Even then, the projections were dire.

The American Journal of Medical Quality warned that by 2030:

• The U.S. could face a shortage of nearly one million nurses

• New York State alone could face a gap of 40,000 nurses

This wasn’t a mystery.
It wasn’t unforeseeable.

It was documented.
It was reported.
It was ignored.

2025: The Pipeline Is Now Being Actively Undermined

Fast forward to the present day.

In an interview on my show We Decide: America at the Crossroads on WBAI, I revisited the conversation around the future health of nursing with nurse practitioner, Michelle Jones and retired physician Dr Steven Auerbach.

Buried inside a Congressional Republican bill was a provision that would cap graduate student loans by redefining what qualifies as a professional degree. I couldn’t help but wonder, if nursing was no longer characterized as a profession, then is the crisis still a looming shortage or has it shifted to systemic sabotage? Not only does does this funding change undermine the training, teaching an preparing of the next generation of nurses, but it will also cut off access to workplace advancement throughout a career.

This is not an abstract budget decision.
It is a structural chokehold on the earning potential of a largely working class healthcare workforce.

What “Advanced Practice” Actually Means

When I spoke with Jones, a nurse practitioner at Flushing Hospital and Secretary of the New York State Nurses Association, about what’s at stake, she broke it down like this:

“You need three years of education post-baccalaureate… then national boards… and some go on another two to three years for doctoral degrees.”

These are the nurses who:

• Provide primary care

• Serve rural and underserved communities

• Teach students

• Train new hospital staff

• Act as mandatory reporters

• Fill gaps where physicians are scarce

Removing professional status doesn’t just hurt nurses.

It shrinks the entire healthcare system.

“This Is Sexist, Classist, and Racist”

Dr. Steven Auerbach, is a frequent guest on the show. He’s a retired physician and former public health advisor to the U.S. Department of Health, and he doesn’t mince words.

“It has a horrible impact throughout health professions,” Auerbach said, “and of course, it’s both sexist, classist, and racist.”

Why?

“Folks with higher income backgrounds will still be able to get these degrees,” he said.
“This disproportionately impacts women and people from lower-income backgrounds.”

Nursing has long been one of the primary professional pathways into the middle class for:

• Women

• Immigrants

• First-generation college students

• People of color

Student loan caps don’t eliminate the need for nurses. They just change who gets to become one and where they can afford to work.

“Rich students will work on Park Avenue,” Auerbach warned, “and fewer people will work in Central Queens or rural America.”

COVID Should Have Settled This Debate

During the COVID pandemic:

• Over one million Americans died

• 3,600 nurses died in the first wave alone, many due to unsafe staffing and lack of Personal Protective Equipment or PPE

• Hospitals ran on fumes, and so did nurses

And yet, in the years since, staffing protections are being rolled back, loan access is being restricted, and the profession is being downgraded.

“They are choosing deliberately as a matter of policy to ignore what we know,” Auerbach said, “and to cause harm.”

Healthcare Doesn’t Function Without Nurses

Jones sees the consequences daily.

At Flushing Hospital, a safety-net hospital in Queens, she says fear of deportation, of cost, of access is already keeping patients away.

“Patients are not coming in for follow-up care. Not coming for vaccinations. Not coming for prenatal care.”

Those choices aren’t just personal. Health is a community endeavor and lack of access doesn’t stay contained.

“They come into the emergency room as a dire emergency,” she said, “when they could have come in earlier.”

This isn’t just bad for patients.

It’s bad for public health.

A Ten-Year Warning We Can No Longer Ignore

In 2016, nurse educators warned of a shortage.

In 2020, COVID exposed the fragility of the system.

In 2025, federal policy is now actively constricting the pipeline needed to keep healthcare functioning.

This isn’t coincidence.
It’s cause and effect.

As now retired Dean Mary Pat Lewis said nearly a decade ago:

“The goal for nursing is to add to the body of science… to be leaders, managers, educators.”

Undermine that and the system collapses from the inside out.

Now The Question Is Simple

Do we treat nursing as essential infrastructure or as expendable labor?

Because no healthcare system survives without nurses.

And this crisis didn’t arrive overnight.
We were warned.

📺 Watch my 2016 story on what was then called a ‘looming shortage of nurses’ here:

📻 Listen to my 2025 interview with Nurse Practitioner Michelle Jones and Dr. Steven Auerbach on WBAI here:

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