NEW HANOVER COUNTY — The area community college is looking to triple the size of its nurse graduates, as well as expand its other health programs, but it needs the county’s help in acquiring a facility to house the growth.
Earlier this week, commissioners voted unanimously to buy Cape Fear Community College an $11.9-million building at 319 N. Front St. to expand the college’s allied health programs. While not a done deal, it puts the state college one step closer to training more healthcare workers.
“Workforce development is one of the primary reasons Cape Fear Community College exists,” CFCC’s President Jim Morton explained to thd commission.
He was joined by Brian Eckle, co-founder of Cape Fear Commercial brokering the deal, and UNCW’s assistant secretary to the board of trustees, Mark Lanier, who also spoke in support of the expansion. Their comments, along with questions from the commission, centered around the national nursing shortage, which could have profound effects on North Carolina’s healthcare systems.
According to N.C. NurseCast, a study led by the UNC-Chapel Hill Sheps Center, N.C. Board of Nursing, and Strategic Modeling Analysis and Planning, the state is projected to have a 12,500 nurse deficit by 2033. According to the data, thousands of nurses will need to be hired every year to replace the large number of employees leaving due to retirement or seeking lower-stress and higher paid positions following the Covid-19 pandemic burnout.
New Hanover County is already feeling the effects. Novant Health, which operates the only full-scale hospital in a seven-county region, was at risk of losing its Medicare license over the summer due to management’s inability to provide adequate staffing of New Hanover Regional Medical Center. Novant officials attribute problems to the shortage.
Now, Novant is partnering with CFCC to provide $2 million to fund scholarships and “other resources” for the new facility, Eckle told commissioners at the meeting.
The new building would provide 50,000 square feet over five stories for allied health programs, located around the corner from its current home in CFCC’s Union Station building. The facility will be renovated with classroom and lab space — which would come with onsite parking — costing $14.8 million across fiscal year budgets until 2027. The long-term financing and debt issuance will need approval from the Local Government Commission, as well.
Once outfitted, the building will support CFCC’s multiple nursing tracks. The college offers two paths to becoming an RN — a two-semester LPN to RN program for current LPNs and a five-semester program to earn an associate degree in nursing, or ADN.
CFCC’s 12-month practical nursing course puts students on the path to becoming an LPN, which has a smaller scope of practice than an RN, although it is dependent on the facility. The institution also offers nurse assistant, or nurse aide, programs. Nurse Aide I certification trains students to work in long-term care facilities, while Nurse Aide II focuses on acute-care settings, or hospitals.
Sonya Johnson, Vice President of Marketing and Community Relations at CFCC, said the college will expand all of its programs over time, but it is looking to immediately triple its associate degree program. Around 60 to 75 graduate from that program every year. So, if admittance triples next fall, for example, the first cohort of 225 RNs could enter the workforce as early as 2026.
The increase of ADNs can be expected to fill holes in Novant’s understaffing if it continues at its current rate. There were over 60 staff nurse positions posted on Novant’s careers page since Oct. 1, spanning multiple facilities, although the majority were at NHRMC. The job description requires an associate degree and “experience preferred,” with multiple years on the job listed as a requirement for specific departments.
However, labor statistics show an increasing number of healthcare facilities prefer, even require, graduates to possess a BSN, or bachelor’s degree. While entry-level positions may accept an ASN, upper-level positions almost always require a bachelor’s, and eventually, a master’s degree. For example, a nurse manager at Novant requires a BSN and five to 10 years of RN experience.
As for other North Carolina systems, UNC Health requires “graduation from a school of professional nursing”; however, some positions require nurses to enroll in a BSN program within seven years of employment. Atrium Health lists “BSN preferred” on itsapplications.
So, if students want to earn their BSN to prepare for a move to a different system or future leadership roles, they might decide to seek out a four-year university, like UNCW. While statistics show CFCC grads are more likely to stick closer to home, UNCW grads tend to seek jobs in the Triangle.
At the meeting, Morton said CFCC “serves as a feeder” into UNCW. Johnson said the college doesn’t collect data on how many students transfer to UNCW.
“We do know that a large number of our ADN graduates complete their BSN degrees, and most of those students attain their BSN degrees at UNCW,” she said.
UNCW graduates 50 students in December and May, but the college increased its admission allowance to 60 students in fall 2020. With more CFCC students seeking a BSN, UNCW will have to increase its cohort once again to match demand.
When UNCW’s Lanier came up to speak in favor of the building purchase, he said UNCW plans to grow its nurse licenses by 50%.
“We’re all in it together,” Lanier said at the meeting. “There’s room for all of us.”
A potential complication with increasing student size is hiring enough faculty. The North Carolina Board of Nursing mandates a teacher to student ratio of 1:10, meaning faculty numbers will need to triple as well. While CFCC relies on the county for its facility needs, salaries are funded by the state.
If CFCC’s ADN program graduates 225 students, 75 teachers will be needed to teach them. At the meeting, Morton confirmed CFCC will need to hire 17 full-time and 20 part-time instructors, with hiring efforts scheduled for next spring.
However, onboarding morefaculty may not be simple either.
Crystal Tillman, chief executive officer of the North Carolina Board of Nursing, told Port City Daily last month that there is not only a shortage of nurses but also nurse educators.
“Nurses who go to get a master’s degree, they’re not wanting to get it in nursing education,” Tillman said. “They’re willing to do it in administration, nurse practitioner, midwife, nurse anesthetists. They won’t do that for an advanced degree because in nursing education, you don’t make that much money.”
At Monday’s meeting Commissioner Rob Zapple questioned if the worst of the nursing shortage would be over by the time the expansion completed, to which commissioner and CFFCC trustee Bill Rivenbark replied:
“I don’t think we are ever going to be in the next 40, 50 years where we don’t need nurses.”
While the CFCC expansion’s main target is the nursing shortage, that is not the only purpose of the new building.
“The hospital has other needs — radiography, CAT scan and MRI, mammography, respiratory therapy,” Morton told commissioners on Monday. “There’s a number of programs that we need to add for medical needs in the community.”
Morton said the dental hygiene and dental assistant program will also expand into the new building.
However, one person did speak against the building purchase at the meeting. Neal Shulman claimed the building purchase would not help the shortage and claimed the shortage was not the product of nationwide issues, but a result of Novant’s mismanagement.
“What would be a better thing for the $14 million would be for us to buy another piece of property and have another hospital system come in — then we’d have a decent hospital,” he said during the meeting.
The county can still pull out of the building purchase deal until Nov. 3, pending any new developments in the appraisal process, which should be complete by the end of the month.
Staff must also perform an inspection and environmental study, complete a title search, review the lease agreements with the building’s current tenants and receive LGC approval for bond issuance.
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