Despite being home to three nursing programs, Abilene continues to face challenges in meeting the demand for nurses in its hospitals. This is part of a broader national issue involving a general shortage of nursing professionals.

Recently, the Patty Hanks Shelton School of Nursing separated from Hardin-Simmons University’s nursing program, giving students three distinct nursing options in Abilene. Patty Hanks is now solely partnered with McMurry University, a change from its previous joint affiliation with Abilene Christian University, Hardin-Simmons University and McMurry.

Although Abilene offers three nursing programs, hospitals remain understaffed. The impact of the nursing shortage has been especially significant in rural communities, and the COVID-19 pandemic worsened this trend. According to the National Nursing Workforce Study, nearly 100,000 registered nurses and 34,000 licensed practical and vocational nurses left the workforce during the pandemic.

The study also found that 62% of nurses reported an increased workload, and about half experienced emotional fatigue or burnout multiple times per week.

“If you don’t have the right support system as a nurse or are going to nursing school, you’re not going to stay in just because it takes a toll on your soul,” said Bryce Tidwell, a junior nursing major from Stephenville.

With limited resources, rural hospitals have been particularly affected.

In Taylor County, hospitals and clinics report continued staffing challenges. While Abilene’s nursing programs continue to educate students, many graduates seek employment in urban facilities that offer higher pay, broader career paths and different lifestyle opportunities.

“The cost of living here versus what they’re being paid doesn’t always equal out,” Tidwell said. “So, people are going more toward the bigger cities where they can actually afford to live.”

Tidwell said many of the nurses in Abilene feel trapped. Nurses can sign up for a program where Hendrick will pay off their nursing school debt if they work for the hospital for a certain number of years.

Many rural hospitals, often operating with limited staff, offer fewer scheduling options and support services. These conditions have contributed to some nurses leaving the profession.

“I think it’s definitely a cyclical process,” said Kacyn Hiley, a junior nursing major from Salem, Oregon. “Because there’s a shortage, you get more burnt out, which means more people leave, which means there’s more of a shortage.”

Tidwell said that part of what is contributing to the national shortage issue is how nurses are treated. Patients can lay their hands on nurses, and Tidwell said if you say anything, you’ll be told it’s just part of the job.

“I’ve been shoved around, pushed into walls, and told, ‘This is normal.’ You just need to get used to it.”

Urban hospitals typically offer higher salaries, more benefits and different working conditions. Staffing shortages can lead to increased workloads, longer shifts and reduced scheduling flexibility, all of which are factors linked to burnout.

The chart above shows the employment rate of nurses in Abilene compared with Dallas, based on data from the U.S. Bureau of Labor Statistics. All data were collected in 2023. The number that is most important to look at here is the ratio between the city’s population and the nurses employed. Despite having a smaller population than Dallas, Abilene has a lower nurse-to-population ratio. Dallas employs approximately one nurse per 25 people, compared with Abilene’s ratio of one nurse per 36 residents.

“Staffing, though, is always a challenge. And likely, you’re gonna make less in Aspermont as a nurse than you would in Dallas as a nurse; funds are different,” said Craig Hunnicutt, director of regional services at Hendrick Health in Abilene. “I will say, though, on the staff side, nursing in particular, you’re never without a job as a nurse.”

Due to the ongoing shortage, hospitals have increasingly relied on travel nurses.

“The challenge with travel nurses is that they cost a fortune,” Hunnicutt said. “The bottom line to the facility that has the travel nurses is they’re paying a huge amount to have a nurse side by side with a local nurse who’s making much less. So at Hendrick, we don’t want travel nurses; they cost too much. But it’s unavoidable in certain situations.”

According to the Bureau of Health Workforce, rural areas are projected to face a greater shortage of registered nurses than urban areas over the next decade. By 2027, rural regions are expected to experience a 24% shortage of RNs, compared with 7% in metropolitan areas.

The American Hospital Association has proposed several strategies to address the issue, including expanding training opportunities, developing in-house staffing solutions, and offering more flexible roles with improved compensation and support.

“We had a therapist come in and talk to us,” Hiley said. “I think they’re slowly getting better at having resources for nurses and meetings.”