RSU Nursing

OKLAHOMA CITY — Oklahoma lawmakers are exploring ways to increase the state’s nursing pipeline as experts testified that the industry is plagued by low pay, tough work conditions, underprepared high school students and declining interest in the profession.

Shelly Wells, president of the Oklahoma Nurses Association, said the shortage is a national issue, but it’s acute in Oklahoma due to the state’s aging population, less than stellar health care outcomes, a growing number of nurse retirements and a lack of trained nurses in the pipeline to replace those leaving.

Wells called on lawmakers to pass legislation and provide funding to increase nurse staffing and improve the workplace environment. She said additional legislation is also needed to further address workplace violence against nurses that has grown since the beginning of the COVID-19 pandemic. Lawmakers should consider nursing faculty tuition loan forgiveness programs as well as offer additional tax credits and scholarships for those who agree to serve in severe shortage areas.

She said a recent online ranking by WalletHub found Oklahoma ranked 50th for registered nurses when looking at scope of practice restrictions, overtime regulation or lack thereof, nurses-per-bed ratios, salaries, the workload in terms of patient population morbidities, workplace culture and a lack of opportunity for advancement.

She said Oklahoma pays an average hourly wage of $32.78, but the cumulative regional average is $35. Sign-on bonuses, which are designed to attract recruits, are actually increasing turnover as nurses serve their agreed upon time and then seek other employment opportunities.

Wells said licensed practical nurses, who make an average hourly wage of $21.59, saw a 62% turnover in 2021 while certified nursing assistants saw a 53% turnover rate with an average hourly wage of $13.86. She said nurses are finding they can make more working in other professions despite expected growth in need in all areas of nursing by 2026.

Some nurses testified that certified nurse assistants aren’t making enough to support their families, and said the workload and workforce culture is pushing many nurses with degrees out of the profession.

Wells also said there’s a lack of applicants to nursing schools with adequate math or science preparation.

Allison Garrett, chancellor of higher education, told lawmakers that just under 9% of Oklahoma high school graduates test as STEM-ready, referring to science, technology, engineering and math classes. Garrett said she’d like to see math and science courses required all four years of high school in an effort to improve proficiency in those areas.

She’s hopeful that increased federal coronavirus aid will soon flow to higher education in a bid to further increase nursing degree production. She also said the state is in the middle of a workforce demand that’s coming on top of years of insufficient nurse supply.

“We’ve all heard there is a tremendous demand that is currently going unmet,” she said.

Garrett said the state ranks 22nd nationally in average annual earnings with a registered nurse making a little over $73,000; licensed practical nurses average a little over $48,000, she said.

She said the state’s public colleges and universities are also struggling to pay for master-level faculty to train the next generation of nursing students. Faculty make about $10,000 a year less than the average nurse, making it challenging for institutions trying to hire the required master-qualified nurses and then retain them. She said some of the two-year colleges pay nursing faculty in the $50,000s.

“We do face a real shortage in nursing faculty across the state,” Garrett said.

But as colleges try to expand their programs, she said they’re also grappling with a limited number of required hands-on opportunities for soon-to-be nurses. Leaders also are also reporting that they’re seeing an increasing number of college students without the ability to persist and thrive in such a demanding field, Garrett said.

A registered nurse, state Rep. Marilyn Stark, R-Bethany, said there was a nursing shortage in 1984 when she got her degree, and there was still one in 1994 and 2004.

Stark said that everyone knows that nursing shortages are a problem, but said the COVID-19 pandemic exacerbated the situation, and she wants to develop strategies to fill the pipeline and improve retention to bolster all sectors of the Oklahoma’s health care industry that rely on trained nursing staff.

“We need to figure out how we can not only build the pipeline, but keep them in,” Stark said.

Janelle Stecklein covers the Oklahoma Statehouse for CNHI's newspapers and websites. Reach her at

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