Karli McGuiness had just accepted her spot in a demanding masters program at the Johns Hopkins School of Nursing when the catastrophe that has rocked the world hit the United States.
It was after “a lot of long and very honest conversations” with mentors in the health-care field that McGuiness, 33, realized her determination to pursue that path was stronger than ever.
“I don’t necessarily want to risk my health or the health of my loved ones, but the situation is horrific, and it’s affecting every single person across the globe,” McGuiness said. “My determination to become a nurse hasn’t faltered. I’m anxious and chomping at the bit to help.”
Health-care officials in Maryland and beyond are hoping that others come to the same conclusion.
A shortage of nurses has been a concern for years in the United States, in part because of the growing demand for their skills in health-care delivery as baby boomers in the field have been retiring.
Studies and federal estimates show that nursing schools have not been graduating enough professionals — and often don’t have the capacity to accept more students.
Now there are worries that fears about the virus could diminish the supply of new nurses at the exact time it should be growing.
Patricia Davidson, dean of the nursing school at Johns Hopkins University, said applications for the fall semester were plentiful, and the entering class for the school year is set.
But applicants made their decisions before the coronavirus outbreak was declared a pandemic, rendering acceptances a less reliable gauge of commitment than usual.
Fears around the contagion could prevent some students from showing up in the fall, Davidson said, and could weaken applicant interest for 2020-21 and beyond.
“I’m hoping that people who feel they want to be part of a profession that has a long history of doing wonderful work will stay with it,” she said. “But we’re holding our breath. I don’t think anyone knows what will be awaiting us in the next few years.”
Classes are set for the fall semester at the University of Maryland School of Nursing in Baltimore, but officials at the highly rated 132-year-old school are keeping an eye on “melt,” Dean Jane M. Kirschling said.
The term is admissions-speak for that group of applicants, usually comparatively small, who commit to attending but decide not to come.
Kirschling said that although it’s unrealistic to surmise that no applicants or students are fearful of facing virus-related health risks, she expects the school’s biggest challenges will center on financial uncertainty.
“Let’s say I’ve paid my admission deposit, and I plan to be at the University of Maryland in August, but as the time draws closer, I’m not sure,” Kirschling said.
“Part of it could be explained by a student thinking, ‘Maybe I don’t want to be on the front lines when people are that sick,’” she said. “But what if . . . both my parents are suddenly unemployed? Are people going to have the wherewithal to come forward and continue their education?
“What’s likely to hit us harder is the economic downturn.”
Among the considerations: Nursing school is expensive, with tuition ranging from upward of $10,000 per year for state schools to about $50,000 for private institutions such as Johns Hopkins University.
Meanwhile, the Journal of Nursing Regulation has projected that 1 million nurses will retire by 2030, leaving continuing shortages in patient-care settings.
Maryland is generally expected to fare better than most states. Thirty of its colleges and universities offer registered nursing degrees, and about 75 percent of graduates typically have gone on to become employed in the state. The National Center for Health Workforce Analysis in 2017 center even projected a surplus of 12,000 nurses in Maryland by 2030.
But that’s far from enough to allay concerns, with the pandemic and its effects expected to escalate demand well into the future.
“We might well have a shortage crisis in the offing,” Davidson said.
One source of optimism, experts say, is that the coronavirus crisis has shone a fresh spotlight on the profession, offering the public a clear view of the talents and determination of health-care practitioners who may receive less acclaim than doctors.
Gene Ransom, chief executive of MedChi, Maryland’s physicians association, said even though doctors and nurses rely on one another in the best and worst of times, Americans are seeing that nurses are often first to a patient’s side and stay there longer.
During a pandemic, that means “they are taking a lot of risks,” he said. “Everyone appreciates what they do.”
At present, that includes such potentially lethal duties as taking the vital signs of infected patients, caring for arriving patients whose status is unknown, operating technologically sophisticated diagnostic equipment in clinical settings, and conducting screenings and contact tracing in the community at large.
Davidson said that at Hopkins, students, faculty and alumni have answered the call with “amazing creativity” during the crisis, working to transform hospital recovery rooms into intensive care units, devising models for providing telephone support for older people at home, and making strides in “telehealth,” a method of care in which “we’ve advanced 20 years in four weeks.”
“I’m so proud to be the dean of this school at this time,” she said. “What I’m hearing people say is, ‘This is what I was called to do. This is what I was trained to do. I just don’t want to bring [the virus] home to my children and family.’ ”
Count Matthew Padgett among them. He chose Hopkins for its focus on both hands-on nursing and public health.
The 33-year-old put his finger on what he believes sets nurses apart.
“We do a lot of medical intervention, but we also understand the importance of the whole person, where they live, who they are, what their goals are,” said Padgett, who has been placing phone calls to elderly Baltimoreans to offer moral and logistical support.
“At this time it’s likely that people feel very isolated, and nurses have a very developed ability to be present with individuals,” he said.
At the University of Maryland School of Nursing, undergraduate Chika Okusogu has taken advantage of an unusual arrangement the school has made with the state nursing board to allow some soon-to-graduate students to enter the workforce amid the crisis.
The 22-year-old used the opportunity to increase the clinical hours he was already spending in the adult emergency department at the University of Maryland Medical Center, where he dons protective gear to work directly with covid-19 patients.
As part of his studies, the Perry Hall native has worked as a volunteer for public health nonprofit groups, explored the effects of poverty on health, and focused on critical and emergency care, and he believes such breadth of experience is essential on the front lines.
“It can be hard on the patients being isolated in their rooms,” he said. “But we treat them all with respect, kindness and empathy, and that’s an important part of promoting health. It’s an honor to be part of a profession that can truly affect the course of the pandemic.”
Padgett, Okusogu and other nursing students in Maryland have gotten a close look at what could be challenging times ahead.
All of the nursing programs in the state moved academic classes online in early March, and each had to find ways of teaching hands-on clinical skills.
Department chair Hayley Marks said that it’s far from ideal, but for now, the priority in nursing education is “focusing on how we can get students the skills they need under the circumstances.”
Meredith Cohn contributed to this report.
