As the nation's healthcare system grapples with a persistent and worsening nursing shortage, a prominent nursing executive is pressing lawmakers to prioritize federal workforce programs in the upcoming appropriations cycle. Patty Knecht, chief nursing officer at Ascend Learning, argues that without robust funding, the pipeline of future nurses will continue to shrink just as demand for care surges.
Knecht, a registered nurse with four decades of experience, points to the Title VIII Nursing Workforce Development Programs as the federal government's most effective tool for expanding the nursing workforce. These programs, established in 1964, provide advanced education support, scholarships, loan repayment, and faculty development opportunities. They also help remove barriers for students entering the profession, making them critical to addressing both the immediate shortage and the long-term sustainability of the nursing workforce.
The urgency is underscored by projections from the U.S. Bureau of Labor Statistics, which expects registered nurse employment to grow faster than the average for all occupations. Advanced practice roles—nurse anesthetists, nurse midwives, and nurse practitioners—are projected to expand by 35 percent by 2034. Meanwhile, the Health Resources and Services Administration estimates a potential shortfall of over 100,000 registered nurses and 245,000 licensed practical nurses by 2038, driven by an aging population and increased healthcare demand.
Nursing schools are already struggling to keep pace. Since 2016, more than 50,000 qualified applicants have been turned away from entry-level baccalaureate nursing programs annually due to capacity constraints, including thousands of graduate applicants who could become future nurse educators. The bottleneck is not a lack of interest but a shortage of faculty, a problem that Title VIII directly addresses through programs like the Nurse Faculty Loan Program.
Congress is currently considering the Title VIII Nursing Workforce Reauthorization Act of 2025, a bipartisan bill that would extend these programs through 2030. However, the Trump administration's proposed fiscal 2027 budget would eliminate all Title VIII programs except the Nurse Corps scholarship and loan repayment initiatives. Knecht warns that such a move would be shortsighted, as the nation has already spent years deliberating over the nursing shortage without decisive action.
“Title VIII is not an experiment or some new initiative searching for a purpose,” Knecht wrote in a recent appeal. “These programs have quietly helped keep the pipeline growing by offering financial assistance, supporting continued education, and creating opportunities for experienced nurses to step into faculty roles.” She argues that the programs have a proven track record and should be a cornerstone of federal healthcare policy.
Knecht's specific recommendations for the fiscal 2027 appropriations package include approving $346 million for Title VIII Nursing Workforce Development Programs, increasing Nurse Faculty Loan Program funding to $57 million, and directing the Health Resources and Services Administration to prioritize nurse faculty retention and expansion of clinical training sites. These measures, she says, are essential to reversing the trend of qualified students being turned away.
The nursing shortage is not a problem that can be solved overnight. As Knecht notes, “You can’t decide in one budget cycle that you need more nurses and then expect them to appear six months later.” The students enrolling today are the nurses, educators, and advanced practice providers who will care for communities for decades to come. Investing in them now is the only way to ensure a stable healthcare workforce in the future.
Knecht's call comes amid broader debates over healthcare funding and workforce policy. The outcome of the appropriations battle will have significant implications for the nation's ability to meet growing care demands. For now, she urges Congress to back up the rhetoric about nurses being the backbone of healthcare with concrete financial support.
“If we want more nurses at the bedside tomorrow, we must keep investing in the people willing to answer that calling today,” Knecht said.
