By Kim Jones, PhD, FNP, RN

Nursing is the largest and most trusted sector of the healthcare workforce. There are more than 5 million registered nurses in the U.S. alone. And the number of people whose lives have been touched by nurses? Unquantifiable.

It is therefore no surprise that the Department of Education (DoE) has begun sending healthcare leaders emails in ALL CAPS asking them to please stop encouraging patients and clinicians to email the DoE about a policy decision that will be catastrophic for nursing and the future of healthcare.

The Policy

In July, the DoE plans to enact a definition of "professional" that excludes nursing. Doing so will diminish the value of nurses -- while restricting their access to federal loans for graduate and doctoral education. Unfortunately for the DoE's inbox, voters know that graduate-prepared nurses staff the clinics, deliver the babies, and lead the hospitals in their communities. (And doctorate-prepared nurses teach all the other nurses -- so we can have more nurses.)

While the calculation -- less funding for nursing education equals less access to care -- appears clear to patients, clinicians, and a voting public, the DoE stands firm in a series of fallacious talking points. They have listed those talking points in a fact sheet-style press release that reveals a troubling disconnect from healthcare reality.

"An Internal Definition"

First, the DoE claims its definition is merely an "internal definition" for loan limits rather than a value judgment against nursing. Nurses, however, know the practical consequences will reverberate through every hospital and clinic in America.

While our health system desperately needs nurses, it does not always treat nurses as respected professionals. Nurses are frequently subject to pay scales that do not reflect their labor, unsafe patient ratios, violence and harassment, and occupational hazards.

Even if it is an "internal definition," judgment has been passed. Whether the DoE speaks this definition publicly or internally, its implied lack of regard for nursing science and clinical wisdom are likely to compound the challenges nurses face.

Borrowing Limits

Next, the DoE asserts that "95% of nursing students borrow below the annual loan limit and therefore are not affected."

Which nurses are they even referring to? The only source offered is a vague reference to "Department of Education data."

And this statistic fundamentally misunderstands how nursing education works.

Nurses who follow a traditional undergraduate nursing pathway don't always reach their loan limits -- but they are not the only nurses in question. What about students who choose nursing as a second career -- and have maxed their undergraduate loan caps on another field? This is a common phenomenon.

Graduate and advanced practice nurses frequently and easily exceed their loan limits as well. It is common for advanced practice nurses to accumulate $100-200K in debt before interest.

Like Cutting Food to Cure Hunger

Perhaps most disingenuous is the DoE's claim that loan caps will "push the remaining graduate nursing programs to reduce their program costs." This logic is akin to saying we should limit food to cure hunger. In an environment where the administration has also slashed federal nursing grants and increased university taxes, tuition reduction is indeed an impossibility. The context the administration has created may, in fact, drive up tuition across disciplines as student dollars become the financial lifeline for American universities.

For nursing specifically, the costs of delivering education are fixed. We're not discussing an inflated commodity -- we're discussing basic investments into patient safety. Overhead from simulation labs, clinical placements, expert faculty, and hands-on training does not fluctuate with the market.

Finally, why wouldn't this logic apply equally to medical, dental, and law schools -- all designated as professional programs with higher loan limits? The DoE cannot have it both ways: Either unlimited borrowing drives up tuition or it doesn't. Selectively applying this reasoning to nursing while exempting other professions reveals an arbitrary bias that has nothing to do with educational economics.

Are We Sure Nurses Don't Need Advanced Education?

The DoE's reassurance that "80% of the nursing workforce does not have a graduate degree" fails to acknowledge the critical care gaps that nurses and advanced practice RNs (APRNs) (like nurse practitioners and midwives) fill in every type of care setting and community.

Nursing isn't one static role. We need nurses of all practice and education levels to address:

- Critical hospital staffing shortages;

- Mental health and maternity health deserts;

- Primary care gaps;

- Anesthesia delivery needs;

- Urgent quality improvement initiatives, and more.

Don't forget that physician shortages are also intensifying, and APRNs -- who do require graduate or doctoral education -- are often the last clinicians available in rural and underserved communities. In states where those APRNs can work to the full extent of their training, we see lower hospitalization rates for conditions that can be treated in primary care -- clear evidence of care quality.

Keep Writing

The DoE is inundated with emails? Maybe now they can relate to the thousands of patient requests that nurses in our short-staffed clinics receive every day.

Keep writing. Write to your elected representatives, write to the DoE, write guest editorials and op-eds. Contribute to the DoE's public comment period expected to start this month.

We must seize this opportunity. Every voice matters in conveying what many patients already know: Nursing is unequivocally a profession; we should be reducing (not artificially creating) barriers to nursing education. More nursing education means more nurses to meet voters' health needs.