As nurses, we are on the frontlines in the war against COVID-19. Deemed healthcare heroes and recipients of nightly applause, the recognition is gratifying but cannot compensate for the risk inherent in our ethical obligation to care for patients, especially when recycled personal protection equipment is all we have. As of July 13, there were 98,150 COVID-19 cases and 521 deaths among healthcare workers, according to the Centers for Disease Control and Prevention. Nurses deserve compensation commensurate with the hazards they endure.
A unique opportunity exists for the federal government to acknowledge the sacrifices made by nurses during the pandemic. While inaction persists at the federal level, some states, such as New York, are working toward loan forgiveness for frontline healthcare workers. Student loan forgiveness is a starting point given the extensive education and training required to enter, advance and excel in our field. The implicit social contract between healthcare professionals requires more than a public thank you in this high-risk era.
Student debt, high-interest student loans and inflation influence those considering a nursing career. Ultimately, the healthcare system will be impacted by diminishing the number of nurses — both RNs and advanced practice nurses (APNs). Ninety percent of nursing students at for-profit schools borrowed upwards of $30,000 to finance their education, according to a 2014 study. Graduates can expect to pay $1,219 every month for 10 years. The 7 percent interest rate adds greatly to the debt. The ability to obtain a mortgage, finance a car and save for retirement are affected. The amount of student debt after nursing school should not impact a nurse’s quality of life when they work every day to improve the lives of others. The fear of student loan debt should not be a barrier to education.
The American Association of Colleges of Nursing currently recommends that by 2025 advanced practice nursing students should obtain doctoral degrees to manage increasing practice complexity. This would double the time and cost to achieve APN status. Yet, between 2018 and 2028, there is a predicted 26 percent increase in the need for APNs, according to federal estimates. COVID-19 highlighted the need for APNs to provide accessible, affordable and high-quality healthcare. Minimizing or eliminating student debt for nurses at all levels of licensure is essential to keeping the healthcare system functional.
New York is setting a precedent as one of the few states proposing student loan forgiveness for frontline healthcare workers. The Student Debt Forgiveness for Frontline Workers Act, sponsored by Rep. Carolyn Maloney (D-N.Y.), aims to alleviate the financial burden of nurses working the frontlines. Successful passage of this bill could encourage diversity among healthcare workers as well as willingness to work in rural or underserved areas, among the hardest hit by COVID-19. An adequate supply of healthcare providers in these areas will be one less barrier to ensuring positive patient outcomes in the coronavirus resurgence. Federal student aid currently requires the borrower to have made 120 payments and be employed full-time by a qualifying employer. However, Maloney’s bill doesn’t discriminate based on hours of service per week for applicants who are frontline healthcare workers.
The sacrifices of the nation’s nursing workforce deserve not just recognition but compensation. The time is now for federal and state governments to take action. Maloney’s bill can do just that by forgiving the principal federal loan borrowed as well as the interest accrued. Loan forgiveness is as much about workforce development as individual recognition. It can facilitate equal opportunity and access to the education needed for this critical-service profession to attend to individual and societal health appropriately as well as increasing the diversity of the workforce. It is important to note how extraordinarily burdensome this pandemic has been for nurses of color or from disadvantaged backgrounds. We need to fight to keep these healthcare professionals in practice. The federal government needs to reduce the loan interest rate for nurses from seven to zero percent. Ideally, if we truly value our healthcare workforce in times of both sickness and health, all past loans and future nursing educational costs for frontline workers will be funded by the federal government.