Healthcare educators: Want to stabilize nurse staffing for years to come? Stand up for the Nurse Faculty Loan Program

Federal policy is bandaging localized nursing shortages while ignoring the patient’s serious internal illness. 

So argue two business-of-health experts in an opinion piece published March 20 in JAMA Health Forum.

The circumstance they see as needing no less attention than immediate staffing shortfalls: ways, means and qualified instructors to train more nurses—“not only for the present moment but also for decades to come.”

Joshua Barrett, PhD, MBA, RN, and Zoey Kernodle, DrPH, MTS, both of the Kenan-Flagler Business School at the University of North Carolina, base their warning on machinations between the White House, Senate and House of Representatives involving the federal government’s 2026 budget. 

First, they note, President Trump’s proposal did fine to allocate $92.6 million for the Nurse Corps Loan Repayment Program—but dropped the ball by seeking to drop five of six programs for long-term nursing workforce development.

The Senate restored these programs, Barrett and Kernodle note, but House appropriations bills advanced the idea of cutting two of those six targeted by the White House. 

One of the two was the Nurse Faculty Loan Program (NFLP), which the authors see as critical to nurse staffing stability over the long haul. 

Although the NFLP ultimately received level funding for now, the authors point out, “the recurring proposals for its elimination suggest its future remains tenuous.”

Barrett and Kernodle offer numerous reasons for healthcare leaders to recognize the importance of the NFLP to the health of the nation’s healthcare delivery system. Among their most compelling points are these three:

1. Most vacant faculty positions in nursing schools (79.8%) require or prefer a doctoral degree—precisely the pipeline the NFLP supports.

The NFLP has demonstrated “remarkable effectiveness,” Barrett and Kernodle state. In academic year 2022 to 2023, they show, the program provided loans to 2,746 advanced practice nursing students in exchange for their commitment to become faculty, with 924 graduating that year. Of those who graduated in 2021 to 2022, 74% were in faculty roles one year later. 

“Without these NFLP graduates,” they write, “the national vacancy rate would have been nearly 11% instead of 9%.” 

2. The potential impact of losing a program like the NFLP is amplified by U.S. Department of Education proposals.

The proposals in question would remove professional degree status for nursing graduate degrees while lowering federal loan limits to $100,000 as of July 1, 2026. Barrett and Kernodle note such a  chance would disproportionately affect Doctor of Nursing Practice (DNP) students—a subgroup greatly needed to fill empty faculty positions. 

“Historically, DNP students rely more heavily on loans than their PhD counterparts,” Barrett and Kernodle explain. PhD programs commonly provide tuition subsidies, but DNP programs typically require students to self-finance, they add. “With loan limit reductions and proposed NFLP elimination occurring simultaneously, prospective nursing faculty face a double constraint: reduced borrowing capacity for their education and eliminated loan forgiveness for faculty service.”

3. Policy approaches focusing exclusively on recruitment are insufficient. 

“Continued NFLP funding and maintaining professional degree status for graduate nursing programs reinforces necessary infrastructure for a positive feedback loop: Investment in trainers leads to more nurses in education and practice,” Barrett and Kernodle underscore. “As the gap between immediate staffing interventions and long-term capacity needs widens, the question is whether policymakers will recognize this structural imbalance before consequences become irreversible.”

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