In my years in higher education, I’ve watched capable students get shut out of demanding programs, not for lack of ability, but because of barriers that had nothing to do with their potential: a job, a family to support, a career change, years away from the classroom.

Those experiences have shaped how I think about one of the most urgent workforce challenges currently facing Utah and the rest of the country. Federal workforce projections estimate a national shortage of nearly 109,000 registered nurses by 2038, with nonmetropolitan communities expected to face even steeper gaps. But the shortage isn’t just about how many people want to become nurses, it’s also about whether capable students can access the education, clinical training and support they need to enter the profession in the first place.

That access problem is already visible, as the American Association of Colleges of Nursing reported that more than 93,000 qualified applications were not accepted at nursing schools nationwide in 2025. Those applications were not turned away because of a lack of interest in nursing, but because programs face limits in faculty, clinical placement sites, preceptors, classroom space and budget capacity.

This is a Utah problem specifically because our nursing workforce is built close to home. Utah’s registered nurse workforce report found that more than 75% of RN respondents graduated from a nursing school here in Utah. If we want a stable nursing workforce here, we have to be paying attention to whether students can actually access and complete nursing education here.

Today’s nursing students don’t all follow the same path or come from the same backgrounds. Some are recent high school graduates. Others already hold degrees and are looking for a career change, are working adults, parents or caregivers, or are practicing nurses ready to take the next step. An education model built around a single type of student is inevitably going to end up leaving capable people behind.

Higher education needs to respond to this changed landscape by creating more accessible paths for students without lowering the standards that patients and the profession deserve. Flexibility can often be confused for convenience or a reduced quality of education, when it should really be seen as creating more realistic pathways for students to progress through their education while managing the responsibilities they already have.

Nursing education can’t simply be reduced to online coursework alone because nursing has always been a hands-on, human profession. Students still need skills development, simulation, clinical experience and the ability to make rational decisions in complex situations. They need to learn how teamwork, compassion and good judgement come together in actual healthcare environments.

When designed intentionally, flexibility and high-quality preparation can reinforce one another. Online coursework gives students more control over when they can engage with class materials. In-person labs and simulation can give them space to apply what they’ve learned and start building confidence before clinical settings, while direct patient-care rotations are still essential.

At Joyce University, we’ve built our program around this same principle: Online coursework can provide greater flexibility, while in-person labs, simulation and direct clinical rotations provide the hands-on preparation nursing demands. But no single institution can close a 109,000-nurse gap alone. Utah needs this same commitment at scale.

We need to expand clinical placement capacity, strengthen preceptor partnerships, invest in the nurse faculty pipeline, and build student services around the lives students actually live. Students rarely see the systems behind scheduling, advising, technology, faculty support or clinical coordination. They just feel it when something breaks.

Opening the door isn’t enough if students don’t have a realistic path to completing their education. A parent shouldn’t have to choose between nursing school and their family because of a scheduling problem we could have designed around. And a working adult shouldn’t be locked out just because the only path on offer assumes they have unlimited daytime hours free. At the same time, no student should graduate without demonstrating the knowledge, skills, judgment and professionalism the practice requires.

Flexible nursing education is workforce strategy, not a shortcut, and Utah’s healthcare system needs us to treat it that way. It gives students a realistic way forward while holding the line on the standards patients and employers have every right to expect. If we want more nurses in the workforce, we have to give more of them a real path to get there.

Patrick Rombalski is chief operating officer of Joyce University and holds a doctorate in higher education management. Prior to joining Joyce University, Rombalski served as chief operating officer at Chamberlain University. Earlier in his career, he served in senior leadership roles at several universities, including Vice President for Student Affairs at Boston College and John Carroll University.

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