College freshman Rachel Weller could be the answer to Ventura County's nursing shortage. She's smart, motivated and committed to a profession that desperately needs new recruits.

The 18-year-old from Moorpark with a 3.46 grade-point average applied to enter the nursing program this fall at CSU Channel Islands in Camarillo, along with 312 other students. Earlier this month, 276 of them ripped open mail from the university only to find rejection notices, though program administrators say many of them are qualified and should have been accepted.

The barrier is money. The state of California and various grants generated enough funding for only 37 students to begin the three-year program this fall. However, hospitals, clinics and public health departments need more young nurses to replace an aging work force and cope with a shortage that will likely get worse as baby boomers need more healthcare.

"It's heartbreaking. They were excellent candidates. They'd make good nurses. We just don't have room," said Dr. Karen Jensen, director of the nursing program at CSUCI. "We're on a bad path with the collision of the nursing shortage and the boomers. It's a recipe for disaster."

An increasingly backed-up educational pipeline blocks would-be nurses from their chosen career. Moorpark College's nursing program carries a waiting list of 400 students. Ventura College's program has 250 students waiting for a spot. Similar waiting lists can be found throughout the state.

The numbers are inflated because students sign up for more than one waiting list. But if all the students who wanted to become nurses could get into a program, the state's problems would be over, said Deloras Jones, executive director of the California Institute for Nursing and Health Care in Berkeley.

"We have the solution in front of us, but we can't fund it," she said. "We're only able to admit 40 percent of the qualified candidates in California. In your area, it's even worse."

Moving on

Weller has wanted to be a nurse since her first year of high school. She enrolled at CSUCI because the university opened a new nursing program last fall. She was bitterly disappointed to get the rejection notice but was hurt more by an accompanying notice. It asked her to choose a new career path.

"This is what I want to do," said Weller, who plans to reapply to the nursing school next year. "Why should I have to change my major? I don't want to change my major."

Rejected nursing students dot the 6-year-old campus at the edge of the Santa Monica Mountains. Sitting with friends at the Islands Cafe, 19-year-old Jasmine Frazier said she decided on a nursing career because nurses showed her how to cope when she received a diagnosis of chronic bronchitis. She's still determined to make her career goal and plans on transferring to CSU San Bernardino.

Two tables over, a girl in a black T-shirt said she opened her rejection letter in her dorm room.

"I kind of freaked out. I started crying because I spent so much time studying. I feel like all my time was wasted," she said, announcing plans to change her major to computer studies. "I'm not going to be a nurse. I kind of felt like I had to accept it and move on."

People want to be registered nurses because of the chance to help others, guaranteed job security and a median salary of about $68,000. Nursing advocates worry the surge in interest won't last long if schools can't accept more students.

"Nursing is going to get a very bad rap," Jones said. "When that happens, we're not going to have people wanting to get on a waiting list."

Not making the grade

New nurses are needed because the Ventura County shortage was ranked in 2004 as fifth worst in a state that had the lowest ratio of nurses to residents in the nation, according to a federal study.

The report card by Jones' Institute for Nursing and Health Care gave the county an F because it had only 3,490 registered nurse positions. That's about 430 for every 100,000 county residents.

The numbers have climbed. A 2006 state survey reported 4,330 registered nursing jobs in the county. The ratio of 541 nurses for every 100,000 in population would have earned the county a D in the 2004 report card.

The shortage means hospitals pay more to go outside the area to find temporary nurses and meet California regulations requiring one nurse for every five general care patients.

"Basically, we steal from other states," said Nancy Seck, a nursing administrator from Los Robles Hospital & Medical Center in Thousand Oaks.

Clinics, nursing homes, urgent care centers and public health departments also struggle, running short of staffs, hiring temporary help or using licensed vocational nurses instead of registered nurses.

Even with the huge waiting lists and rejections, more students are entering nursing in Ventura County because of expansions at the community colleges and the launch of the CSUCI program a year ago. State officials cite a $90 million initiative that started in 2005 as a prime reason graduation rates across the state have increased 61 percent over the past three years.

The cost of nursing

Other observers say the shortage is improving because of a state law that took effect five years ago and pushes hospitals to follow ratios that in general care units mean one nurse for every five patients.

The gains have not ended the concerns of nursing leaders who worry about aging baby boomers. Not only will more people need hospital care but also a huge chunk of the nursing force will enter retirement. Some observers predict the shortage will become a crisis in about 2010, threatening hospitals and potentially forcing the state to make dramatic changes in patient care.

"They're going to have to find a solution other than nurses to take care of people," said Jensen.

The pipeline is clogged in part because nursing programs are expensive to run, with each student at Channel Islands costing the college about $10,000.

"You can educate a heck of a lot more English majors than nursing majors for that same dollar," said Jones.

Other barriers include limited classroom space at community colleges and problems in finding enough hospital sites so students can do clinical training. The biggest problem is faculty.

CSUCI doesn't have the money to hire the additional teachers needed to enroll more students. Even with money, those teaching positions are hard to fill because the state pays new professors about $75,000, much less than hospitals pay experienced nurses with advanced degrees.

"There are masters and doctorate people in the faculty who are making less than their students once the students graduate," said Lee Abramo, a registered nurse and director of education at Los Robles Hospital & Medical Center.

Area hospitals already subsidize the cost of education at the community colleges and the university. They paid $400,000 to a partnership program that allowed 33 nursing students to enroll simultaneously at Moorpark College and CSUCI, taking classes at both campuses.

Some nursing advocates think hospitals should contribute more, but Jensen is trying to find other sources. The university pursues every grant possible and approaches everyone from Rotary Club members to philanthropists for scholarship money or other donations.

Permanent funding needed

State officials say the governor's $90 million initiative has already expanded capacity at community colleges and universities and will bring 10,900 new nurses into the work force by 2010. They cite programs that pay off college loans for students who go on to become professors and private-public partnerships that bring hospitals and schools together.

Observers say the initiative has helped but worry that much of the money available to schools is tied to grants that will eventually expire. They say more permanent funding is needed.

But the state is in the grips of a $16 billion deficit, meaning nursing schools are competing for general fund money with high schools, law enforcement and everyone else.

Stephanie Leach, an assistant secretary of the California Labor and Workforce Development Agency, said the problems involve much more than budgets. The state has to find ways to restructure the pipeline and not just use money as Band-Aids.

"You can throw as much money as you want, and it's not going to fix it," she said.

But Jensen of CSUCI worries about a proposed budget cut that she says could eventually squeeze even more students out of the classrooms. She said money is what the program needs.

As for the students, they want any solution that will get them into a nursing school.

"Nursing is needed so bad," said Olivia Tilleard of Ocean-side, a sophomore who was rejected from the CSUCI program. "There's just a lot of people who need help health-wise, and there's a lot of people who want to help, but there's just not enough room education-wise, which I think is ridiculous."