It’s no secret that Rhode Island hospitals, like many health care facilities throughout the U.S., have grappled with increasingly steep nurse shortages in recent years.
Due to a federal shift in nursing degree classifications, observers say the crisis could grow more severe.
The U.S. Department of Education has long recognized nursing as a “professional” career. The label has typically included professions that require specialty knowledge, licensing and, oftentimes, an advanced degree – all cornerstones of nursing, according to Danny Willis, dean of the University of Rhode Island College of Nursing.
But under provisions of the so-called One Big Beautiful Bill Act, federal education officials are removing nursing from the professional degree classification. The change has raised outcry among many in the health care sector who say the shift not only disrespects the profession but also intensifies financial barriers faced by some students trying to obtain advanced degrees.
“The impact is severe, and it has ripple effects,” Willis said of the change, which goes into effect on July 1. Beyond hospital staffing shortages, the reclassification also stands to escalate the state’s scarcity of primary care providers.
Observers say it’s part of the fallout from the One Big Beautiful Bill Act, enacted in December, which capped federal unsubsidized loans at $50,000 a year for medical students, for no more than $200,000 total. But the law also gave the U.S. Department of Education authority to decide which graduate degrees count as professional, qualifying for those loan limits, and which degrees fall under a stricter cap of $20,500 a year and $100,000 overall.
After the federal education department’s new rule takes effect in July, nursing, public health, social work – as well as education, accounting and architecture – will no longer have the professional designation when it comes to federal loan eligibility.
Those students also lose access to an additional funding source, Grad PLUS loans, which can pay for school costs not covered by other aid.
The U.S. Department of Education has argued that the loan limits will drive down the cost of graduate programs and reduce the need for bigger loans. And it says that data indicates that 95% of nursing students already borrow at amounts lower than the annual loan limit.
Still, Willis said the reduction in access to financial aid has the potential to decrease enrollment in nursing programs. “I do think that there will be students who just can’t afford to do [nursing programs] or look into private loans,” he said.
Area health systems are bracing for the fallout.
Doreen Scanlon Gavigan, a spokesperson for Care New England Health System, said the federal reclassification “has the potential to deepen staffing shortages, slow the timeliness of care and limit the ability to sustain essential services.”
Other health workers, or those who collaborate closely with providers, are also slated to lose professional degree classification, Scanlon Gavigan said, further burdening the overall system. The U.S. Department of Education also reclassified physician assistants, midwives, physical therapists, audiologists, speech pathologists and social workers as nonprofessional degrees in its November decision.
“Anyone who has received care at a Care New England facility understands that professionals in these disciplines are indispensable to our care delivery system, both at CNE and hospitals nationwide,” Scanlon Gavigan said. “Health care systems are already under significant pressure. Policies should be designed to support workforce growth and stability, not undermine it.”
Willis also expects the reclassification to aggravate the state’s glaring shortage of primary care providers, as nurses need an advanced degree to serve in this role.
And outside of the health system, reduced access to advanced degrees means that universities will struggle to hire nursing educators, Willis said. In 2023, the American Association of Colleges of Nursing found nearly 2,000 full-time faculty vacancies across U.S. nursing schools with advanced programs, with another 103 new positions needed to meet student demand.
That same year, the association also found that U.S. nursing schools rejected 65,766 qualified applicants from advanced programs due to a lack of faculty and resources.
And with just over 17% of registered nurses holding an advanced degree, Willis said, resources were scarce to begin with.
“Nursing is the nation’s largest health care profession,” Willis said, with registered nurses providing essential health services such as diagnosing and treating illnesses; prescribing medication; and creating complex plans of care. “It’s very shortsighted to think about declassifying it as professional.”
The decision has also sparked backlash from labor groups.
In a statement, Service Employees International Union District 1199 New England, which represents almost 4,000 health care workers in Rhode Island, called the reclassification “deeply offensive to every caregiver who has committed their life to healing and protecting our communities,” with troubling impacts on public perception.
“This federal decision to strip nursing of its ‘professional’ designation threatens to undermine public trust, reduce access to financial aid, and make it even harder to recruit and retain the workforce our states desperately need,” the organization said.
