The pandemic took a toll on the nursing profession, resulting in shortages across the nation and especially Texas, ranked the second-hardest-hit state.

In addition to needing more nurses, ethnic diversity in the nursing profession is a growing concern as the nation's demographics change.

Kenya Beard, associate provost for social mission and academic excellence at Chamberlain University, said a diverse workforce can result in greater patient choice, communication, and ultimately, satisfaction.

"Sometimes, we make assumptions based on our life experiences that can interrupt the patient's ability to achieve their highest level of health," Beard acknowledged. "Having a diverse workforce and a diverse student body can mitigate some of those problems."

The nursing shortage has left Texas with 10 nurses per 1,000 people, according to the publication Nurse Journal. Chamberlain has three colleges of nursing in Texas.

Dr. Anita L. Harris-Brown, director of clinical support operations for Texas Children's Hospital, has introduced programs focused on diversity, equity and inclusion. Pregnant at 16, Harris-Brown initially did not expect her life's trajectory to include helping others on their career paths.

She said the compassion shown by her doctors and nurses led her to a nursing degree and a doctorate from Chamberlain University to improve health equity. She is now focused on developing more racially diverse nursing leadership, starting with the basics.

"Job descriptions to make sure we are taking out language that can perceive racism, and to identify words that put our families and our patients in this 'racism box,' " Harris-Brown outlined.

Health outcomes sometimes depend on whether a provider looks like you and understands your challenges, according to Harris-Brown, who added more minority nurses could help the health of an individual, group of people, or population.

"Now what it's doing, because of our nurse shortage, it is really putting the diversity on a front to say, 'Our nurses are not meeting our patients, so patients aren't feeling comfortable to ask a question,' " Harris-Brown noted.

She stressed a high priority for the nursing profession is attracting students from underrepresented groups, specifically men and people from African American, Hispanic, Asian, American Indian, and Alaskan Native backgrounds.

Students are still struggling with learning loss from the COVID-19 pandemic.

A study from the research group NWEA showed 2022 test scores are not rebounding to the same level as they were pre-pandemic.

In New York, math scores declined sharply throughout the state, according to the Empire Center for Public Policy.

Researchers said the issue goes beyond test scores. The study also found existing education inequities were amplified by the pandemic.

Elisa Villanueva Beard, CEO of Teach for America, said the learning loss is also the result of numerous issues coming to a head. She described it as trains on a collision course.

"On one train, we have children who are not well, both from a learning perspective and also from an overall wellness perspective," Villanueva Beard observed. "On another train, we have a teacher crisis happening where teachers are being asked to do more with less."

Villanueva Beard argued another issue is having an outmoded system which could not meet the moment. Some solutions she thinks will get kids back on track are hiring and retaining good teachers, and providing students with equitable learning opportunities, but noted a lack of innovation within the current education system could be a challenge.

Students have been facing problems with mental illness, due in part to the pandemic. According to data from the Centers for Disease Control and Prevention, 44% of students felt persistently sad or hopeless during the first two years of the pandemic.

Villanueva Beard is concerned it will affect children in the long term.

"We are living in a society where uncertainty is the only guarantee," Villanueva Beard asserted. "Our children actually need to be able to be creative, have very clear skills around reading and math computational thinking."

She added a community approach must be taken to ensure kids fully recover from the pandemic, in terms of social emotional health and educational skills.

Like other states, South Dakota has a program allowing high school students to take courses offered at universities and technical colleges. Now, there is a legislative plan to help ensure younger students get a chance to participate and get a head start on a career path.

Under South Dakota's dual-credit program, juniors and seniors can apply for state aid to defer the costs of courses like auto-body welding or accounting.

Rep. Kameron Nelson, D-Sioux Falls, has introduced a bill to expand aid to tenth graders. He said expenses for courses can be a barrier, and thinks students also deserve a chance to start collecting credits if they have a career in mind.

"A sophomore might be able to start this dual-credit program, collect credits by the time that they graduate from high school, receive and earn their associate's degree," Nelson explained.

He noted it could especially help in health care-related fields. It is projected South Dakota will need at least 14% more registered nurses to meet demand in the years ahead. Nelson's bill is seeing bipartisan support, in terms of sponsors, but no hearings have been scheduled.

Nelson acknowledged at the start, enrollment for sophomores would likely be lower than for other grade levels, but he noted the additional costs are forecast at around $900,000 if there's strong demand. He is convinced it would be a worthwhile investment for the state.

"Anytime we can invest in our young people to become more educated, I will always back that," Nelson emphasized.

South Dakota has a budget surplus of more than $400 million, but some leaders, including Gov. Kristi Noem, have a range of other ideas to put the money to use, including tax cuts.

Advocates for higher education in the Commonwealth will gather today to collaborate on how to use revenue generated by the Fair Share Amendment which has officially been signed into law.

Voters approved the creation of a surtax on million-dollar incomes to help pay for public education, but lawmakers must still guarantee how the money will be used.

Femi Stoltz, Massachusetts policy director for the nonprofit uAspire, said she hopes the funding will help lower costs for tuition and fees at state colleges, which have increased nearly 60% in the past two decades.

"This new funding revenue hopefully gives us the chance to be innovative, think outside the box and hopefully think of better ways to serve students," Stoltz stated.

Stoltz pointed out the cost of public college has risen faster here than in any other state, while the average student borrower in Massachusetts is burdened with nearly $32,000 in federal student loans.

The UMass system currently holds some $3 billion in debt itself, and at Mass State Colleges, it is more than $1 billion. It is estimated students pay more than $2,500 in annual fees just to help cover their school's debt.

Stoltz noted the MassGrant system, the state's largest need-based grant for students, is also grossly underfunded, leaving disadvantaged students with few pathways to earn a debt-free degree.

"That grant a couple decades ago used to cover about 80% of a student's tuition and fees at a public school, and now it covers about 8% of tuition and fees for a student in the UMass system," Stoltz explained.

Stoltz and other higher education advocates said Fair Share revenue could also go toward repairs of campus infrastructure, fair and equitable pay for all faculty and staff, and more hiring of desperately needed student counselors.

In one of the country's wealthiest states, Stoltz argued, there should be ample resources to ensure all students get the education they deserve.

Support for this reporting was provided by Lumina Foundation.