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STEVE INSKEEP, HOST:

Now that the Supreme Court has upheld President Obama's Affordable Care Act, we can game out some consequences. The law should make it easier for people to get healthcare, and that in turn will likely lead to a greater demand for nurses. But it may be hard to train extra nurses. In the past year, more than 76,000 qualified applicants were turned away from nursing programs. Nursing schools did not have enough professors. Here's Sandy Hausman of Virginia Public Radio.

SANDY HAUSMAN, BYLINE: There have been lots of parties this year at the University of Virginia School of Nursing. So far, 11 professors have retired. That's one-fourth of the faculty, and Dean Dorrie Fontaine is in no mood to celebrate. She worries because the Affordable Care Act will boost demand for nurses.

DORRIE FONTAINE: There are 34 million people that are going to need health insurance. So I need faculty to teach the nurse practitioners that are going to take care of these uninsured.

HAUSMAN: Demand will also rise because nurses comprise the oldest workforce in the nation. Polly Bednash heads the American Association of Colleges of Nursing.

POLLY BEDNASH: We have nurses who are in their 70s who are working. And many of those individuals are working for a temporary period of time to get themselves through this financial crunch. And they are going to leave in droves, and are already leaving in some places where the economy is getting better.

HAUSMAN: Finding professors to teach new nurses will be difficult, because faculty members usually need a PhD. Of three million nurses in this country, less than 1 percent have their doctorate. Associate Professor Emily Drake says most nurses are ready to go with a two or four-year degree.

EMILY DRAKE: Nurses want to practice right away. After you finish your degree, it's just what we want to do is take care of patients.

HAUSMAN: Pay is also a problem. Nurses with a Master's degree and special training can be certified as nurse practitioners - paid $120,000 a year or more. After 10 years as a professor with a PhD, Drake earns about $75,000.

DRAKE: I talked to colleagues from around the country who are getting recruited to teach right now. I have a colleague who's a nurse administrator. She interviewed, she loved it. They loved her. They offered her the job. She said, Emily, when they called and offered a 50 percent pay cut, she said I just can't take it.

HAUSMAN: And it's about the money alone. By the time most nurses consider a PhD, Dean Fontaine says their lives are complicated.

FONTAINE: Nurses, when they have a Master's degree and could go back to school, often have mortgages and children if they're older. And so it is serious and worrisome. And the diversity pieces of it are worrisome, too. We want to have our faculty and students match the population we serve. So we do not have enough Hispanic nurses or faculty, as well as African-Americans and other minorities and men.

HAUSMAN: Men make up just 10 percent of the nursing workforce, and Fontaine hopes the field can draw more of them to join young women in getting PhDs and stepping into the classroom.

UNIDENTIFIED WOMAN: So if you have an infusion going, even if it's the same drug, that's our standard protocol that's changed that whole setup.

HAUSMAN: In the meantime, you might expect classes like this one, with just 26 students, to get bigger. But Professor Drake says that can't happen, because much of the training for nurses is hands on.

DRAKE: By law, for each additional 10 students we take, we need another clinical faculty member to supervise them in the hospital.

HAUSMAN: Nationwide, nearly 8 percent of nursing school jobs - about 1,200 - are vacant. So the American Association of Colleges of Nursing is lobbying for more state, federal and foundation money to train PhDs. And Polly Bednash says schools are looking for other ways to teach.

BEDNASH: Faculty are getting more and more creative about how they prepare students, how they bring in other clinicians to the educational experience - having pharmacists, for instance, be involved in teaching the pharmacotherapeutics.

HAUSMAN: They're also using technology - simulators and computer-based lessons - to supplement classroom and lab experience. And they're urging their most promising students to get the advanced degree before they acquire a family and a mortgage. For NPR News, I'm Sandy Hausman in Charlottesville, Virginia.

INSKEEP: Her story is part of a collaboration with NPR, Virginia Public Radio and Kaiser Health News.

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