MESA, Ariz. — Inside a simulation lab at Pima Medical Institute’s Tucson campus, students move through staged scenarios that mirror a busy hospital floor: drawing blood, hanging IV fluids and monitoring high-fidelity manikins that mimic real patients. The exercises are designed to compress foundational clinical training into an intensive schedule so graduates are ready to step into patient care in significantly less time than traditional four-year tracks. A Pima Medical Institute nursing student works with airway tubing on a training mannequin during a simulation lab — part of the college’s accelerated program preparing nurses to enter patient care quickly.
Statewide demand for registered nurses has surged to levels health workforce analysts warn are unprecedented: Arizona is projected to face a shortage of about 28,100 registered nurses as early as 2025, a gap the National Center for Health Workforce Analysis says is the largest in the nation. Hospital units that once operated with one nurse for every five patients are increasingly pushed to one-to-seven ratios and overnight shifts that stretch to one-to-eight. Jennifer Morelli, nursing program director at Pima Medical Institute’s Tucson campus and a PMI alumna, described the strain on care delivery: “Every hour, nurses are supposed to be laying eyes on their patient. The hard part is it's hard to give quality care when you have eight patients at a time that you're trying to see.” Medical-surgical floors, which handle a wide range of pre- and post-surgical needs, have been among the hardest hit by staffing pressures and burnout.
Pima Medical Institute offers an Associate Degree in Nursing program that can be completed in 22 months — roughly half the time of a traditional four-year degree — and lists a total program cost of about $54,000, a figure that includes tuition, registration, textbooks and uniforms. Many hospitals in the Valley provide tuition reimbursement of up to $5,000 per year, a benefit Morelli said lets graduates begin repaying education expenses while they earn nursing wages from day one. “In two years, they can be making nursing wages, they can be at bedside, they can start working in the field,” Morelli said. She added that graduates often continue their education with employer support after entering the workforce.
The Tucson campus currently enrolls 140 students in the nursing program, and the school reports strong outcomes that its leaders say validate the accelerated model. Nearly 97% of Tucson campus graduates passed the NCLEX-RN licensure exam on their first attempt in the most recently reported data, and more than 94% of graduates were placed into nursing jobs after completing the program. Retention has remained above 85% in each of the past six reported years, reflecting sustained student persistence through the program’s rigorous curriculum.
Coursework is structured so students build clinical competencies in sequence: finger sticks during the first semester, venipuncture in the second, and intravenous placement and fluid management before clinical rotations shift from long-term care into acute care settings. Morelli pushed back on criticism that an accelerated associate degree produces less-prepared nurses: “With the associate degree, we're making them into a novice nurse,” she said. “They're learning the foundation of their skills, the foundation of knowledge. An ADN nurse is not any less, they're learning the skills to get in there and to start.” The program’s clinical and lab experiences aim to create a foundation that students can expand through on-the-job learning and further education.
Many students combine work and study as they progress through the program. Fifth-semester student Yasmine Urcadez works overnight shifts in a Tucson emergency department as a unit clerk while completing coursework, a role that exposes her to hospital operations, shift rhythms, patient diagnoses and transfer decisions. Urcadez started as a medical assistant through Pima Medical Institute before enrolling in the nursing program, using each credential as a step along a career pathway. “Being in the ED hospital setting, it's very, very good to understand what the shifts look like, what the nurses do,” she said. She also witnesses staffing shortfalls firsthand: “We have a lot of shifts where we are, unfortunately, a little bit short-staffed. Burnout is ridiculously high.” Urcadez said she frequently encourages others to consider nursing if they have compassion and empathy and want to help people.
Classmate Paolina Aguirre, 22 and due to graduate in August, said she chose the accelerated program after applying to a traditional four-year university and deciding she wanted to begin clinical work sooner. “It's two years, it's going to be really hard, but I can do it,” Aguirre said. “I'd rather get started now than later so I can make that change I wanted to.” Her motivation has personal roots: a past hospitalization and time spent with a grandmother in hospice shaped her view of care and bedside conduct. “I had a phenomenal nurse who treated me more like a human than a patient,” Aguirre said. “I think it's really important to treat patients more like people rather than just a diagnosis or a room number.”
Training at the school extends beyond hands-on bedside skills. Students use a digital charting platform called DocuCare that mirrors hospital electronic health records, creating patient charts, documenting head-to-toe assessments and logging medications and lab results for faculty review. Simulation labs require teamwork: groups of three students have 20 minutes to assess and manage a mock patient, and by the fifth semester simulations elevate the challenge to two simultaneous patients so students must triage and prioritize care. “We want to teach them priority,” Morelli said. “Do I need to take care of my patient with pneumonia, or do I need to go to the person with the chest tube? Which one is more urgent?” She added that success is measured not only by graduation rates but by the professional growth students demonstrate: “I tell them on orientation day: you are not a nurse right now. Our goal is to push you and grow you so you can become the nurse you want to be. The goal is that the last day of the program, you are not the same person sitting in front of me at orientation day.”
The shortage extends beyond hospitals. National health advocacy groups estimate that one in three students nationwide lacks access to a full-time school nurse, and Arizona has no state law requiring schools to employ one. Pima Medical Institute said it works with local school districts to place interested students in preceptorships with school nurses so they can complete required clinical hours in that setting. The program’s mix of accelerated classroom instruction, simulation, digital charting practice and clinical placements is aimed at moving graduates into a workforce that state analysts say will need tens of thousands more nurses in the near term. This story was made possible through grant funding from the Arizona Local News Foundation’s Arizona Community Collaborative Fund.