Why can’t nursing schools meet the growing demand for nurses?

So why can’t schools accept more students?

The problem is that Massachusetts’ nursing training programs — which graduated around 5,000 students in 2020 — cannot easily scale up to meet the demand. While state regulations limit the pace at which schools can grow, and relaxing those rules may be worth considering, the biggest barriers are a lack of faculty and of the clinical placements required for training.

Senate President Karen Spilka’s proposal to offer free tuition to nursing students at community colleges would diversify the applicant pool and give lower-income students an easier entrée. Helping students graduate community college without debt is a valuable goal, especially since nurses with associate’s degrees often are relegated to lower-paying nursing jobs unless they continue their education. The proposed $20 million includes money for schools to provide student support services, which could help retain students.

But Spilka’s proposal is only a small step toward increasing the number of trained nurses. Doing that on a broader scale will require increasing the availability of faculty and clinical placements.

The challenges with attracting faculty are nurses generally enter the profession because they want to do patient care and the salaries for practicing nurses are far higher than salaries for nursing educators, especially at public colleges.

“Each time I earned a degree, my salary went down,” said Judith Pare, director of nursing education at the Massachusetts Nurses Association and a clinical nursing professor at University of Massachusetts Boston.

Teachers are generally required to have a master’s degree or be working toward one — and those are also the nurses able to command the highest clinical salaries. The skills learned with a master’s are important to teach a classroom curriculum. But the Board of Registration in Nursing could grant more flexibility to allow nurses without a master’s to work as clinical instructors in a hospital or lab. Previously, experienced nurses with a bachelor’s degree were able to obtain a waiver to teach clinically, but recent rule changes made that more difficult.

There is also a need for money to incentivize people to get a master’s degree and become nursing educators.

Money to increase salaries at public colleges and offer student loan forgiveness to nursing instructors could help recruit and retain teachers. The US Department of Labor recently gave the MGH Institute of Health Professions a $5.8 million, five-year grant to pay tuition for 224 nurses who want to earn advanced degrees and become nurse educators. A state grant program to schools or a scholarship program to nurses could similarly help working nurses return to school. Some states offer tax credits to nurses who work as clinical instructors.

Another problem is finding hospitals willing to teach nursing students. Unlike the system for physicians, where medical schools partner with academic medical centers and doctors train medical students as part of their job, no such partnership exists for nursing. Instead, nursing schools pay clinical instructors, then partner hospitals let in those instructors with small groups of students. Although the state offers a centralized placement system, many school officials report having trouble finding hospital placements. Some hospitals charge for placements, which can burden a public college’s finances or raise costs for students.

That problem also stems from workforce struggles. Regis College President Antoinette Hays said her nursing students have run into particular challenges with their senior year requirement that they work one-on-one alongside a hospital nurse. “Hospitals have limitations on how many students they can absorb,” Hays said. “They have nursing shortages, nurses are overworked.”

That creates a catch-22. “The fewer the nurses, the fewer the clinical opportunities, the fewer the opportunities, the fewer new nurses we can produce,” said Amanda Choflet, assistant dean at Northeastern University’s Bouve College of Health Sciences’ School of Nursing.

Some nursing schools have created simulation labs so students can get a virtual clinical experience and put in fewer hospital hours, but that is not equivalent to in-person work. Schools are placing students at community health centers and clinics.

Hospitals and nursing schools, along with state policy makers, should consider innovative solutions to alleviate this bottleneck. This could mean paying hospital nurses to do education as part of their job, or establishing partnerships between particular schools and hospitals, with money so hospitals can employ dedicated nursing educators. It is not novel for public funds to support medical education — the federal Medicare program pays for doctors’ residencies.

Endicott College developed a unique model with Beverly Hospital and Addison Gilbert Hospital where Endicott undergraduates work as nursing assistants at the hospitals, providing labor and a pipeline where students can do clinical placements and often find a post-graduation job.

There are new nursing schools opening. Massachusetts College of Liberal Arts, a public college in North Adams, is opening a nursing school this fall. Several schools have started offering accelerated nursing programs to help certain populations — like students switching careers or majors — complete school more quickly.

But without the ability to hire more faculty and find more hospital placements, expanding the number of trained nurses will be nearly impossible.

Correction: An earlier version of this editorial misstated the job description of Endicott College students working at Beverly Hospital and Addison Gilbert Hospital. They are working as nursing assistants.

Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.