Nurses Are NOT Optional
The Department of Education's Reclassification Is a Direct Threat to America’s Health
Over the last 72 hours, something seismic has shifted in healthcare and it’s not being covered loudly enough.
Nurses, physical therapists, social workers, educators, and allied health professionals have been stripped of their “professional degree” status under the new “One Big Beautiful Bill Act.”
This decision quietly tucked into a sweeping overhaul of federal spending and student loan programs is not just bureaucratic language. It’s an earthquake. It slashes federal loan access. It disqualifies entire fields from the borrowing levels they need to complete graduate education and it directly threatens the stability of the U.S. healthcare system.
As a doctoral-prepared clinician, as an educator, and as someone who has mentored hundreds of healthcare providers let me be clear:
This is an attack on America’s healthcare workforce.
And every patient in this country will feel the consequences.
A wave of anger and alarm has swept across the medical and academic community after the Trump administration moved to exclude nursing and many allied health fields from the federal definition of a “professional degree.”
Under the new rules:
Grad PLUS loans are eliminated entirely.
“Professional degree” programs may borrow up to $200,000.
All other graduate degrees are capped at $100,000.
Nursing, PT, social work, education, and many women-dominated fields have been reclassified as “not professional.”
This instantly prices out tens of thousands of aspiring nurses and advanced practice providers.
It also guts the pipeline of future nurse educators the very people who train the next generation.
Nursing organizations have not minced words:
“This threatens the very foundation of patient care.”
— American Nurses Association (ANA)
ANA President Dr. Jennifer Mensik Kennedy told NewsNation:
“We are short tens of thousands of nurses and advanced practice nurses already. This is going to stop nurses from going to school to be teachers for other nurses.”
The AACN (American Association of Colleges of Nursing) issued its own warning:
“Excluding nursing from the definition of professional degree programs disregards decades of progress … and would be devastating to the nation’s already strained nursing workforce.”
National Nurses United was even more blunt:
“If the Trump administration truly wanted to support nurses, it would be expanding education opportunities, not stripping them away.”
Nursing School Can Cost $211,390. But Now Students Can Only Borrow $100,000
According to NurseJournal, a four-year BSN can cost:
$89,560 – $211,390
including tuition, fees, and housing.
With Grad PLUS loans eliminated and nursing kicked out of the “professional” category, future nurses simply cannot borrow enough to complete their degrees.
Meanwhile, nurses earn an average of $45/hour, per the Bureau of Labor Statistics.
And at the same time, Trump’s bill includes over $1.5 trillion in tax cuts, largely benefiting the wealthiest 5%, according to the Center for American Progress.
You don’t need a political science degree to understand the priorities here.
Women-Dominated Fields Hit the Hardest
Nursing is not alone. Other fields reclassified as “non-professional” include:
Physician assistants
Physical therapists
Educators
Social workers
Audiologists
Architects
Accountants
Many of these fields are majority-women.
Meanwhile, the following degrees remain eligible for full $200,000 loan access:
Medicine
Dentistry
Law
Pharmacy
Optometry
Veterinary medicine
Osteopathic medicine
Chiropractic
Theology
Clinical psychology
The inclusion of theology ignited immediate criticism.
Kentucky Senate candidate Amy McGrath asked:
“Can someone explain how a theologian is considered more ‘professional’ than a nurse practitioner?”
And she followed with the truth many are afraid to say out loud:
“This is a way to quietly push women out of professional careers.”
Implementation Begins July 1, 2026 and the Healthcare System Is Not Ready
Universities and students are being given almost no time to prepare before funding collapses.
Nursing schools warn:
fewer students will enroll
fewer nurses will graduate
fewer educators will exist to train future cohorts
burnout will accelerate
shortages will deepen
patient care will suffer
This is not a minor shift.
This is the potential collapse of the U.S. nursing workforce.
What This Means for Us and Why I Refuse to Stay Silent
I’ve worked bedside.
I’ve worked in trauma-informed care.
I run a practice in hormone health and sexual medicine.
I teach. I mentor. I precept. I advocate.
And I know one thing deep in my bones:
Nurses are not accessories. Nurses are not “help.” Nurses are not optional.
Nurses ARE professionals and the entire American healthcare system depends on us.
To redefine us out of professional status is not just disrespectful.
It is deadly.
It undermines patient safety.
It pushes women out of healthcare at a time when maternal mortality is rising.
It prices out future nurse practitioners, nurse midwives, nurse educators, and bedside nurses.
It destabilizes rural care.
It widens inequities.
It hurts veterans, seniors, and families.
And it will take decades to recover from.
The Education Department Calls Concerns “Fake News”
Instead of responding to the legitimate alarm, the administration dismissed nursing organizations as “crying wolf” because universities “lost their unlimited tuition ride.”
This is gaslighting at a national level.
When the people who are TRULY keeping the system alive nurses, PAs, PTs, teachers, social workers express fear, you listen.
You don’t mock them.
This Is Bigger Than Politics. This Is About America’s Health.
This is not a Republican issue.
This is not a Democrat issue.
This is a human issue.
Every American every parent, every child, every aging loved one, every person living with chronic illness depends on the nursing workforce.
To gut our education pipeline is to gut the future of American healthcare.
I will not stay silent while that happens.
What You Can Do Right Now
1. Share this Substack.
Awareness is power.
Silence is complicity.
2. Contact your representatives.
Go to https://www.commoncause.org/find-your-representative/?source=adwords&gad_source=1&gad_campaignid=1494728290&gbraid=0AAAAADyMmbw8Jch4lku5fHZqnQP_46VQc&gclid=Cj0KCQiAoZDJBhC0ARIsAERP-F_kviekJmvwdJIUnD5oCfNd55sjYTEVkBDlb8Nb4sCm5rw7n2VGROMaAnzmEALw_wcB (nonpartisan).
Tell them:
“Reverse the reclassification. Protect America’s healthcare workforce.”—this is also in my linktree on my instagram @drquailenp
3. Support and uplift nurses & allied health professionals.
We need solidarity, not division.
4. Demand healthcare leaders speak up.
Hospitals, universities, and professional associations MUST take a stand.
We Are the Heartbeat of Healthcare and We Are Not Going Anywhere
Nurses ARE professionals.
PAs ARE professionals.
PTs, educators, social workers all professionals.
Highly trained. Highly skilled. Essential.
This reclassification will not define us.
But it will damage the country if we let it stand.
And let me say this clearly:
I am not speaking in fear.
I am speaking in solidarity, in advocacy, and in truth.
Because when the health of America is at stake?
We speak up.
We stand together.
And we fight back.