By Jennifer Decker Arevalo, MA, contributor
Jan. 15, 2010 - A study published last summer in Health Affairs found that the recession may have temporarily ended an 11-year-long nursing shortage in many areas of the country. Similarly, 27 percent of hospital CEOs recently surveyed on workforce issues indicated that the nursing shortage has improved in the past six months. But as we enter the third year of this economic downturn, will vacancy rates continue to drop, or will 2010 be the year that nursing shortages return to previous levels--or even higher?
Several health care workforce experts indicate that the U.S. nursing shortage will return once the economy improves, but whether these economic improvements will occur in 2010 or beyond remains uncertain.
"The nursing shortage has not ended and there are still many healthcare organizations with open positions to be filled," said Debianne Peterman, Ph.D., director of nursing education and development and assistant clinical professor at Vanderbilt University Medical Center (VUMC) in Tennessee. "We still need to prepare for the future and be careful not to get lulled into complacency because we have experienced staffing rosters that have remained robust this year."
At one point the nursing shortage was projected to grow to 285,000 nurses in 2020, according to a research team led by Peter Buerhaus, Ph.D., from the Center for Interdisciplinary Health Workforce Studies Institute for Medicine and Public Health at VUMC, and published in their 2008 book, The Future of the Nursing Workforce in the United States. Some experts were projecting an even higher demand for RNs in the years ahead. While a recent bump in nursing employment and the tightening job market due to the recession have caused a reduction in these estimates, the looming shortage is still of major concern.
"All projections point to the significant outflow of RN and LPN supply that is about to hit us as baby boomers retire," said Susan Skillman, MS, deputy director for the Center for Health Workforce Studies and Rural Health Research Center at the University of Washington in Seattle. "Remember that today's workforce still includes most of the baby boomers, but they are going to begin hitting retirement age in the next couple of years."
This is one of many reasons why the U.S. Bureau of Labor Statistics (BLS) reported in 2007 that registered nursing will have the largest growth rate (23.5 percent) of all occupations between 2006 and 2016--about 587,000 new jobs. In December 2009, the BLS projected that from 2008 to 2018 the health care sector will add approximately 4 million positions--600,000 will be for RN positions, with about 106,500 of these new jobs in physician offices and 274,000 in hospitals.
While the jobs may be forthcoming, filling them will be challenging.
Even though vacancy rates for registered nurses appear to have improved dramatically over the past several years, from 10.4 percent reported in 2006 (Journal of the American Medical Association) to 8.1 percent in 2007 (American Hospital Association) to 6 percent in a 2009 hospital CEO survey conducted by AMN Healthcare, this trend is likely to reverse once the economy rebounds. Buerhaus projects a 40 percent RN vacancy rate nationwide by 2025.
In today's tough economy, many retired nurses have returned to work and those contemplating retirement are keeping their jobs to maintain household income. Some hospitals have instituted hiring freezes and reduced services, releasing some experienced nurses back into the applicant pool.
"Nurses who worked part-time or per diem have taken full-time positions or increased their hours during the downturn," said Peterman. "Many of these nurses will reduce their hours again once the economy improves."
These developments, however, are not adding new nurses into the workforce to fill the RN positions that are being created.
"Nursing schools must continue to educate nurses," said Peterman. "We will soon be entering into a critical nursing faculty shortage which will perpetuate a growing problem that we have had across the nation; one in which nursing schools have had to turn away qualified applicants because they did not have enough faculty to support the number of students wanting to enroll."
Faculty vacancies have dropped this year, as fewer faculty members are retiring, and many schools are facing budget cuts and hiring freezes. The American Association of Colleges of Nursing (AACN) reports that the nurse faculty vacancy rate in 2009 was 6.6 percent, down from 7.6 percent in 2008.
"Though AACN is pleased to see a lower faculty vacancy rate this year, we fully expect the shortage of nurse educators to re-emerge when the U.S. economy rallies and faculty retirement patterns resume," said AACN President Fay Raines in a statement. "Over the next 15 years, workforce analysts project that the nation's nursing shortage will grow twice as large as any shortage experienced in this country since the mid-1960s, and this will no doubt impact the supply of nurse faculty."
Although the stimulus bill does provide funding for health care professionals, "it is still too early to tell if it will impact nurse staffing levels in 2010," said an American Hospital Association (AHA) spokesperson. "However, solutions to workforce problems are a vital component of any true health care reform package."
In early January, the American Organization of Nurse Executives, a subsidiary of AHA, recommended that congressional leaders keep certain nursing-related provisions in the final healthcare reform bill, including expanding the nursing workforce and improving representation on a proposed National Healthcare Workforce Commission.
"There is a great deal of discussion around the bill because, if certain programs receive increased funding, then there will be more nurses needed to provide increased services," said Peterman.
For more information:
Healthcare Workforce
HRSA Health Professions
Health Workforce Information Center
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