Recent efforts to pump up interest in the nursing profession may finally be paying off, although not enough to alleviate all concerns about an ongoing nursing shortage exacerbated by an aging labor pool.
Nearly 66,200 registered nurses in their early to mid-30s joined the U.S. healthcare work force in 2003, helping boost RN employment to 2.2 million, up 6% from 2002, researchers reported in the Nov. 17 online edition of Health Affairs.
Overall, employers hired an additional 118,700 RNs in 2003. The increase, paired with the addition of 85,900 full-time nurses in 2002, marks the largest two-year growth in nursing employment since 1983, the first year authors collected data. Nearly six out of 10 RNs who joined the labor force since 2001 were age 50 or older, and a steady growth of foreign-born nurses-about 66,000 during the two-year span-contributed to the gain in 2003.
Peter Buerhaus, senior associate dean of research at Vanderbilt University's School of Nursing, who co-authored the study, said the historic increase reflects private- and public-sector efforts to promote nursing and boost access to higher education. However, it is not enough to alleviate the nation's chronic shortage of RNs. "Don't relax," Buerhaus cautioned. "Take a deep breath and get back at it."
Minneapolis-based Fairview Health Services, which employs 3,136 RNs, has seen its vacancies drop recently, said Laura Beeth, Fairview's director of talent management. That doesn't mean the seven-hospital system, which has 145 RN job openings, has relaxed its recruiting and retention efforts. "We are still working hard, if not harder, than we have been," she said in anticipation of an ongoing demand fueled by an aging population.
Minnesota needs an additional 2,000 nurses to meet current demand, said Beeth, who is chairwoman of the Minnesota State Colleges & Universities Health Education Industry Partnership. By 2008, the state shortage is projected to reach 8,000. The industry partnership will seek $6 million to boost MnSCU nursing program capacity by 500 students in 2005.
Health experts caution that an aging population will only exacerbate the problem in coming years, despite some signs that demand for RNs is relaxing. Minnesota, Florida and Arizona, among others, have reported a drop in nurse vacancy rates, according to the American Association of Colleges of Nursing (Sept. 6, p. 14).
Small and midsize hospitals and healthcare providers reported a drop in the time needed to fill vacant RN jobs from 2001 to 2003, according to a report released by the American Society for Healthcare Human Resources Administration. The median number of days it took for healthcare providers with fewer than 1,000 workers to hire an RN fell by about 18%, to 45 days in 2003. Providers with 1,000 to 2,499 employees experienced similar relief: The median number of days needed to recruit RNs at midsize organizations fell from 60 to 49.
And though interest in nursing careers may be on the rise, schools are reporting too few faculty and not enough clinical sites to keep up with demand. U.S. baccalaureate programs turned away nearly 16,000 qualified applicants in 2003, the AACN said. Educators say a coming wave of faculty retirements will create further difficulties. The average age of faculty with a Ph.D. was 53 in 2002 and 49 for faculty with a master's degree, according to the AACN.
The National League for Nursing, a professional faculty association, reports applications to RN diploma, associate's degree and bachelor's degree programs jumped from 190,000 in 2002 to 248,000 in 2003 as the percentage of those accepted fell from 46% to 41%, said Kathy Kaufman, a league research specialist.
Colleges and universities searching to expand faculty face a highly competitive market for RNs with master's degrees who can command significantly higher salaries from hospitals and health systems, said the league's chief program officer, Terry Valiga.
Nursing faculty reported earning an average annual salary of $52,000 in 2004, according to an informal, self-reported online and mail-in survey by the journal Nursing2004. That's less than the average yearly salaries reported by advanced practice nurses, $72,400; nurse administrators, $67,100; nurse case managers, $56,700; and charge nurses, $54,700. Nearly 1,480 nurses responded to the survey, which was conducted from January to March and was published in October; 1% of respondents were faculty.
In 2003, the AACN reported a similar gap between academic and clinical nursing jobs and cited schools' lower pay as one reason for the shortage in nursing faculty. A nurse with a master's degree earned an average of $60,357 as a professor in 2003, $20,000 less than a nurse with identical education working in an emergency room, according to data compiled by the AACN from salary surveys.
Three-fourths of nurses younger than age 35 who entered the labor market in 2003 held two-year associate's degrees, according to the Health Affairs study, which may be a reflection of increased capacity in associate's degree nursing programs, Buerhaus said.
Two forces continued to lure nurses into the healthcare workforce, Buerhaus said. Nurses' wages rose for a second year as the overall job market soured. Wages rose 1.8% in 2003, according to the authors' estimate, an increase, though less than 2002's estimated 4.9% increase. Unemployment rose slightly also, from an average of 5.8% in 2002 to 6% in 2003.