The number of licensed nurses has been on the upswing, newly released federal figures show, which is welcome news for hospitals seeking relief from a shortage projected to worsen in coming years. Perhaps less welcome: The figures show wages rose, too, as did registered nurses average age.
Growth in the supply of nurses rebounded between 2000 and 2004 after a record slowdown the previous four years, HHS Bureau of Health Professions said in a final report summarizing the agencys eighth survey of the U.S. nursing workforce since 1980. The survey, conducted every four years, included roughly 35,700 RNs in 2004, and estimated the nations stock of the high-demand professionals rose 8% from 2000-04 to 2.9 million licensed RNs compared with 5.4% growth from 1996-2000.
Wages rose significantly, the report said, a potentially negative turn for a labor-intensive industry facing pressure from employers and lawmakers to control costs. Once adjusted for inflation, RNs wages climbed 14% from 2000-04 to $57,785, on average. Thats the largest inflation-adjusted salary increase since 1980, and a sharp departure from the 90s, when adjusted, or real, wages remained largely stagnant.
Nurses average age crept upward as well, a trend that reflects fewer young nurses entering the profession, the report said. The average age climbed more than one year to an estimated 46.8 years in 2004 from 45.2 years in 2000. The federal data include licensed RNs not employed in nursing or who are retired. A recently published study suggests an unanticipated shift into nursing among those in their late 20s and early 30s may be under way as the professions wages and job security attract more early-career professionals (Jan. 15, p. 10).
The numbers underscore the demographic and financial pressures facing hospitals as baby boomers age and a chronic nursing shortage persists. Policymakers and industry officials should not ease away from efforts to boost supply of the sought-after nurses, said Kathleen Sanford, senior vice president and chief nursing officer for Catholic Health Initiatives and past-president of the American Organization of Nurse Executives. The shortage is expected to worsen despite recent gains, Sanford said. We cant be shortsighted, she said.
Increasingly, industry officials see nurse vacancies as more than a strain on the budget. Federal estimates project a shortfall of 800,000 nurses by 2020. Researchers are investigating how nurse staffing levels affect the quality of care. The Joint Commission, the largest U.S. hospital accreditation organization, unveiled Feb. 20 a Robert Wood Johnson Foundation-funded two-year study of emerging nursing-specific measures of healthcare quality.
Sanford applauded the occupations reported growth in supply and wages. The latter reflects nurses importance within the healthcare industry, she said, a value not adequately reflected in payment from federal officials.
The nurse executives association, an affiliate of the American Hospital Association, lobbied the CMS in 2006 to adjust Medicare reimbursement to compensate hospitals for acutely ill patients who require highly skilled nurses or greater oversight from nursing staff. Sanford said such a change is necessary to offset hospitals investment in nursing to improve patient quality and safety.
Sanford said nurse executives within Catholic Health Initiatives, a 55-hospital system based in Denver, have reported lower vacancy rates in recent years, suggesting continued growth in the nursing workforce.
And the release of the figures, nearly 3 years old, raised the hackles of a prominent health workforce researcher. Peter Buerhaus, director of the Vanderbilt Universitys Center for Interdisciplinary Health Workforce Studies noted the lag between the survey and its release leaves policymakers without timely data needed to make crucial decisions.
The federal agency first published preliminary data on the 2004 nurse survey in December 2005. Its out of date, Buerhaus said. Given the importance of the registered nurse workforce, this is kind of a slap in the face.