The study, which used U.S. Census Bureau figures, found the nurse workforce rose as RNs hourly wages climbed4.3% in 2002 and 1.7% in 2003and overall unemployment increased. Wages and unemployment fell, as did the RN workforce, the following two years, the study said.
Demographic data suggest nurses may be sensitive to economic forcessluggish hiring, falling stocks, a troubled housing marketthat can shake consumer confidence or erode household income, said Peter Buerhaus, director of Vanderbilt Universitys Center for Interdisciplinary Health Workforce Studies. Nearly 70% of nurses are married and 45% are age 50 or older, Buerhaus and researchers reported in a separate analysis of nearly 1,400 nurses surveyed in 2006. Spouses job security during an economic downturn can influence nurses decision to return to the job market or work more hours, he said.
Still, an unpublished analysis of 2006 data shows employment gains of 75,700 RNs as hourly wages remained flat and unemployment continued to slide, he said. The shaky housing market and a 0.3% increase in wages among nurses working at hospitals, which employed 60% of nurses, or 1.35 million RNs, in 2006, may have contributed to the turnaround, he said. And foreign-born nurses made up half the employment gains in 2006, or 39,075 RNs, the figures show.
Foreign-born and older nurses contributed heavily to the rising number of employed RNs since 2002. Last year, there were roughly 40,100 fewer nurses age 35 to 49 in the workforce than in 2002. During the same period, the number of nurses age 21 to 34 increased by about 35,800. Thats compared with the more than 257,100 nurses age 50 and older who joined the labor market between 2002 and 2006. Buerhaus called such growth unsustainable as older workers retire and too few younger nurses enter the profession to take their place. The figures show little progress in efforts to close a widening gap between supply and demand for nurses, he said.
Nora Triola, chief nursing officer and senior vice president at 450-bed Holy Cross Hospital, in Ft. Lauderdale, Fla., said she has witnessed how economic forces can powerfully affect a nurse labor market. Holding onto Holy Cross nurses grew increasingly difficult as the housing market peaked and hurricanes drove insurance premiums higher in recent years, she said.
Sixty percent of nurses who left Holy Cross in 2006 reported moving elsewhere, up from 44% a year earlier and 28% in 2004, Triola said. The hospital, which employs 800 full- and part-time nurses, has a 12% RN vacancy rate that Triola is forced to fill partially with temporary nurses.
Executives also contend competitive pay isnt enough to keep nurses from moving on, or exiting the profession altogether. Dale Beatty, vice president of patient services and chief nursing officer for 412-bed Northwest Community Hospital, Arlington Heights, Ill., said sought-after nurses seek competitive pay and an attractive work environment. Without one or the other, recruits will likely exit quickly, he said.
More than 200 hospitals, including Holy Cross and Northwest Community Hospital, have earned recognition for their nursing workplace from the American Nurses Associations credentialing arm, which executives say is an edge in recruitment. Increasingly, hospitals hire and hang onto RNs with mentoring for recent graduates, flexible schedules, less physically demanding jobs for older nurses, greater professional autonomy and perks, including tuition reimbursement or incentives for professional advancement, executives said.
Northwest Community, which employs 1,300 full- and part-time RNs, has a vacancy rate of 1.5%, he said.
Andrea Beals, director of oncology for Trinity Regional Health System, in Rock Island, Ill., took advantage of her employers expanded retention efforts to return to school for a masters degree. Beals, a mother of three whose youngest is in sixth grade, earned her nursing diploma degree in 1978. She returned to school in 1996 and gradually earned a bachelors degree, finally graduating in 2004.
When Trinity offered generous tuition reimbursement, Beals returned to school for a masters in nursing administration, a choice she said gives her greater confidence on the job and greater professional opportunities in the future. Its so valuable, said Beals, who said she returned to school with an eye on eventually becoming a nursing professor. I have it for life.