What do I need to know about the nursing shortage? Those in, or thinking about joining, the nursing profession frequently wonder about job stability. Perhaps you’ve heard talk of a looming healthcare crisis as the American population ages. What does this mean for you? Currently, nursing is the largest health profession in the United States. A sufficient supply of nurses is crucial to any healthcare system. The Bureau of Labor Statistics estimates, from 2014 to 2024, employment of registered nurses will grow 16 percent and employment of nurse practitioners, nurse midwives and nurse anesthetists will grow 31 percent. The Nursing Shortage Shortages have occurred in healthcare throughout history. The 1990s saw a substantial slowing in employment growth, decreased earnings, declining enrollments in nursing schools and two separate hospital nursing shortages. The most recent nursing shortage is easing in certain regions due to the increase in total full-time equivalent (FTE) RN employment from 2 million in 2001 to 2.35 million in 2007. The looming nursing shortage is considered both a supply and a demand shortage. By 2020, a deficit in the number of nurses, relative to their expected demand, will increase to an estimated 285,000 FTE RNs (almost 3 times larger than any deficit experienced in the U.S. over the last 50 years). The United States Registered Nurse Workforce Report Card and Shortage Forecast published by the American Journal of Medical Quality projected 48 states would experience nursing shortages by 2030 and an overall shortage of 923,629 RNs. Researchers have reached conflicting conclusions regarding their projections about the nursing workforce and an impending nursing shortage. While most conclude there will be a nursing shortage on the national level, the Health Resources and Services Administration (HRSA) projected the RN supply between 2012 and 2025 will outpace the demand. Despite this anticipated excess of RNs at the national level, variation is expected at the state level with sixteen states experiencing shortages as their supply of RNs is outpaced by increases in demand. Ten of these states are in the West, four are in the South, and two are in the Northeast. Factors Contributing to Nursing Shortage Experts point to a wide range of factors impacting the impending nursing shortage including:
- An aging nursing workforce. The recent recession prompted many nurses to reenter the workforce but many of these nurses were older RNs. With approximately 1 million nurses currently over 50 years of age, one-third of the today’s nursing workforce will reach retirement age within 10 to 15 years. It’s estimated that 700,000 nurses will retire or leave the labor force by 2024.
- Overall growth in the demand for health care services. This demand will primarily result from the aging baby-boom population. By 2030, one in five Americans will be age 65 and older. In general, senior citizens require more complex medical care. Large numbers of newly insured patients resulting from federal health insurance reform, greater access to primary care and an emphasis on preventive care will also add to this increased demand for services.
- Higher hospital census and greater acuity. Acuity has been rapidly rising in hospitals, with only the sickest patients requiring hospitalization. This has been due to a declining average length of stay and technologies that allow for rapid assessment, treatment and discharge. Hospitals are taking on the appearance of large intensive care units with most patients receiving specialized treatment.
- Lower baccalaureate enrollment and a diminishing supply of new nursing students. In 2000, entry-level BSN enrollment fell 2.1%, dropping for the sixth year in a row. Every year since 2001, nursing education programs have had to turn away thousands of qualified applicants due to faculty shortages, limited classroom space, and lack of clinical education sites.
How Will the Shortage Impact Employment? In coming years, you can expect to see an abundance of job opportunities in the field of nursing fueled by the need to replace workers who retire and because of a greater number of people with access to healthcare services. Some organizations are offering large sign-on bonuses and impressive salaries for key specialties in an attempt to recruit nursing staff. Nurses will be in high demand if they can lead multidisciplinary teams, serve as patient educators and managers of care or demonstrate a high level of skill in a specialty unit. The number of new nurse graduates entering the labor market has increased from approximately 68,000 individuals in 2001 to more than 150,000 in 2013. As a result, some regions of the country have seen stiffer competition for jobs. Sigma Theta Tau International Honor Society of Nursing (STTI) recommends nurses of all educational levels pursue higher education. Nurses who have obtained a Bachelor of Science degree (BSN) will have better job prospects than those nurses with an associate degree. A nurse may also opt to obtain advanced clinical education and training to become an Advanced Practice Nurse (APN). APNs typically have a master's degree, although some complete doctoral-level training. They can perform many of the same tasks as physicians and serve the public as a source for primary healthcare. Job opportunities for APRNs will likely be excellent in the coming years. APRNs will be in high demand, especially in medically underserved areas. The nurse shortage will be due to the aging population in some states, but in other states it will be due to the consequence of limited numbers of nurse-education opportunities. Nurses tend to stay in the same markets where they are educated. When there are fewer schools in a region, fewer nurses are available for employment there. Online RN-BSN programs are a great choice for associate level nurses looking to improve their job prospects. Online MSN programs are also available for those interested in an advanced degree. Online programs are designed to fit into a nurse’s already busy schedule and students can participate from home without relocating for school. While no one is certain to what extent the potential nursing shortage will impact the country in the coming years, you will be well positioned for professional opportunities if you choose to obtain a RN-BSN or a MSN degree.