Is there a nursing shortage? The Robert Wood Johnson Foundation predicts by the year 2020, the U.S. will face a shortage of 800,000 nurses.1
"Nurses retiring plays a very big part," explained Beverly Malone, PhD, RN, FAAN, CEO, National League for Nursing. As Malone explained, many nurses felt the need to hold onto their jobs during the recession of the aughts. "As the economy is getting better, nurses are thinking of retiring." Predictions from the Health Resources and Services Administration confirm her thinking. In the next 10 to 16 years, over 1 million more nurses will hit retirement age.2
As ADVANCE reported in January, it is not just bedside nurses who are aging out of the healthcare system. The average age of nurse educators is over 60, and naturally, they too are preparing for the next phase of their lives. Malone cites this "amazing faculty shortage" as contributing to the cycle of nursing shortage. With a lack of qualified faculty, clinical placements for students become very competitive. Malone claims tens of thousands of qualified nursing students are turned away each year, as there is not enough faculty to meet the growing demands.
Back to School
And demand continues to grow. Nursing school is a hot commodity. The American Association of Colleges of Nursing tells us in 2014, enrollment in BSN, MSN, and doctoral programs increased.3 There was a 4.2% increase in entry level BSN programs and a 10.4% growth in bridge RN-to-BSN programs. Those numbers are not surprising as more hospitals strive for Magnet status, which requires a certain percentage of nurses employed there to hold a minimum of a Bachelor's degree.
Yet with all these nurses in school, one questions whether there will be a shortage in the coming decade. The Bureau of Labor Statistics reports occupation of registered nurses-including both those with Associate's degrees and Bachelor's degrees- to grow 19% between 2012 and 2022.4
Once those new nurse grads get their diploma, it should be smooth sailing onto careers, right? There are thousands of new nurses with fresh, shiny BSNs and nursing licenses ready to fill the upcoming shortages, but they are sometimes denied the opportunity. A survey of healthcare human resources managers concluded two-fifths of those hiring nurses were only interested in those with experience.5 22% of HR managers were only interested in nurses with specialized training. Specialty certification tends to come after nursing school graduation, again leaving new nurses at a disadvantage when job searching.
As with any entry-level position, those fresh out of school are caught between the proverbial rock and hard place. They can't get hired without hands-on experience, but they can't get that experience without a job.
Go West, Young Nurse
To further complicate matters and frustrate those nurses who can't find work, the Health Resources and Services Administration, in its own research, predicts a nationwide surplus of over 340,000 nurses by the year 2020.6 They broke it down by region, and the West is the only area of the U.S. where a shortage is forecasted, with that area in need of approximately 64,000 registered nurses.
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Malone concurs that much of the predicted shortage is geographical. Nurses are in need across specialties and practice areas, but rural areas are desperate to take nurses, a theory that plays out when you look at the sparsely populated states where the government estimates a shortage. "Nurses tend to work where they are trained," explained Malone. "The idea of moving to look for work was not in the mentality of nursing." Newly minted nurses will need to reconcile the fact that where they got their education might not be where they are most needed. Adjusting that customary career path of nursing school, then employment in the same town or even the same hospital where a nurse was trained, will be a hurdle, but one Malone thinks is necessary to ensure the growth of the profession.
Beyond the specific geographic regions where nurses are needed, there is a shift in where they will be giving care. "The front doors of nursing are changing all the time," said Malone. Nurses used to be on the frontlines of care in just hospitals; now they are moving into the community in store-based clinics, home care, and other outlets. Nurses in the community keep people healthy and at home. With more older adults wanting to age-in-place, this transition to community-based care presents what Malone dubbed a "wonderful challenge."
Curbing the Tide
A two-pronged approach is needed to push back against the predicted shortage, according to Malone and the National League for Nursing. "We have to keep the nurses we have," she explained. "Once you become a nurse, you really want to give care." Often, nurses are tied up with administrative tasks that take away from patient care time and can cause stress and burnout. Electronic health records reduce physical paperwork and streamline processes, saving nurses precious time.
Simply keeping existing nurses will not stem the tide of upcoming retirements. Malone is partnering with the Johnson & Johnson Campaign for Nursing's Future which includes a revival of successful television spots from a few years ago to show the truth of nursing and all the roles nurses play in different settings. The upcoming advertising campaign will also highlight the contributions of minorities in nursing, including male nurses.
As Malone says, although nursing is better than other health professions at including minorities, it is still working on diversity and inclusion. The demographics of the country are changing and providers need to meet those patients' needs.
"Nursing is an open door," she said. Whether the profession will open that wide enough to accommodate the predicted upcoming exodus of nurses remains to be seen.
1.Johnson & Johnson. "Nursing Now." http://www.discovernursing.com/nursing-now#fact-3.
2. American Association of Colleges of Nursing. "Nursing Shortage" http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage.
3. American Association of Colleges of Nursing. "New AACN Data Confirm Enrollment Surge in Schools of Nursing" http://www.aacn.nche.edu/news/articles/2015/enrollment
4. Bureau of Labor Statistics. "Registered Nurses Job Outlook. http://www.bls.gov/ooh/healthcare/registered-nurses.htm%23tab-6
5. Tuten, Tera. "Five Reasons Why New Nurses Can't Find a Job. Soliant Health. http://blog.soliant.com/careers-in-healthcare/five-reasons-why-new-nurses-cant-find-a-job/
6. Health Resources and Services Administration. "The Future of the Nursing Workforce: National- and State-Level Projections,2012-2025."
Danielle Bullen is on staff at ADVANCE. Contact: firstname.lastname@example.org