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Nursing Shortage Fact Sheet

CONTACT:
Robert Rosseter, (202) 463-6930, x231
rrosseter@aacn.nche.edu

The United States is in the midst of a nursing shortage that is projected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that the pipeline of new nurses is shrinking with enrollments at nursing colleges and universities now in a six-year decline.

The American Association of Colleges of Nursing (AACN) is concerned about the nursing shortage and is working with member schools, policy makers, kindred organizations, and the media to bring attention to this health care crisis. AACN is directing its efforts toward enacting legislation, identifying strategies, and forming collaborations to address the nursing shortage.

To keep AACN members, the media, and other stakeholders abreast of current statistics related to the shortage, this fact sheet has been developed and will be updated on a regular basis. A companion Web resource has also been created.


Current and Projected Shortage Indicators

  • According to American Hospital Association's June 2001 TrendWatch, 126,000 nurses are currently needed to fill vacancies at our nation's hospitals. Today, fully 75% of all hospital personnel vacancies are for nurses. www.aha.org

  • According to a study by Dr. Peter Buerhaus and colleagues published in the Journal of the American Medical Association (June 14, 2000), the U.S. will experience a 20% shortage in the number of nurses needed in the U.S. health care system by the year 2020. This translates into a shortage of more than 400,000 RNs nationwide. http://jama.ama-assn.org

  • According to the National Council of State Boards of Nursing, the number of first-time, U.S. educated nursing school graduates who sat for the NCLEX®-RN®, the national licensure examination for all entry-level registered nurses, decreased by 28.7% from 1995-2001. A total of 27,679 fewer students in this category of test takers sat for the exam in 2001 as compared with 1995. www.ncsbn.org
Number of Candidates Taking the NCLEX®-RN® Exam
First-Time, U.S. Educated Candidates Only
Program 1995 1996 1997 1998 1999
2000
2001
Diploma 7,335 6,346 5,240 3,978 3,161
2,679
2,310
Baccalaureate 31,195 32,278 31,828 30,142 28,107
26,048
24,832
Associates 57,908 55,554 52,396 49,045 45,255
42,665
41,567
Total 96,438 94,178 89,464 83,165 76,523
71,392
68,759
  • According to the latest projections from the U.S. Bureau of Labor Statistics published in the November 2001 Monthly Labor Review, more than one million new nurses will be needed by the year 2010. The U.S. Department of Labor projects a 21 percent increase in the need for nurses nationwide from 1998 to 2008, compared with a 14 percent increase for all other occupations. www.bls.gov

Contributing Factors Impacting the Nursing Shortage

Schools of nursing are reporting a decline in enrollment and graduations which translates into fewer nurses in the educational pipeline.

According to the fall 2001 survey by the American Association of Colleges of Nursing, enrollment in generic (entry-level) baccalaureate programs in nursing increased by 3.7% nationwide since last year, ending a six-year period of decline. Despite this slight increase, enrollments in all programs are still down 17% or 21,126 students from 1995. On average over the last five years, the number of enrollees and graduates from generic programs declined by 1,567 and 1,420 each year, respectively. The 1997-2001 cohort contains 358 schools that reported data every year for each of the past five years. www.aacn.nche.edu

A shortage of nursing school faculty is restricting nursing program enrollments.

  • According to a survey by the American Association of Colleges of Nursing, 2000-2001 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, more than a third (38.8%) of schools who responded pointed to faculty shortages as a reason for not accepting all qualified applicants into entry-level baccalaureate programs. www.aacn.nche.edu

  • According to a study released by the Southern Regional Board of Education (SREB) in February 2002, a serious shortage of nursing faculty was documented in 16 SREB states and the District of Columbia. Survey findings show that the combination of faculty vacancies (432) and newly budgeted positions (350) points to a 12% shortfall in the number of nurse educators needed. Unfilled faculty positions, resignations, projected retirements, and the shortage of students being prepared for the faculty role pose a threat to the nursing education workforce over the next five years. www.sreb.org

With fewer new nurses entering the profession, the average age of the RN is climbing.

  • According to the latest National Sample Survey of Registered Nurses, the average age of the working registered nurse population was 43.3 in March 2000, up from 42.3 in 1996. The RN population under the age of 30 dropped from 25.1% of the nursing population in 1980 to 9.1% in 2000. http://bhpr.hrsa.gov/dn/dn.htm

  • According to a July 2001 report released by the Government Accounting Office, Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors (GAO-01-944), 40% of all RNs will be older than age 50 by the year 2010. www.gao.gov
The total population of registered nurses is growing at the slowest rate in 20 years.

According to the preliminary findings of The National Sample Survey of Registered Nurses released in February 2001 by the Division of Nursing within the Bureau of Health Professions, the total RN population has increased at every 4-year interval in which the survey has been taken since 1980. Although the total RN population increased from 2,558,874 in 1996 to 2,696,540 in 2000, it was the lowest increase (5.4%) reported in the previous national surveys. Of the total RN population in 2000, an estimated 58.5% work full-time in nursing, 23.2% work part-time, and 18.3% are not employed in nursing. http://bhpr.hrsa.gov/dn/dn.htm

High nurse turnover and vacancy rates are affecting access to health care.

  • According to a February 2002 report on health workforce shortages prepared by First Consulting Group for the American Hospital Association and other trade groups, the average nurse vacancy rate in U.S. hospitals was 13%. Over one in seven hospitals reported a severe RN vacancy rate of more than 20%. High vacancy rates were measured across rural and urban settings and in all regions of the country. Survey respondents indicated that a shortage of personnel is contributing to emergency department overcrowding and ambulance diversions. www.aha.org

  • According to the report Acute Care Hospital Survey of RN Vacancies and Turnover Rates in 2000 released in January 2002 by the American Organization of Nurse Executives, the average RN turnover rate in acute care hospitals was 21.3%. The average nurse vacancy rate was measured at 10.2% with the highest rates found in critical care units (14.6%) and medical-surgical care (14.1%). Nurse executives surveyed indicated that staffing shortages are contributing to emergency department overcrowding (51%) and the need to close beds (25%). www.aone.org

Job burnout and dissatisfaction are driving nurses to leave the profession.

  • According to a study published by Dr. Linda Aiken and colleagues in the May/June 2001 issue of Health Affairs, more than 40% of nurses working in hospitals reported being dissatisfied with their jobs. The study indicates that 1 out of every 3 hospital nurses under the age of 30 are planning to leave their current job in the next year. www.healthaffairs.org

  • According to a study commissioned by the Federation of Nurses and Health Professionals in April 2001, The Nurse Shortage: Perspectives from Current Direct Care Nurses and Former Direct Care Nurses, currently 1 out of every 5 nurses currently working is considering leaving the patient care field for reasons other than retirement within the next five years. www.aft.org/fnhp/publications/index.html

Changing demographics signal a need for more nurses to care for our aging population.

  • According to a July 2001 report released by the Government Accounting Office, Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors (GAO-01-944), "a serious shortage of nurses is expected in the future as demographic pressures influence both supply and demand. The future demand for nurses is expected to increase dramatically as the baby boomers reach their 60s, 70s, and beyond." www.gao.gov

  • According to a May 2001 report, Who Will Care for Each of Us?: America's Coming Health Care Crisis, released by the Nursing Institute at the University of Illinois College of Nursing, the ratio of potential caregivers to the people most likely to need care, the elderly population, will decrease by 40% between 2010 and 2030. Demographic changes may limit access to health care unless the number of nurses and other caregivers grows in proportion to the rising elderly population. www.kaisernetwork.org/healthcast/nursing/may01.

The nursing community and other stakeholders are working together to identify strategies to address the shortage.

  • The Call to the Profession is a group of top leaders from national nursing organizations who are working together to ensure safe, quality nursing care for consumers and a sufficient supply of registered nurses to deliver that care. The group is currently working on an action plan called Nursing's Agenda for the Future. www.ana.org

  • The TriCouncil for Nursing, an alliance of four autonomous nursing organizations (AACN, ANA, AONE, NLN) each focused on leadership for education, practice and research, issued a joint policy statement in January 2001 on Strategies to Reverse the New Nursing Shortage. www.aacn.nche.edu/Publications/positions/tricshortage.htm

  • The Nurse Reinvestment Act (HR 3487 and S 1864), legislation introduced to address the nursing shortage, was passed by Congress in December 2001 and is now in conference committee. Current provisions provide funding for a fast-track faculty scholarship program, student loan repayment program, grants for internships and residencies, and public service announcements. www.aacn.nche.edu/Media/shortageresource.htm#legislation

  • In April 2001, a coalition of 23 national nursing organizations issued a joint call to Congress to stem the nursing shortage. The group released a comprehensive plan to address the shortage entitled Assuring Quality Health Care for the United States: Supporting Nurse Education and Training that outlined funding priorities and called for new initiatives to recruit and retain nurses. www.aacn.nche.edu/Media/NewsReleases/consensus.pdf

  • Two national media campaigns have been launched recently to help polish the image of nursing. Nurses for A Healthier Tomorrow is a coalition of 35 nursing and health care organizations working together to raise interest in nursing careers among middle and high school students. The coalition has conducted nationwide focus groups with students ages 6-15 years; secured over $600,000 in sponsorship, launched a Web site; created a televised public service announcement, and designed print ads that can be downloaded for free from the Web. In February 2002, Johnson & Johnson launched the Campaign for Nursing's Future, a multimedia initiative to promote careers in nursing that includes paid television commercials, a recruitment video, a Web site, and brochures mailed to schools across the country. www.nursesource.org and www.discovernursing.com