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
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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
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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
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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 |
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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
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