June 12, 2009

Economy impacting nurse shortage: study

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Peter Buerhaus, Ph.D.

Economy impacting nurse shortage: study

The U.S. recession may temporarily end an 11-year nursing shortage in many areas of the country, according to a study by Vanderbilt's Peter Buerhaus, Ph.D., R.N., and colleagues in today's issue of Health Affairs.

However, this may only be a temporary respite for the nation's health care system, as the study also projected a nursing shortage of 260,000 registered nurses developing by 2025 — twice as large as any nursing shortage experienced since Medicare and Medicaid were introduced in the mid-1960s.

According to the study, during the current recession, hospital employment of full-time equivalent registered nurses increased by 8.6 percent, well above the 5.3 percent average increase during the previous four economic bust periods starting with the 1981 recession. In 2007-2008, registered nurse employment in hospitals increased by an estimated 18 percent — the largest two-year increase in 30 years.

The impact of the recession reversed a two-decade trend in which the total share of registered nurses employed in hospitals was decreasing. According to last year's study, 64 percent of registered nurses were employed in hospitals, up from 60 percent in 2006.

The drop in employment of registered nurses among non-hospital settings amounted to 50,000 full-time positions in 2008 and was attributed to factors such as higher earning, more generous fringe benefits and the 12-hour shifts commonly offered by hospitals.

“The increase of hospital employment of nearly 250,000 RNs in such a short period of time is stunning,” said Buerhaus, director of the Center for Interdisciplinary Health Workforce Studies in the Vanderbilt Institute for Medicine and Public Health.

“We were surprised by the magnitude and by the shift from non-hospital settings into the hospital. This surge in employment will ease, if not end, the hospital nursing shortage.

“However, relief is likely to be temporary, and we need to focus on how the current workforce is changing and the implications for future imbalances in the nurse labor market in the years ahead,” he added.

According to the study, the current recession induced older nurses to delay retirement or re-enter the workforce. Since 70 percent of registered nurses are married, many had little choice as spouses' lost their jobs or feared they might.

However, between 2001 and 2008, the fastest growing age group in professional nursing was registered nurses over the age of 50.

The study projects another nursing shortage, one that will be larger than any experienced in the past.

Since registered nurses over age 50 will soon be the largest age group in the nursing workforce, their retirement over the next decade will lead to a projected shortfall developing by 2018 and growing to approximately 260,000 registered nurses by 2025.

Although most of the nurse labor market increases in recent years has come from older registered nurses, the number of younger registered nurses entering the workforce increased by 130,000 full-time nurses in 2008, reversing a two-decade-long decrease in this age group.

“This is very encouraging and suggests that all the effort to promote the nursing profession over the past several years is beginning to pay off,” Buerhaus said.

“We must find ways to sustain and strengthen this trend, otherwise it will be very difficult to replace all those retiring baby boom R.N.s and prevent the long-term shortage that we expect will develop during the latter part of the next decade.”