The long-predicted nursing shortage may have been averted, according to Vanderbilt professor Peter Buerhaus.
Buerhaus, one of the nation’s leading experts on nursing labor supply, spoke at a recent healthcare workforce summit in Grapevine sponsored by Irving-based AMN Healthcare.
There are a significant number of people in their 30s entering nursing, aided by the growth in the number of institutions offering nursing programs and accelerated degree programs, Buerhaus said. He also noted that there is a strong demand among young people. Privately funded campaigns that boosted the image of nursing and warnings of impending shortages should also be credited, he said.
The number of new registered nurse graduates has more than doubled in the past decade. Buerhaus said there has been a rapid growth in the number of programs offered by private, for-profit schools. He said fewer than 20 for-profit programs produced fewer than 400 graduates in 2002, compared with more than 200 programs graduating 19,000 in 2012.
The number of nurses earning bachelor’s degrees is now exceeding those earning two-year degrees, as well.
Nurses with bachelor’s and master’s degrees are more likely to receive a job offer upon graduation than any other field, according to the American Association of Colleges of Nursing. About two-thirds had offers at the time of graduation and about 90 percent were employed four to six months after graduation.
Despite the ample supply of nurses, Buerhaus warned that there are no accurate projections of future demand. Factors that will boost nursing demand include population growth and aging, increasing chronic disease, insurance expansion under the Affordable Care Act, quality and safety initiatives, and physician shortages. The healthcare workforce added 125,000 RNs in 2011 and 2012.
Buerhaus said the Midwest and South—including Texas—are experiencing the fastest per capita growth of RNs.
Baylor Scott & White has been swamped. In the past 12 months, it has received nearly 25,000 applications for about 4,000 openings, according to Rosemary Luquire, senior vice president and chief nursing officer.
Chris Loy, director of human resources for Methodist Richardson Medical Center, said the facility has received more than 14 applications for every posted nursing opening.
Other areas of the U.S. are less fortunate. The national nursing vacancy rate has increased from 5.5 percent in 2009 to 17 percent in 2013, according to an AMN Healthcare survey.
Luquire said it is too early to assess the impact of the Affordable Care Act on future nurse demand. She said she anticipates a greater need for nurses in specialty areas such as palliative care, hospice and home care, especially for those with bachelor’s and master’s degrees. She also anticipates shortages as baby boomer nurses reach retirement age.
Of the nation’s 2.4 million nurses, nearly one million are over age 50. Many who stayed in the workforce during the economic slowdown are expected to retire in the next decade. Buerhaus said he is hearing anecdotally that they are, in fact, leaving the workforce. He said such turnover is healthy because the lack of nursing jobs could discourage young people from pursuing RN degrees, which could be significant given that the U.S. cannot gauge the time and size of long-term labor supply.
Buerhaus urged healthcare facilities to have plans for both a rapid or slow exit of nurses over 50 years old in the near future. The challenge for nursing programs is to prepare students for a healthcare delivery system that is evolving toward coordinated care, greater teamwork and population-focused. He said educators and employers will need to find ways to engage nursing students and graduates knowing that they will be needed in the future but who may find it difficult to secure immediate employment.
Buerhaus said the demand for nurse practitioners will continue to be strong because of primary-care physician shortages. The U.S. is adding 6,000-7,000 NPs annually, he said, and there could be nearly 250,000 by the 2025.
Between 1990 and 2012, the number of physicians increased by 50 percent. Meanwhile, the number of NPs and physician assistants increased five-fold.
Penny Jensen, former president of the American Academy of Nurse Practitioners, said the number of NPs would equal the number of primary-care physicians by 2024.
Steve Jacob is editor-at-large of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at [email protected]