Focusing on

1

• Focusing on
• South Dakotas Nursing Workforce

Gaining Traction on the Slippery Slope of the
Nursing Shortage
Linda Young South Dakota Center for Nursing
Workforce
2
Focusing on South Dakotas Nursing Supply

• SUPPLY
• What are characteristics of SDs current
  workforce projections of future supply
• DEMAND
• What are present future expectations for
  industry hiring and employment trends in SD
• TRENDS
• What are the trends in SDs demographics, public
  health status that are driving the need for
  nursing services

3
Projected Supply, Demand, and Shortages of RNs

• Health Resources and Service Administration,
  Bureau of Health Professions National Center for
  Health Workforce Analysis
• Federal agency responsible for information and
  analysis related to supply and demand of nurses
• Quadrennial National Sample Survey of Registered
  Nurses

4
South Dakotas Present Reality

• RN Supply

10,881
5
South Dakotas Present Reality

• LPN Supply

2183
6
2005
7
2010
8
2015
9
2020
10
Projected RN FTE Demand South Dakota
Source The Nursing Demand Model Development
and Baseline Projections, Final Report, September
2004 Bureau of Health Professions, HRSA
11
Factors Driving Increased Demand for Nurses

• 18 increase in population
• Larger proportion of elderly persons
• Medical advances that heighten the need for nurses

12
Driving Forces

• Declining number of nursing school graduates
• Aging of the RN workforce
• Declines in relative earnings
• Emergence of alternative job opportunities

13
Decline of New NursingExam Writers

• Based on number of first time candidates on
  National Licensing exam for nurses, about 71,000
  RNs graduated from US nursing programs.

• This number continues to decline
• 1999 76,300
• 1998 83,000

14
Implications

• Associate degree grads are declining at a faster
  rate than baccalaureate grads
• Baccalaureate grads comprise greater share of
  total graduates
• Shift has effected the growth in supply of nurses
• Increased length of time needed for the RN
  student to enter the workforce

15
Shortage SolutionChange in Output from Nursing
Programs

• To meet projected growth in demand for RN
  services
• US must graduate approximately 90 more nurses
  from US nursing programs
• Nursing supply model includes an annual migration
  of 3500 foreign educated nurses

16
the South Dakota Story on Supply

• 2002 Legislature Expanded Enrollment in public
  nursing programs

BON, DOL, and BOR developed a formula to
project the number of RN grads needed annually to
meet the demand for nurses through 2008
Projected that SD needs 535-587 new grads
annually Additional numbers needed annually
135-187
17
NCSBN Graduate Projection StudyActual Graduation
NumbersProjection 535-587 Grads Annually
18
SD Nursing Education Programs Capacity

• USD reported receiving 134 qualified applicants
  who were denied admission due to space /capacity
  during 2004
• SDSU reported receiving 145 qualified applicants
  who were denied admission due to space /capacity
  during 2004

Private schools did not deny admission to any
qualified applicants in 2004 several had room
to take more applicants
19
SD Registered Nursing Education Programs
Percentage of New RN Graduates Prepared October
1, 2003 to September 30, 2004
20
Associate Degree Programs
47
21
Baccalaureate Degree Programs
53
22
SD LPN Programs
23
GRADUATES 1995-2004
24
2005 Preliminary NCLEX ResultsJanuary 1, 2005
September 6, 2005IN-STATE WRITERS ONLY
25
Driving Force Decline in Relative Earnings

• Real earnings amount available after adjusting
  for inflation - have been flat since 1991
• Actual earnings have increased
• No increase in purchasing power for RNs
• Elementary school teachers in 2000 earned an
  average of 13,600 more than nurses
• Wage growth for nurses occur early in career

26
Implications

• Potential for increased earnings diminishes over
  time

Nurses may be motivated to leave patient care for
additional education or other careers
NSM assumes that each 1 increase in wages
increases number of RN graduates by 0.8 and
increases FTE activity rates by 0.3
27
Shortage SolutionWages

• A continuous 3 annual increase in RN wages will
  still result in a shortfall of 100,000 FTE RNs,
  but would prevent the shortage from growing more
  severe
• RN hourly earnings increased nearly 7 on average
  between 2002 and 2003 (Robinson and Mee 2003)

28
Change in RN WagesShort Term Benefits

• Licensed RNs not practicing return to nursing
• Part-time RNs work more hours
• RNs delay retirement or
• Leave retirement

29
Change in RN WagesLong Term Benefits

• Attract new entrants to the nursing workforce

Constraints on nursing school capacity will
impact how many new entrants can be accepted
30
Driving Force Aging of the RN Workforce

• Decline in number of nursing school graduates
• Higher average age of graduating classes
• Aging of existing pool of licensed nurses
• Accelerated retirement rate for older RNs
• Currently one half million licensed nurses not
  employed in nursing

31
Average Age of South Dakota Licensee
Average Age
Source IFMC Sep 27 2005
32
South Dakotas Present Reality

• Age of Licensed RNs

2005
2002
1999
33
Why is Age Important?

• Workforce participation
• Cross-state migration
• Retirement patterns
• Vary systematically by education level and age

34
South Dakota Migration Pattern

• Nursing Licenses Issued

Source IFMC Sep 27 2005
35
Shortage SolutionChange in RN Retirement Patterns

• Delaying retirement by an average of four years
  would increase the FTE RN supply by nearly
  158,000 (9) by 2020

36
South Dakotas Present Reality

• Race ? Ethnicity ? Gender
• of SD RNs to US and SD population

Source U.S. Census Bureau, 2000 data Findings
from the National Sample Survey of Registered
Nurses, March 2000, Division of Nursing, Bureau
of Health Professions, HRSA, USDHHS