This feature on the predicted nursing shortage is the latest entry in our 2020 Vision series. With the 2020 Vision title, we stress the importance of anticipating issues that will impact professional practice in the year 2020 and beyond. This report highlights supply-and-demand issues that will impact all professions in the years ahead. It is adapted from the full report presented to the Board of Regents.

Educators, legislators, researchers, regulators, employers, and professionals agree: current signs and a powerful mix of factors point to an imminent shortage of nurses unlike any we have seen before. This report provides an orientation to the problem, describes how this shortage is different from past shortages, details the contributing factors, and suggests that collaboration is essential to ensure the quality delivery of health services.

The Supply of Nurses

According to a recent national survey, there are currently over 2.6 million registered professional nurses (RNs) in the United States, an increase of 5.4% since 1996. This is the lowest increase reported since these surveys were first conducted. Just over 2.2 million RNs are employed in nursing; of those, about 1.5 million or (71%) are practicing full time. This year, the National Sample Survey of Registered Nurses projected that 2.6 million full-time practicing RNs will be needed nationally by the year 2005.

New York State mirrors this national trend. The number of LPNs registered to practice increased by only 6% between 1997 and 1999 (to over 74,000), and it has since dropped by 7% in the past two years. The number of registered RNs has grown slowly by 5% between 1997 and 2001 (to 234,820). Overall, the total number of nurses registered to practice in New York State (LPNs and RNs) grew by just over 3% between 1997 and 2001, reaching its peak in 1999.

Among the nine states within the New England and Middle Atlantic regions, New York ranks next to last in the number of RNs employed per 100,000 people (Source: National Sample Survey of Registered Nurses). The state with the highest ratio, Massachusetts, was also the first to declare a statewide nursing crisis. By 2005, projections indicate that the demand for RNs in New York will exceed supply by over 17,000 nurses. By 2015, that gap is expected to almost double.

While the total supply of nurses is currently adequate in some parts of the State, we are already seeing an uneven distribution of the existing nurse supply. Some practice settings are experiencing a shortage now, including hospital emergency departments, critical care units, and peri-operative units (units associated with pre-surgery, surgery and recovery). These settings are the most physically demanding and require the highest level of specialized education and experience.    continue