Highlights of the Regents Report on the Nursing Shortage

In April 2001, the New York State Education Department presented a report to the Board of Regents on the impending nursing shortage in New York State. The health and well-being of over 18 million New Yorkers is dependent upon the State's nursing workforce. Yet, reports point to a nationwide nursing shortage that, if left unaddressed, will be more severe and longer in duration than those previously experienced.

The full-length report presented to the Board of Regents by the Education Department provides a detailed orientation to the problem and proposed solutions. It describes the shortage, explains how the shortage differs fundamentally from previous shortages, and defines the relationship between nursing education and the supply of nurses. A summary of recommendations to address the problem includes proposed strategies described in the literature currently being explored by the broad health care, education and regulatory community. This report also includes specific actions that the Board of Regents and others may consider in addressing the impending nurse shortage and its implications for the health care system as a whole.

The National Outlook

In 2001, a total of 2.7 million RNs are registered to practice in the United States. Of those, 1.6 million RNs are practicing full-time. By 2005, it is predicted that 2.6 million full-time practicing nurses will be needed. The need is expected to exceed the supply by over 1 million registered nurses. According to the Bureau of Labor Statistics, the need for RNs will grow faster than the average for all U.S. occupations through 2008.

New York State

In New York State, 303,732 RNs and LPNs are currently registered to practice. As nursing school enrollment continues to decline, by 2005, demand for RNs is expected to exceed supply by 17,000. By 2015, that gap may double.

It is estimated that there are approximately 843 registered nurses per 100,000 people in New York State. With 1,194 RNs per 100,000 people, Massachusetts was the first state to declare a nursing crisis.

Hospitals are already feeling the impact of the nursing shortage, primarily in acute care settings. Among the 260 hospitals in New York State, 92% have reported vacant RN positions and 71% are reporting vacant LPN positions. In New York City, 30% of 82 greater New York metropolitan area hospitals report taking over three months to fill vacated RN positions.

Factors Affecting the Shortage

The projected nursing shortage is inherently different from shortages of the past. Several distinct factors exacerbate this impending health care crisis.

1. Aging Work Force
   
   

   The nursing workforce is aging rapidly. In New York the average age of an RN is 46, while the average retirement age is 49. Today, fewer than 10% of practicing RNs are under 30 years old.

   
   
2. Under-representation of Minorities
   
   

   Only 13% of practicing RNs in March 2000 were from minority populations; compared to 28% of the general population.

   
   
3. More Career Opportunities for Women
   
   

   Nearly 95% of nursing professionals are women. However, in the 21st century, women have more career opportunities than ever before. Doors are wide open for women in economics, architecture, law, and other fields. Additionally, the current image of nursing as a career choice is not as appealing to young people as images and descriptions of other professions.

4. Inaccurate Projections of Need
   
   

   Previous inaccurate projections of need for nurses led to fewer nursing students; fewer faculty hired; consolidation and downsizing; and increased use of unlicensed personnel. Due to these factors, we are now faced with:

   • an unmet demand for nurses
   • nurses leaving the profession
   • smaller pools of potential students and less faculty
   
   
5. Workplace Environment
   
   

   55% of nurses surveyed nationwide by the American Nurses Association say they would not recommend nursing as a career for children and friends. 76% report an increased patient care load and 75% maintain that the quality of patient care has declined. Perceived downsides of nursing include:

   • Lack of respect for professional practice
   • Night and weekend shifts
   • Exposure to contagions
   • Less time for patient care
   • Higher patient to nurse ratio
   
   
6. Aging Population
   
   Nationwide, the population is aging. That means fewer young people entering the workplace and an increased aging population in need of health care. According to a recent report of the University of Illinois at Chicago, College of Nursing, Nursing Institute, between 2010 and 2030, as the U.S. population age 65 and older is projected to increase 7%, the population between the ages of 18-64 is predicted to decrease 6%.
   
   

   In New York State, as the total population is expected to increase 7% by 2020, the population over 65 is expected to climb 24%.

Impact: Impending Shortage

The combination of these multiple factors affecting the nursing workforce will have a profound impact on health care in New York State. Solutions are needed now!