16 Modern Healthcare | August 19, 2019
How bad is the
nursing shortage?
The supply of nurses in the U.S. is looking up—but not
everywhere.
Employment for registered nurses is expected to grow
much faster than the average for all occupations through 2026,
according to the Bureau of Labor Statistics. The agency still
expects 203,800 job openings in the field each year, but it’s
likely these vacancies will be centralized in key areas of the
country, while others will experience steep competition for jobs.
Another government projection of supply and demand for
RNs suggests that, by 2030, there will be a surplus of 53,
full-time equivalents in Florida, compared with a shortage of
44,500 in California, according to a 2017 report from the Health
Resources and Services Administration.
“These projections highlight the inequitable distribution of
the nursing workforce across the United States, as recent
research shows that nursing workforce represents a greater
problem with distribution across states than magnitude at the
national level,” the report reads.
There’s also variation in the type of nurses most in-demand.
“It’s both regional, but also specialty within nursing,” said
Kendra McMillan, a senior policy adviser with the American
Nurses Association. “How many nurses do we have that are
going into labor and delivery, for example? How many nurses
do we have electing to go into the (intensive-care unit)?”
Pamela Ograbisz, a nurse practitioner and director of
telehealth for LocumTenens.com, an online job board
and staffing agency for advanced-practice clinicians,
said she’s noticed a high demand for specialty-trained
nurse practitioners, including psychiatric, cardiothoracic,
gastrointestinal and oncology nurse practitioners.
The shortage is a multifaceted problem.
Part of the issue is an aging workforce, as many who flocked
to the profession in the 1970s prepare to retire, according to an
article in the Journal of Nursing Regulation. Since 2012, roughly
60,000 RNs have exited the workforce each year, and some
1 million RNs are projected to retire between 2017 and 2030.
The population is also aging nationwide. By 2035, adults age
65 and older are expected to outnumber children, according to
estimates from the U.S. Census Bureau.
Many of those patients will have complex needs, possibly
sparking a higher demand for specialty nurses, said Simmy
King, nursing director for clinical information systems andprofessional development at Children’s National Health System
in Washington, D.C., and an American Organization for Nursing
Leadership board member.
And that’s not to mention an ongoing shortage of
instructors. More than 75,000 qualified applicants to bachelor
and graduate nursing programs were turned away last
year due to factors like insufficient faculty, clinical sites or
classroom space, as well as budget constraints, according
to the American Association of Colleges of Nursing. “There’s
not enough professors there to actually teach the next crop of
nurses,” Ograbisz said.
A few actions hospitals have taken to address these
challenges, according to McMillan, include setting up
residency programs to train nurses who are recent
graduates or are entering a new specialty, as well as
offering tuition reimbursement or loan repayment programs.
“We have to look at the whole picture,” she added, noting
these efforts can help with both recruitment and retention.
—Jessica Kim CohenFive states with the largest projected surplus
of RNs by 2030
Florida
Ohio
Virginia
New York
MissouriFive states with the largest projected shortage
of RNs by 2030
California
Texa s
New Jersey
S. Carolina
AlaskaSource: HHS, Health Resources and Services Administration, National
Center for Health Workforce Analysis, 2017. National and Regional
Supply and Demand Projections of the Nursing Workforce: 2014-2030.53,
49,
22,
18,
16,-5,-10,4 0 0-11,4 0 0-15,9 0 0-44,50,000 40,000 30,000 20,000 10,000 00 10,000 20,000 30,000 40,000 50,Which states will be hit
by nursing shortages?
Forty-three states and Washington, D.C., are projected to
experience a surplus of registered nurses by 2030, while
seven will experience shortages.volumes and events in the broader community, such as if
there’s a heavy flu season. “That helps us be tighter about
when we need nurses,” Feistritzer said. “If we’ve got a bunch
of (predicted) discharges on Thursday, but not so many on
Tuesday, perhaps we can shift our resources to be smart
about how we’re scheduling people.”
Scripps Health, which boasts only a 2.7% vacancy rate for
nursing roles, uses an electronic scheduling tool from Kro-nos. It’s planning to combine that system with nursing work-
load acuity data from the electronic health record so that
staffing managers can better forecast nursing demand, said
Shane Thielman, the San Diego-based health system’s inter-
im chief information officer.
Scripps uses these workload acuity tools to help make pa-
tient assignments for its clinical staff, taking into account fac-
tors like staff-to-patient ratios and where the patient is in the