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April 10, 2014Rapid job growth in nursing and a pending tsunami in nurse retirements will create a need for more than 1 million new registered nurses (RNs) for the 10-year period ending in 2022, according to the US Bureau of Labor Statistics (BLS) new Employment Projections for 2012-2022. Through 2022, the healthcare and social assistance sector is now projected to grow at an annual rate of 2.6%, adding 5 million jobs and accounting for nearly one-third of the total projected increase in jobs. By 2022, total employment of RNs and advanced practice registered nurses (APRNs) will increase by 574,400 jobs. The BLS also projected that 555,100 RNs and APRNs would retire or otherwise leave the labor force during that time — the tsunami at hand.
The large number of retirements is due in part to a historical confluence of events from the 1970s. The Comprehensive Health Manpower Training Act of 1971 substantially increased the availability of funds for nurse training in the mid-1970s. (Title VIII funds for nurse education would not exceed the 1973 levels until 2009.) At the same time, the “Women’s Lib” movement was increasing the number of then nontraditional occupations accessible to educated women, drawing large numbers of women away from applying to nursing schools in the late 1970s. Those who had already headed down that path were unlikely to have changed course, but the changes in the pipeline would not have become evident for another 5 to 7 years. The result was a supercohort of RNs who entered the profession from 1978 to 1987, in their first jobs after becoming a registered nurse. On each side of that decade there were substantially fewer young nurses in the profession.
The BLS separately projected job needs resulting from expansion of demand and from retirements (and other reasons for leaving the profession). They are presented in the Table.
Table. BLS-Selected Employment Projections and Replacement Needs
| Change, 2012-2022 (in thousands) | |||
|---|---|---|---|
| Occupational Category | Increased New Jobs | Replacement Needs | Total Openings |
| RNs | 526.8 | 525.7 | 1052.6 |
| Nurse anesthetists | 8.8 | 6.8 | 15.6 |
| Nurse midwives | 1.7 | 1.2 | 2.9 |
| Nurse practitioners | 37.1 | 21.4 | 58.5 |
| RNs and APRNs | 574.4 | 555.1 | 1129.6 |
| Nursing instructors and teachers, postsecondary | 24.0 | 10.2 | 34.2 |
Source: US Department of Labor, Bureau of Labor Statistics
Because of the retirements, the projected number of RNs needed to fully staff all of the various healthcare sectors is virtually double the number of jobs needed to cope with the expanded demand for services. The nation will need to produce 1.13 million new RNs to fill jobs for both the demand expansion and the required replacements. Similarly, nursing colleges will need to recruit an additional 34,200 new faculty members, a 35.4% increase. Furthermore, the nursing colleges need to raise compensation levels to attract more new faculty members who are doctorally prepared RNs and APRNs. With respect to hospitals and other health industry employers, replacing retiring RNs will be a major fact of life through 2030. With improved and continuing Title VIII funding and successful nurse faculty recruitment, the nursing colleges may be able to produce sufficient new RNs to fill both the expansion and replacement slots, but the loss of the experience of retiring nurses will not be recouped overnight.
What Should We Do Now?
There is also some chance that these retirement estimates are too low. However, even if the BLS projections of retirements are reasonably accurate, several issues must be addressed to avoid the return of a catastrophic nurse shortage:
• On an inflation-adjusted basis, current Title VIII funding is 74% less than that provided in 1973. Title VIII funding must be increased and maintained over time to keep pace with — if not to exceed — inflation.
• In 2012, the average annual salary of a nurse faculty member was $68,640 compared with averages of more than $91,000 for nurse practitioners and certified nurse-midwives. Nursing colleges must increase faculty compensation to APRN levels to attract the doctorally prepared and other qualified instructors needed for educating tomorrow’s RNs. Additional clinical placements must also be secured.
• Hospitals should reverse course and begin again to hire new RNs with opportunities for them to gain experience so that those hospitals can grow their own experienced nurses over the next few years. All health sector employers need to plan a long-term strategy that starts today for developing and retaining a stable, loyal, and home-grown, increasingly experienced RN staff.
Source: Medscape
