Is there a national nursing shortage? That question has been much-debated recently, and it’s one Minnesota Public Radio introduced to us last summer and we followed up on with a state-by-state look at the supply and demand of registered nurses.
Now, nearly a year later, we’ve decided to revisit the complicated topic after seeing stories continue to crop up in big-time media outlets, such as NPR, about the struggles new nursing grads are having to find jobs.
“Nursing degrees have long been touted as the golden tickets to immediate employment,” NPR’s Ashley Gross reported. “But recent nursing graduates … are coming into an unexpectedly tight job market.”
NPR’s piece from earlier this month does a nice job outlining why gauging the supply and demand of RNs is so tricky. There are an estimated 2.6 million RNs in the workforce — making it in the fifth-largest occupation in the US. RN employment has jumped 22% nationally since 2001, and nurses are paid far more handsomely — median wage: $30.39 — than workers in other similarly large occupations (e.g., retail salespersons, cashiers, office clerks).
Yet there are reasons to temper the enthusiasm. Among them …
1. Year-over-year job growth for RNs has slowed from nearly 3% in 2002 to a projected 1.3% in 2011 — still higher than the growth rate for all other occupations nationally, but it’s leveling off nonetheless.
2. EMSI’s most recent estimates for RNs through 2011 show a major revision in employment at the national level. Our first of four major data updates for 2011 showed RN jobs would grow by 72,383 in 2010-11 — but the latest estimates in our second update, derived from the most recent data from the BLS, indicate the new job growth will be just over 33,000. That’s a decrease in national estimates of nearly 40,000 new jobs for RNs.
3. We’re seeing other evidence at the state and local level of a slowdown in the RN market. The employment rate for bachelor-level RNs in Minnesota, to use just one example, dropped from 98% in 2008 to 91.1% the next year while job vacancies are still lagging after the recession.
Meanwhile, the output of RN graduates and those who pass the national nursing licensure exam, the NCLEX-RN, continues to go up. Here is a graphic from Paul Tosto of MPR that shows the number of people who have passed the NCLEX-RN since 1995.
Notice the steady dip in exam passers in the late 1990s and the huge increase of licensed RNs since the early 2000s. (There’s also been an influx of international students passing the exam).
Last year our rudimentary analysis showed all but two states were oversupplying the job market with RNs. Shortly after we released our data, nursing experts, educators, workforce development professionals — and nurses themselves — weighed in.
The most formal response to our analysis came from the Tri-Council for Nursing, a group of four national nursing organizations that raised questions about EMSI’s data sources and methodology. Its rebuttal read in part:
Given the fluctuations in the economy, no one can accurately project how long the nation will take to recover and exactly when old workforce patterns may re-emerge. In the short term, the changing characteristics of employment options for new nurses is causing frustration to many new graduates who expected a different occupational outlook from what currently exists in many places. However, we know that the Baby Boomers are entering their retirement years and their demand for care is escalating, the nursing workforce is aging rapidly, and healthcare reform will soon provide subsidies for 32 million citizens to more fully utilize the healthcare system. At the same time, we know that health care was the only sector of the economy to maintain steady growth since the recession was first identified in December 2007 and that the Bureau of Labor Statistics has identified Registered Nursing as the top profession in terms of projected growth through 2018.
Since our initial post, we’ve learned more and more about the complexities of analyzing RNs from a labor market perspective. Several of the points raised by the Tri-Council are no doubt valid. For instance, our source for the supply of nurses was the IPEDS database from the National Center for Education Statistics, which estimates completers by program at all education levels.
A more accurate barometer happens to be passing rates of the NCLEX-RN, which we highlighted above and will continue to highlight in subsequent posts. We’ll also look at the issue with a more regional lens, examine how RNs in urban areas are faring compared to rural regions, and present some the key nuances to keep in mind when doing this analysis for your area.
As always, if you have any questions or feedback, email Josh Wright or leave a comment below. We’d love to hear your thoughts.
Illustration by Mark Beauchamp.