Nursing shortage might not be as dire as feared

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Elizabeth Newman
Elizabeth Newman

For the past decade, healthcare experts, including those in long-term care, have been drumming the beat of a looming nursing shortage.

A new study in Medical Care, the journal of the American Public Health Association, indicates that while we need to continue to recruit future nurses, the shortage may not be as terrible as feared.

Montana State University nursing economists, working through a funded grant from the Gordon and Betty Moore Foundation, looked at a  cohort analysis of employment trends by birth year and age that were used to project age and employment of registered nurses through 2030. The goal was to compare this to the demand projected by the Health Resources and Services Agency. Researchers were looked at full-time employment of RNs in total, and by single year of age.

The conventional wisdom has been we expect baby boomer RNs to retire in large numbers. But research from the RAND Corporation last year found nurses are working 2.5 years longer after they turn 50 than RNs in previous decades. Older RNs, interestingly, are more likely to work outside of hospitals, which is good news for nursing homes. Part of nurses working longer relates to the recession, some of it relates to keeping good health insurance until reaching 65, and some of it reflects delayed retirement among all baby boomers, not just nurses.

The recession also led many students to choose nursing starting around 2008, and nursing school enrollments doubled from 2000 onwards, along with young registered nurses in the workforce.

"As the healthcare industry continued to hire people while other industries were laying people off, students started migrating towards degrees that offered a better chance at getting a good paying job, and a job that was likely to bring personal satisfaction and reward," Montana State researcher Peter Buerhaus, Ph.D, RN, FAAN, said.

His team's analysis projects the registered nursing workforce will increase from roughly 2.7 million FTE RNs in 2013 to 3.3 million in 2030.

To be clear, it's not going to meet the demand, but it's better than the shortage of hundreds of thousands of nurses expected a decade ago by economists, and, among others, Buerhaus.

"It's important to keep in mind that this doesn't get us out of the woods — the woods just are not as dark and scary as they appeared. We still project the nation will have a shortage of around 130,000 nurses by 2025, which is by no means a small number, but not the overwhelming shortage that we had once anticipated," Buerhaus said.

So, good news. But there is another piece of the puzzle: As young RNs come into the healthcare industry, what is long-term care doing to show them the benefits of working in a nursing home or seniors housing facility? Once they arrive, what work is being done to “grow your own” MDS coordinators or clinical leaders? If there's been a theme lately among providers I've talked to, it's that some long-term care facilities are doing a good job with recruitment, but not with retention. Nurses are being lured away to managed care companies that need people with clinical experience. I suspect some of the problems with retention relate not only to better salaries elsewhere, but also hours, physical workload and perceived respect. If I were being berated by residents and my director of nursing on a regular basis, I too might mosey over to a place that let me focus on calm documentation.

There needs to be a continued focus on highlighting the importance of nursing, but we also need researchers such as those at Montana State to analyze the data. Buerhaus and his co-authors have plans to monitor the size, geographic distribution and degree mix, among other factors, of the nursing workforce in the coming years. I look forward to seeing what they find.

Elizabeth Newman is Senior Editor at McKnight's Long-Term Care News. Follow her @TigerELN.

Etiquette tip: While it would be rare for someone in a long-term care business setting to launch into an official joke, a la a priest and a rabbi, it's not uncommon to hear someone crack wise about someone else's gender or sexuality. Ask yourself: Is your Caitlyn Jenner joke worth losing business, or a client's respect over?  


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.