The recent surge in nurse employment: Causes and implications

Health Affairs

Volumn 28, Issue 4, 2009, Pages

  Buerhaus, Peter I ^a,b   Auerbach, David I ^c   Staiger, Douglas O ^d,e  

^a VANDERBILT UNIVERSITY SCHOOL OF NURSING   (United States)

^b VANDERBILT UNIVERSITY   (United States)

^c U S DEPARTMENT OF HEALTH AND HUMAN SERVICES   (United States)

^d Dartmouth College   (United States)

^e NATIONAL BUREAU OF ECONOMIC RESEARCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONTROLLED STUDY; EMPLOYMENT; FOREIGN WORKER; HEALTH ECONOMICS; NURSING CARE; NURSING EDUCATION; POLICY; REGISTERED NURSE;

EMPLOYMENT; FOREIGN PROFESSIONAL PERSONNEL; HUMANS; MALE; NURSES; NURSING STAFF, HOSPITAL; PERSONNEL SELECTION; UNITED STATES;

EID: 67651238314     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.4.w657     Document Type: Article

References (28)

1. First Consulting Group, American Hospital Association, The Healthcare Workforce Shortage and Its Implications for America's Hospitals (Chicago: AHA, 2001);
2. and AHA, "The Hospital Workforce Shortage: Immediate and Future," Trend Watch 3, no. 2 (2001): 1.
3. S. Clarke and N. Donaldson, "Nurse Staffing and Patient Care Quality and Safety," in Patient Safety and Quality: An Evidence-Based Handbook for Nurses, ed. R.G. Hughes, Pub. no. 07-0015 (Rockville, Md.: Agency for Healthcare Research and Quality, 2008);
4. P.I. Buerhaus, D.O. Staiger, and D.I. Auerbach, "Implications of an Aging Registered Nurse Workforce," Journal of the American Medical Association 283, no. 22 (2000): 2948-2954;
5. and D.I. Auerbach, P.I Buerhaus, and D.O Staiger, "Better Late than Never: Workforce Supply Implications of Later Entry into Nursing," Health Affairs 26, no. 1 (2007): 178-185.
6. National Bureau of Economic Research, Public Information Office, "Business Cycle Expansions and Contractions," http://wwwdev.nber.org/ cycles/cyclesmain.html (accessed 23 April 2009).
7. K. Evans and K. Maher, "Yearly Job Losses Worst since 1945,"Wall Street Journal, 9 January 2009.
8. A. Johnson and K. Evans, "Recession Now Hits Jobs in Health Care,"Wall Street Journal, 16 April 2009.
9. P.I. Buerhaus and D.O. Staiger, "Managed Care and the Nurse Workforce," Journal of the American Medical Association 276, no. 18 (1996): 1487-1493;
10. P.I. Buerhaus, D.O. Staiger, and D.I. Auerbach, "Is the Current Shortage of Hospital Nurses Ending?" Health Affairs 22, no. 6 (2003): 191-198;
11. and P. Buerhaus, D. Staiger, and D. Auerbach, The Future of the Nursing Workforce in the United States: Data, Trends, and Implications (Boston: Jones and Bartlett, 2009).
12. Auerbach et al., "Better Late than Never."
13. The influence of spouses' earnings on an RN's decision to participate in the labor market and number of hours worked is reported in numerous studies. See, for example, C.R. Link and R.F. Settle, "Financial Incentive and Labor Supply of Married Professional Nurses: An Economic Analysis," Nursing Research 29, no. 4 (1980): 238-243;
14. M. Bognano, J. Hixson, and J. Jeffers, "The Short-Run Supply of Nurses' Time," Journal of Human Resources 9, no. 1 (1974): 80-93;
15. and F. Sloan and S. Richupan, "Short-Run Supply Responses of Professional Nurses: A Microanalysis," Journal of Human Resources 10, no. 2 (1975): 241-257.
16. The wage offered by hospitals also effects RN employment. However, to avoid confusion and distraction from the impact of bust periods on increased RN employment, we did not include RN wages in Exhibit 1. Briefly, in 2002 and 2003 real RN wages increased, which would have had a positive impact on RN employment and thus have reinforced the recession's impact on stimulating increased RN employment. However, during the current recession, real wages have decreased, which would negatively effect RN employment. Yet RN employment rose by record levels in both 2007 and 2008, indicating that the effect of real or anticipated loss of spouses' income and jobs due to the recession, rather than wage changes, dominated RNs' employment decisions.
17. Although the CPS does not capture where people received their nursing education, comparison with data from the National Sample Survey of RNs from 2004 suggests that the number of foreign-educated RNs is just under one-third the number of foreign-born RNs; therefore, employment growth in this group does not solely reflect growth in the number of foreign nurse graduates (FNGs) working in the United States.
18. For example, HRSA's 2004 projections indicate that by 2020, if current trends continue, the national shortage of RNs will slightly exceed one million FTE RNs, suggesting that only 64 percent of projected demand will be met. Health Resources and Services Administration, "What Is Behind HRSA's Projected Supply, Demand, and Shortage of Registered Nurses?" September 2004, ftp://ftp.hrsa.gov/bhpr/workforce/behindshortage.pdf (accessed 12 May 2009).
19. Based on industry surveys, the Office of Occupational Statistics and Employment, Bureau of Labor Statistics, expects that employment of RNs will grow 23 percent from 2006 to 2016 - much faster than the average for all occupations. BLS, Occupational Outlook Handbook, 2008-09 Edition, http://www.bls.gov/oco/ocos083.htm#outlook (accessed 18 May 2009).
20. Auerbach et al., "Better Late than Never."
21. HRSA, "What Is Behind?"
22. One in four respondents to a 2007 survey (N = 1,604) said that they had considered a nursing career. See K. Donelan et al., "Public Perceptions of Nursing Careers: Influence of the Media and the Nursing Shortage," Nursing Economic$ 26, no. 3 (2008): 143-150, 165.
23. K. Evans, "Fewer Openings in Nursing Field,"Wall Street Journal, 16 April 2009.
24. K.A. Paez, L. Zhao, and W. Hwang, "Rising Out-of-Pocket Spending for Chronic Conditions: A Ten-Year Trend," Health Affairs 28, no. 1 (2009): 15-25.
25. A 2008 national survey of RNs found that 45 percent reported experiencing a back or musculoskeletal injury in the workplace during the past year. P. Buerhaus et al., "Still Making Progress to Improve the Hospital Workplace Environment? Results from the 2008 National Survey of Registered Nurses," Nursing Economic$ (forthcoming).
26. See the Johnson and Johnson Campaign for Nursing's Future home page, http://www.discovernursing.com (accessed 24 January 2009).
27. B. Kuehn, "No End in Sight to Nursing Shortage: Bottleneck at Nursing Schools a Key Factor," American Journal of Medicine 298, no. 14 (2007): 1623-1625.
28. Buerhaus et al., The Future of the Nursing Workforce.