Commentary on Health Affairs Article: Registered Nurse Supply- shortage not over

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    American Association Colleges of Nursing (AACN) commentary/talking points regarding journal Health Affairs article: Registered Nurse Supply Grows Faster than Projected Amid Surge in New Entrants Ages 23-26. NRSKarenRN

    Read: Registered Nurse Supply:
    On December 5, 2011, the journal Health Affairs published an article titled Registered Nurse Supply Grows Faster than Projected Amid Surge in New Entrants Ages 23-26, which focused on a large cohort of younger nurses entering the profession and the impact this may have on the future workforce. Funded by the Gordon and Betty Moore Foundation, this study was conducted by Drs. David Auerbach, Peter Buerhaus, and Douglas Staiger who found a 62% increase in the number of 23-26 year olds who became registered nurses (RNs) between 2002 and 2009. Though welcome news given the rapid aging of the nursing workforce, the study authors do not conclude that nursing shortage is over given the growing demand for nursing care by older adults, new opportunities for nurses through healthcare reform, and the need for more highly educated RNs.

    To this point, the authors recognize the following in the article:

    * Considerable uncertainty persists about whether or not interest in nursing will continue to grow in the future.
    * The aging of the population is likely to increase demand for RN at a greater rate than in the past.
    * Full implementation of the Affordable Care Act and expanding roles for nurses in primary care will likely increase demand for RNs and result in future shortages.
    * Ongoing bottlenecks in nursing education (i.e. faculty shortages, insufficient clinical training sites) could narrow the future pipeline of nurses below optimal levels.

    Dr. Auerbach and colleagues also were concerned that though the number of RNs prepared each year is increasing, schools of nursing many not be “preparing the workforce ideally suited for population needs.” .....

    Interesting read. What do you think? (Please do not comment before actually reading the entire "Talking Points" article. Thank you.)


    This is the link to the Talking Points article: - This is free and requires no registration.

    This is the original abstract that the Talking Points is referring to:


    Registered Nurse Supply Grows Faster Than Projected Amid Surge In New Entrants Ages 23–26
    • David I. Auerbach,
    • Peter I. Buerhaus,
    • and Douglas O. Staiger

    Health Aff December 2011 30:2286-2292; doi:10.1377/hlthaff.2011.0588

    Last edit by NRSKarenRN on Dec 9, '11 : Reason: Added article title and links
    lindarn likes this.

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  2. 12 Comments...

  3. 0
    To read the article requires registering and paying for it.. so...
  4. 0
    Quote from Wise Woman RN
    To read the article requires registering and paying for it.. so...
    This is the link to the Talking Points that I was referring to: No registration required, freely available.
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    This talking points summary concentrates on the possibility of a future shortage of nurses and does not weigh on the present argument regarding an oversupply - or shortage - of nurses. The authors speculate that the aging population and the implementation of the Affordable Care Act (sometimes derisively referred to as "Obamacare") are likely to increase demand for nurses. While there may be some data to back up the former assertion, there is none for the second. Quite frankly, it looks to me as if large segments of the Affordable Care Act will be neutralized in the very near future, if not by invalidation by the Supreme Court then by legislation after the 2012 elections. Unlike the authors of the article however, I freely admit that is speculation on my part.

    The authors also claim that the this speculative shortage will be exacerbated by a potential decline in nursing students, either as a result of a loss of interest by future nursing students or because of the "ongoing bottlenecks" in nursing education. The authors identify nursing faculty shortages and insufficient clinical training sites as the culprits behind the bottlenecks. I would be interested in seeing the data that lead the authors to conclude this. The data I see show nursing enrollment increasing, which to say the least, would seem to obviate the argument that there is a faculty shortage. With respect to clinical site shortages, the authors may be on firmer ground but only because the number of sites available have not kept pace with the increased numbers of nursing students requiring clinical rotations. Actually, given the flood of hospital closings, the number of clinical sites may well have declined. To me however, this argument seems somewhat similar to the one made by the child who, after murdering both of his parents, begs the court for mercy because he is an orphan.

    Despite these doubts, I do believe that the authors are right to be worried about a future shortage of nurses, but for very different reasons than the ones expressed in the talking points. Since about 2008, new grad RN's, especially those from ADN programs, have been having a very difficult time find nursing employment. This trend seems poised to continue for some time. It is well-recognized that there is a "expiration" date for new RN's, generally about 12 months after passing the boards. After this date, these RN's become essentially unemployable and so will move to other careers. This is worrisome because it means that the nursing student has invested a significant amount of money and time in training, as has the institution that they attended, and to no effect. It is also worrisome because, should this trend continue, it will have that dampening effect on attracting new nursing recruits that the authors mention.

    It is ironic that the authors conclude that
    taking actions now that would stop the flow into the nursing profession would be a very risky and unwise gamble
    I submit that doing nothing to ameliorate the oversupply of new nurses - and by this I mean increasing the numbers of new RN's that are hired - will have precisely the effect of staunching the flow into the profession that the authors worry about.

    Just my two cents. And full disclosure: I'm one of those new RN's now well past the usual sell-by date.
    Last edit by chuckster on Dec 9, '11
    Jarnaes, IowaKaren, kalevra, and 6 others like this.
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    I tell everybody I can not to go into nursing. To wait at least 5 years before reconsidering. Simply there will not be a job most likely for them and taking a debt of college knowing this would be ridiculous. I tell them to go into something broad and non-healthcare based, then in 5 years, reassess the situation for NG nurses and residencies and then think about it again. I also tell them... go a head and mix some science into your curriculum while you in college for that other degree if you can... your chems, bios... wait on the A&P.
    lindarn likes this.
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    Another issue that should be considered is that many of those going to nursing school have no intention of being "bedside" nurses for any length of time.

    There is a greater number of students using RN as a stepping stone to NP or CRNA or nonbedside positions. Witness the large number of posters here seeking nonbedside positions or positions involving limited inpatient care.

    And more so, how many are going in with expectations that unrealistic and will leave when those expectations are not fulfilled. Increasingly, I deal with precepting new grads or students that do not realize the physical work involved.
    Jarnaes, mystory, DoGoodThenGo, and 7 others like this.
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    I too tell everyone not to go into nursing. Why- because of the dragging down of the profession that the financial mogals have done. The my hospital is better than yours philosopy and the heck with the patient survival. This ridiculous notion of "cusomer satisfaction" How many people you know who had any of their organs cut out of them rated the experience right up there with a all expense paid trip to Disney?Illness is uncomfortable, nursing tasks are uncomfortable- I don't know of too many MI's wanting to see the beautifully appointed lobby before they are wisked off to the cath lab.
    Then there is their stop at nothing ( even murder by another's hand through short staffing ) to maintain that multi million dollar salary with perks and bene's.
    How many new grads in the most recent years are going to hang around without a paycheck to pay off all that student loan debt-I don't think too many of them have a mommy or daddy CEO to foot the bill.
    These Nursing academia's need to first figure out how nursing can take back it's profession and protect it's license from these charlatans for profit( their own)
    They need to stop wasting paper and precious research time expounding on the obvious.
    netglow, IowaKaren, kalevra, and 2 others like this.
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    Nursing is going down the tubes, so to speak. Hospitals are talking customer satisfaction and having the Ritz Carlton train their nurses (if you do not believe, google it). Healthcare is done as far as I am concerned. I will be moving on after I get my masters. I also have a Bachelor of Science in Business so I can move to other fields as well. So done with all of this.
    netglow, mystory, IowaKaren, and 2 others like this.
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    From the standpoint of policy and planning, we really are in a bind right now.
    On the one hand, we probably do have a long term structural shortage of nurses brought about by the retirement and aging of the Baby Boom generation. On the other hand, we have an acute over supply right now. It seems highly likely that the oversupply in the short run will discourage people from going into the field and worsen the shortage in the long run.
    It also seems apparant that the source of the article - AACN - is the organization for people in the business of educating nurses and they are desperately anxious not to cut their business by allowing people to understand how severe the current oversupply really is - their desire to talk up long term shortage is clearly in their own self-interest.
    The best answer is a real, broad based economic recovery as fast as possible, but with neither party having a real plan to promote that and one party doing all they can to prevent it, I can't see that happening any time soon. It's important to understand that the nursing glut is not quite the same as unemployment in other fields. In other lines of work there are actually fewer jobs. That's not the case in nursing - the number of nurses employed is about the same as before the recession. What has created the glut is people coming back into the nursing work force who were (or would like to be) out of it: Nurses who were working in another field and lost their jobs, Nurses who were being supported by a spouse and went back to work when the spouse lost their job, Nurses who were retired or on the point of retirement who were forced to delay retirement or come back to work because their retirement funds were decimated, Nurses who were working part-time who went to full time when a spouse lost their job.
    IowaKaren, TheCommuter, and TheChair1 like this.
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    I think these academia prophets need to stop focusing on this "nursing shortage" and start focusing on the problem of why hospitls are closing their doors. We ( the healthcare community, the US) can not continue to shell out the multi millions to top management in salaries, bonuses, perks and pensions. Ultimately, no healthcare system will be able to keep their doors open. Small hospitals are taken over by larger ones, larger ones are taking them over and so on. This runaway gravey train for the execs needs to stop. Pretty soon Humpty Dumpy is going to fall down. Then it won't matter how many nurses we have and don't have.
    Temple University Hospital announced yesterday that it's current CEO- Sue Gromberg, the reining queen who was in power during the Temple Unive. nursing strike of April 2010 will be stepping down and a Mr Kaiser( oh brother don't tell me this is one in the same from California) Temple sited that it is $84 million in the red ink and partly due to the 1 month nursing strike?? Again- it's nursing's fault. First- I don't think it was the nursing strike that put Temple in it's red ink. Second- how much moolah does anyone want to guess Madam Gromberg will get as a parting gift. Give her a watch and a goodbye dinner- cut her pension( my guess it will be greater than the $12,000-$13,000 given to the CEO thugs of Westchester in NY state) and any other pay out she feels she is ENTITLE$D to. Temple is a very large healthcare system that also has a medical school attached to it and various degree levels of nursing programs. She was only CEO for a little over 1 yr= gravey train indeed!
    Last edit by kcmylorn on Dec 11, '11
    IowaKaren likes this.

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