The Recession's Effect on Hospital Registered Nurse Employment Growth

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Read the authors disclosures, one is employed by an independent healthcare research group in Boston called RAND.

Read page seven which references eliminating older Nurses to improve morale and make room for new graduates.

It is really too bad that they does not suggest using mandatory staffing ratios to improve patient outcomes and will produce a need for bedside nurses.

If staffing ratios were introduced across the country, in hospitals and nursing homes, there would indeed be a nursing shortage. This "artificial glut", of nurses is not only a result of poor staffing (one nurse can care for 15 patients), but a reflection of the lack of support from our nursing leaders, who have shouted," massive nursing shortage in the near future- produce more nurses", ad nauseum. They have allowed this situation to occur and as usual, show a complete lack of support and understanding, for the nurses who they are supposed to represent.

JMHO and my NY $0.02.
Lindarn, RN, BSN, CCRN
somewhere in the PA

The data for my geographic area (the 5th largest SMSA in the US) is at odds with the findings in this article. For example, RN full-time jobs (not FTE) in my 5-county area, which is not the full SMSA but should suffice to illustrate the point, from 2006 through 2009 (the latest year I have jobs data for) were:
2006 - 44,840
2007 - 42,420
2008 - 42,740
2009 - 42,820
You can see that this represents a net decrease of just over 2,000 nursing jobs over 4 years. Over that same period, the state BON reported the following numbers of first-time NCLEX candidates passing the exam as:
2006 - 1,935
2007 - 1,797
2008 - 1,986
2009 - 2,142
This means that from 2006 to 2009, there were nearly 8,000 new RN’s entering the workforce at the same time the number of nursing jobs was decreasing by nearly 5%. Obviously, some RN’s retired or otherwise left the workforce during the period but unless those numbers were very large – and during a recession they typically would not be – it would appear that RN creation is far outpacing the ability of the local job market to absorb the increase. While this may be a localized phenomenon, much of the anecdotal evidence I’ve seen here on AN seems to indicate that most major metropolitan areas in the US are experiencing something similar at least with respect to jobs, with either stagnant or declining growth in Registered Nursing employment.

We see quite a different jobs picture in the article however. Looking at the table of “hospital-employed FTE registered nurses” (Table 3) over the same period we see the following:
2006 – 1,345,711
2007 – 1,429,989
2008 – 1,588,226
2009 – 1,569,496
This indicates an increase of over 220,000 jobs nationwide in the same 2006 – 2009 timeframe. Note that these figures are for “full-time equivalent” (FTE) heads, which is defined as “the number of full-time employees plus half the number of part-time employees, where fulltime employment is defined as working 30 or more hours per week.” This would seem to tend to skew the employment numbers upward - perhaps by design. Even so, how can we explain this seeming contradiction with the local data? Could it be that RN job growth has been robust in small cities and rural areas across the country while declining in more urban areas? I honestly do not know the answer but think this could be an interesting topic for someone to more fully investigate.

This article does have flaws but in fairness to the authors, the RAND Corporation is a well-known and relatively highly regarded multi-faceted independent research organization. In fact, the term "think-tank" was actually first applied to RAND. They do not focus on any one subject and per their website, state that "RAND focuses on the issues that matter most such as health, education, national security, international affairs, law and business, the environment, and more."

I don't want to be seen as an apologist for RAND but they are not an agenda-driven organization in the way that the Center for American Progress or Americans for Prosperity (both funded by very conservative groups such as the Koch Bros foundation) are.

Donald Rumsfeld was once on the board of the RAND corporation.

[quote=libbyliberal;5933099]Read the authors disclosures, one is employed by an independent healthcare research group in Boston called RAND.

Read page seven which references eliminating older Nurses to improve morale and make room for new graduates.[/quote

Actually, isn't it eliminating low performers?

"Meanwhile, as relatively high unemployment rates continue to stimulate record high RN workforce participation, hospitals should not forgo the opportunity to induce low-performers to leave the organization, not only for reasons related to improving quality of care and promoting staff morale, but to create room for new RN graduates. Similarly, while so many veteran RNs are in the hospital workforce, hospitals may consider how they could serve as mentors to those newly entering the workforce."

http://www.medscape.com/viewarticle/749072_6