30% of Nurses Leaving the Workforce - 2017 Salary Survey Results Part 2
We have been hearing about “The Nursing Shortage” for decades now. We are either in the middle of, coming out of, or going into a shortage. In our 2017 salary survey we asked nurses when they anticipate leaving the nursing workforce and factors influencing their decisions. Using data from more than 18,000 participants, projections for the future of the healthcare industry, and statistics about nurses and patient population, we can discuss ideas about what seems to be continuously driving this shortage and perhaps how a difference can be made.
Nursing is one of the fastest growing occupations, yet with more than 3 million nurses in the U.S., demand for nurses is rapidly catching up with the supply. Let's take a look at where we stand right now in the shortage and where we can predict the next decade to take us. Using the 2017 allnurses salary survey, projections for the future of the healthcare industry, and statistics about nurses and patient population, we can discuss ideas about what seems to be continuously driving this shortage and perhaps how a difference can be made.
A Bit of History
The shortage of nurses at the bedside has been an ongoing problem for decades that has ebbed and flowed due to several factors. Looking back at the 70's you will see a large number of women entered nursing schools around the country. This is In some part due to the demand, but primarily due to the limited number of choices for women in the workforce.
As we jump forward to the present, we can see how those same nurses of the 70's who are part of the largest generation in American history, the Baby Boomers, are getting ready for retirement. However, due to economic uncertainty and recession, many nurses of this age and generation who might consider retiring, have deferred doing so. As the economy begins to stabilize and is projected to continue to upswing, a very large portion of our nursing population will be leaving the full-time workforce. According to the ANA, nearly 700,000 nurses are projected to retire or leave the labor force by 2024.
In a 2013 study conducted by the U.S. Health Resources and Services Administration, 187,200 nurses reported that they intend to retire or take a non-nursing job when the economy improved. Almost 82,000 intend to change to Part-time employment, which would add up to about 270,000 Registered nurses leaving full-time employment. With these retirement statistics added to other factors we will discuss, the nation will need to produce 1.13 million NEW Registered nurses by the year 2022 to fill these jobs.
FIGURE 1 Ages of Nurses - 30% Age 50 and Above (Boomers)
The Aging Boomers
The aging Baby Boomers will present other challenges that will impact the nursing shortage and the healthcare industry in general. America has had a vast increase in the number of people over 65 with chronic medical and health issues that put a strain on the health system. As baby boomers continue to age, it is projected by the Centers for Medicare and Medicaid Services, that between 2010 and 2030 the population of senior citizens will increase by 75% to 69 million. That will make 1 in every 5 Americans a senior citizen. Approximately 80% of senior citizens have 1 chronic condition and 69% of seniors have at least 2 chronic medical conditions. As people live longer with multiple chronic diseases, demand for services will increase including hospitalizations, driving the demand for bedside nurses even higher.
In addition to the aging Baby Boomers, the combination of the inundation of new patients with access to the healthcare system due to federal insurance reform (yet to be seen), plus a stronger economy will result in a flooding of the healthcare system. Shortages are expected to occur across the entire healthcare field, but nurses will take the biggest hit.
According to the US Department of Labor Statistics (BLS), employment projections for nurses between 2012 and 2022, total employment rates for Registered Nurses and Advanced Practice Nurses will need to increase by 575,000 to meet the demands of all of the factors influencing healthcare today. You would think that this means an increase in the number of students entering into nursing programs, however, that is not the case. The BLS mentions that "US nursing schools turned away almost 80,000 qualified applicants from BSN and graduate nursing programs in 2012 due to insufficient faculty, clinical sites, class space, clinical preceptors and budget constraints."
While there have been some strides in several states and national programs in offering incentives for students to attend nursing school, aging faculty leaving the workforce again becomes a barrier. Some universities are providing fellowships and loan forgiveness for nurses who agree to teach after graduation in the university's state. Also, some companies associated with healthcare have jumped on the bandwagon of support for nurses during this shortage.
Where is the Nursing Shortage Today?
The top 5 states that are feeling the nursing shortage the most in 2017 are:
- New York
- North Carolina
There are several others close behind due to either aging population in that state, decrease in nursing school graduates, or nurses leaving the bedside due to various reasons. Nurses also want to practice to the fullest scope of practice and some states limit what nurses can do legally. South Dakota, for example, limits the scope of how Advanced Practice Nurses can practice clinically. Therefore those states may have lower desirability for nurses looking to practice healthcare to the fullest extent of their license.
Why & When are Nurses Leaving?
FIGURE 2 Factors Affecting Leaving Nursing
FIGURE 3 When nurses age 50 and above will leave
The 2017 allnurses Salary Survey results show the bulk of nurses from all levels of education, experience, specialty, locations, etc. plan to leave the nursing profession due to retirement and age as we would expect. While the statistics for all respondents show almost 54% leaving in more than 16 years, Figure 3 above shows statistics for those 50 years of age and above. 61.78% of nurses in that age group will leave the workforce within 10 years, 39.46 leaving before 7 years. That will account for more than one million nurses across the U.S. This will definitely impact the timing and severity of the nursing shortage.
Job dissatisfaction is the next primary reason nurses report leaving. All of the reasons come back to the nursing shortage in some way. Nurses are leaving due to nurse/ patient ratios being unsafe. This may be one of the most discussed topics in nursing today. Groups have been formed to put pressure on the legislature to improve these ratios. Many feel (and studies support) that caring for too many patients leads to increase in medical errors, low patient satisfaction, decreased quality of care. Having poor staffing numbers also increases the amount of overtime that nurses are required to work; which increases fatigue and high burnout rates. Nurses do not feel safe in caring for their patients when they are stretched so thin. As nursing is a profession that incorporates technology, critical thinking, and emotional connection with patients and families, you can see where these factors would lead to job dissatisfaction. Nurses feel unable to give what patients deserve and this can take an emotional toll on individuals and alter the tone of the work environment. Increased patient loads equal high turnover which is costly, disruptive and potentially harmful to patient safety.
Overall the nursing shortage is a circular problem. Nurses are leaving the bedside faster than they can be replaced. The patient population will continue to increase which will make the nursing shortage that much more dramatic. As nurses are dissatisfied and feel unsafe and under supported, they are either choosing to leave healthcare altogether, advance their degree, or continue nursing but in a non-bedside capacity. Although nurses from all areas, levels and specialties will be exiting in great numbers, the bedside exodus will be felt the greatest. This shortage is projected to worsen as baby boomers retire from nursing and create a larger patient volume to be absorbed into the healthcare system. Several states are already feeling the effects of the "nursing shortage tsunami" as it has been called and the trend will continue unless we can make changes.
What Do You Think?
Take a look at the interactive graphs below to see why and when nurses are leaving the workforce. Do you see anything surprising? How does your thinking about the why and when of leaving the nursing workforce compare with the results?
Let us know your thoughts. Are you feeling the shortage in your area already? What other factors go into the shortage? How do we make a positive impact?
Nurses Leaving the Workforce
FIGURE 4 When Do You Anticipate Leaving the Workforce
FIGURE 5 When Do You Anticipate Leaving the Workforce
Why Do You Plan to Leave the Nursing Workforce?
FIGURE 7 Leaving Because of Age
FIGURE 8 Leaving Because of Career Change
FIGURE 9 Leaving Because of Declining Health
FIGURE 10 Leaving Because of Job Dissatisfaction
FIGURE 11 Leaving Because of Nurse/Patient Ratio
FIGURE 12 Leaving Because of Pay
FIGURE 13 Leaving Because of Unsafe Work Environment
FIGURE 14 Leaving Because of Retirement
FIGURE 15 Leaving Because Unable to Find a Job
Be sure to view the 2017 allnurses Salary Survey Results Part 1
BHW.HRSA - The Future of the Nursing Workforce: National and State Level Projections, 2012-2025
NursingWorld.org Nursing Shortage
Bureau of Labor Statistics Employment Projections: 2014-24 Summary
TheAtlantic.com/The U.S. Is Running Out of Nurses/Feb 3, 2016Last edit by Joe V on Jun 14, '18
About tnbutterfly, BSN, RN Admin
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allnurses Community Manager; from US
Specialty: 30+ year(s) of experience in Peds, Med-Surg, Disaster Nsg, Parish NsgJul 2, '17I am one of those nurses. 65 years old and frustrated and angry over years of being treated like a servant. Also nursing has to take a lot of blame for this upcoming shortage. Today we are no longer RN's or LPN's primarily, we are defined by our degrees, And in the very forward thinking state of NY there is a push by the schools, primarily to make the minimum degree be a batchelors.Jul 3, '17I do find it interesting that California, as usual is one of the top states "suffering" from a nursing shortage, but is one of the states that also makes if extremely hard for a new graduate RN to find a job. I had to relocate to Kentucky just to land my first RN job out of school in an ER because after applying to over 100 hospitals, 90 replied "Unfortunately one year of acute care experience needed" and the others had such competitive residency programs the chances were slim to none (tens of thousands of applicants for 80 spots). Just a catch 22 if you ask me. I’m sure New York and Florida are similar. If the shortage is so drastic, hire nurses...there are plenty trying to get hired, believe me.Jul 3, '17I agree with NC being on the list of places feeling the shortage the most.
For those complaining about not being able to find jobs as new grads... come here! 90% of the hires on my unit this year have been new grad RNs. We'll take anybody with a pulse and a nursing license. Really. It's that bad.
My manager states she ends up hiring most of the people she interviews. The problem is that we don't have applicants. Nobody applies, so nobody gets hired... so we stay short.Jul 3, '17Quote from FatsWallerFlorida is not similar, at least not yet. Most of the RNs hired into our ER over the past few years have been new grads. Pressure is mounting here too for BSNs, and experience is good if you have it, but for now the shortage wins out.I do find it interesting that California, as usual is one of the top states "suffering" from a nursing shortage, but is one of the states that also makes if extremely hard for a new graduate RN to find a job. I had to relocate to Kentucky just to land my first RN job out of school in an ER because after applying to over 100 hospitals, 90 replied "Unfortunately one year of acute care experience needed" and the others had such competitive residency programs the chances were slim to none (tens of thousands of applicants for 80 spots). Just a catch 22 if you ask me. I’m sure New York and Florida are similar. If the shortage is so drastic, hire nurses...there are plenty trying to get hired, believe me.
I was intrigued to see the line "leaving the bedside" repeatedly referring to RNs leaving the profession. Of course "the bedside" is where the unheralded core of the profession grinds it out day after day. I'm wondering if the shortage is less acute in management?Jul 4, '17I too am a little surprised by that. I have left the bedside to work in professional development....partly because I am passionate about nursing and love to teach and interact with nurses, partly because in just the five years between my starting bedside practice/graduating and when I left that role, the changes were getting so stressfully bad. I am staying in nursing, but not at the bedside.Jul 4, '17Quote from RobbiRNI was intrigued to see the line "leaving the bedside" repeatedly referring to RNs leaving the profession. Of course "the bedside" is where the unheralded core of the profession grinds it out day after day. I'm wondering if the shortage is less acute in management?
Quote from not.done.yetI too have left the bedside but am still an active nursing professional.I too am a little surprised by that. I have left the bedside to work in professional development....partly because I am passionate about nursing and love to teach and interact with nurses, partly because in just the five years between my starting bedside practice/graduating and when I left that role, the changes were getting so stressfully bad. I am staying in nursing, but not at the bedside.
I edited the text in the article slightly. The survey included nurses from all areas and levels of nursing - bedside, management, etc. The shortage will occur throughout nursing, but will be felt the greatest at the bedside. As the number of patients is expected to rise due to the factors discussed in the article, there won't be enough nurses to care for them unless the number of incoming nurses increases dramatically.
Thanks for your comments.Jul 5, '17I've been a nurse now 40yrs, last 15yrs in non-bedside position in Home Health. Started planning my retirement 2yrs ago with plans to decrease from FT to 2days wk in about 4 years. Reading allnurses one would assume no one wants bedside positions. In Philly area, BSN push has been on for about 5 years with glut of graduating nurses and not enough hospital/SNF bedside positions available. Five new BSN grads I'd hired into Home Health Central Intake roles all left after that magical first year as able to obtain hospital bedside positions.
As part of retirement planning, I increased 403b contribution to 10% salary 3 years ago to take advantage of health system match for those over 16years employment getting $.60 for every $1.00 up to 6% salary if making less than $100,000. Paid off all credit cards; use just 1 debit card with monies out of checking account. I rarely go to Starbucks/ Dunkin Donuts/Wawa for Chai tea, instead buy individual sealed Chai + Constant Comment tea bags (my stress relievers) along with Truvia carrying them in separate area in my handbag to cut down on spending. My work pension is anticipated @ $900/mo now --just enough to pay PA state and school Taxes.
One of my friends continues to work 2days week at age 82 as "keeping her sharp". I would like to volunteer at local library or assisted living activity center as something to keep me busy, rather than have deadlines to meet. All depends on how health insurance plays out over next few years as might need to keep working to pay for insurance cost.Jul 7, '17Quote from FatsWallerIt's complicated because some states, like California, have a combined shortage along with a glut of new grads. Basically a shortage of experienced nurses. To make matters worse, many experienced nurses stay in the workforce (and so are counted) but leave the bedside for non-clinical roles because of the dis-satisfiers.I do find it interesting that California, as usual is one of the top states "suffering" from a nursing shortage, but is one of the states that also makes if extremely hard for a new graduate RN to find a job. I had to relocate to Kentucky just to land my first RN job out of school in an ER because after applying to over 100 hospitals, 90 replied "Unfortunately one year of acute care experience needed" and the others had such competitive residency programs the chances were slim to none (tens of thousands of applicants for 80 spots). Just a catch 22 if you ask me. I’m sure New York and Florida are similar. If the shortage is so drastic, hire nurses...there are plenty trying to get hired, believe me.
I'm so glad to see more nurses contacting their representatives to legislate safe nurse-patient ratios- it's the only way to bring about this change- if nurses stick together with one voice. I live in California, and nurse-patient ratios do provide some assurance of safety for patients and nurses.
Many new grads are forced to relocate to get their first job, like the OP above. But even in competitive areas, new grads do get hired- but only the ones who know how to stand out from the others. It's been my passion to help those newbies get started. New grads are our future.
Author "Your Last Nursing Class: How to Land Your First Nursing Job..and your next!"Jul 9, '17Maybe instead of "bedside" we should use a term like "direct patient care." Where do school nurses figure in? I work directly with patients (students), but not at a bedside. Don't forget about the thousands of us school nurses! We also need nurse-student ratios in my opinion. I have over 1200 students under my one RN license, including dozens of medically fragile and developmentally disabled children, which I believe is too much.Jul 19, '17I am College Health Nurse and the only one still left employed here with an Associate Degree. As the push to obtain a BSN degree keeps getting stronger I will be retiring hopefully next year. I do not plan to take money out of my savings to pay for an BSN degree to continue to make the same a salary. And that is what is not okay in my situation. I hopefully with be able to work part - time some where once retired in Nursing but if not then I will do a non-nursing related job. I have a lot of experience from working in the Emergency Room for 11 years. I do picc line infusions and care of picc lines if needed, apply cast and splints, do IV infusions and medication administration if needed. handle all prescription refills if Physician is not available, prior authorizations, Immunizations. Spirometry Testing on students. So when I retire, hopefully I can find something in Nursing to do part-time.Jul 19, '17I'm not good with numbers so please excuse me if I misunderstood this article. It appears to predict a future nursing shortage. Personally, I'm skeptical about this. Do employers predict this also? I recall working in 1988 when there was a nursing shortage and we used to believe that more students entering the nursing profession would resolve the nursing shortage, but nurses are still working short staffed in 2017. Personally, when I worked direct patient care, I informed my employer that another RN should be hired to resolve our frantic pace at work. However, my employer informed me they would hire a person to draw blood to alleviate our work load, not another Registered Nurse. It did not relieve much of my work load. Presently I work in phone triage, and working short staffed one nurse for more than one year. Management is looking at ways to alleviate the nursing load by reassigning work they feel may be delegated to others. So where is the other nurse that my employer promised to hire over a year ago.
The "nursing shortage" has to due with profits, revenue, $$$. Perhaps many of the health care facilities are not for profit or so I'm told. However, I believe someone is profiting, weather it be the CEO or some upper level administrator meeting goals, quotas or whatever gets them the end of the year or quarter bonus $$$. There may be a few states that are suffering a nursing shortage and hiring, but I don't believe this is generally the case. During the real nursing shortage in 1988, I recall employers would hire and provide training. There were no excuses. It did not matter that you did not have a BSN, did not have acute care experience, did not work in that specialty previously, did not have certifications, were a staff nurse 1 as opposed to a staff nurse II or III, or did not participate in community service. There is a hospital in my state that actually requires that nurses do some form of community service. Unreal !
There is no nursing shortage today and I doubt there will be a nursing shortage in the future, unless there is some type of regulation of staffing ratios by states or government. The nursing profession is changing, with less use of bedside nurses, and more team nursing as opposed to primary care nursing. The push for BSN, certifications, clinical ladders, is expensive so why not continue one's nursing education to become a nurse practioner and have some autonomy. If I were younger and could afford it, I certainly would choose the APN route.Mar 9Yes..........it is not difficult to see where profits are more important than patient care. IF it was a question of providing care to people, there would be pressure to decrease the expense of education. Instead the focus is on making sure the person who gives you a bed bath has a BSN behind her RN. Case in point, the local education facility in my town just announced their answer to the shortage. They are offering a 12 month program for $45K to anyone with a previous 4 year degree..any field, no experience in nursing required. In turn the person gets a BSN.
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