Wednesday, Nov. 17, 2004, 12:01 a.m EDT

Jon Gardner, Health Affairs,


Nurse Workforce Growing, Yet Long-Term Shortage Still Looms On Horizon,
Health Affairs
Article Says

Young Nurses And Those Ages 50–65 Drove Much Of The Increase;
Nursing Demand Still Expected To Exceed Supply By 600,000 In 2020

BETHESDA, MD — The number of nurses entering the workforce rose rapidly for a second consecutive year, driven by younger nurses and those ages 50–65 rejoining the workforce, according to a new report published today on the Health Affairs Web site.

The report warns, however, that the current growth spurt will not be able to address the longer-term shortage of registered nurses (RNs). Many older nurses will retire in the coming years, and the supply of younger nurses is not big enough to meet the demand for nurses.

Peter Buerhaus, professor and senior associate dean for research at the Vanderbilt University School of Nursing, and two colleagues analyzed U.S. Census Bureau data to estimate growth in the nurse workforce. Among his findings:

— Nurse employment grew by 118,698 in 2003 from a base of 2 million

— Nurses ages 21-34 represented 87,131 of the new nurses

— Nurses ages 50-64 represented another 65,839 new nurses

— The number of nurses ages 35-49 shrank by 34,271

— Foreign-born nurses represented 24,190 of the new nurses

— Inflation-adjusted wages grew 1.8 percent for nurses in hospital settings and 1.2 percent for those in nonhospital settings

Buerhaus says that the statistics on older nurses rejoining the workforce suggests that they are doing so because of economic insecurity. “It appears that these older RNs are sensitive to economic incentives, particularly to changes affecting their spouses’ incomes and job security,” he says. “Thus, as long as unemployment rates remain high and hospitals continue to raise RN wages, older RNs will likely remain in the workforce. However, should unemployment rates decrease, it is unclear whether RN wage increases alone will be enough to retain all of those older RNs who recently became employed.”

The sudden growth in the number of nurses ages 21–35 is a positive sign for the nurse supply, Buerhaus says, indicating that both the wage increases and the private-sector initiatives to beef up the nurse workforce have begun to have an effect.

Yet the long-term impact of that increase appears to be relatively modest. Even with the new growth among younger nurses, the report says, the nurse workforce is expected to peak at 2.3 million in 2012 and shrink to 2.2 million in 2020, an increase of just 60,000 nurses above current forecasts. That is well below the 2.8 million that will be required, Buerhaus says.

“Replacing the large cohorts of RNs born in the baby-boom generation who will retire between 2010 and 2020 will require a rapid expansion in the number of graduates from nursing education programs, particularly from baccalaureate nursing programs, as those graduates are typically in their twenties, and therefore more likely to contribute a greater number of years in the workforce,” Buerhaus says. “Yet nurse education programs continue to report turning away thousands of qualified applicants because of shortages of faculty, classroom space, and clinical sites for students.”

Buerhaus’s coauthors are Douglas Staiger, an economics professor at Dartmouth College and a research associate with the National Bureau of Economic Research, and David Auerbach, an associate analyst with the Congressional Budget Office.

You can read the article at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.526.



Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. The study article on the survey findings is available as a Web Exclusive at www.healthaffairs.org. Additional peer-reviewed papers are published weekly online as Health Affairs Web Exclusives at www.healthaffairs.org. Health Affairs Web Exclusives are supported in part by a grant from the Commonwealth Fund. Address inquiries to Jon Gardner, Health Affairs, at 301-347-3930, or via e-mail, jgardner@projecthope.org.

©2004 Project HOPE–The People-to-People Health Foundation, Inc.