california’s nursing workforce: new research
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California’s Nursing Workforce: New Research. Joanne Spetz, Ph.D. University of California, San Francisco February 7, 2012. What is going on in our RN labor market?. More than a decade of severe shortage, 1998-2008 Reports that new graduates cannot find jobs 2009-now - PowerPoint PPT PresentationTRANSCRIPT
California’s Nursing Workforce:New Research
Joanne Spetz, Ph.D.University of California, San FranciscoFebruary 7, 2012
What is going on in our RN labor market?• More than a decade of severe shortage,
1998-2008• Reports that new graduates cannot find
jobs 2009-now• Stories that nurses are not retiring when
expected• Shortages in some regions
Context: Ongoing recession, high unemployment, severe regional differences
2
Survey of Nurse Employers, Fall 2010• Collaboration between UCSF, CINHC, and HASC• Email survey with option to return paper survey
via fax or email• Questions based on previous CINHC survey and
National Forum of State Nursing Centers “Minimum Demand Data Set” recommendations
• Follow-up short survey conducted Spring 2011
3
Perceptions of employers, fall 2010
4
Differences across regions, Fall 2010 & Spring 2011
5Lower number = more shortage
Rural versus urban perceptions
6Lower number = more shortage
Staff RN Vacancies, Fall 2010 & Spring 2011
7
Estimated 1,772 vacancies for new RN graduates in Fall 2010
Planned employment growth for 2011 & 2012, from Fall 2010
8These data are for respondents, not all California hospitals
BRN surveys
• Survey of RNs, 2010– 10,000 RNs sampled, ~65% response rate– Paper survey with option to do online survey
• Annual Schools Survey, 2010-11– Online survey of all nursing programs – 100% response rate
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Employment rates by age, 2008 & 2010
10
Source: California Board of Registered Nursing Survey of RNs, 2010
Reasons for not working in nursing% important or very important
Retired
Childcare responsibilities
Stress on the job
Job-related illness/injury
Salary
Dissatisfied with benefits
Other dissatisfaction with your job
Dissatisfaction with the nursing profession
Wanted to try another occupation
Inconvenient schedules in nursing jobs
Difficult to find a nursing position
Laid off
0% 10% 20% 30% 40% 50%
20102008
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Source: California Board of Registered Nursing Survey of RNs, 2010
Nurse earnings over time
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Source: California Board of Registered Nursing Survey of RNs, 2010
Future plans of RNs
Under 35,
2008
Under 35,
2010
65+, 2008
65+, 2010
0%10%20%30%40%50%60%70%80%90%
100%
Plan to retirePlan to leave nurs-ing entirely, but not retirePlan to increase hours of nursing workPlan to reduce hours of nursing workPlan to work approx-imately as much as now
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Source: California Board of Registered Nursing Survey of RNs, 2010
RN Graduations are expected to drop in 2012-2013
New enrollment
Projected enrollment from 1 yr
Projected enrollment from 2 yrs
Graduations
2008-2009 13,988 14,621 13,692 10,5262009-2010 14,228 14,917 14,216 11,5122010-2011 13,055 14,835 12,447*2011-2012 13,223 13,273*2012-2013 11,616*2013-2014 11,766*
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Source: California Board of Registered Nursing Annual Schools Report, 2009-2010
Board of Registered Nursing Forecasts of Supply
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Nurses with Active Licenses
Living in CaliforniaOutflow of nursesInflow of nurses
Full-time equivalent supply of RNs
Share of nurses who work, and how much they work
The range of supply forecasts (RNs living in California)
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0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
Best Supply ForecastLow Supply ForecastHigh Supply Forecast
Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011
Variation in FTE employment with assumptions about work and retirement
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2011
2013
2015
2017
2019
2021
2023
2025
2027
2029
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
500,000
Best Supply ForecastLow Employment Rate ForecastHigh Employment Rate Forecast2009 Forecast
Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011
Forecast of Full-time Equivalent RNs per 100,000 population
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2011
2013
2015
2017
2019
2021
2023
2025
2027
2029
0
100
200
300
400
500
600
700
800
900
1,000
Best Supply Forecast
U.S. average
US 25th percentile
Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011
What is demand?
• National benchmarks: Employed RNs per 100,000• Bureau of Labor Statistics, forecast of 2018
demand• Growth based on current hospital employment &
expected growth in patient days• Potential impact of PPACA
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Forecasts of RN demand
20
20112013
2015201
72019
2021202
32025
20272029
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
National 25th percentile FTE RNs/population
National average FTE RNs/population
California Employment Development Dept. forecast
Maintain 2011 FTE RNs/Population
OSHPD hours per patient day-based forecast, BRN calibration
OSHPD hours per patient day-based forecast, EDD calibration
Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011
Best supply and demand forecasts for RNs, 2009-2030
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0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
Best Supply ForecastNational 25th percentile FTE RNs/populationOSHPD hours per patient day-based forecast, BRN calibrationLow Supply Forecast (low count & employment)National average FTE RNs/population
Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011
Implications for policy
• How do we define shortage?– Are current employment levels adequate?– Should California be at the national average? 25th
percentile? Bottom?– Economic demand vs. need-based demand
• In this economy…– Demand estimates have dropped and supply is high
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What is happening next?
• UCSF, CINHC, and the Hospital Associations is analyzing Year 2 of the employer survey
• UCSF & BRN are nearly done with the 2011-12 Annual Schools Survey
• 2012 BRN Survey of RNs (mailed in spring)
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Questions?
Thoughts?
Ideas?
Perspectives?
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