CALIFORNIA S NURSING LABOR FORCE: DEMAND, SUPPLY, AND SHORTAGES

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1 CALIFORNIA S NURSING LABOR FORCE: DEMAND, SUPPLY, AND SHORTAGES Appendix A: Regional Summary of California s Nursing Labor Markets Joanne Spetz, Ph.D. Wendy Dyer, M.S. Laurie Hailer, M.A

2 Appendix A: Regional Summary of California s Nursing Labor Markets 1. General Information 4 2. Southern Border Region 7 A. Board of Registered Nursing 2004 Survey Summary 7 B. Board of Registered Nursing Annual Schools Report Summary 11 C. Chief Nursing Officer Survey Summary Inland Empire 17 A. Board of Registered Nursing 2004 Survey Summary 17 B. Board of Registered Nursing Annual Schools Report Summary 21 C. Chief Nursing Officer Survey Summary Los Angeles Area 27 A. Board of Registered Nursing 2004 Survey Summary 27 B. Board of Registered Nursing Annual Schools Report Summary 31 C. Chief Nursing Officer Survey Summary Central Coast 38 A. Board of Registered Nursing 2004 Survey Summary 38 B. Board of Registered Nursing Annual Schools Report Summary 41 C. Chief Nursing Officer Survey Summary San Joaquin Valley and Central Sierra Regions (combined) 46 A. Board of Registered Nursing 2004 Survey Summary 46 B. Board of Registered Nursing Annual Schools Report Summary 50 C. Chief Nursing Officer Survey Summary Bay Area 56 A. Board of Registered Nursing 2004 Survey Summary 56 B. Board of Registered Nursing Annual Schools Report Summary 60 C. Chief Nursing Officer Survey Summary Sacramento Area 66 A. Board of Registered Nursing 2004 Survey Summary 66 2

3 B. Board of Registered Nursing Annual Schools Report Summary 70 C. Chief Nursing Officer Survey Summary Northern California and Northern Sacramento Valley Regions 75 A. Board of Registered Nursing 2004 Survey Summary 75 B. Board of Registered Nursing Annual Schools Report Summary 78 C. Chief Nursing Officer Survey Summary 83 3

4 1. General Information This appendix to the Nurse Workforce Initiative Final Labor Market Report provides regional data for the California Economic Strategy Panel Regions. We have modified the regions to combine the Northern Sacramento Valley with the other Northern counties, due to small sample sizes. We also have combined the Central Sierra with the Central San Joaquin Valley due to the small number of nurses in the Sierra region and the lack of Registered Nurses (RN) education programs in the region. Finally, we divided the Los Angeles region into the core Los Angeles counties of Los Angeles, Orange, and Ventura, and the Inland Empire counties of San Bernardino and Riverside. The data presented here focus on the RN workforce, primarily because (Licensed Vocational Nurses) LVN data are not available. Many of these figures and tables are drawn from surveys conducted by the California Board of Registered Nursing. The Board of Registered Nursing conducts periodic sample surveys of Registered Nurses throughout California. They also conduct an annual survey of RN education programs. Updated data can be obtained from the Board of Registered Nursing website: The remaining figures and tables are developed from three surveys of Chief Nursing Officers in California hospitals, conducted in 2004 by the Hospital Association of Southern California, the California Institute for Nursing and Health Care, and the University of California, San Francisco (UCSF) Center for the Health Professions. In some regions, there are too few respondents to the surveys to report data without risking the confidentiality of individuals. When there are too few observations to report a data item, this is indicated with an asterisk (*). Regional Definitions Region # Region Name Counties in Region 1 Southern Border Imperial, San Diego Region 2 Inland Empire Riverside, San Bernardino 3 Los Angeles Area Los Angeles, Orange, Ventura 4 Central Coast Monterey, San Benito, San Luis Obispo, Santa Barbara 5 Central Sierra and San Joaquin Valley Alpine, Amador, Calaveras, Fresno, Inyo, Kern, Kings, Madera, Mariposa, Merced, Mono, San Joaquin, Stanislaus, Tulare, Tuolumne 6 Bay Area Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma 7 Sacramento Area El Dorado, Placer, Sacramento, Sutter, Yolo, Yuba 8 Northern California Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Siskiyou, Sierra, Tehama, Trinity 4

5 BRN 2004 Sample Distribution: Region Name SAMPLE SIZE PERCENT OF SAMPLE Southern Border Region Inland Empire Los Angeles Area 1, Central Coast Central Sierra and San Joaquin Valley Bay Area 1, Sacramento Area Northern California Missing Total 5, Source: Center for the Health Professions analysis of Board of Registered Nursing 2004 Survey data. Distribution of Foreign Educated Nurses Region NUMBER OF FOREIGN EDUCATED PERCENT OF FOREIGN EDUCATED Southern Border Region Inland Empire Los Angeles Area Central Coast * Central Sierra and San Joaquin Valley Bay Area Sacramento Area Northern California * Missing Total Source: Center for the Health Professions analysis of Board of Registered Nursing 2004 Survey data. 5

6 Number of Pre-licensure Nursing Education Programs, 2004 Region NUMBER OF RN EDUCATION PROGRAMS NUMBER OF LVN EDUCATION PROGRAMS Southern Border Region 9 8 Inland Empire 8 22 Los Angeles Area Central Coast 5 7 Central Sierra and San Joaquin 9 19 Valley Bay Area Sacramento Area 5 7 Northern California 5 10 Total Source: Center for the Health Professions analysis of Board of Registered Nursing Annual Schools Reports and Board of Vocational Nursing and Psychiatric Technicians web pages. Note that some schools have more than one entry-level education program. Number of Hospital Respondents to the 2004 Survey of Chief Nursing Officers, 2004 Region NUMBER OF RESPONDENTS IN REGION PERCENT OF TOTAL IN SURVEY Southern Border Region Inland Empire Los Angeles Area Central Coast Central Sierra and San Joaquin Valley Bay Area Sacramento Area Northern California Total Respondents

7 2. Southern Border Region This region includes San Diego and Imperial Counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 383. Demographics 93% of survey participants are female. 49% of survey participants report having children living at home. 68% of survey participants are married, while 17% are separated or divorced. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under Over All Ages Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to 99% Total

8 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic * * White, Non-Hispanic Black/African American * * Asian or Pacific Islander Other * * Total Work Settings/Conditions and Attitudes 85.9% of survey participants are currently employed in nursing. 15.2% of survey participants currently hold more than one nursing position. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied/ Dissatisfied Neither satisfied nor dissatisfied Satisfied Very Satisfied Total Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care Nursing Care Facilities * * Home Health Care * * Facilities Other Total

9 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * 2.68 Middle Management, service setting Direct Patient Care Provider Clinical Nurse Specialist * * Nurse Practitioner * * School Nurse * * Public Health Nurse * * Case Manager * * Other Total Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT Increase hours of nursing work * * No change Decrease hours of nursing work Leave nursing entirely * * Plan to retire from profession Total Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate/Masters/PhD Total

10 Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) * * Associate (other) * * Baccalaureate (nursing) Baccalaureate (other) * * Master s (nursing) Master s (other) PhD (any) * * None Note: Percentages are based on total sample of 383 nurses. Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Nurse Anesthetist, Nurse Midwife or Nurse Midwife with Furnishing Number * * Nurse Practitioner (with or without Furnishing Number) Public Health Nurse Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist * * None Note: Percentages are based on total sample of 383 nurses. Of the survey participants who are enrolled or planning to enroll in a nursing degree program in the next three years, 39.3% indicate a degree objective of Associate or Baccalaureate, and 60.7% indicate that of Master s degree or higher. For those survey participants not currently working in nursing, 52.7% are either retired or are not currently seeking work and 31.1% are either working outside nursing or seeking work outside nursing. The remainder is either seeking work in nursing or other. 10

11 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region College County Type Program Grossmont College San Diego Community College AD Imperial Valley College Imperial Community College AD Maric College San Diego Private 2-year College AD Palomar College San Diego Community College AD Point Loma Nazarene College San Diego Private 4-year College BSN San Diego City College San Diego Community College AD San Diego State University San Diego California State University BSN Southwestern Community College San Diego Community College AD University of San Diego San Diego Private 4-year College Entry-level master s RN Program Applications and Slots for Admission, , Border Region Slots Applicants

12 RN Program Completions, , Border Region Ethnic Distribution of Graduating Students, , Border Region Other/Unknown Hispanic Filipino African-American Asian Native American White 12

13 Percent of Males Among Graduating Students, , Border Region 2 18% 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, , Border Region Other/Unknown 56 + years years years years years 13

14 Success of Students, , Border Region Left Program Behind Schedule Completed on Time 2 Total faculty and faculty vacancy rate, , Border Region % % 14% Total faculty Vacancy rate 12% 8% 6% 4% 2% 14

15 Ethnic Distribution of Faculty, , Border Region Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, , Border Region Other/Unknown 60+ years years years years Under 30 years 15

16 C. Chief Nursing Officer Survey Summary There are approximately 32 total hospitals in this region. Twelve hospitals responded to the survey from this region. 67% of hospitals have space for more student rotations. 75% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 19%. of hospitals report that vacancy levels are up from last year, 5 report they are down and 4 report that they are the same. The average number of travelers per hospital used to provide supplemental services is 40; the range is from 1 to 100. The total number of travelers reported by eleven of the respondents in the region is 441. The average overall turnover rate is 7%; the range is from to 14%. 55% of hospitals report having recruited foreign nurses in the previous two years. From the three hospitals reporting, average recruitment expenditures per foreign nurse were about $10,800. Most hospitals in the region provide financial support to employees in the form of tuition reimbursement and scholarships. Less than half provide financial support to their employees in the form of student loan payments, work/stipend programs, forgivable loans, RN to BSN support and BRN approved work-study programs. Adequacy of staff in Regional hospitals One month ago One year ago Surplus of RN resources Adequate RN resources Mild Shortage 45% Moderate shortage 45% 82% Severe shortage * * Strategies to address shortages in Regional hospitals One Month Ago One year ago Overtime/extra shifts Temporary agency 73% 73% Travelers 91% 91% Temporary limit of clinical 27% 27% services Permanent closure of services 16

17 3. Inland Empire This region includes Riverside and San Bernardino counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 456. Demographics: 55.7% of survey participants report having children living at home. 92.4% of survey participants are female. 68% of survey participants are married, while 2 are separated or divorced. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under Over All Ages Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to 99% Total

18 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic White, Non-Hispanic Black/African American Asian or Pacific Islander Other Total Work Settings/Conditions and Attitudes 87.5% of survey participants are currently employed in nursing. 24.1% of those currently employed in nursing currently hold more than one nursing position. Approximately 7.2% of the sample indicated that they work for either a temporary, traveling or registry agency. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied/ Dissatisfied Neither satisfied nor dissatisfied Satisfied Very Satisfied Total Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care Nursing Care Facilities Home Health Care Facilities Other Total

19 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * * Middle Management, service setting Direct Patient Care Provider Clinical Nurse Specialist * * Nurse Practitioner * * School Nurse * * Public Health Nurse * * Case Manager Other Total Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT Increase hours of nursing work No change Decrease hours of nursing work Leave nursing entirely Plan to retire from profession Total Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate/Masters/PhD Total

20 Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) Associate (other) * * Baccalaureate (nursing) Baccalaureate (other) Master s (nursing) Master s (other) PhD (any) * * None Note: Percentages are based on total sample of 456 nurses. Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Nurse Anesthetist, Nurse Midwife or Nurse Midwife with Furnishing Number * * Nurse Practitioner (with or without Furnishing Number) Public Health Nurse Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist * * None Note: Percentages are based on total sample of 456 nurses. Twenty-seven percent of survey participants plan to enroll in a degree program in the next three years. Of those, approximately 39% plan to pursue a Master s or Doctoral Degree. For those survey participants not currently working in nursing, 28% are retired and 33% are not currently seeking work. The rest are about evenly either working outside nursing, seeking work (either in or outside nursing) or other. 20

21 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Chaffey College San Bernardino Community College AD College of the Desert Riverside Community College AD California State University, San Bernardino San Bernardino California State University BSN Loma Linda University San Bernardino Private 4-year University BSN Mount San Jacinto College Riverside Community College AD Riverside Community College Riverside Community College AD San Bernardino Valley College San Bernardino Community College AD Victor Valley College San Bernardino Community College AD Nursing Student Admission Applications and Slots, , Inland Empire Sum of Slots Sum of Applicants

22 RN Program Completions, , Inland Empire Ethnic Distribution of Graduating Students, , Inland Empire Other/Unknown Hispanic Filipino African-American Asian Native American White 22

23 Percent of Males Among Graduating Students, , Inland Empire 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, , Inland Empire Other/Unknown 56 + years years years years years 23

24 Success of Students, , Inland Empire Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, , Inland Empire % % Total faculty Vacancy rate 14% 12% 8% 6% 4% 2% 24

25 Ethnic Distribution of Faculty, , Inland Empire Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, , Inland Empire Other/Unknown 60+ years years years years Under 30 years 25

26 C. Chief Nursing Officer Survey Summary There are approximately 27 hospitals in this region. Sixteen hospitals responded to the survey from this region. 75% of hospitals have space for more student rotations. 56% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 13%. 31% of hospitals report that vacancy levels are up from last year and 56% report they are down. Nine of sixteen hospitals gave information about the number of travelers they hire. The average number of travelers per hospital used to provide supplemental services is 19; the range is from 1 to 72. The total number of travelers reported by the nine respondents in the region is 172. The average overall turnover rate is 15%; the range is from 3% to 28%. 38% of hospitals report having recruited foreign nurses in the previous two years. From the four hospitals reporting, average recruitment expenditures per foreign nurse were about $11,000. The range was from $6,500 to $17,500. Most hospitals in the region provide financial support to employees in the form of tuition reimbursement and scholarships. About half provide support of RN to BSN programs. Less than half provide financial support to their employees in the form of student loan payments, work/stipend programs, forgivable loans, and BRN approved work study programs. Adequacy of staff in Regional hospitals One month ago One year ago Surplus of RN resources Adequate RN resources Mild Shortage 36% 29% Moderate shortage 36% Severe shortage 21% 36% * Percentages do not add to 10 because some hospitals did not respond to specific items. Strategies to address shortages in Regional hospitals One Month Ago One year ago Overtime/extra shifts 87% 93% Temporary agency 8 87% Travelers 67% 6 Temporary limit of clinical 2 27% services Permanent closure of services 26

27 4. Los Angeles Area This region includes Los Angeles, Orange, and Ventura counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 1,561. Demographics 55.31% of survey participants report having children living at home % of survey participants are female. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT CURRENTLY EMPLOYED IN NURSING (%) Under * * * * Over All Ages 1, Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married Married Separated or Divorced Widowed Total 1,

28 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to 99% Total 1, Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic White, Non-Hispanic Black/African American Asian or Pacific Islander Other Total 1, Work Settings/Conditions and Attitudes 84.1% of survey participants are currently employed in nursing. 24.3% of those currently employed in nursing currently hold more than one nursing position. Approximately 2.0 % of the sample indicated that they work for either a temporary or traveling agency, while 4.4% indicated they work for a registry. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very Satisfied Total 1,

29 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care Nursing Care Facilities Home Health Care Facilities Other Total 1, Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting Middle Management, service setting Direct Patient Care Provider Clinical Nurse Specialist Nurse Practitioner School Nurse Public Health Nurse Case Manager Other Total 1, Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work No change Decrease hours of nursing work Leave nursing entirely Plan to retire from profession Total 1,

30 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate/Masters/PhD Total 1, Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) Associate (other) Baccalaureate (nursing) Baccalaureate (other) Master s (nursing) Master s (other) PhD (any) * * None Note: Percentages are based on total sample of 1,561 nurses. Certificates received from California Board of Registered Nursing since initial licensure. CERTIFICATE TYPE FREQUENCY PERCENT Nurse Anesthetist, Nurse Midwife or Nurse Midwife with Furnishing Number Nurse Practitioner Nurse Practitioner with Furnishing Number Public Health Nurse Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist None 1, Note: Percentages are based on total sample of 1,561 nurses. Twenty-two percent of survey participants plan to enroll in a degree program in the next three years. Of those, approximately 57% plan to pursue a Master s or Doctoral Degree. For those survey participants not currently working in nursing, 24% are retired and 29% are not currently seeking work. There are about 2 who are working outside nursing or seeking work outside nursing, and 11% are seeking work in nursing. 30

31 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Antelope Valley College Los Angeles Community College AD Azusa Pacific University Los Angeles Private 4-year College BSN Biola University Los Angeles Private 4-year College BSN Cerritos College Los Angeles Community College AD College of the Canyons Los Angeles Community College AD Compton Community College Los Angeles Community College AD California State University, Long Beach Los Angeles California State University BSN California State University, Los Angeles Los Angeles California State University BSN Cypress College Orange Community College AD East Los Angeles College Los Angeles Community College AD El Camino College Los Angeles Community College AD Glendale Community College Los Angeles Community College AD Golden West Community College Orange Community College AD L.A. County Medical Center Los Angeles County-operated program AD L.A. Harbor College Los Angeles Community College AD L.A. Pierce College Los Angeles Community College AD L.A. Southwest College Los Angeles Community College AD L.A. Trade-Tech College Los Angeles Community College AD L.A. Valley College Los Angeles Community College AD Long Beach City College Los Angeles Community College AD Moorpark College Ventura Community College AD AD, BSN Mount Saint Mary's College Los Angeles Private 4-year College Mount San Antonio College Los Angeles Community College AD Pasadena City College Los Angeles Community College AD Rio Hondo College Los Angeles Community College AD Saddleback College Orange Community College AD Santa Ana College Orange Community College AD Santa Monica College Los Angeles Community College AD University of Southern California Los Angeles Private 4-year College BSN Ventura College Ventura Community College AD 31

32 Nursing Student Admission Applications and Slots, , Los Angeles Area Sum of Slots Sum of Applicants RN Program Completions, , Los Angeles Area

33 Ethnic Distribution of Graduating Students, , Los Angeles Area Other/Unknown Hispanic Filipino African-American Asian Native American White Percent of Males Among Graduating Students, , Los Angeles Area 18% 16% 14% 12% 8% 6% 4% 2% 33

34 Age Distribution of Graduating Students, , Los Angeles Area Other/Unknown 56 + years years years years years Success of Students, , Los Angeles Area Left Program Behind Schedule Completed on Time

35 Total faculty and faculty vacancy rate, , Los Angeles Area Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% Ethnic Distribution of Faculty, , Los Angeles Area Other/Unknown Hispanic Filipino African-American Asian Native American White 35

36 Age Distribution of Faculty, , Los Angeles Area Other/Unknown 60+ years years years years Under 30 years 36

37 C. Chief Nursing Officer Survey Summary There are approximately 175 hospitals in this region. Seventy-five hospitals responded to the survey from this region. 72% of hospitals have space for more student rotations. 48% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 11%. 39% of hospitals report that vacancy levels are up from last year, 27% report they are down and 35% report that they are the same. Fifty-seven of seventy-five hospitals gave information about the number of travelers they hire. The average number of travelers per hospital used to provide supplemental services is 25; the range is from 1 to 220. The total number of travelers reported by the nine respondents in the region is The average overall turnover rate is 14%; the range is from 4.5% to 35%. 55% of hospitals report having recruited foreign nurses in the previous two years. From the 41 hospitals reporting, average recruitment expenditures per foreign nurse were about $13,600. The range was from $2,500 to $35,000. Most hospitals in the region (81%) provide financial support to employees in the form of tuition reimbursement, spending about $1,700 annually per person. Less than half provide financial support to their employees in the form of student loan payments, work/stipend programs, scholarships, forgivable loans, BRN approved work study programs and RN to BSN programs. Adequacy of staff in Regional hospitals One month ago One year ago Surplus of RN resources * * Adequate RN resources Mild Shortage 34% 28% Moderate shortage 51% Severe shortage 19% 13% Strategies to address shortages in Regional hospitals One Month Ago One year ago Overtime/extra shifts 96% 94% Temporary agency 9 89% Travelers 83% 7 Temporary limit of clinical 18% services Permanent closure of services 37

38 5. Central Coast This region includes Monterey, San Benito, San Luis Obispo, and Santa Barbara counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 144. Demographics 41.3% of survey participants report having children living at home. 84.9% of survey participants are white, non-hispanic. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under Over All Ages Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married * Married Separated or Divorced Widowed * Total

39 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to Total Work Settings/Conditions and Attitudes 85.59% of survey participants are currently employed in nursing % of survey participants currently hold more than one nursing position. 65.8% of survey participants work as direct patient care providers. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied/ Dissatisfied * Neither satisfied nor dissatisfied * Satisfied Very Satisfied Total Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care * Nursing Care Facilities * Home Health Care * Facilities Other Total Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT 39

40 Increase hours of nursing work * No change Decrease hours of nursing work Leave nursing entirely * Plan to retire from profession * Total Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate/Masters/PhD Total 140 Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Baccalaureate or Associate Master s and above None Note: Percentages are based on total sample of 144 nurses. Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Any Type None Note: Percentages are based on total sample of 144 nurses. Twenty of the 144 survey participants either are enrolled or are planning to enroll in a nursing degree program in the next three years. 40

41 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Allan Hancock College Santa Barbara Community College AD San Luis Obispo Community College AD Cuesta College Hartnell College Monterey Community College AD Monterey Peninsula College Monterey Community College AD Santa Barbara City College Santa Barbara Community College AD Nursing Student Admission Applications and Slots, , Central Coast Sum of Slots Sum of Applicants 41

42 RN Program Completions, , Central Coast Ethnic Distribution of Graduating Students, , Central Coast Other/Unknown Hispanic Filipino African-American Asian Native American White 42

43 Percent of Males Among Graduating Students, , Central Coast 18% 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, , Central Coast Other/Unknown 56 + years years years years years 43

44 Success of Students, , Central Coast Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, , Central Coast Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% 44

45 Ethnic Distribution of Faculty, , Central Coast Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, , Central Coast Other/Unknown 60+ years years years years Under 30 years C. Chief Nursing Officer Survey Summary There are approximately 19 total hospitals in this region. Three hospitals responded to the survey from this region. This number is too few for detailed analysis, due to small cell counts. 45

46 6. San Joaquin Valley and Central Sierra Regions (combined) This combined region includes San Joaquin, Stanislaus, Merced, Madera, Fresno, Kings, Tulare, Kern, Amador, Alpine, Calaveras, Tuolumne, Mariposa, Mono and Inyo counties. The first eight counties listed above comprise the San Joaquin Valley region, and the last seven comprise the Central Sierra region. A. Board of Registered Nursing 2004 Survey Summary There are 400 survey participants from two Economic Strategy Panel regions, the San Joaquin Valley region and the Central Sierra region. Demographics 51.58% of survey participants report having children living at home % of survey participants are female. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under Over All Ages Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married Married Separated or Divorced Widowed Total

47 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to 99% Total Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic White, Non-Hispanic Black/African American * Asian or Pacific Islander Other * Total Work Settings/Conditions and Attitudes 90.1% of survey participants are currently employed in nursing. 21.1% of survey participants currently hold more than one nursing position. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very Satisfied Total

48 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care Nursing Care Facilities * Home Health Care * Facilities Other Total Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * Middle Management, service setting Direct Patient Care Provider Clinical Nurse Specialist * Nurse Practitioner * School Nurse * Public Health Nurse * Case Manager * Other Total Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work No change Decrease hours of nursing work Leave nursing entirely Plan to retire from profession Total

49 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate/Masters/PhD Total Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) Associate (other) * Baccalaureate (nursing) Baccalaureate (other) * Master s (nursing) Master s (other) * PhD (any) * None Note: Percentages are based on total sample of 400 nurses. Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Nurse Anesthetist, Nurse Midwife or Nurse Midwife with Furnishing Number * Nurse Practitioner (with or without Furnishing Number) Public Health Nurse Psychiatric/Mental Health Nurse * Clinical Nurse Specialist * None Note: Percentages are based on total sample of 400 nurses. Approximately 17% of the 400 participants either are enrolled or are planning to enroll in a nursing degree program in the next three years. Of those, about half are or will be enrolled in a baccalaureate degree and the other half are or will be enrolled in a master s or higher degree program. 49

50 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Bakersfield College Kern Community College AD College of the Sequoias Tulare Community College AD California State University, Bakersfield Kern California State University BSN California State University, Fresno Fresno California State University BSN Fresno City College Fresno Community College AD Merced College Merced Community College AD Modesto Junior College Stanislaus Community College AD San Joaquin Delta College San Joaquin Community College AD There are no nursing programs in the Central Sierra area. Nursing Student Admission Applications and Slots, , San Joaquin Valley Sum of Slots Sum of Applicants

51 RN Program Completions, , San Joaquin Valley Ethnic Distribution of Graduating Students, , San Joaquin Valley Other/Unknown Hispanic Filipino African-American Asian Native American White 51

52 3 25% 2 15% 5% Percent of Males Among Graduating Students, , San Joaquin Valley Age Distribution of Graduating Students, , San Joaquin Valley Other/Unknown 56 + years years years years years 52

53 Success of Students, , San Joaquin Valley Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, , San Joaquin Valley % % Total faculty Vacancy rate 14% 12% 8% 6% 4% 2% 53

54 Ethnic Distribution of Faculty, , San Joaquin Valley Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, , San Joaquin Valley Other/Unknown 60+ years years years years Under 30 years 54

55 C. Chief Nursing Officer Survey Summary There are approximately 71 total hospitals in this region. Thirty-three hospitals responded to the survey from this region. 72% of hospitals have space for more student rotations. 68% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 27%. (There are six responses that are greater than 5, out of 24 respondents). 36% of hospitals report that vacancy levels are up from last year, 52% report they are down and 12% report that they are the same. Twenty-two of thirty-three hospitals gave information about the number of travelers they hire. The average number of travelers per hospital used to provide supplemental services is 16; the range is from 1 to 84. The total number of travelers reported by the nine respondents in the region is 346. The average overall turnover rate is 11%; the range is from to 3, with twentytwo hospitals reporting. 61% of hospitals report having recruited foreign nurses in the previous two years. From the fourteen hospitals reporting, average recruitment expenditures per foreign nurse were about $17,000. The range was from $6,000 to $75,000. Most hospitals in the region provide financial support to employees in the form of tuition reimbursement and scholarships. Less than half provide financial support to their employees in the form of student loan payments, work/stipend programs, forgivable loans, BRN approved work study programs and RN to BSN programs. Adequacy of staff in Regional hospitals One month ago One year ago Surplus of RN resources * * Adequate RN resources 9% 9% Mild Shortage 47% 25% Moderate shortage 44% 34% Severe shortage * 22% Strategies to address shortages in Regional hospitals One Month Ago One year ago Overtime/extra shifts 94% 9 Temporary agency 68% 61% Travelers 71% 71% Temporary limit of clinical 23% 23% services Permanent closure of services * * 55

56 7. Bay Area This region includes Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, and Sonoma counties.this region includes Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, and Sonoma counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 1,105. Demographics 49.4% of survey participants report having children living at home. 93% of survey participants are female. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT CURRENTLY EMPLOYED IN NURSING (%) Under Over All Ages Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married Married Separated or Divorced Widowed Total 1,

57 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% to to 75% to 99% Total Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic White, Non-Hispanic Black/African American Asian or Pacific Islander Other Total 1, Work Settings/Conditions and Attitudes 83.5% of survey participants are currently employed in nursing. 20.3% of survey participants currently hold more than one nursing position. Only 2.7% of the sample indicated that they work for either a temporary, traveling or registry agency. Overall RN satisfaction with most recent nursing position SATISFACTION LEVEL FREQUENCY PERCENT CUMULATIVE PERCENT Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very Satisfied Total 1,

58 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals Ambulatory Care Nursing Care Facilities Home Health Care Facilities Other Total Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * Middle Management, service setting Direct Patient Care Provider Clinical Nurse Specialist Nurse Practitioner School Nurse * Public Health Nurse * Case Manager Other Total Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work No change Decrease hours of nursing work Leave nursing entirely Plan to retire from profession Total

59 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma Associate Degree Baccalaureate Degree Masters/Ph.D Total 1, Degrees received since initial RN licensure n=1,105. PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) Associate (other) Baccalaureate (nursing) Baccalaureate (other) Master s/phd (nursing) Master s/phd (other) None Note: Percentages are based on total sample of 1,105 nurses. Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Nurse Anesthetist, Nurse Midwife or Nurse Midwife with Furnishing Number * Nurse Practitioner Nurse Practitioner with Furnishing Number Public Health Nurse Psychiatric/Mental Health Nurse * Clinical Nurse Specialist None Note: Percentages are based on total sample of 1,105 nurses. Of the survey participants who are enrolled or planning to enroll in a nursing degree program in the next three years, 38.7% indicate a degree objective of Baccalaureate, and 52.4% indicate that of Master s degree. For those survey participants not currently working in nursing, 27.5% are retired, 31.8 % are not currently seeking work and 10. are seeking work in nursing. There are 20.4% who are either working outside nursing or seeking work outside nursing, while the remaining 10.4% have indicated other. 59

60 B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Cabrillo College Santa Cruz Community College AD Chabot College Alameda Community College AD City College of San Francisco San Francisco Community College AD College of Marin Marin Community College AD College of San Mateo San Mateo Community College AD Contra Costa Community College Contra Costa Community College AD California State University, East Bay (Hayward) Alameda California State University BSN De Anza Community College Santa Clara Community College AD Dominican College Marin Private 4-year college BSN Evergreen Valley College Santa Clara Community College AD Gavilan College Santa Clara Community College AD Los Medanos College Contra Costa Community College AD Merritt College Alameda Community College AD Napa Valley College Napa Community College AD Ohlone College Alameda Community College AD Pacific Union College Napa Private 2-year college AD Samuel Merritt-St. Mary's Intercollegiate Alameda Private 4-year college BSN, ELM San Francisco State University San Francisco California State University BSN, ELM San Jose State University Santa Clara California State University BSN Santa Rosa Junior College Sonoma Community College AD Solano Community College Solano Community College AD Sonoma State University Sonoma California State University BSN University of California San Francisco San Francisco University of California ELM BSN, University of San Francisco San Francisco Private 4-year college ELM 60

61 Nursing Student Admission Applications and Slots, , San Francisco Bay Area Sum of Slots Sum of Applicants RN Program Completions, , San Francisco Bay Area

62 Ethnic Distribution of Graduating Students, , San Francisco Bay Area Other/Unknown Hispanic Filipino African-American Asian Native American White 12% Percent of Males Among Graduating Students, , San Francisco Bay Area 11% 9% 62

63 Age Distribution of Graduating Students, , San Francisco Bay Area Other/Unknown 56 + years years years years years Success of Students, , San Francisco Bay Area Left Program Behind Schedule Completed on Time

64 Total faculty and faculty vacancy rate, , San Francisco Bay Area Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% Ethnic Distribution of Faculty, , San Francisco Bay Area Other/Unknown Hispanic Filipino African-American Asian Native American White 64

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