Nursing Demographics Art Viterito Research Associate
Characteristics of the Registered Nurse Population RNs Employed in Nursing RNs Per 100,000 Average Age Average Age at Graduation Average Salary Percent Female Percent Male 2,201,813 782 45.2 30.5 $46,782 94.6% 5.4% Source: Health Resources Services Administration 2001
States With the Highest Number of RNs Per 100,000 District of Columbia Massachusetts South Dakota Rhode Island North Dakota Iowa Maine Pennsylvania Missouri Nebraska 1,675 1,194 1,128 1,101 1,096 1,060 1,025 1,010 960 958 Source: Health Resources Services Administration 2001
States With the Lowest Number of RNs Per 100,000 Nevada California Utah Texas Arizona Oklahoma Idaho New Mexico Georgia Arkansas 520 544 592 606 628 635 636 656 683 701 Source: Health Resources Services Administration 2001
Racial/Ethnic Characteristics of the Registered Nurse Population White 84.7% Am Indian 0.7% Asian 3.3% Black 7.1% Hispanic 4.2% Source: Health Resources Services Administration 2001
A Recent Survey by the American Hospital Association Points to a Shortage of Nurses: 126,000 Positions for Registered Nurses in Hospital Settings are Currently Unfilled Source: American Hospital Association 2000
Recent Developments That Have Characterized the Shortage Include
A Faster Rise in the U.S. Population Than the Nursing Population From 1995 to 2000 Sources: Health Resources Services Administration 2001, Woods & Poole Economics 2001
This Has Resulted in a Decline From 798 RNs Per 100,000 in 1996 to 782 RNs Per 100,000 in 2000, a 2% Drop 800 795 790 785 780 775 770 1996 2000 RN/100,000 798 782 Source: Health Resources Services Administration 1996, 2001
Geographically, There is a Large Disparity in RN Losses and Gains. The 3 Regions That Gained RNs Per 100,000 From 1996 to 2000 Were the West North Central + 40.0 RN s/100,000 Source: Health Resources Services Administration 2001
The East South Central + 37.0 RN s/100,000 Source: Health Resources Services Administration 2001
And the West South Central + 4.8 RN s/100,000 Source: Health Resources Services Administration 2001
In That Time, Losses Were Realized in the East North Central - 0.4 RN s/100,000 Source: Health Resources Services Administration 2001
The South Atlantic - 6.7 RN s/100,000 Source: Health Resources Services Administration 2001
The Pacific - 26.5 RN s/100,000 Source: Health Resources Services Administration 2001
New England - 30.1 RN s/100,000 Source: Health Resources Services Administration 2001
The Middle Atlantic - 46.5 RN s/100,000 Source: Health Resources Services Administration 2001
The Mountain Region - 50.4 RN s/100,000 Source: Health Resources Services Administration 2001
Composite Regional Picture of RN Losses and Gains Per 100,000 From 1996 to 2000 40.0 30.0 20.0 10.0 Change per 100,000 0.0-10.0-20.0-30.0-40.0-50.0-60.0 West North Central East South Central West South Central East North Central South Atlantic Pacific New England Middle Atlantic Mountain RN Change/100,000 40.0 37.3 4.8-0.4-6.7-26.5-30.1-46.5-50.4 Source: Health Resources Services Administration 2001
On a State by State Basis, the Majority of States Have Seen Proportional Declines in Their RN Populations From 1996 to 2000 NUMBER OF STATES GAINING RNs PER CAPITA NUMBER OF STATES LOSING RNs PER CAPITA 23 28 Source: Health Resources Services Administration 1996, 2001
By State, The Largest Increases in RNs Per 100,000 From 1996 to 2000 Have Been: Louisiana Kansas Kentucky Iowa South Dakota North Carolina West Virginia Idaho Oklahoma Mississippi 114 87 84 70 67 62 61 52 51 48 Source: Health Resources Services Administration 1996, 2001
The States With Largest Declines in RNs Per 100,000 From 1996 to 2000 Have Been: Alaska Delaware Arizona Connecticut Virginia Colorado New York New Hampshire Nevada District of Columbia -193-107 -92-89 -80-72 -70-62 -50-42 Source: Health Resources Services Administration 1996, 2001
In Large Part, the Shortage Has Been Driven by a Decline in the Number of Students Completing Nursing Programs. Since 1995, the Number of Graduates Taking the NCLEX-RN Exam Has Dropped 28.8% 100,000 95,000 90,000 85,000 80,000 75,000 70,000 65,000 60,000 1995 1996 1997 1998 1999 2000 2001 All NCLEX 96,610 94,326 89,619 83,239 76,607 71,475 68,759 Source: National Council of State Boards of Nursing 2001
By Geographical Setting, the Largest Proportional Decline in Nursing Graduates From 1996 to 2000 Has Been Experienced in Low Population Density Areas -21.0% -23.0% -25.0% -27.0% -29.0% -31.0% -33.0% -35.0% Rural Large Town Small Town Suburban- Medium City Medium City Suburban- Large City Large City Setting -33.9% -32.4% -27.6% -26.6% -24.0% -22.5% -21.9% Source: Integrated Postsecondary Education Data System 1996, 2000
By Race and Ethnicity, the Largest Proportional Declines Have Been Seen in the White Nursing Student Population 1995 2000 White 85% Am Indian 1% Asian 3% Am Indian 1% Asian 4% Hispanic 7% Hispanic 4% Black 7% White 75% Black 13% Source: Integrated Postsecondary Education Data System 1995, 2000
Further Exacerbating the Shortage is a Decline in the Rate at Which Graduates Pass the NCLEX-RN Exam From 1995 to 2001 % Pass 92 91 90 89 88 87 86 85 84 83 82 ADN BSN 1995 1996 1997 1998 1999 2000 2001 ADN 91.0 88.9 88.1 85.0 84.7 83.8 85.3 BSN 88.7 85.9 86.7 84.6 84.8 83.9 85.9 Source: National Council of State Boards of Nursing 2001
Mounting Dissatisfaction With the Profession Is Yet Another Problem, and the GAO and Federation of Nurses and Health Professionals Cite the Following Issues: Heavy Workloads Insufficient Support Staff Inadequate Wages Diminished Job Security Reduced Patient Contact Loss of Autonomy Higher Patient Acuity Sources: Government Accounting Office 2000, Federation of Nurses and Health Professionals 2000
Community Colleges Play a Critical Role in the Supply of Registered Nurses as 60% of All New RNs Educated in the US Were Educated at the Associate Level BSN 37% ADN 60% Diploma 3% Source: National Council of State Boards of Nursing 2001
The States With the Highest Percentage of Newly Licensed, U.S. Educated RN s With an Associate Degree Are Wyoming New Mexico New York Florida Idaho Kentucky Iowa California New Hampshire Arizona 79% 77% 76% 76% 74% 73% 71% 71% 71% 71% Source: National Council of State Boards of Nursing 2000
For Underrepresented Populations, the Associate Degree is the Preferred Gateway Into the Profession. In Rural Settings, 73% of All Entry-Level Nursing Degrees Are Associate Degrees. Only 27% Are Bachelor Degrees Bachelors 27% Associate 73% Source: Integrated Postsecondary Education Data System 1997
The Ratio of Associate to Bachelor Recipients Is Also High for Most Underrepresented Racial/Ethnic Groups Am. Indian 65.7% Hispanic 61.4% Black 56.9% White 56.7% All 56.5% Asian 48.1% 0% 20% 40% 60% 80% 100% Source: Integrated Postsecondary Education Data System 1997