Length of Program Regional Workforce Planning Collaborative Topic: Nursing Education Programs North Texas Region Background This report was compiled with information from the Texas Center for Nursing Workforce Studies (TCNWS for 2012) in collaboration with the Texas Board of Nursing. The data was collected in the 2012 Board of Nursing s (BON) Nursing Education Program Information Surveys (NEPIS) for the reporting period Academic Year 2012 (or September 1, 2011 August 31, 2012), unless otherwise noted. TCNWS collaborated with the BON in the design and implementation of the survey. Scope of the North Texas Region Nursing Program Characteristics In 2009, TCNWS did not report length of curriculum because that information was unavailable. Also, between the 3 years, some of the response options in the demographic questions changed. Finally, for 2011, the terminology changed in how information on faculty positions was gathered (employed rather than budgeted). Chart 1. 30 27 28 24 24 24 24 25 20 20 20 21 21 21 20 16 16 16 16 18 21* 15 10 5 0 2012 Nursing Program - Length of Curriculum (months) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 *Avg. length of program Number of Programs Chart 1 shows the 2012 program/curriculum distribution regarding number of programs being offered and the relevant duration. Similar distribution pattern was seen in 2011. A total of 17 programs were offered in 2012, 11 ADN and 6 BSN. The length of these programs does not include nursing prerequisites but does show how varied the length of a program may be, anywhere from 16 to 28 months. All four of the 16-months programs are found to be ADN programs. Interestingly, seven of the ten 20-27 months programs were also ADN programs.
Collin Cooke Dallas Denton Erath Grayson Johnson Kaufman Parker Tarrant Regional Workforce Planning Collaborative Chart 2. North Texas 2012 Nursing Program by Chart 2 shows the spread of programs by type, Type and County across a 10-county region with Dallas County owning over 35 percent of these programs having five ADN programs 7 and one BSN. Tarrant County has half as much with one 6 ADN and two BSN. 5 School participation has grown by 17.6% over the 4 BSN years with 14 back in 2009 to now having 17 participating 3 ADN schools in 2012. Also for 2012, two private alternative 2 1 schools participated from Dallas County, both offering ADN programs. 0 County distribution of participating schools for 2012 were; Johnson-1, Tarrant-3, Collin-1, Dallas-6, Kaufman-1, Cooke-1, Grayson-1, Parker-1, Erath-1, Denton-1. The contributing programs from all participating counties remained the same for 2009, 2010 and 2011. Program types are ADN and BSN (ADN-11, BSN-6) for 2012 as it was in 2011. ADN programs are on the increase as more private alternative programs are being added in Dallas County. Chart 2 also shows a total of six programs were offered in Dallas County (ADN-5, BSN-1) in 2012 as in 2011 with three in Tarrant County (ADN-1, BSN-2). Of all the BSN and ADN programs, two of the six BSN programs are offered in Tarrant County and five of the eleven ADN programs are offered in Dallas. Chart 3. North Texas 2012 Nursing Program by According to data published June 2012, from the School Type DFWHC Foundation,, Nursing Education Programs, 38% of active RNs have BSN and 47% have ADN degrees. Also, with a nursing workforce 2 of over 184,000 RNs, Texas has more RNs than any other 3 health profession. 12 Private/For-Profit Private/Non-Profit Public See GPS Map (Appendix) with current nursing school locations for Region. Chart 3 shows the distribution of programs by school type with 12 of the 17 programs are offered at public institution, three in private non-profit and two in private forprofit schools. Page 2
Page 3 The number of graduates from both ADN and BSN programs was a lot less in 2009 but has shown steady growth since then (see Chart 4). It also shows that as ADN and BSN programs enrolled students in 2011 the proportionate number of students graduating from these programs is relatively high. Because the number of enrolled has almost doubled over the last year, the gap between 2012 enrolled and graduated is significantly reduced (see Chart 5). Chart 4. 1300 1200 1100 1000 900 800 880 852 989 954 1170 1023 1213 1145 Governing Institutions are private/non-profit, private/for-profit and public. Chart 6 shows that over 70% of the 2012 governing institutions is public universities and colleges, while 18% is private. The remainder, 12%, is alternative private for-profit institutions. This 12% is significant as we consider the workforce pipeline. Generally, those trained in these alternative institutions will work outside the hospital setting. There are opportunities to consider how to attract this 12% to the workforce. All counties have some sort of program track (See Chart 7.) which may include LVN to ADN, paramedic to ADN, LVN to BSN, RN to BSN, BS to BSN, accelerated compressed, other. Chart 6. Graduates from ADN and BSN Programs by Year 2009 2010 2011 2012 North Texas 2012 Nursing Program by School Type 70.6% 11.8% 17.6% ADN BSN Chart 5. Program Tracks: In 2011 LVN to ADN was 6, in 2012, 8, a 25% increase. 2011 paramedic to ADN was 2, 2012 increase by 1 or 33%. LVN to BSN-2, RN to BSN-4, Bachelor s to BSN-2. These tracks remained the same for both 2011 and 2012. Articulation Agreements: All ADN programs have some sort of articulation agreement. As defined by Dallas County Community College District, an articulation agreement is a contract that sets forth the terms and conditions of students transfer from Dallas County Community College District to the partner institution. Private/For-Profit Private/Non-Profit Public Articulation between institutions of higher education means transferring credit for courses and/or programs from one institution to another without misinterpretation. [Students] are responsible for making sure they are taking the appropriate courses for transfer to another institution. Students should check the current catalog for the latest course information and course prerequisite requirements. 13 of the 17 nursing programs have articulation agreement. 3000 2000 1000 0 1464 Enrollment and Graduate Distribution by Program Type 1170 1245 1023 2605 1213 2762 ADN BSN ADN BSN 2011 2012 1145 enroll graduate
Students with various educational backgrounds are granted advanced placements: Prior VN and RN; nursing education; paramedics; LVN; BS/MS in discipline other than nursing; and military healthcare personnel. Student Demographics Race and Ethnicity Chart 7. 7% 25% 7% 2012 North Texas Nursing Programs 14% 7% 29% 11% diversely reflective of the population it will serve. LVN to ADN Paramedic to ADN LVN to BSN RN to BSN BS to BSN Accelerated Compressed None/Other Table 1 and Table 2 below show the enrollment and graduate distribution by race/ethnicity from 2009 to 2012 academic school years. White/Caucasian continues to dominate students enrolled by more than a 4:1 margin to its closes rival, African, all three years. Hispanic/Latin and Asian/Pacific Islander have even wider disparities. The same is true for those who graduate during those same periods the margin is over 5:1 between White/Caucasian and African and the gap gets even wider for the other ethnic groups and is not reflective of the patient/family populations it serve. As the population becomes more racial and ethnically diverse, the potential workforce needs to be more Table 1. Race/Ethnicity of ALL pre-rn licensure students enrolled as of September 30, 2009, 2010, 2011and 2012 Year Enrolled White/ Caucasian African Hispanic/ Latin Asian/Pacific Islander Indian/Alaskan 2009 2625 522 502 360 29 235 2010 1750 445 376 301 17 106 2011 2012 1668 1625 303 398 270 366 201 294 24 32 Other/ Undefined 57 129 Table 2. Race/Ethnicity of ALL pre-rn licensure graduates during AYs 2008-2011 Academic Year White/ Caucasian African Hispanic/ Latin Asian/Pacific Islander Indian/Alaskan Other/ Undefined 2008-2009 1133 246 146 132 10 65 2009-2010 1183 226 204 183 22 125 2010-2011 2011-2012 1319 1464 303 265 270 252 201 228 24 17 76 131 Page 4
Gender Disparity Generally, there tends to be more females enrolled in RN programs than males, who account for only 15% of all students in 2009 to 35% in 2011 and a drastic falling off back to pre-2010 numbers in 2012 (see Chart 8.) The same is true of prelicensed Chart 8. Male Gender Disparity 14% RN graduates where 13.6% were male in 2009 and 27% in 2011 and a significant drop in 2012. In Tarrant and Dallas counties the percentage of male graduates tends to be higher that other counties, at over 22%. 2009 2010 2011 2012 In 2011 it appears that the male population of ADN prepared nurses is significantly higher than the male population in the BSN program at 13% and 8%, respectively. This follows the fact that 21% of ADN nursing students were males while only 14% of BSN students were males. graduated enrolled Another significant observation for 2011 was that both male enrolled and graduated students exceeded their female counterpart in Dallas County in the ADN program enrolled by 115% and graduates by 42%. The comparative data was not available for 2012. Age Cohort 15% 13% 14% 20% 26% 27% 35% Chart 9. 2012 Age Distribution Overall, the 2012 age distribution 40.0% (Chart 9) shows majority of enrolled students and graduates fall into the 21-30.0% 25 cohort. A closer examination does show that a majority of both enrolled and graduates 20.0% are between 20-39 years of age. This would suggest that those in this age 10.0% range who are committed to the profession could possibly be in the nursing workforce for 20 to 40 years 0.0% 17-20 21-25 26-30 31-40 41-50 51-60 >60 before retiring. This is also quite typical Admitted 11.3% 33.6% 19.3% 24.9% 8.0% 2.8% 0.0% of those in nursing today. It is also Graduates 1.6% 37.3% 21.7% 27.1% 10.1% 2.1% 0.0% worth noting that the 12% of those RNs with less than 20 years of service before retiring will become part of the aged population needing more and more medical care themselves. This will also impact the nursing workforce as the12% will be needed to be replaced but additionally, the lost in experience and knowledge will be irreplaceable, a major challenge for nursing. Page 5
Total Faculty Resignations Retirements Regional Workforce Planning Collaborative Scope of Faculty Positions 2012 faculty information is available as part of the North Texas nursing education data. It includes headcount, vacancy and turnover (resignations and retirements) as well as demographic data such as education level, race and ethnicity, gender and age distribution. Total full time and part time faculty employed in North Texas for 2012 numbered around 554 in both the ADN and BSN nursing programs (see Chart 10). Chart 10 also shows the number of resignations and retirements of faculty from both ADN and BSN programs. Chart 10. 2012 Faculty with Resignations and Retirements 3 Full time 2 4 Part time 1 15 Full time 19 BSN 9 Part time 21 ADN 255 Full time 158 Vacancy Rate 2012 faculty vacancy rates for ADN and BSN programs are 10.6% and 6.3%, respectively with the overall North Texas region for all programs is 8.2%, an increased vacancy rate of 2% from 2011. Vacancy rate has increased each successive year since 2009 from 4.9% to 5.6% in 2010. 2011 rate of 6.2% is slightly lower than the national nursing faculty vacancy rate of 7.7%, according to the April 2, 2012, Nursing Faculty Report by the Association of Colleges of Nursing (AACN). Part time 52 89 0 50 100 150 200 250 300 Turnover Rate 2012 faculty turnover rate across all programs was 13.2 %, a decrease of over 3.5% from 2011 (see Chart 11). A total of 55 faculty members resigned in 2011 (Chart 10) whereas retirement accounted for 10. Both vacancy and turnover rates continue to increase year over year. However, 2012 turnover rate decreased by 3.5% to nearly pre-2011 levels as see in Chart 11. Demographics Profile Gender and Race/ethnicity Disparities 94% of the faculty has been female and a significant percent (80%) are White/Caucasian with the next closest ethnic group being Blacks at ten percent (Chart 12). The numbers are identical to those of 2011 with the exception of a 1% increase in Black/African faculty in 2012. Page 6 Chart 11. 20 15 10 5 0 Nursing Faculty Vacancy and Turnover 2012 16.8 12 12.7 13.2 6.2 8.2 4.9 5.6 2009 2010 2011 2012 Vacancy Turnover
Chart 12. Race/Ethnicity for Nursing Faculty 2012 Age Cohort 7.5% 80.2% 10.0% 2.4% Black/African Hispanic/Latino White/Caucasian Other Chart 13 shows 38% of faculty is in the 55-64 age group with another 11% at or above 65 years of age. This would suggest that nearly half or 49% of faculty is at or approaching retirement age in 10 years or less. The next largest group is those between 45-54 years of age at about 25%. With only 26% of faculty below 45 years of age, it is safe to conclude that a strategic campaign is needed to attract younger persons to become faculty. Aside from financial, much creative incentives must be employed to attract and retain younger faculty such as work/life balance. Chart 13. Age Category for Nursing Faculty 2012 Education Level 40% 35% 30% 25% 20% 15% 10% 5% 0% In 2012 the majority of faculty has a Master of Science in Nursing at 466, up by 30 from 2011. Another 12 has a Doctorate in Nursing Science/Practice and 87 have a PhD in Nursing (Chart 14). These professional academic accolades are attained over several years of study, practicum and experience. As is the sentiment in other part of the country, the outlook for faculty is not very positive for the nursing profession in North Texas. Some of the factors impacting nursing faculty outlook, according to AACN are, age limiting productive instruction year, retirement, low professionally prepared, and attractive compensation in clinical and private-sector settings. 8% 34 and younger 38% 25% 18% 11% 35-44 45-54 55-64 65+ Chart 13. Highest Degree for Nursing Faculty 2012 Other Doctorate in Other Field Doctorate in Nursing Science Doctorate in Nursing Practice PhD Nursing Master's Other Field MSN Bachelor's in Other Field Baccalaureate in Nursing 1 46 2 10 87 13 12 1 466 Page 7
Appendix Page 8
References: Texas Center for Nursing Workforce Studies (TCNWS), Board of Nursing s (BON) Nursing Education Program Information Surveys (NEPIS), 2009-2011 Dallas County Community College District, Articulation Agreements, 2012, from website: http://www.dcccd.edu/ss/academics/ts/transferfromdcccd/agreements/pages/default.aspx Association of Colleges of Nursing, Nursing Faculty Shortage, April 2, 2012 from website: http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-faculty-shortage Map, North Texas Schools Offering Nursing Education by County, by Jaylene Jones, DFWHC Foundation, October 2012 DFWHC Foundation Workforce Center. All rights reserved. For questions about this information or our collaborative work contact Neguiel Francis at the DFWHC Foundation Workforce Center nfrancis@dfwhcfoundation.orgor 972-717-4279. Page 9