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. 2007 1
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 16 3. 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 26 4. 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 37 5. 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 45 6. 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 55 7. 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 65 8. Sacramento Area 66 A. Board of Registered Nursing 2004 Survey Summary 66 2
B. Board of Registered Nursing Annual Schools Report Summary 70 C. Chief Nursing Officer Survey Summary 74 9. 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
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: www.rn.ca.gov. 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
BRN 2004 Sample Distribution: Region Name SAMPLE SIZE PERCENT OF SAMPLE Southern Border Region 383 7.38 Inland Empire 456 8.79 Los Angeles Area 1,561 30.09 Central Coast 144 2.78 Central Sierra and San Joaquin Valley 400 7.71 Bay Area 1,105 21.30 Sacramento Area 318 6.13 Northern California 181 3.49 Missing 639 12.32 Total 5,187 100.00 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 62 7.53 Inland Empire 59 7.17 Los Angeles Area 360 43.74 Central Coast * Central Sierra and San Joaquin 40 4.86 Valley Bay Area 172 20.90 Sacramento Area 31 3.77 Northern California * Missing 83 10.09 Total 823 100.0 Source: Center for the Health Professions analysis of Board of Registered Nursing 2004 Survey data. 5
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 33 85 Central Coast 5 7 Central Sierra and San Joaquin 9 19 Valley Bay Area 27 33 Sacramento Area 5 7 Northern California 5 10 Total 101 191 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 12 6.45 Inland Empire 16 8.60 Los Angeles Area 75 40.32 Central Coast 4 2.15 Central Sierra and San Joaquin Valley 33 17.74 Bay Area 29 15.59 Sacramento Area 3 1.61 Northern California 14 7.53 Total Respondents 186 100.00 6
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 35 29 9.51 35-39 28 9.18 40-44 40 13.11 45-49 50 16.39 50-54 56 18.36 55-59 49 16.07 60-64 30 9.84 Over 64 23 7.54 All Ages 305 100.00 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 49 14.98 25 to 5 88 26.91 51 to 75% 74 22.63 76 to 99% 43 13.15 10 73 22.32 Total 327 100.00 7
Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic * * White, Non-Hispanic 258 71.27 Black/African American * * Asian or Pacific Islander 69 19.06 Other * * Total 362 100.00 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 38 10.27 10.27 Neither satisfied nor dissatisfied 61 16.49 26.76 Satisfied 177 47.84 74.59 Very Satisfied 94 25.41 100.00 Total 370 100.00 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 162 51.92 Ambulatory Care 35 11.22 Nursing Care Facilities * * Home Health Care * * Facilities Other 83 26.60 Total 312 100.00 8
Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * 2.68 Middle Management, service setting 65 21.81 Direct Patient Care Provider 143 47.99 Clinical Nurse Specialist * * Nurse Practitioner * * School Nurse * * Public Health Nurse * * Case Manager * * Other 45 15.10 Total 298 100.00 Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT Increase hours of nursing work * * No change 160 54.98 Decrease hours of nursing work 63 21.65 Leave nursing entirely * * Plan to retire from profession 39 13.40 Total 291 100.00 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 95 26.46 26.46 Associate Degree 143 39.83 66.39 Baccalaureate/Masters/PhD. 121 33.70 100.00 Total 359 100.00 9
Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) * * Associate (other) * * Baccalaureate (nursing) 55 14.36 Baccalaureate (other) * * Master s (nursing) 33 8.62 Master s (other) 23 6.01 PhD (any) * * None 211 55.09 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 21 5.48 Furnishing Number) Public Health Nurse 55 14.36 Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist * * None 241 62.92 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
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, 2001-2004, Border Region 1800 1600 1400 1200 1000 800 600 400 Slots Applicants 200 0 11
RN Program Completions, 2001-2004, Border Region 700 600 500 400 300 200 100 0 Ethnic Distribution of Graduating Students, 2001-2004, Border Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 12
Percent of Males Among Graduating Students, 2001-2004, Border Region 2 18% 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, 2001-2004, Border Region 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years 13
Success of Students, 2001-2004, Border Region 10 9 8 7 6 5 4 3 Left Program Behind Schedule Completed on Time 2 Total faculty and faculty vacancy rate, 2001-2004, Border Region 250 2 18% 200 16% 14% 150 100 50 0 Total faculty Vacancy rate 12% 8% 6% 4% 2% 14
Ethnic Distribution of Faculty, 2001-2004, Border Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, 2001-2004, Border Region 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years 15
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 10 10 Temporary agency 73% 73% Travelers 91% 91% Temporary limit of clinical 27% 27% services Permanent closure of services 16
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 34 47 13.39 35-39 28 7.98 40-44 42 11.97 45-49 68 19.37 50-54 62 17.66 55-59 53 15.10 60-64 29 8.26 Over 64 22 6.27 All Ages 351 100.00 Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 43 10.62 25 to 5 107 26.42 51 to 75% 92 22.72 76 to 99% 56 13.83 10 107 26.42 Total 405 100.00 17
Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic 36 8.33 White, Non-Hispanic 274 63.43 Black/African American 25 5.79 Asian or Pacific Islander 81 18.75 Other 16 3.70 Total 432 100.00 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/ 47 10.71 10.71 Dissatisfied Neither satisfied nor 60 13.67 24.37 dissatisfied Satisfied 212 48.29 72.67 Very Satisfied 120 27.33 100.00 Total 439 100.00 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 246 63.08 Ambulatory Care 36 9.23 Nursing Care Facilities 17 4.36 Home Health Care 21 5.38 Facilities Other 70 17.95 Total 390 100.00 18
Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * * Middle Management, service setting 61 16.35 Direct Patient Care Provider 207 55.50 Clinical Nurse Specialist * * Nurse Practitioner * * School Nurse * * Public Health Nurse * * Case Manager 21 5.63 Other 53 14.21 Total 373 100.00 Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT Increase hours of nursing work 21 5.97 No change 198 56.25 Decrease hours of nursing work 80 22.73 Leave nursing entirely 16 4.55 Plan to retire from profession 37 10.51 Total 352 100.00 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 68 15.89 15.89 Associate Degree 256 59.81 75.70 Baccalaureate/Masters/PhD. 104 24.30 100.00 Total 428 100.00 19
Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) 35 7.68 Associate (other) * * Baccalaureate (nursing) 59 12.94 Baccalaureate (other) 36 7.89 Master s (nursing) 23 5.04 Master s (other) 22 4.82 PhD (any) * * None 237 51.97 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 20 4.38 Furnishing Number) Public Health Nurse 45 9.87 Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist * * None 310 67.98 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
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, 2001-2004, Inland Empire 2000 1800 1600 1400 1200 1000 Sum of Slots Sum of Applicants 800 600 400 200 0 21
RN Program Completions, 2001-2004, Inland Empire 700 600 500 400 300 200 100 0 Ethnic Distribution of Graduating Students, 2001-2004, Inland Empire 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 22
Percent of Males Among Graduating Students, 2001-2004, Inland Empire 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, 2001-2004, Inland Empire 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years 23
Success of Students, 2001-2004, Inland Empire 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, 2001-2004, Inland Empire 250 2 18% 200 16% 150 100 50 0 Total faculty Vacancy rate 14% 12% 8% 6% 4% 2% 24
Ethnic Distribution of Faculty, 2001-2004, Inland Empire 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, 2001-2004, Inland Empire 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years 25
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
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. 92.74% of survey participants are female. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT CURRENTLY EMPLOYED IN NURSING (%) Under 30 57 4.73 * 30-34 126 10.46 * 35-39 101 8.38 * 40-44 136 11.29 83.8 45-49 211 17.51 86.7 50-54 228 18.92 88.6 55-59 141 11.70 * 60-64 104 8.63 77.9 Over 64 101 8.38 43.6 All Ages 1,205 100.00 84.07 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married 203 13.72 Married 973 65.74 Separated or Divorced 240 16.22 Widowed 64 4.32 Total 1,480 100.00 27
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 195 14.29 25 to 5 278 20.37 51 to 75% 305 22.34 76 to 99% 202 14.80 10 385 28.21 Total 1,365 100.00 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic 117 7.87 White, Non-Hispanic 800 53.84 Black/African American 71 4.78 Asian or Pacific Islander 449 30.22 Other 49 3.30 Total 1,486 100.00 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 23 1.54 1.54 Dissatisfied 105 7.02 8.56 Neither satisfied nor 225 15.04 23.60 dissatisfied Satisfied 819 54.75 78.34 Very Satisfied 324 21.66 100.00 Total 1,496 100.00 28
Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 803 62.88 Ambulatory Care 119 9.32 Nursing Care Facilities 55 1.31 Home Health Care 46 3.60 Facilities Other 254 19.89 Total 1,277 100.00 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting 29 2.34 Middle Management, service setting 222 17.90 Direct Patient Care Provider 636 51.29 Clinical Nurse Specialist 21 1.69 Nurse Practitioner 45 3.63 School Nurse 30 2.42 Public Health Nurse 16 1.29 Case Manager 52 4.19 Other 189 15.24 Total 1,240 100.00 Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work 97 8.21 No change 648 54.82 Decrease hours of nursing work 253 21.40 Leave nursing entirely 43 3.64 Plan to retire from profession 141 11.93 Total 1,182 100.00 29
Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 340 22.96 22.96 Associate Degree 657 44.36 67.32 Baccalaureate/Masters/PhD. 484 32.68 100.00 Total 1,481 100.00 Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) 89 5.70 Associate (other) 49 3.14 Baccalaureate (nursing) 254 16.27 Baccalaureate (other) 117 7.50 Master s (nursing) 122 7.82 Master s (other) 85 5.45 PhD (any) * * None 773 49.52 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 20 1.28 Nurse Practitioner 51 3.27 Nurse Practitioner with Furnishing Number 43 2.75 Public Health Nurse 221 14.16 Psychiatric/Mental Health Nurse * * Clinical Nurse Specialist 45 2.88 None 1,016 65.09 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
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
Nursing Student Admission Applications and Slots, 2001-2004, Los Angeles Area 7000 6000 5000 4000 Sum of Slots Sum of Applicants 3000 2000 1000 0 RN Program Completions, 2001-2004, Los Angeles Area 2300 2200 2100 2000 1900 1800 1700 1600 32
Ethnic Distribution of Graduating Students, 2001-2004, Los Angeles Area 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Percent of Males Among Graduating Students, 2001-2004, Los Angeles Area 18% 16% 14% 12% 8% 6% 4% 2% 33
Age Distribution of Graduating Students, 2001-2004, Los Angeles Area 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years Success of Students, 2001-2004, Los Angeles Area 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 34
Total faculty and faculty vacancy rate, 2001-2004, Los Angeles Area 900 800 700 600 500 400 300 200 100 0 Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% Ethnic Distribution of Faculty, 2001-2004, Los Angeles Area 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 35
Age Distribution of Faculty, 2001-2004, Los Angeles Area 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years 36
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 1432. 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
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 40 20 17.39 40-49 34 29.56 50-59 41 35.65 Over 60 20 17.39 All Ages 115 100.00 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married * Married 94 68.12 Separated or Divorced 29 21.01 Widowed * Total 138 100.00 38
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 23 18.11 25 to 5 31 24.41 51 to 75% 31 24.41 76 to 10 42 32.97 Total 127 100.00 Work Settings/Conditions and Attitudes 85.59% of survey participants are currently employed in nursing. 16.81% 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 73 51.77 74.47 Very Satisfied 36 25.53 100.00 Total 141 100.00 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 68 58.12 Ambulatory Care * Nursing Care Facilities * Home Health Care * Facilities Other 23 19.66 Total 117 100.00 Intentions regarding amount of time spent nursing in next five years INTENTION FREQUENCY PERCENT 39
Increase hours of nursing work * No change 65 59.63 Decrease hours of nursing work 22 20.18 Leave nursing entirely * Plan to retire from profession * Total 109 100.00 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 28 20.00 20.00 Associate Degree 74 52.86 72.86 Baccalaureate/Masters/PhD. 38 27.14 100.00 Total 140 Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Baccalaureate or 28 19.4 Associate Master s and above 23 16.0 None 83 57.6 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 41 28.5 None 98 68.1 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
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, 2001-2004, Central Coast 450 400 350 300 250 200 150 100 50 0 Sum of Slots Sum of Applicants 41
RN Program Completions, 2001-2004, Central Coast 250 200 150 100 50 0 Ethnic Distribution of Graduating Students, 2001-2004, Central Coast 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 42
Percent of Males Among Graduating Students, 2001-2004, Central Coast 18% 16% 14% 12% 8% 6% 4% 2% Age Distribution of Graduating Students, 2001-2004, Central Coast 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years 43
Success of Students, 2001-2004, Central Coast 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, 2001-2004, Central Coast 70 60 50 40 30 20 10 0 Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% 44
Ethnic Distribution of Faculty, 2001-2004, Central Coast 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, 2001-2004, Central Coast 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 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
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. 93.14% of survey participants are female. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under 34 40 12.62 35-39 29 9.15 40-44 48 15.14 45-49 69 21.77 50-54 50 15.77 55-59 45 14.20 60-64 22 6.94 Over 60 36 11.36 All Ages 317 100.00 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married 33 8.68 Married 277 72.89 Separated or Divorced 57 15.00 Widowed 13 3.42 Total 380 100.00 46
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 45 12.75 25 to 5 77 21.81 51 to 75% 99 28.05 76 to 99% 56 15.86 10 76 21.53 Total 353 100.00 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic 37 9.79 White, Non-Hispanic 263 69.58 Black/African American * Asian or Pacific Islander 50 13.23 Other * Total 378 100.00 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 0 0.00 0.00 Dissatisfied 30 7.65 7.65 Neither satisfied nor dissatisfied 50 12.76 21.41 Satisfied 214 54.59 75.00 Very Satisfied 98 25.00 100.00 Total 392 100.00 47
Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 210 59.83 Ambulatory Care 41 11.68 Nursing Care Facilities * Home Health Care * Facilities Other 70 19.94 Total 351 100.00 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * Middle Management, service setting 63 19.03 Direct Patient Care Provider 165 49.85 Clinical Nurse Specialist * Nurse Practitioner * School Nurse * Public Health Nurse * Case Manager * Other 45 13.60 Total 331 100.00 Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work 22 6.53 No change 199 59.05 Decrease hours of nursing work 65 19.29 Leave nursing entirely 10 2.97 Plan to retire from profession 41 12.17 Total 337 100.00 48
Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 56 14.70 14.70 Associate Degree 215 56.43 71.13 Baccalaureate/Masters/PhD. 110 28.87 100.00 Total 381 100.00 Degrees received since initial licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) 20 5.00 Associate (other) * Baccalaureate (nursing) 68 17.00 Baccalaureate (other) * Master s (nursing) 33 8.25 Master s (other) * PhD (any) * None 206 51.50 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 22 5.50 Number) Public Health Nurse 71 17.75 Psychiatric/Mental Health Nurse * Clinical Nurse Specialist * None 248 62.00 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
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, 2001-2004, San Joaquin Valley 2000 1800 1600 1400 1200 Sum of Slots Sum of Applicants 1000 800 600 400 200 0 50
RN Program Completions, 2001-2004, San Joaquin Valley 700 600 500 400 300 200 100 0 Ethnic Distribution of Graduating Students, 2001-2004, San Joaquin Valley 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 51
3 25% 2 15% 5% Percent of Males Among Graduating Students, 2001-2004, San Joaquin Valley Age Distribution of Graduating Students, 2001-2004, San Joaquin Valley 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years 52
Success of Students, 2001-2004, San Joaquin Valley 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, 2001-2004, San Joaquin Valley 250 2 18% 200 16% 150 100 50 0 Total faculty Vacancy rate 14% 12% 8% 6% 4% 2% 53
Ethnic Distribution of Faculty, 2001-2004, San Joaquin Valley 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, 2001-2004, San Joaquin Valley 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years 54
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
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 30 34 3.91 94.12 30-34 73 8.40 91.78 35-39 71 8.17 92.96 40-44 114 13.12 85.09 45-49 143 16.446 86.71 50-54 156 17.95 91.67 55-59 137 15.77 83.94 60-64 76 8.75 69.74 Over 64 65 7.48 47.69 All Ages 869 10 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married 140 13.30 Married 708 67.24 Separated or Divorced 177 16.81 Widowed 28 2.66 Total 1,053 100.00 56
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 154 16.01 25 to 5 234 24.32 51 to 75% 215 22.35 76 to 99% 120 12.47 10 239 24.84 Total 962 100.00 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic 32 3.06 White, Non-Hispanic 703 67.21 Black/African American 31 2.96 Asian or Pacific Islander 248 23.71 Other 32 3.06 Total 1,046 100.00 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 16 1.51 1.51 Dissatisfied 78 7.34 8.84 Neither satisfied nor dissatisfied 176 16.56 25.40 Satisfied 529 49.76 75.16 Very Satisfied 264 24.84 100.00 Total 1,063 100.00 57
Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 536 60.09 Ambulatory Care 103 11.55 Nursing Care Facilities 39 4.37 Home Health Care Facilities 39 4.37 Other 175 19.62 Total 892 100.00 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * Middle Management, service setting 145 16.76 Direct Patient Care Provider 456 52.81 Clinical Nurse Specialist 23 2.66 Nurse Practitioner 34 3.93 School Nurse * Public Health Nurse * Case Manager 34 3.93 Other 137 15.84 Total 865 100.00 Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work 77 9.24 No change 450 54.02 Decrease hours of nursing work 184 22.09 Leave nursing entirely 30 3.60 Plan to retire from profession 92 11.04 Total 833 100.00 58
Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 220 20.81 20.81 Associate Degree 412 38.98 59.79 Baccalaureate Degree 402 38.03 97.82 Masters/Ph.D. 23 2.18 100.00 Total 1,057 100.00 Degrees received since initial RN licensure n=1,105. PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) 31 2.81 Associate (other) 21 1.90 Baccalaureate (nursing) 152 13.76 Baccalaureate (other) 66 5.97 Master s/phd (nursing) 131 11.85 Master s/phd (other) 64 5.79 None 569 51.49 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 39 3.53 Nurse Practitioner with Furnishing Number 35 3.17 Public Health Nurse 182 16.47 Psychiatric/Mental Health Nurse * Clinical Nurse Specialist 38 3.44 None 712 64.43 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
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
Nursing Student Admission Applications and Slots, 2001-2004, San Francisco Bay Area 5000 4500 4000 3500 3000 Sum of Slots Sum of Applicants 2500 2000 1500 1000 500 0 RN Program Completions, 2001-2004, San Francisco Bay Area 1600 1400 1200 1000 800 600 400 200 0 61
Ethnic Distribution of Graduating Students, 2001-2004, San Francisco Bay Area 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 12% Percent of Males Among Graduating Students, 2001-2004, San Francisco Bay Area 11% 9% 62
Age Distribution of Graduating Students, 2001-2004, San Francisco Bay Area 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years Success of Students, 2001-2004, San Francisco Bay Area 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 63
Total faculty and faculty vacancy rate, 2001-2004, San Francisco Bay Area 700 600 500 400 300 200 100 0 Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% Ethnic Distribution of Faculty, 2001-2004, San Francisco Bay Area 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 64
Age Distribution of Faculty, 2001-2004, San Francisco Bay Area 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years C. Chief Nursing Officer Survey Summary There are approximately 102 total hospitals in this region. Forty-five hospitals responded to the survey from this region. 62% of hospitals have space for more student rotations. 69% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 15%. 28% of hospitals report that vacancy levels are up from last year, 53% report they are down and 19% report that they are the same. Thirty-seven of forty-five 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 80. The total number of travelers reported by the nine respondents in the region is 718. The average overall turnover rate is not reported for this region. 43% of hospitals report having recruited foreign nurses in the previous two years. From the twelve hospitals reporting, average recruitment expenditures per foreign nurse were about $18,800. The range was from $2,500 to $80,000. Most hospitals in the region provide financial support to employees in the form of tuition reimbursement. 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. This region was not asked about adequacy of staff and strategies to overcome shortages. 65
8. Sacramento Area This region includes El Dorado, Placer, Sacramento, Sutter, Yolo, and Yuba counties. A. Board of Registered Nursing 2004 Survey Summary The number of survey participants for this region is 318. Demographics 58.2% of survey participants report having children living at home. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under 34 26 10.92 35-39 33 13.87 40-44 24 10.08 45-49 36 15.13 50-54 54 22.69 55-59 31 13.03 Over 60 34 14.29 All Ages 238 100.00 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married * Married 229 74.59 Separated or Divorced 51 16.61 Widowed * Total 307 100.00 66
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 52 18.71 25 to 5 70 25.18 51 to 75% 58 20.86 76 to 99% 36 12.95 10 62 22.30 Total 278 100.00 Race/Ethnicity of Registered Nurses Race/Ethnicity FREQUENCY PERCENT Hispanic * White, Non-Hispanic 238 80.13 Black/African American * Asian or Pacific Islander 38 12.79 Other * Total 297 100.00 Work Settings/Conditions and Attitudes 81.7% of survey participants are currently employed in nursing. 14.8% 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 24 7.77 7.77 Neither satisfied nor dissatisfied 43 13.92 21.68 Satisfied 150 48.54 70.23 Very Satisfied 92 29.77 100.00 Total 309 10.00 67
Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 137 54.80 Ambulatory Care 36 14.40 Nursing Care Facilities * Home Health Care * Facilities Other 55 22.00 Total 250 100.00 Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * Middle Management, service setting 37 14.98 Direct Patient Care Provider 120 48.58 Clinical Nurse Specialist * Nurse Practitioner * School Nurse * Public Health Nurse * Case Manager * Other 55 22.27 Total 247 100.00 Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work * No change 144 62.07 Decrease hours of nursing work 41 17.67 Leave nursing entirely * Plan to retire from profession 26 11.21 Total 232 100.00 68
Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 60 19.93 19.93 Associate Degree 142 47.18 67.11 Baccalaureate/Masters/PhD. 99 32.89 100.00 Total 301 100.00 Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) * Associate (other) * Baccalaureate (nursing) 42 13.21 Baccalaureate (other) * Master s (nursing) * Master s (other) 20 6.29 PhD (any) * None 171 53.77 Note: Percentages are based on total sample of 318 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 55 17.30 Psychiatric/Mental Health Nurse * Clinical Nurse Specialist * None 207 65.09 Note: Percentages are based on total sample of 318 nurses. About 15% of the participants either are enrolled or are planning to enroll in a nursing degree program in the next three years. Of those, 55% are or will be enrolled in a baccalaureate degree program and 45% are or will be enrolled in a master s degree program. Of those participants who are no longer working in nursing, 5 are either retired or not currently seeking work. 69
B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region College County Type Program American River College Sacramento Community College AD California State University, Sacramento Sacramento California State University BSN Sacramento City College Sacramento Community College AD Sierra College Placer Community College AD Yuba College Yuba Community College AD Nursing Student Admission Applications and Slots, 2001-2004, Sacramento Region 1000 900 800 700 600 Sum of Slots Sum of Applicants 500 400 300 200 100 0 70
RN Program Completions, 2001-2004, Sacramento Region 350 300 250 200 150 100 50 0 Ethnic Distribution of Graduating Students, 2001-2004, Sacramento Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 71
25% Percent of Males Among Graduating Students, 2001-2004, Sacramento Region 2 15% 5% Age Distribution of Graduating Students, 2001-2004, Sacramento Region 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years 72
Success of Students, 2001-2004, Sacramento Region 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 Total faculty and faculty vacancy rate, 2001-2004, Sacramento Region 140 120 100 80 60 40 20 0 Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% 73
Ethnic Distribution of Faculty, 2001-2004, Sacramento Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Age Distribution of Faculty, 2001-2004, Sacramento Region 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years C. Chief Nursing Officer Survey Summary There are approximately 27 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. 74
9. Northern California and Northern Sacramento Valley Regions This combined region includes Del Norte, Siskiyou, Modoc, Humboldt, Trinity, Mendocino, Lake, Lassen, Plumas, Sierra, Nevada, Shasta, Tehama, Butte, Sierra, Glenn and Colusa Counties. A. Board of Registered Nursing 2004 Survey Summary There are 181 survey participants from the two Economic Strategy Panel regions, the Northern California Region and the Northern Sacramento Valley Region. Demographics 40.1% of survey participants report having children living at home. 93.2% of survey participants are white, non-hispanic. Age Distribution of Registered Nurses AGE RANGE FREQUENCY PERCENT Under 45 24 17.4 45-49 26 18.8 50-59 55 39.9 Over 59 33 23.9 All Ages 138 100.00 Marital Status of Registered Nurses CURRENT MARITAL STATUS OF THE RESPONDENT FREQUENCY PERCENT Never married * Married 119 67.23 Separated or Divorced 42 23.73 Widowed * Total 177 100.00 75
Importance of Nursing Income to Households APPROXIMATE PERCENTAGE OF TOTAL HOUSEHOLD INCOME THAT COMES FROM SURVEY PARTICIPANTS NURSING INCOME FREQUENCY PERCENT Less than 25% 34 21.25 25 to 5 31 19.38 51 to 75% 33 20.63 76 to 99% 28 17.50 10 34 21.25 Total 160 100.00 Work Settings/Conditions and Attitudes 79.1% of survey participants are currently employed in nursing. 25.4% 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 28 15.82 24.29 Satisfied 92 51.98 76.27 Very Satisfied 42 23.73 100.00 Total 177 100.00 Work Settings of Registered Nurses TYPE OF ORGANIZATION FREQUENCY PERCENT Hospitals 78 54.93 Ambulatory Care * Nursing Care Facilities * Home Health Care * Facilities Other 31 21.83 Total 142 100.00 76
Job Title Categories of Registered Nurses TITLE FREQUENCY PERCENT Senior Management, service setting * 1.47 Middle Management, service setting 26 19.12 Direct Patient Care Provider 66 48.53 Clinical Nurse Specialist * Nurse Practitioner * School Nurse * Public Health Nurse * Case Manager * Other 17 12.50 Total 136 100.00 Intentions regarding amount of time spent nursing in next three years INTENTION FREQUENCY PERCENT Increase hours of nursing work * No change 78 60.47 Decrease hours of nursing work 22 17.05 Leave nursing entirely * Plan to retire from profession * Total 129 100.00 Education Pre-licensure Education of Registered Nurses PROGRAM TYPE FREQUENCY PERCENT CUMULATIVE PERCENT Diploma 32 17.98 17.98 Associate Degree 93 52.25 70.23 Baccalaureate Degree 53 29.78 100.00 Masters/entry-level master s 0 0.00 100.00 Total 178 100.00 Degrees received since initial RN licensure PROGRAM TYPE FREQUENCY PERCENT Associate (nursing) * Associate (other) * Baccalaureate (nursing) 20 11.05 Baccalaureate (other) * Master s/phd (any) 22 12.15 None 104 57.49 Note: Percentages are based on total sample of 181 nurses. 77
Certificates received from California Board of Registered Nursing since initial licensure CERTIFICATE TYPE FREQUENCY PERCENT Public Health Nurse 36 19.89 Other Certificate 32 17.68 None 115 63.54 Note: Percentages are based on total sample of 181 nurses. Twenty of the 181 survey participants either are enrolled or are planning to enroll in a nursing degree program in the next three years. B. Board of Registered Nursing Annual Schools Report Summary Entry-Level RN Education programs in this region: College County Type Program Butte Community College Butte Community College AD College of the Redwoods Humboldt Community College AD California State University, Chico Butte California State University BSN Humboldt State University Humboldt California State University BSN Mendocino College (new) Mendocino Community College AD Shasta College Shasta Community College AD 78
Nursing Student Admission Applications and Slots, 2001-2004, Northern Region 500 450 400 350 300 Sum of Slots Sum of Applicants 250 200 150 100 50 0 RN Program Completions, 2001-2004, Northern Region 220 200 180 160 140 120 100 79
Ethnic Distribution of Graduating Students, 2001-2004, Northern Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White Percent of Males Among Graduating Students, 2001-2004, Northern Region 16% 14% 12% 8% 6% 4% 2% 80
Age Distribution of Graduating Students, 2001-2004, Northern Region 10 9 8 7 6 5 4 3 2 Other/Unknown 56 + years 46-55 years 36-45 years 26-35 years 18-25 years Success of Students, 2001-2004, Northern Region 10 9 8 7 6 5 4 Left Program Behind Schedule Completed on Time 3 2 81
Total faculty and faculty vacancy rate, 2001-2004, Northern Region 80 75 70 65 60 55 50 Total faculty Vacancy rate 2 18% 16% 14% 12% 8% 6% 4% 2% Ethnic Distribution of Faculty, 2001-2004, Northern Region 10 9 8 7 6 5 4 3 2 Other/Unknown Hispanic Filipino African-American Asian Native American White 82
Age Distribution of Faculty, 2001-2004, Northern Region 10 9 8 7 6 5 4 3 2 Other/Unknown 60+ years 50-59 years 40-49 years 30-39 years Under 30 years C. Chief Nursing Officer Survey Summary There are approximately 41 total hospitals in this region. Fourteen hospitals responded to the survey from this region. 36% of hospitals have space for more student rotations. 29% of hospitals can contribute staff to precept or support student clinical rotations. Average vacancy levels are about 16%. 43% of hospitals report that vacancy levels are down from last year. Eight of fourteen hospitals gave information about the number of travelers they hire. The average number of travelers per hospital used to provide supplemental services is 7; the range is from 1 to 22. The total number of travelers reported by the nine respondents in the region is 58. The average overall turnover rate is 7%; the range is from to 2, with ten hospitals reporting. 29% 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 $16,000. 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. 83
Adequacy of staff in Regional hospitals One month ago One year ago Surplus of RN resources Adequate RN resources * * Mild Shortage 57% 43% Moderate shortage 29% 21% Severe shortage * 21% Strategies to address shortages in Regional hospitals One Month Ago One year ago Overtime/extra shifts 92% 92% Temporary agency 67% 67% Travelers 67% 67% Temporary limit of clinical 33% 33% services Permanent closure of services * * 84