Findings from the 2015 National Nursing Workforce Study: A Collaboration between the National Council of State Boards of Nursing & The National Forum of State Nursing Workforce Centers Presented by: Jill Budden, PhD 1
Learner Objectives #1 The learner will be able to describe how the nursing workforce may change in the coming years, specifically relating to age, gender, ethnic/diversity, and educational background. #2 The learner will be able to describe the implications that change in age, education, specialty, and settings of the US nursing workforce may have for health care provision in the years to come.
Background & Introduction Collaborative partnership with The National Forum of State Nursing Workforce Centers Patricia Moulton, PhD President, The National Forum of State Nursing Workforce Centers Executive Director, North Dakota Center for Nursing Kimberly Harper, RN, MS CEO, Indiana Center for Nursing Mary Lou Brunell, MSN, RN Executive Director, Florida Center for Nursing Data from HRSA s final NSSRN was completed in 2008, and reported out in 2010 NCSBN & The Forum Partnered to fill the void of RN supply data in 2013 2015 included LPN/VNs for the first time
Method Sample All active RN and LPN/VN licensees were eligible for survey participation Sampling was stratified by state Approx. 140,000 RNs and 121,000 LPN/VNs were selected to be sent a survey Materials Minimum Data Set Additional telehealth and specialty setting questions added
Method Procedure Week 1: announcement postcard Week 2: letter and survey mailed (first class) Week 2: letter and survey mailed (nonprofit/standard rate) Week 8: letter and survey mailed (first class) Week 8: letter and survey mailed (nonprofit/standard rate) Week 14: deadline for survey receipt Weighting Nonresponse bias analysis was conducted Survey responses weighted based on: Age Gender State nursing population size Descriptive Analysis 5
Participants Response Approx. 46,000 RN responded: 34.3% response rate 12.3% online 87.7% paper Approx. 32,000 LPN/VN responded: 28.0% response rate 8.6% online 91.4% paper 6
Registered Nurse Results 7
Age & Employment Status Age Distribution of RNs Average age = 48.8 81.7% of RN licensees were actively employed in nursing 9.5% 9.9% 9.5% 10.2% 10.7% 11.5% 13.6% 12.7% 12.4% Younger than 30 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Younger than 30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Employed in nursing (overall) Employment Status and Age Employed full time Employed in other field Unemployed, seeking work as a nurse 8
Gender Men 8.0% Men most prevalent in Anesthesia (32.2%) Emergency/trauma (17.8%) Acute care/critical care (15.2%) Men least prevalent in Maternal-child health (0.2%) Women s health (0.5%) School health (1.2%) Male workforce expected to grow 5.8% LICENSED PRIOR TO 2000 Percent of Male RNs 9.8% LICENSED 2000-2009 12.8% LICENSED 2010-2012 14.1% LICENSED 2013-2015 9
Racial/Ethnic Diversity Individuals from racial and ethnic minority groups accounted for 37.9% of the US population in 2014 19.5% of respondent RNs were minorities; approximately the same as in 2013 Racial/ethnic diversity expected to increase 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Younger than 30 Race/ethnicity & Age 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Asian Hispanic/Latino White/Caucasian African American 10
Demographic Trends Age 2013 2015 Mean = 50 Median = 52 Mean = 48.8 Median = 50 Gender Men (7%) Men (8%) Race/ethnicity American Indian or Alaska Native 1% 0.4% Asian 6% 6.6% Black/African American 6% 5.5% Native Hawaiian or Other Pacific Islander 1% 0.4% White/Caucasian 83% 80.5% Hispanic/Latino 3% 3.6% Other 1% 0.8% Mixed 2.1% 11
Education 39.0% held a BSN as their initial nursing education BSN as initial nursing education is expected to continue to grow Newly-licensed RNs were more likely to have obtained a BSN as their initial education (48.6%) vs RNs licensed prior to 2000 (34.8%) 3.0% held a graduate degree as their initial nursing education 65.0% had baccalaureate or higher degree as their highest level of education 12
Initial Education 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Younger than 30 Initial Nursing Education, by Age 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older LPN Certificate Diploma A.D.N. BSN 13
Highest Level of Education, by Initial Nursing Education Highest LPN Certificate (n = 2,373) Diploma (n = 6,446) ADN (n =16,997) Initial BSN (n =17,066) MSN (n = 1,231) DNP (n = 42) LPN Certificate -- -- -- -- -- -- Diploma 2% 54% -- -- -- -- ADN 48% 3% 60% -- -- -- Associate s-other field.1% 2% 1% -- -- -- BSN 27% 14% 16% 73% -- -- Baccalaureate-other field 6% 9% 13% 2% -- -- MSN 12% 10% 7% 16% 95% -- Master s-other field 3% 6% 3% 7% 3% -- DNP 1%.3% 1% 1% 1% 100% PhD-nursing.2% 1%.2% 1% 1% 0% Doctoral-nursing other 0%.1% 0%.1% 0% 0% Doctoral-other field 1% 1%.4% 1% 1% 0% 14
Education Trends Initial education Highest level of education 2013 2015 BSN (36%) graduate degree (3%) 61% baccalaureate degree or higher BSN (39.0%) graduate degree (2.9%) 65% baccalaureate degree or higher Foreign-educated 6% 6.7% 15
Faculty Education Primary Position Title, by Highest level of Education: NURSE FACULTY DOCTORAL-OTHER FIELD DOCTORAL-NURSING OTHER PHD-NURSING DNP MSN BSN A.D.N. DIPLOMA 4% 1% 5% 2% 8% 14% 25% 36% 16
Foreign-Educated Nurses 6.7% of RNs obtained initial nursing education outside of US For newly-licensed RNs, foreign-educated were more likely to have obtained a BSN as initial education (72.2%) versus US-educated (47.2%) States with more than 10% foreign-educated RNs currently practicing: California (18.2%) Nevada (17.5%) DC (14.1%) Hawaii (12.8%) New Jersey (11.5%) New York (10.9%) 17
Employment Setting & Position Title Primary Employment Setting & Year Licensed 74.0% 67.7% 59.7% 45.7% 4.2% LICENSED 2013-2015 8.3% LICENSED 2010-2012 Ambulatory care setting 10.6% LICENSED 2000-2009 13.2% LICENSED PRIOR TO 2000 Hospital Primary Position Title & Year Licensed 88.2% 77.0% 61.0% 47.4% 1.8% 4.1% 9.2% 9.8% LICENSED 2013-2015 LICENSED 2010-2012 Advanced practice nurse LICENSED 2000-2009 LICENSED PRIOR TO 2000 Staff nurse 18
Advanced Practice Registered Nurses APRN 8.6% Nurse Practitioner 70.4% Clinical Nurse Specialist 13.0% Certified Registered Nurse Anesthetist 12.9% Certified Nurse Midwife 3.8% 19
Advanced Practice Registered Nurses Certified Nurse Midwives 48.2% were 55 or older Trend towards aging more so than other APRN groups Clinical Nurse Specialists 26.6% were 55 or older Only 9% were younger than 40 Certified Registered Nurse Anesthetists 33.2% were 55 or older 28.2% younger than 40 Compared to other APRN groups, CRNAs are younger 6.0% Younger than 30 11.5% Age Distribution of NPs 13.1% 14.2% 11.2% 10.5% 12.5% 11.7% 9.4% 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older 20
Median Annual Earnings $65,000 overall State differences $51K $90K Gender Female $64K Male $72K APRNs NP $90K CNS $89K CNM $85K CRNA $150K DOCTORAL-OTHER DOCTORAL-NURSING OTHER PHD-NURSING MASTERS-OTHER BACCALAUREATE-OTHER ASSOCIATES-OTHER A.D.N. DIPLOMA Median Annual Earnings in Primary Position, by Highest Level of Education DNP MSN BSN $62,000 $62,000 $65,000 $60,000 $60,000 $80,000 $76,000 $96,000 $92,500 $85,000 $104,000 $0 $40,000 $80,000 $120,000 21
Telehealth Overall 48.8% of RNs indicated they engage in telehealth 31.4% between 1 25% of their time 6.9% between 26 50% of their time 4.8% between 51 75% of their time 5.8% between 76 100% of their time 22
Cross-Border Telehealth 20.0% engaged in telehealth across a state border 16.1% between 1 25% of their time 1.7% between 26 50% of their time 0.8% between 51 75% of their time 1.4% between 76 100% of their time 3.8% engaged in telehealth across a national border 3.3% between 1 25% of their time 0.3% between 26 50% of their time 0.0% between 51 75% of their time 0.2% between 76 100% of their time 23
Modes of Communication Used for Telehealth Telephone (97.1%) Email (32.3%) Electronic messaging (ex: text message, instant message) (18.6%) Voice over internet protocol (VoIP)(Skype, FaceTime) (3.3%) Video call (2.9%) Virtual ICU (also known as: tele-icu, remote ICU, eicu) (1.1%) Other (6.8%) 24
Licensed Practical/Vocational Nurse Results 25
Age & Employment Age Distribution of LPNs 12.3% 12.4% 11.3% 12.9% 12.0% 9.9% Average age = 47.8 77.0% of LPN/VN licensees were actively employed in nursing 9.8% 9.5% 9.9% Younger than 30 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Younger than 30 Employment Status and Age 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Employed in nursing (overall) Employed full time Employed in other field Unemployed, seeking work as a nurse 26
Gender Percentage of Male LPNs Men 7.5% Women 92.5% 8.4% 10.3% 12.7% Male workforce expected to grow 4.7% LICENSED PRIOR TO 2000 LICENSED 2000-2009 LICENSED 2010-2012 LICENSED 2013-2015 27
Racial/Ethnic Diversity Individuals from racial and ethnic minority groups accounted for 37.9% of the US population in 2014 31.9% of LPN/VNs were minorities Racial/ethnic diversity expected to increase 20.0% 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Younger than 30 Race/ethnicity & Age 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and older Asian White/Caucasian Hispanic/Latino African American 28
Education Highest Level of education: 64.9% vocational/practical certificate-nursing 7.5% associate s degree-other field 6.0% baccalaureate degree-other field 1.2% master s degree-other field 29
Foreign-Educated Nurses 4.9% received entry-level education outside of United States Percentage of Male LPNs: US-educated vs. foreign-educated 22.7% 6.7% US-EDUCATED FOREIGN-EDUCATED 30
Foreign-Educated Nurses States with more than 10% foreigneducated LPN/VNs currently practicing: California (17.9%) Hawaii (17.3%) DC (14.9%) Maryland (11.3%) Nevada (11.7%) Associate's-other field Baccalaureate-other field Highest Level of Education: US- vs Foreign-educated LPNs LPN certificate Diploma ADN BSN 12.3% 12.9% 5.5% 6.4% 7.0% 7.6% 17.6% 0.3% 5.5% Foreign-educated 18.8% 32.1% US-educated 66.3% 31
Employment Employment setting 30.1% nursing home/extended care 15.0% home health 10.8% hospitals Position title 68.8% staff nurse Employment specialty 27.6% geriatric/gerontology 7.7% primary care 6.0% pediatrics 32
Median Annual Earnings $38,000 overall State differences $30K $53K Gender Female $38K Male $43K 33
Telehealth Overall 46.1% of LPNs indicated they engage in telehealth 23.3% between 1 25% of their time 9.3% between 26 50% of their time 6.3% between 51 75% of their time 7.2% between 76 100% of their time 34
Cross-Border Telehealth 16.9% engaged in telehealth across a state border 13.8% between 1 25% of their time 1.6% between 26 50% of their time 0.8% between 51 75% of their time 0.7% between 76 100% of their time 3.9% engaged in telehealth across a national border 2.7% between 1 25% of their time 0.6% between 26 50% of their time 0.4% between 51 75% of their time 0.2% between 76 100% of their time 35
Modes of Communication Used for Telehealth Telephone (58.9%) Email (18.2%) Electronic messaging (ex: text message, instant message) (13.5%) Voice over internet protocol (VoIP)(Skype, FaceTime) (1.3%) Video call (1.4%) Virtual ICU (also known as: tele-icu, remote ICU, eicu) (0.6%) Other (6.1%) 36
Conclusions Trending toward slightly younger, more diverse, and higher initial nursing education Newly-licensed nurses are more likely to be found in hospital settings as compared to more experienced nurses CNM and CNS populations tend to be older; NP and CRNA populations have more representation in younger age cohorts. Similar to other recent studies, our data does not suggest an impending nurse shortage due to large age cohorts retiring Almost half of RNs and LPNs engage in telehealth 20% of RNs and 17% of LPN/VNs engage in telehealth across a state border 37
Discussion/Questions 38