NURSE PRACTITIONERS IN VERMONT 2013 RE-LICENSURE SURVEY Prepared by: Mary Val Palumbo DNP, APRN AHEC NURSING WORKFORCE, RESEARCH, PLANNING and DEVELOPMENT University of Vermont 1
PURPOSE The UVM Area Health Education Center (AHEC) program conducts a biennial re-licensure survey of Vermont s Advance Practice Registered Nurses (APRNs), including Nurse Practitioners (NPs), in order to provide Vermonters, healthcare employers, educators and policymakers with useful information on the status of this important segment of the nursing workforce. 2
METHODS The invitation to participate from AHEC and a paper survey were included in re-licensure materials sent out by the Vermont Board of Nursing to 593 APRNs licensed in Vermont as of January 1, 2013. A reminder postcard was sent at two weeks and a replacement paper survey was also mailed to all APRNs who did not initially participate at four weeks. A paper survey was also available at the Board of Nursing. 3
RESULTS The survey was completed by 340 APRNs (57% response rate). 294 APRNs reported working in Vermont and 75% (231) were licensed as NPs and used in this analysis. As of April 1, 2013 there were 575 APRNs with active licenses in the state of Vermont. 4
NP DEMOGRAPHIC INFORMATION 100% 90% NP by Gender 96% Total n = 231 80% 70% 60% 50% 40% 30% 20% 10% 0% 4% Male Female 5
NP DEMOGRAPHIC INFORMATION 100% 90% 80% 70% Race/Ethnicity 94% Total n = 233 60% 50% 40% 30% 20% 10% 0% 2.00% 0.90% 0.40% 0 2.00% 6
Percent NP DEMOGRAPHIC INFORMATION Birth Year 50% 46% 54-63 yrs. Mean age: 45% 40% 35% 52 years 44-53 yrs. 30% 25% 20% 15% 10% 64-71 yrs. 12% 22% 15% 34-43 yrs. 28-33 yrs. 5% 5% 0% 1941-1949 1950-1959 1960-1969 1970-1979 1980-1985 Year 7
Vermont Counties of primary practice Total n = 224, (2 were not in VT) County in Vermont # NPs Percent Addison 6 3% Bennington 11 5% Caledonia 14 6% Chittenden 86 38% Franklin 9 4% Lamoille 10 4% Orange 13 6% Orleans 4 2% Rutland 18 8% Washington 17 8% Windham 17 8% Windsor 15 7% Various Northern VT 1 0.4% Missing 7 3% 8
COUNTIES OF EMPLOYMENT (NUMBER OF APRNS REPORTING A SECONDARY POSITION) Various Windsor Windham Washington Tolland CT Saratoga NY Rutland Orange Maui HI Lamoille Hartford CT Grand Isle Grafton NH Franklin Coos OR Chittenden Cheshire NH Caledonia Bennington 1 1 1 1 1 1 2 4 1 1 1 1 1 6 6 Total n = 64 2 3 25 5 0 5 10 15 20 25 30 # NPs 9
ENTRY LEVEL LICENSURE & EDUCATION n=109 n= 43 Associate Degree - Nursing, 19% Baccalaureate Degree - Nursing, n=25 47% Master's Degree - Nsg, 11% Total n = 231 Diploma - Nursing, 13% n=31 Vocational/Practical Certificate, 5% n=12 Other, 1% n=7 Master's Degree - Nsg (In Progress), 3% Doctoral Degree - Nursing, 1% n=1 n=3 10
NP HIGHEST LEVEL OF EDUCATION Master's Degree - n=18 Non-Nsg 8% Doctoral Degree - Nsg (PhD) 1% n=3 Total n = 230 Master's Degree - Nsg 77% n=177 Doctoral Degree - Nsg (DNP) 3% Doctoral Degree - Non-Nsg 3% Diploma - Nsg1% Associates Degree -Nsg 2% Baccalaureate Degree - Nsg 3% n=3 n=6 n=8 n=4 n=6 Baccalaureate Degree - Non-Nsg 2% n=5 11
CURRENT ENROLLEES IN HIGHER NURSING EDUCATION Doctoral Degree DNP 6 (2.6%) Master s Degree 2 (0.9%) Not Enrolled 223 (96.5%) Total n = 231 12
COUNTRY OF ENTRY LEVEL LICENSURE & EDUCATION 13
EMPLOYMENT STATUS Nursing - Part Time, 32% n=76 Nursing - Full Time, 61% n=144 Nursing - Per Diem, 6% Other - Full Time, 1% Other - Part Time, 0% Retired, 0% Unemployed, 0% n=1 n=1 n=13 n=1 [100% of respondents indicate their primary position is in Vermont.] 14
CREDENTIALED SPECIALTIES HELD BY NURSE PRACTITIONERS Gerontology, 3% n=9 Family, 44% n=119 Midwifery, 4% OB/Gyn, 9% n=10 Pediatrics, 8% n=23 n=22 Acute/Emergency Care, 1% Medical/Surgical, 0% n=3 n=1 *Other includes: Diabetes (2), Neonatal (4), Oncology (1) and Urology (1). Adult, 19% n=52 *Other, 3% Psych/Mental Health, 9% n=8 n=25 15
NURSE PRACTITIONER YEARS PRACTICED 25% n=52 23% Total n = 226 20% 15% n=33 15% n=32 14% n=31 14% n=25 n=19 11% 10% 5% n=12 5% 8% n=15 7% n=7 3% 0% < 1 Year 1-5 Years 6-10 Years 11-15 Years 16-20 Years 21-25 Years 26-30 Years 31-35 Years > 36 Years 16
PRACTICE SETTINGS (PRIMARY POSITION) Business or Work Site Home Health APRN Practice Group Extended Care School or College Solo APRN Practice Community Health Center Hospital- Inpatient Other Hospital - Outpatient Physician/APRN Practice 0.40% 0.70% 1% 3% n=1 n=2 4% n=2 5% n=9 n=12 n=13 10% 11% n=29 n=30 14% n=41 Total n = 231 22% 30% 0% 5% 10% 15% 20% 25% 30% 35% n=61 n=84 17
PRACTICE SETTINGS (SECONDARY POSITION) Public Health Correctional Facility Community Health Mental Health Center Home Health Independent Practice School Health Service Academic Setting Hospital Other Ambulatory Care No Secondary 1% 1% 2% n=1 n=1 3% n=2 5% n=3 6% 6% n=4 n=5 n=5 10% n=9 12% n=11 15% 15% n=13 n=13 Total n = 231 25% n=22 0% 5% 10% 15% 20% 25% 30% 18
NPs HOLDING HOSPITAL PRIVILEGES IN VERMONT Yes, 25% n=57 No, 75% n=173 Total n = 230 19
NPs ACCEPTING NEW PATIENTS No, 8% n=18 Yes, 87% n = 202 Missing, 5% n=11 Total n = 220 20
NPs PARTICIPATING IN MEDICAID PARTICIPATE IN MEDICAID No 11% NP PARTICIPANTS ACCEPTING NEW MEDICAID PATIENTS No 13% Yes 89% Yes 87% n = 227 n = 216 21
NPs PARTICIPATING IN MEDICARE PARTICIPATE IN MEDICARE No 15% APRN PARTICIPANTS ACCEPTING NEW MEDICARE PATIENTS No 17% Yes 85% Yes 83% n = 224 n = 211 22
Total n= 229 EMPLOYED POSITIONS IN NURSING (PER RESPONDENT) One, 74% Two, 23% n=169 n=53 Three or more, 3% n=7 23
WEEKLY WORK HOURS (PRIMARY POSITION) 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% n=38 17% 20 Hours or Less 21-39 Hours n=98 n=93 43% 41% 40 Hours or More Total n = 229 Missing = 2 24
WEEKLY WORK HOURS (SECONDARY POSITION) 30% 25% 20% 15% 10% 5% 0% n=60 26% n=2 n=1 1% 0% Total n = 63 Missing = 168 20 Hours or Less 21-39 Hours 40 Hours or More 25
PRIMARY POSITION TITLES Primary Position Title Percent In Title Nurse Executive 2.6% Nurse Manager 0.9% Nurse Faculty 2.6% Advanced Practice Nurse 92.2% Staff Nurse 0.4% Other Health Related 0.9% Other Non-Health Related 0.4% 26
Home Health Rehabilitation Public Health Palliative Care Occupational Health Medical/Surgical Community School Health Oncology Maternal-Child Health Gerontology Acute/Critical Care Other Women's Health Pediatrics/Neonatal Psych/Mental Health Adult/Family NP EMPLOYMENT SPECIALTY (PRIMARY POSITION) 0% 1% 1% 1% 2% 2% 2% 2% n=1 n=2 n=2 n=3 n=4 2% 2% n=4 n=4 n=5 n=6 n=6 5% 6% n=13 n=14 9% n=23 9% n=23 10% 11% n=251 More than one could be chosen n=26 n=28 Other*: Dermatology, Disability Evaluation, Endocrinology, Internal Medicine, Lactation, Nurse Educator, Obstetrics, Orthopedics, & Vascular Surgery 35% 0% 5% 10% 15% 20% 25% 30% 35% 40% n=87 27
SECONDARY POSITION TITLES Primary Position Title Percent In Title No Secondary Position 25% Consultant/Nurse Researcher 1% Nurse Manager 1% Nurse Faculty 8% Advanced Practice Nurse 49% Staff Nurse 9% Other Health Related 6% 28
Medical/Surgical ternal-child Health Women's Health Acute/Critical Care Pediatrics/Neonatal sych/mental Health EMPLOYMENT SPECIALTY (SECONDARY POSITION) 1% 1% 1% 1% 1% 1% 2% 2% 2% Trauma n=1 Rehabilitation Community Public Health Oncology Palliative Care Home Health Gerontology School Health Other Adult/Family No Secondary n=1 n=1 n=1 n=1 n=1 n=2 n=2 n=2 3% 3% n=3 n=3 4% n=4 6% n=6 9% n=8 Total n=94 11% n=10 2% 15% Other*: Consultant/Educator, Emergency Department, Policy/Leadership 0% 5% 10% 15% 20% 25% n=12 n=14 n=22 29 23%
YEARS WORKED IN CURRENT POSITION 31 to 35 1% n=3 26 to 30 21 to 25 2% 4% n=3 n=10 Total n= 230 YEARS 16 to 20 11 to 15 10% n=22 16% n=37 6 to 10 16% n=37 1 to 5 35% n=80 < 1 16% n=36 0% 5% 10% 15% 20% 25% 30% 35% 40% #NPs 30
45% 40% 35% 30% 25% 20% 15% 10% 5% 0% n=11 4% n=36 13% CLIENT TYPE n=117 42% n=39 14% n=74 26% n=281 More than one response is possible. n=4 1% 31
JOB SATISFACTION (PRIMARY POSITION) Total n=228 Somewhat Satified 34% n=78 n=134 Very Satisfied 59% Somewhat Dissatified 6% n=13 Very Dissatisfied 1% n=3 32
HOW LIKELY ARE YOU TO LEAVE YOUR PRIMARY POSITION IN THE NEXT 12 MONTHS? Total n=191 Somewhat satisfied 21% n=41 n=123 Very satisfied 64% Somewhat dissatisfied 11% n=20 Very dissatisfied 3% n=7 Please note: An error on the survey repeated the above choices for question responses rather than: Very Unlikely, Somewhat Unlikely, Somewhat Likely and Very Likely 33
IF VERY LIKELY OR SOMEWHAT LIKELY, WOULD YOU LEAVE THE NURSING PROFESSION? Total n= 120 n=96 No 80% Yes 7% n=9 Unsure 13% n=15 34
REASON FOR LEAVING POSITION - CHECK ALL THAT APPLY Health/Illness Promotion Co-worker Relationships Return To School Supervisor Relationships Job Assignment Move/Relocation Family Responsibilities Other Retirement Position Change Management Practices Salary/Benefits Job Stress 2% 2% 2% 2% n=2 n=2 n=2 n=3 4% 4% n=5 n=5 6% 6% n=7 n=8 9% 10% 11% 13% 15% 15% 0% 2% 4% 6% 8% 10% 12% 14% 16% n=11 Total n= 127 n=13 n=14 n=17 n=19 35
CONTACT: Mary Val Palumbo DNP, APRN University of Vermont AHEC Nursing Workforce, Research, Planning and Development (802) 656-0023 mpalumbo@uvm.edu www.vtahec.org 36