Bet­ter-ed­u­cated RNs fill­ing a need

Modern Healthcare - - THE WEEK IN HEALTHCARE - Ashok Sel­vam

The reg­is­tered nurs­ing work­force is grow­ing and get­ting bet­ter ed­u­cated, with more RNs pur­su­ing ad­vanced de­grees, ac­cord­ing to the lat­est num­bers from the Health Re­sources and Ser­vices Ad­min­is­tra­tion. And that’s ex­actly what the In­sti­tute of Medicine and many hos­pi­tal sys­tems want to see.

Over a 10-year pe­riod, the num­ber of RNs hold­ing a bach­e­lor’s or higher de­gree has in­creased to 55% in 2010 from 50% in 2000, ac­cord­ing to the HRSA nurs­ing work­force re­port. That means of the 2.8 mil­lion RNs in the work­force—as es­ti­mated by HRSA—more than 1.5 mil­lion have at least a four-year de­gree. The rest have two-year as­so­ciate de­grees.

The RN work­force has grown by 24.1% since 2000, in­creas­ing by nearly 550,000. HRSA con­cluded that “growth in the nurs­ing work­force out­paced growth in the U.S. pop­u­la­tion,” cit­ing the num­ber of RNs per 100,000 pop­u­la­tion in­creased about 14% from 2000 to 2010. But lead­ers of nurs­ing or­ga­ni­za­tions warned that growth is barely keep­ing up with the ris­ing de­mand for nurses, which is ex­pected to con­tinue be­cause of health­care re­form and baby boomer re­tire­ments.

“We will have to con­tinue to see this very bold pro­duc­tion of new nurses, and we may need to in­crease pro­duc­tion with spe­cific tar­gets in mind,” said Geral­dine “Polly” Bed­nash, CEO of the Amer­i­can As­so­ci­a­tion of Col­leges of Nurs­ing.

A larger and bet­ter ed­u­cated work­force is good news for a health­care world that’s de­mand­ing higher per­for­mance out of nurses, said Peter Buer­haus, a pro­fes­sor of nurs­ing at Van­der­bilt Univer­sity in Nashville. The find­ings are in line with IOM’s 2010 rec­om­men­da­tions that 80% of nurses hold a bac­calau­re­ate de­gree by 2020. Buer­haus isn’t sure if the work­force will hit the IOM’s sug­gested tar­get in seven years, but the HRSA data show Buer­haus the prom­ise of progress.

The an­nual pay for full-time nurses has in­creased by 45.6% since 2000, grow­ing from $43,906 to $63,944 in 2010, ac­cord­ing to HRSA data.

Health­care re­form, and pres­sure for

“We will con­tinue to see this very bold pro­duc­tion of new nurses, and we may need to in­crease pro­duc­tion with spe­cific tar­gets in mind.” —Geral­dine “Polly” Bed­nash Amer­i­can As­so­ci­a­tion of Col­leges of Nurs­ing

higher qual­ity and ef­fi­ciency, is also driv­ing the trend to­ward bet­tere­d­u­cated nurses. Mul­ti­ple stud­ies have tied nurses with ad­vanced de­grees to lower pa­tient mor­tal­ity rates, fewer med­i­ca­tion er­rors and bet­ter out­comes.

“Hos­pi­tals are more in­ter­ested now in a nurs­ing work­force that will de­crease those risks of mor­tal­ity, there­fore they’re more in­ter­ested in bac­calau­re­ates,” Buer­haus said.

The in­flux of nurses un­der age 30 en­ter­ing the pro­fes­sion is also speed­ing the trend to­ward more school­ing. Younger nurses un­der­stand that in­vest­ing in a four-year de­gree will help their ca­reers. The num­ber of RNs un­der 30 jumped to about 420,000 in 2010 from 325,000 in 2000, even though the aver­age age of RNs rose to 44.6 in 2010, from 42.7 in 2000.

An in­flux of younger nurses is needed as older nurses re­tire. The re­port called the num­ber of RNs reach­ing re­tire­ment a con­cern. About 1 mil­lion RNs older than 50—about a third of the work­force—will reach re­tire­ment age over the next 10 to 15 years.

“Re­tire­ment of large num­bers of RNs over the next two decades means a loss of ex­pe­ri­en­tial knowl­edge and lead­er­ship brought to the work­force by sea­soned RNs,” ac­cord­ing to the re­port. “The re­tire­ment de­ci­sions of this older co­hort, which may be in­flu­enced by the pace of eco­nomic re­cov­ery, will af­fect the nurs­ing work­force go­ing for­ward.”

Bed­nash is par­tic­u­larly in­ter­ested in the in­creased num­ber of RNs with as­so­ciate de­grees who en­rolled in bach­e­lor’s pro­grams. That num­ber grew by 86% over four years, jumping from 14,946 in 2007 to 27,485 in 2011. De­spite lower pay, two-year pro­grams are still at­trac­tive as they churn out li­censed nurses in a shorter pe­riod of time to meet work­force de­mands.

Even if as­so­ciate-de­gree hold­ers don’t pur­sue a bach­e­lor’s de­gree, they will still find work at long-term care fa­cil­i­ties and have other op­por­tu­ni­ties, Bed­nash said.

There’s also pres­sure for bet­ter-ed­u­cated nurses from pol­i­cy­mak­ers. Some state leg­is­la­tors have drafted bills man­dat­ing four-year de­grees from nurses.

Last year, a bill in New York that would re­quire all RNs to earn a bach­e­lor’s de­gree within 10 years failed. Bed­nash said there’s still a pos­si­bil­ity that the leg­is­la­tion could be res­ur­rected. How­ever, law­mak­ers sup­port­ing such mea­sures would be hard pressed to find sup­port from the HRSA num­bers.

“I think it’s the mar­ket, rather than the leg­is­la­ture, that’s tak­ing care of this is­sue,” Bed­nash said.

HRSA’s data are a bit dated, com­ing from 2010. The num­bers might not re­flect changes made in an­tic­i­pa­tion of health­care re­form, said Peter McMe­namin, a se­nior fel­low at the Amer­i­can Nurses As­so­ci­a­tion. As the in­dus­try braces for re­form, hav­ing upto-date in­for­ma­tion is in­valu­able.

“We need the in­for­ma­tion to be able to tell the story of nurses,” McMe­namin said. “The more in­for­ma­tion we have, the more vis­i­ble nurses be­come and then they won’t be for­got­ten.”

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