Nursing Shortage Is Over in U.S. Until Retirement Glut Hits

A nursing shortage in the U.S. that led to a decade-long push for new hires and more graduates in the field is over, at least until 2020 when a glut of retirees will leave a new gap to fill, researchers said.

The number of full-time nurses grew by about 386,000 from 2005 to 2010 and about a third of the growth occurred as unemployment rose to a high of 10 percent during that period, according to a report published in the New England Journal of Medicine.

The increase in the nursing workforce from 2005 to 2010 was the largest of any five-year period during the last 40 years, the authors said. Hospitals began experiencing a shortage of nurses in 1998, according to the American Hospital Association in 2002.

“It’s really been a long-standing shortage,” Douglas Staiger, the study author and a professor of economics at Dartmouth College in Hanover, New Hampshire, said in a March 19 telephone interview. “Probably for the first time in memory there were actually reports of nurses having difficulty finding jobs and reports from hospitals of almost a glut of nurses.”

In the early part of this century, many registered nurses were leaving the profession saying they were overworked, underpaid and unable to provide good patient care, according to a 2002 report in the New England Journal of Medicine. Hospitals responded by encouraging people to become nurses by offering more benefits, signing bonuses, scholarships and tuition reimbursement.

Graduates Double

Those efforts paid off as the number of people who graduated from entry-level baccalaureate nursing programs more than doubled to 161,540 in 2010 from 72,986 in 2000, according to the American Association of Colleges of Nursing based in Washington.

The gains continued unabated even as the recession began in 2007 as nurses who had left the work force or were employed part-time returned to full-time work to shore up family finances, said Staiger.

As the economy improves, and the mostly married, female workforce quits, reduces working hours to part time or reaches retirement age, a shortage of nurses is expected again. The renewed need for nurses will hit just as demand for health care increases as more Americans gain medical insurance under provisions of the U.S. health-care law that goes into effect in 2014, Staiger said.

“We had suspected that the supply of nurses is counter cyclical, when the economy goes down, nurses work more, pile back into work in part because the jobs are there,” he said. “The concern was this was a temporary surge into the labor market, a bubble, and as soon as the economy recovered, a lot of nurses would exit and we would be back and the shortage would emerge.

Bigger Shortage

“Going ahead into 2020 and beyond, there are concerns that the kind of shortages we’ve had will be larger than what we’ve seen,” Staiger said.

The nursing workforce is now expected to grow about 109,000 full-time positions from 2010 to 2015, as the economy improves and by 227,000 if the economic downturn persists, the authors said.

The authors used data from a workforce model to compare the U.S. unemployment rate with the difference between the actual size of the nurse workforce and the model’s expected size over 40 years. They were then able to project what effect the recession had on the workforce in 2005 and 2010 and what effects an improving economy would have beyond 2010.

Changing Job Market

They found that from 2010 and 2015, 118,000 nurses will stop working full time as the economy grows.

“The nursing shortage is likely to re-emerge and nursing is going to continue to be a good occupation choice for young people,” Staiger said.

The current median age of nurses is 46 years, while the largest group is in their 50s, according American Association of Colleges of Nursing.

Polly Bednash, chief executive officer of the group, said she’s worried the report will lead policy makers to think they don’t need to invest in the nursing field.

“We need to put all the support we can into keeping the pipeline robust,” she said in a March 19 telephone interview.

To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

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