2013 - Is there a Nursing Shortage? - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

We have just begun our spring semester at colleges and schools of nursing throughout the country. Many senior nursing students will soon become new graduates. They are already worrying about their job prospects based on the feedback that they have received from last year’s graduates and recent stories in the media. An article published online this month on CNN Money, For nursing jobs, new grads need not apply, has done little to alleviate their anxiety. The story points out that many new graduates remain unable to find positions more than one year after graduation. This leads to an interesting question about the nursing shortage – is there one and if not now, when will it start?

Factors that are impacting the nursing job market

The health care environment remains volatile especially in hospitals where more than 80% of new nurses have traditionally begun their careers. The anticipated changes in reimbursement from Medicare and Medicaid that accompany health reform could mean lower revenue, and there is also a new focus on keeping patients from being readmitted. Staffing budgets are very closely monitored in healthcare today and new hire is charged almost immediately to the hours per patient day. This reality has played a big part in the decision making of nurse managers as they recruit for vacancies on their units.

In response to concern about a pending nursing shortage, schools and colleges of nursing have increased enrollment, and are graduating double the number of nurses today from a decade earlier. In a 2012 article in the New England Journal of Medicine, Peter Buerhaus a nursing workforce expert points out that many nurses returned to full-time employment between 2005 and 2010 because of the economic downturn. How long they will stay in the workforce as the economy improves is a question that is not easily answered at this point in time. Recent data from a nationwide study conducted by Jackson Healthcare (Nursing Vital Signs 2012) indicates that most nurses currently working are satisfied and plan to stay in their jobs for at least five years. Based on their findings, they predict that the first significant wave of retirements will occur around 2022.

What could change

The effects of the enrollment of uninsured patients through health exchanges which is likely to increase demand for health care services will probably not be seen until 2014. Nurses surveyed by the Jackson group expressed concern about the potential surge in patients. They worry whether the current health care system has the capacity to absorb these patients, and what it might mean for their workload. The aging population could also have a significant impact on the demand for nursing services. More than 8000 Baby Boomers are retiring each day. Surgical volumes especially in orthopedics increased in 2012. The number of Total Knee Arthoplasties surged 161% over the past decade and this is expected to increase with an aging population.

So what are the job prospects?

Many Chief Nursing Officers that I talk with are optimistic that they will continue to hire new graduates but caution that there will be significant competition for new graduate residency and internship slots. Data from the American Association of Colleges of Nursing indicates that Baccalaureate graduates definitely have an edge in employment unless the applicant is a current employee of the health agency.

Before declaring that the nursing shortage is over as some have, it is important to watch the trends that can quickly shift. What we do know is that a significant number of Baby Boomer nurses are likely to retire by 2020 and this will leave a huge gap in the workforce. These shortages have already begun in certain specialities such as perioperative nursing. This year, new graduates again will have fewer employment options, and will need to explore jobs outside the hospital setting.

In the not to distant future, most nurse leaders believe that we will experience another nursing shortage. It is likely that the newest members of our profession who are struggling to find employment today will again be in great demand. The long-term career opportunities for nursing in general look very bright when compared with other economic sectors.