Throughout much of the past decade, workforce projections and nursing associations have indicated a nurse shortage that is expected to continue beyond 2020, but now there is information on a possible surplus. In fact, the U.S. Health Resources and Services Administration (HRSA) predicts an excess supply of nurses numbering 340,000 in the U.S. by 2025.
What’s the Discrepancy Here?
The HRSA study has several notable caveats, which are especially important for nurses to consider when making strategic decisions regarding these future projections.
First, this model assumes the graduation rate of nurses will remain consistent, which isn’t likely. The enrollment numbers for nursing school are like every other profession; they have always had high and low points depending on a wide variety of factors. For more than ten years now, we’ve been experiencing record-breaking growth, but it’s possible that this trend could reverse at any time, which would obviously impact the HRSA’s projections.
Second, the HRSA study excludes growth in nursing demand that may come from additional responsibilities shouldered by nurses due to the emergence of new healthcare delivery models. Commenting on these new models’ impact on RN demand, the HRSA report states:
“… emerging care delivery models, with a focus on managing health status and preventing acute health issues, will likely contribute to new growth in demand for nurses, e.g., nurses taking on new and/or expanded roles in preventive care and care coordination.”
Newly created demand for RNs via these emerging care models or the demand elicited by the Affordable Care Act might be enough to offset the projected supply imbalance, although not enough information currently exists to quantify the impact.
What is the takeaway in light of these new projections? The following considerations can help nurses pursuing their RN to BSN degree:
Look to the Economy for Signs of Job Growth
An interesting phenomenon affects the demographics of the nursing workforce when the economy is weak. Periods of recession can create a false bubble of job scarcity, according to research by Peter Buerhaus, a registered nurse and economist who teaches at the Vanderbilt University School of Nursing.
In a paper he co-authored in the New England Journal of Medicine in 2012, he showed how during economic downturns, demand for healthcare continues unabated, and RNs tend to fill existing job vacancies because of their concerns about their personal (or their family’s) economic uncertainty and diminished alternative opportunities.
About 90 percent of nurses are women, 60 percent are married, and roughly a quarter are over 50 years old. It’s typical for many nurses to take time off to raise children in their 30s, and given the long days spent working on their feet, many often retire in their late 50s.
But when the recession hit, spouses lost jobs, 401(k)s lost money, and facing financial uncertainty, fewer nurses chose to leave work, Buerhaus said.
“Many of those nurses are still in the workforce, and they’re not leaving because we don’t see a convincing jobs recovery yet,” Buerhaus said. “This made it harder for RNs with no experience to get hired.”
With that in mind, it’s easy to see that the demand for healthcare services will rise as more and more Baby Boomers retire from the medical profession, and changes in healthcare reform make care more accessible to everyone.
Advanced Education Creates Opportunity
The current trend for nursing is advanced education, so the new graduate with a bachelor’s degree or higher is more likely to secure a job than one who holds an associate degree.
“Based on completed responses from 515 schools of nursing, 43.7% of hospitals and other healthcare settings are requiring new hires to have a bachelor’s degree in nursing (up 4.6 percentage points since 2012), while 78.6% of employers are expressing a strong preference for BSN program graduates,” according to the American Association of Colleges of Nursing.
The growing rates of chronic conditions such as obesity and diabetes will lead to an increased demand for healthcare services. From this perspective, nursing is still a better bet than many other occupations.
Look to Regional Pockets of Need
It is important to keep in mind that even though a national surplus is projected, there will still be regional shortages. The HRSA report made the following predictions:
Sixteen states are likely to need more RNs than they’ll have by 2025.
Arizona is predicted to be the worst off with 28,100 fewer nurses than needed by 2025.
Growth is expected to exceed demand in 34 states.
Going forward, there are several factors that will continue to affect nurse supply and demand, including the economy, an aging workforce, and an increase in specialty care just to name a few.
Although experts still recognize the hard work and expertise of RNs with associate degrees and diplomas alone, it’s no secret that nurses with higher degrees are in demand these days. The healthcare system has become increasingly complex over the years and patients are living longer with more chronic conditions, so it’s easy to see why we need an adequate supply of highly educated nurses.
