RN shortage expected to increase in next few years

Although RN shortages have been less apparent in recent years, employers and workforce policymakers should expect significant shortages to reemerge in coming years, according to an article in the New England Journal of Medicine.

The authors referred to the "countercyclical nature of the healthcare industry, in which job gains occur faster in recessionary than in non-recessionary periods." They reported data from the Current Population Survey, which found the number of full-time RNs increased by 386,000 between 2005 and 2010. Using an analytical model, they estimated that more than a third of the increase (146,000) could be attributed to the rise in the unemployment rate from 5.1% in 2005 to 9.6% in 2010.

Douglas Staiger, PhD, of Dartmouth College, David Auerbach, PhD, of the RAND Corporation and Peter Buerhaus, RN, PhD, FAAN, of Vanderbilt University Medical Center wrote that with unemployment projected to decrease to 6.1% by 2015, "the substantial expansion in the RN workforce is largely a temporary bubble that is likely to deflate during the next several years."

According to their projections, about 118,000 full-time RNs will leave the workforce by 2015. With such an exodus, the full-time RN workforce would grow by only about 109,000 during that span — a major drop-off from 2005-10 and a smaller expansion than the authors have found during any five-year period over the previous four decades.

Although the number of young people entering nursing rose over the past decade, the authors wrote, the increase is not expected to affect the RN workforce until later in the decade and, especially, after 2020. "Thus it seems likely that growth in the demand for RNs over the next few years will outstrip the projected growth in the workforce, leading to renewed shortages of RNs in the near term."

The resulting shortages "may reduce access to care and increase costs as employers raise salaries to attract nurses, potentially imperiling the success of healthcare reform," the authors concluded. "Therefore, plans to counter the reemergence of a post-recession shortage and to use existing RNs … as efficiently and effectively as possible should be a priority for policymakers."

The authors attributed the rise in RN employment during the recent recession to several factors, including individual nurses' tendencies to fill existing job vacancies because of concern about their personal financial situations and diminished opportunities elsewhere. They noted that about seven in 10 RNs are married women and may rejoin the workforce or change to full-time status to help their household's economic outlook during a downturn.

The report — "Registered Nurse Labor Supply and the Recession — Are We in a Bubble?" — appeared March 21 on www.nejm.org.