Category Archives: Workforce supply and demand
The Association of American Medical Colleges (AAMC) has released its 2013 State Physician Workforce Data Book, a biennial report that examines current physician supply, medical school enrollment, and graduate medical education in the United States.
Between 2008 and 2012, there were small increases in the state median number of active physicians and active patient-care physicians, the state median percentage of female physicians, and the percentage of physicians age 60 or older. While the median number of students enrolled in undergraduate medial education has increased relative to the population, the number of students enrolled in graduate medical education per population has remained flat.
Among key findings, in 2012 there were 260.5 active physicians per 100,000 population in the United States, ranging from a high of 421.5 in Massachusetts to a low of 180.8 in Mississippi. The states with the highest number of physicians per 100,000 population are concentrated in the Northeast.
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
Creating Healthy Workspaces for Older Nurses
The nursing workforce is aging, in part because the nation's economic difficulties have prompted some nurses to delay retirement. A new literature review by Jaynelle Stichler, DNSc, NEA-BC, FACHE, of the San Diego State University School of Nursing, examines ways hospital work environments might be fine-tuned to help older nurses navigate the health challenges associated with their physically demanding work. The article was published online on October 17 by the Journal of Nursing Management.
Noting that Centers for Disease Control & Prevention data indicate that older workers' on-the-job injuries tend to be more severe than those suffered by younger workers, Stichler offers recommendations culled from 25 separate studies conducted since 2002. They include:
- Ergonomic seating and countertops with the correct height for charting tables, and adequate space for keyboards, in order to prevent strains caused by working in improper body positions;
- Adequate lighting and non-slip floor surfaces to reduce the risk of falling;
- Decentralized linen, equipment, and supply storage in or near patient rooms, and decentralized nursing stations, in order to diminish walking distances;
- Electrical and medical gas outlets placed on either side of the patients' beds and at an easily accessible height, rather than behind or above the head of the bed, so that nurses won't have to strain to plug in equipment;
- Enhanced task lighting options over beds or on swing arms to ease eye strain and help nurses with visual acuity problems; and
- Barrier-free patient bathroom and shower designs, with floor drains and shower curtains, so nurses needn't use towels to mop up water.
More than 1,000 veterans will obtain undergraduate degrees in nursing over the next four years with the help of a grant from the Health Resources and Services Administration. The grant was announced earlier this fall.
The multi-million-dollar effort, known as the Veterans’ Bachelor of Science in Nursing (VBSN) program, will allow veterans to build on their combat medical skills and experience and receive academic credit for prior military training and experience. The program provides funding to nine institutions to recruit veterans and prepare VBSN undergraduates for practice and employment in local communities, and also develop career ladders that include academic and social supports, career counseling, mentors, and linkages with veteran service organizations and community health systems.
Participating institutions include three in Florida: Jacksonville University, Florida International University, and the University of South Florida; two in Virginia: Hampton University and Shenandoah University; as well as the University of Texas at Arlington, the State University of New York at Stony Brook, Davenport University in Michigan, and the University of Alabama at Birmingham (UAB).
Staffing company AMN Healthcare has released the results of its 2013 Survey of Registered Nurses, highlighting generational differences that have implications for the imminent nursing shortage and the shape of the profession in years to come.
Among key findings, nearly 190,000 nurses may leave nursing or retire now that the economy is recovering, and nearly one in four nurses age 55 and older (23 percent) say they will change their work dramatically by retiring or pursuing work in another field.
Fewer than half the RNs with an associate degree or diploma who were surveyed say they will pursue additional education in nursing. However, younger and mid-career nurses are more likely to do so. The landmark Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, recommends that 80 percent of the nation’s nurses have BSN or higher degrees by the year 2020.
While nurses of all ages say they are very satisfied with their career choice, younger nurses (19-39) are much more positive than nurses 55 and older about the quality of nursing today. Sixty-six percent of nurses 55 and older say they believe that nursing care has generally declined.
“The younger generation is more optimistic about the profession and more receptive to the changes the industry is experiencing,” Marcia Faller, PhD, RN, chief financial officer of AMN Healthcare, told Advance for Nurses. “These are differences that health systems must understand as they work with multiple generations of nurses.”
This was the fourth annual RN survey conducted by AMN Healthcare, which emailed 101,431 surveys in April to opted-in members of NurseZone.com and RN.com. The company received 3,413 responses, reflecting a response rate of 3.36 percent. Statistical analyses were run with a 95 percent confidence threshold.
What do you think about the survey findings? Do they reflect your views about the future of nursing? Register below to leave a comment.
The health care sector has created 166,800 new jobs so far this year, according to data from the Bureau of Labor Statistics—but that’s down from the 266,400 new jobs created in the first nine months of 2012. The sector created 6,800 jobs this September, compared with 36,600 in September of last year.
Experts note that these numbers have yet to reflect any slowing demand for physicians and other clinicians.
With health reform taking effect, consolidations and other changes in the health care industry, “what you are seeing is simple action-reaction,” Travis Singleton, senior vice president at the health care staffing firm Merritt Hawkins & Associates, told Health Leaders Media. “[A]nytime you have mass change to an industry you are going to get a reaction.” Singleton says that Merritt Hawkins saw a 14 percent increase in its physician and advanced practice recruiting assignments from 2012 to 2013, and he expects recruitment and hiring to continue to increase, especially in nursing.
Susan Reinhard, PhD, RN, FAAN, is senior vice president of the AARP Public Policy Institute and chief strategist at the Center to Champion Nursing in America, which coordinates the Future of Nursing: Campaign for Action. Here, Reinhard reflects on the impact of the Institute of Medicine’s Future of Nursing report during its third anniversary week.
The Center to Champion Nursing in America was founded six years ago as an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation (RWJF). Ever since, we have devoted considerable energies and resources to transforming the nursing profession to better serve consumers.
Why is AARP so invested in this work? One simple reason: Nurses, the largest segment of the health care workforce, provide critical care to our members, many of whom are aging and managing multiple chronic health conditions. Our work is not as much about improving conditions for nurses as it is about making life better for consumers and their families. A larger, more highly skilled nursing workforce will improve access to higher-quality, more patient-centered, and more affordable care. That is especially important now, with demand for nursing care growing as the population ages and as millions more people enter the health care system under the Affordable Care Act.
That is why we, at AARP, have made it our mission to ensure that all people have access to a highly skilled nurse when and where they need one.
Italo M. Brown, MPH, is a third year medical student at Meharry Medical College. He holds a BS from Morehouse College, and an MPH in epidemiology and social and behavioral sciences from Boston University, School of Public Health. He is a Health Policy Scholar at the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College.
In an ad-hoc poll among classmates, I recently inquired about the most important date (in 2013) to a second year medical student. The overwhelming majority of respondents cited their respective STEP 1 exam dates as most important, followed closely by the season finales of ABC’s Scandal and Grey’s Anatomy. While the top three responses are noteworthy, the one date that should bear the most gravity in the minds of medical students across cohorts is October 1st.
This October marks the launch of open enrollment for health insurance exchanges, a much-anticipated provision of the Affordable Care Act (ACA). The ACA seeks to reduce the number of nonelderly uninsured Americans by half; in other words, a projected 20 million new patients will enter the health care system over the next 18 months.
Ying Xue, DNSc, RN, is an associate professor at the University of Rochester School of Nursing and an alumnus of the Robert Wood Johnson Foundation Nurse Faculty Scholars program. This is part of a series of posts for National Nurses Week, highlighting how nurses are driving quality and innovation in patient care.
For the past two decades, supplemental nurses have been about 4 percent of the nursing workforce. These are nurses hired from staffing agencies to temporarily fill vacant nursing positions. The business of supplemental nurse staffing began in the 1970s as a symptom and a response to the nursing shortage. A central concern over the decades has been whether quality of patient care provided by supplemental nurses is the same as that provided by permanent nurses.
On the one hand, some argue that the temporary nature of the position (which varies from per-diem to a few months) might have an adverse effect on patient outcomes due to supplemental nurses’ lack of familiarity with unit policies and health care providers, and disruption in continuity of care. Others contend that supplemental nurses might have a positive effect on patient outcomes because they alleviate deficiencies in nurse staffing.
What’s the answer to this decades’ old question? Surprisingly, relatively little research has been conducted to provide a definitive answer, but several recent studies not only are shedding light on the issue, but helping to reframe the question by challenging some old myths.
Monique Trice, 24, is a University of Louisville School of Dentistry student who will complete her studies in 2015. Trice completed the Summer Medical and Dental Education Program (SMDEP) in 2008 at the University of Louisville site. Started in 1988, SMDEP (formerly known as the Minority Medical Education Program and Summer Medical and Education Program), is a Robert Wood Johnson Foundation–sponsored program with more than 21,000 alumni. Today, SMDEP sponsors 12 sites, with each accepting up to 80 students per summer session. This is part of a series of posts looking at diversity in the health care workforce.
Diversity is more than ethnicity. It also includes geography, perspective, and more. I was raised in Enterprise, Ala., which is in Coffee County. The community’s demographic and geographic makeup set the stage for an oral health care crisis. Here’s how:
- Enterprise is a community of 27,000 and just 15 licensed general dentists, three Medicaid dental providers, and zero licensed pediatric dentists to service Coffee County, a population of 51,000. In 2011, Alabama’s Office of Primary Care and Rural Health reported that 65 of the state’s 67 counties were designated as dental health shortage areas for low-income populations.
- According to this data, more than 260 additional dentists would be needed to bridge gaps and fully meet the need. For some residents, time, resources, and distance figure into the equation, putting dental care out of reach. In some rural communities, an hour’s drive is required to access dental services.
- Lack of affordable public transportation creates often-insurmountable barriers to accessing dental care.
Growing up in a single-parent household, my siblings and I experienced gaps in dental care. Fortunately, we never suffered from an untreated cavity from poor oral health care, but many low-income, underserved children and adults are not so lucky.
A report released Monday by the Health Resources and Services Administration (HRSA) indicate that efforts to grow and diversify the nursing workforce are showing results—a welcome finding given the looming shortage of nurses and primary care providers in general.
According to the data from HRSA's National Center for Health Workforce Analysis, the nursing profession grew substantially in the 2000s, adding 24 percent more registered nurses (RNs) and 15.5 percent more licensed practical nurses (LPNs). Significantly, the growth in the supply of nurses outpaced growth in the U.S. population, with the number of RNs per capita growing by about 14 percent and the number of LPNs per capita increasing by 6 percent.
The "pipeline" carrying nurses from school to the workforce also expanded during the past decade. The number of would-be nurses who passed national nurse licensing exams to become RNs more than doubled between 2001 and 2011, while the number of LPN test-passers grew by 80 percent. Significantly, the share of licensure candidates with bachelor's degrees increased during that time, as well.
The profession also is growing more diverse, according to the data. Non-white RNs are now 25 percent of the profession, up from 20 percent 10 years ago. Nine percent of RNs are men today, up slightly from 8 percent at the beginning of the decade.