Nurse Researcher Bemoans End of National Survey on Nursing Workforce
This year, the federal government did not continue a long-running survey of registered nurses that, since 1977, had provided a rich source of national data about nursing education and practice. Some nurse researchers are mourning the lapse of the survey, known as the National Sample Survey of Registered Nurses (NSSRN). Joanne Spetz, PhD, FAAN, professor, Philip R. Lee Institute for Health Policy Studies & School of Nursing; and faculty researcher, Center for the Health Professions, University of California, San Francisco, explains why she is among them.
Human Capital Blog: What does the lapse of the NSSRN mean for research about nurses and nursing?
Joanne Spetz: The NSSRN has been an important source of data for national and state policy-makers because it was designed to provide valid information about the nursing workforce at both the national and state levels. There are a few other surveys that can be used to get decent information about employed nurses for the nation, and for the largest states, such as the Current Population Survey (from the U.S. Bureau of Labor Statistics and the U.S. Census Bureau) and the American Community Survey (from the U.S. Census Bureau), but these data don’t yield any information about licensed nurses who are not working. They also don’t have enough data to help smaller states.
What many people don’t realize is that the NSSRN also has been used to learn about the basic behavior of the registered nurse (RN) workforce. Whenever we hear somebody talk about how much RN supply increases when wages go up, it is based on research from the NSSRN. What little we know about foreign-educated nurses comes from the NSSRN. Most research on wage discrimination, and the value of higher nursing education to nurses, also comes from these data. So, losing the NSSRN means we will lose a stream of basic research that helps us develop policies that will truly work to ensure adequate nursing resources.
HCB: The Forum of State Nursing Workforce Centers and the National Council of State Boards of Nursing (NCSBN) are working together to create a minimum data set (MDS) on the supply of the nurse workforce. Will that project help to compensate for the loss of the NSSRN?
Spetz: The nursing minimum data set is reliant upon states collecting data. So, it won’t make up for it for years since many states do not collect the type of data that are recommended. However, NCSBN and the Forum of State Nursing Workforce Centers do intend to collaborate so NCSBN can conduct a national sample survey of registered nurses. From what I understand, the survey would be much shorter than the historical federal NSSRN but would provide some information about education, employment, demographics, and inter-state practice. I hope this effort is successful and also that a public-use data set will be available so that researchers and policy analysts can use these data to fill in some of the gaps left by the loss of the federal NSSRN.
HCB: The National Center for Health Workforce Analysis at the Health Resources and Services Administration has fielded a new survey on nurse practitioners (NPs). What insights will that yield for the profession?
Spetz: The National Sample Survey of NPs will provide much-needed information about the work that NPs are doing now and will help guide policies to ensure they meet health care needs as the Affordable Care Act is implemented. The NSSRN has provided some information about the work of NPs, but because that survey is designed for the broader nursing workforce, it has been of limited use in understanding the NP workforce. There are significant shortages of primary care providers in many parts of the United States, and NPs can play an important role in ensuring access to health care services. The new survey will help us measure the supply of NPs both in general and to primary care.
HCB: What is your outlook for data on the nursing workforce? When will we have the data we need to ensure adequate delivery of nursing care?
Spetz: Ideally, we should have both a MDS and an NSSRN. The MDS can provide ongoing, longitudinal data that would enrich our understanding of both current employment and trends over nurses’ lifecycles. The NSSRN provides in-depth information about nurse intentions regarding future work, satisfaction, changes in practice, and family circumstances. The U.S. Census Bureau has a long history of having both a short-form census and a long-form survey that a subset of people complete. Having both an MDS and a sample survey would be similar.
But, at this point, only a handful of states are collecting MDS data, and only a few others have sample surveys. More than half of the states have nearly nothing, apart from the most basic education and licensure data. And, many state policy-makers are not paying attention to this issue because the nursing shortage has abated due to the recession. We have every reason to expect the shortage to re-emerge, and we are going to be very poorly positioned to address it without good data.
To read more about the end of the NSSRN, click here.