More Nurses Advancing Their Education, Study Finds

    • July 26, 2013

The national call for a more highly educated nursing workforce is apparently resonating among nurses.

In a new survey of registered nurses (RNs) based on data collected earlier this year for two national nursing organizations, 61 percent of respondents say they have obtained a baccalaureate degree or higher.

That’s up from the 55 percent of nurses who said the same in a study released in May by the Health Resources and Services Administration (HRSA) that was based on data from 2008 to 2010. The increase continues a trend that has been seen over the last decade.

More nurses are also entering the field with bachelor’s degrees, rather than starting with associate degrees and continuing their studies later, according to the new study, 2013 National Workforce Survey of Registered Nurses. Thirty-nine percent of respondents say their initial degree is a bachelor’s—a point that the survey’s authors say aligns with the results from the 2013 HRSA study, which found an increase in the percentage of bachelor’s-prepared nurses taking nurse licensure examinations for the first time.

The new survey was conducted from January to March of this year for the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers (the Forum). The instrument used to conduct it differed from that used for earlier HRSA studies and the authors urged readers to bear that in mind when making comparisons.

“This new study provides a richly detailed portrait of our nation’s nursing workforce,” said Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing at the Robert Wood Johnson Foundation (RWJF). “I’m especially encouraged to see that more nurses are choosing to advance their education—a goal strongly supported by the Institute of Medicine’s (IOM) Future of Nursing report. A more highly educated nursing workforce is urgently needed to meet the demands of an increasing, and increasingly complex, patient population.”

For the survey conducted by NCSBN and the Forum, a battery of questions based on a Minimum Data Set developed by the Forum was sent to a random sample of nearly 110,000 registered nurses across the country. More than 42,000 nurses responded, for a response rate of 39 percent. The results were published this month as a special supplement to the July issue of the Journal of Nursing Regulation.

Demographics of the Nursing Workforce

The composition of the nursing workforce remains predominately female (93 percent), according to the survey. Male nurses are most heavily represented at correctional facilities, where they represent 17 percent of the nursing workforce, and are least well represented at school health services, where they represent 1 percent of the nursing workforce. The most common job title held by male nurses is advanced practice nurse (held by 12 percent of respondents) and the least common is nurse researcher (held by 2 percent of respondents).

The study found 6 percent of respondents identifying as Asian, another 6 percent as Black, 3 percent as Hispanic/Latino, and 1 percent each American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and “other.” Staff nurses are the most diverse group of respondents, while nurse faculty are the least diverse.

The average age of respondents was 50, indicating a looming nursing shortage as working nurses enter their retirement years—just as the nation’s population is aging and as millions more patients enter the health care system under the Affordable Care Act.

The survey suggests a looming acute shortage of certified nurse midwives: 63 percent are 50 or older and 31 percent are older than 65—the traditional age of retirement. Only 20 percent are younger than 40.

In academia, fully 72 percent of respondents who hold full-time faculty positions are 50 and older. At the same time, few young nurses are entering academia; only 14 percent are younger than 40. “It continues to be evident that younger RNs are not choosing to work as faculty in academic settings,” study authors write.

Many nurse faculty lack requisite educational preparation, the new survey finds. Of respondents who identified as nurse faculty, only 10 percent reported having a PhD in nursing, and an additional 3 percent said they have a DNP. Fewer than half—43 percent—said they hold a master’s degree in nursing, the minimal educational qualification for a nurse faculty position.

Overseen by National Nursing Organizations

The new study was managed by four nursing workforce researchers, including Patricia Moulton, PhD, executive director of the North Dakota Center for Nursing, Chair of the Forum’s Research Committee, and co-lead of the state’s Action Coalition—a group of nurses and nurse champions who are working to implement the IOM report recommendations as part of the Future of Nursing: Campaign for Action. The three other researchers are: Jill S. Budden, PhD, who was the project lead from NCSBN; Elizabeth H. Zong, PhD, from NCSBN; and Jeannie P. Cimiotti, DNSc, RN, from the New Jersey Collaborating Center for Nursing.

2013 National Workforce Survey of Registered Nurses is meant to fill a gap in data about the nursing workforce that is needed to ensure the nation has an adequate supply of nurses.

Last year, HRSA announced it would discontinue the National Sample Survey of Registered Nurses (NSSRN), which had been conducted every four years since 1977.  That decision prompted the NCSBN and the Forum to team up to fill the void with this new national survey. Read more about the end of the NSSRN survey in a story on the RWJF website and in a post on the RWJF Human Capital Blog.

“The need for research related to the nursing workforce has never been greater,” Maryann Alexander, PhD, RN, editor-in-chief of the Journal of Nursing Regulation, wrote in an editorial accompanying the survey. “The United States is on the brink of a potential transformation of its health care system. Analysts continue to predict an impending shortage of health care providers, especially in primary care, and there is a call for increased cultural and gender diversity in nursing.”