AACN Nursing Shortage Facts

The American Association of Colleges of Nursing has collected the following data on the current state of the nursing shortage and actions different organizations are taking to address it. More information is available on the association’s web site: www.aacn.org.

  • Current and projected shortage indicators

— According to American Hospital Association’s June 2001 TrendWatch, 126,000 nurses are currently needed to fill vacancies at our nation’s hospitals. Today, fully 75% of all hospital personnel vacancies are for nurses. www.aha.org.

— According to the National Council of State Boards of Nursing, the number of first-time, U.S.-educated nursing school graduates who sat for the NCLEX-RN, the national licensure examination for all entry-level registered nurses, decreased by 28.7% from 1995-2001. A total of 27,679 fewer students in this category of test takers sat for the exam in 2001 as compared with 1995. www.ncsbn.org.

— According to the latest projections from the U.S. Bureau of Labor Statistics published in the November 2001 Monthly Labor Review, more than 1 million new nurses will be needed by the year 2010. The U.S. Department of Labor projects a 21% increase in the need for nurses nationwide from 1998 to 2008, compared with a 14% increase for all other occupations. www.bls.gov.

  • Contributing factors impacting the nursing shortage

Schools of nursing are reporting a decline in enrollment and graduations, which translates into fewer nurses in the educational pipeline.

According to the fall 2001 survey by the American Association of Colleges of Nursing, enrollment in generic (entry-level) baccalaureate programs in nursing increased by 3.7% nationwide since last year, ending a six-year period of decline. Despite this slight increase, enrollments in all programs still are down 17% or 21,126 students from 1995. On average over the last five years, the number of enrollees and graduates from generic programs declined by 1,567 and 1,420 each year, respectively. The 1997-2001 cohort contains 358 schools that reported data every year for each of the past five years. www.aacn.nche.edu.

  • A shortage of nursing school faculty is restricting nursing program enrollments.

— According to a survey by the American Association of Colleges of Nursing, 2000-2001 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, more than a third (38.8%) of schools who responded pointed to faculty shortages as a reason for not accepting all qualified applicants into entry-level baccalaureate programs. www.aacn.nche.edu.

— According to a study released by the Southern Regional Board of Education (SREB) in February 2002, a serious shortage of nursing faculty was documented in 16 SREB states and the District of Columbia. Survey findings show that the combination of faculty vacancies (432) and newly budgeted positions (350) points to a 12% shortfall in the number of nurse educators needed. Unfilled faculty positions, resignations, projected retirements, and the shortage of students being prepared for the faculty role pose a threat to the nursing education work force over the next five years. www.sreb.org.

  • With fewer new nurses entering the profession, the average age of the RN is climbing.

— According to the latest National Sample Survey of Registered Nurses, the average age of the working registered nurse population was 43.3 in March 2000, up from 42.3 in 1996. The RN population younger than age 30 dropped from 25.1% of the nursing population in 1980 to 9.1% in 2000. http://bhpr.hrsa.gov/nursing.

— According to a July 2001 report released by the Government Accounting Office, Nursing Work Force: Emerging Nurse Shortages Due to Multiple Factors (GAO-01-944), 40% of all RNs will be older than age 50 by the year 2010. www.gao.gov.

  • The total population of registered nurses is growing at the slowest rate in 20 years.

— According to the preliminary findings of The National Sample Survey of Registered Nurses released in February 2001 by the Division of Nursing within the Bureau of Health Professions, the total RN population has increased at every four-year interval in which the survey has been taken since 1980. Although the total RN population increased from 2,558,874 in 1996 to 2,696,540 in 2000, it was the lowest increase (5.4%) reported in the previous national surveys. Of the total RN population in 2000, an estimated 58.5% work full time in nursing, 23.2% work part time, and 18.3% are not employed in nursing. http://bhpr.hrsa.gov/nursing.

  • High nurse turnover and vacancy rates are affecting access to health care.

— According to the report Acute Care Hospital Survey of RN Vacancies and Turnover Rates in 2000 released in January 2002 by the American Organization of Nurse Executives, the average RN turnover rate in acute care hospitals was 21.3%. The average nurse vacancy rate was measured at 10.2% with the highest rates found in critical care units (14.6%) and medical-surgical care (14.1%). Nurse executives surveyed indicated that staffing shortages are contributing to emergency department overcrowding (51%) and the need to close beds (25%). www.aone.org.

  • Job burnout and dissatisfaction are driving nurses to leave the profession.

— According to a study commissioned by the Federation of Nurses and Health Professionals in April 2001, The Nurse Shortage: Perspectives from Current Direct Care Nurses and Former Direct Care Nurses, currently one out of five nurses currently working is considering leaving the patient care field for reasons other than retirement within the next five years. www.aft.org.

  • Changing demographics signal a need for more nurses to care for aging population.

— According to a July 2001 report released by the Government Accounting Office, Nursing Work force: Emerging Nurse Shortages Due to Multiple Factors (GAO-01-944), "a serious shortage of nurses is expected in the future as demographic pressures influence both supply and demand. The future demand for nurses is expected to increase dramatically as the baby boomers reach their 60s, 70s, and beyond." www.gao.gov.

— According to a May 2001 report, Who Will Care for Each of Us?: America’s Coming Health Care Crisis, released by the Nursing Institute at the University of Illinois College of Nursing, the ratio of potential caregivers to the people most likely to need care, the elderly population, will decrease by 40% between 2010 and 2030. Demographic changes may limit access to health care unless the number of nurses and other caregivers grows in proportion to the rising elderly population. www.kaisernetwork.org/healthcast/nursing/may01.

  • The nursing community and other stakeholders are working together to identify strategies to address the shortage.

— The Call to the Profession is a group of top leaders from national nursing organizations who are working together to ensure safe, quality nursing care for consumers and a sufficient supply of registered nurses to deliver that care. The group currently is working on an action plan called Nursing’s Agenda for the Future. www.ana.org.

— The TriCouncil for Nursing, an alliance of four autonomous nursing organizations (American Association of Colleges of Nursing, American Nurses Association, American Organization of Nurse Executives, and National League for Nursing) each focuses on leadership for education, practice and research, issued a joint policy statement in January 2001 on Strategies to Reverse the New Nursing Shortage. www.aacn.nche.edu/Publications/positions/tricshortage.htm.

— The Nurse Reinvestment Act (HR 3487 and S 1864), legislation introduced to address the nursing shortage, was passed by Congress in December 2001 and now is in conference committee. Current provisions provide funding for a fast-track faculty scholarship program, student loan repayment program, grants for internships and residencies, and public service announcements. www.aacn.nche.edu/Media/shortageresource.htm#legislation.

— In April 2001, a coalition of 23 national nursing organizations issued a joint call to Congress to stem the nursing shortage and released a comprehensive plan to address the shortage, titled Assuring Quality Health Care for the United States: Supporting Nurse Education and Training, that outlined funding priorities and called for new initiatives to recruit and retain nurses. www.aacn.nche.edu/Media/NewsReleases/consensus.pdf.

— Two national media campaigns have been launched recently to help polish the image of nursing. Nurses for A Healthier Tomorrow is a coalition of 35 nursing and health care organizations working together to raise interest in nursing careers among middle and high school students. In February 2002, Johnson & Johnson launched the Campaign for Nursing’s Future, a multimedia initiative to promote careers in nursing that includes paid television commercials, a recruitment video, a web site, and brochures mailed to schools across the country. www.nursesource.org and www.discovernursing.com.