Fact Sheet on the Hospital Nursing Shortage

The Problem - An Overview

• California ranks 50th among the states in the number of RNs per capita.
  
• Need is for experienced RNs in all areas, including critical care, OR, ER, neonatal - and for cultural diversity.
  
• The problem is local, regional, national and global. This shortage is unlike any in the past and is projected to persist far into the future.
  
• Traditional recruitment remedies won't work. Strategies such as raising wages, offering sign-on bonuses and hiring from other communities, states, or countries only drive up costs for everyone.
  

The Demand Side - Why We Need More RNs

• People over 85 are the fastest growing U.S. population segment.
  
• Baby boomers are on the brink of retirement; they become eligible for Medicare in 2011.
  
• California's population is surging, projected to grow from 32.5 million to 49.3 million between 2000 and 2025.
  
• 50 percent of California's licensed RNs are educated outside the state.
  
• California's demographic diversity calls for nurses with a wide range of multicultural and multilingual skills.
  
• All racial and ethnic groups are underrepresented among RNs; the gap is most pronounced for Hispanics, who account for 30 percent of California's population but only 4 percent of the state's RNs.
  
• Demand is climbing across an array of sites - home care, managed care, nursing homes, school nursing, clinics, etc.
  
• The Bureau of Labor Statistics projects a 12.5 percent increase in RN hospital positions by 2005. However, as a percentage of total RN jobs in all settings, RN hospital jobs will decrease from 64 percent to 57 percent.
  
• Nurses have many more work options today; hospitals face stiff competition in recruitment and retention.
  

The Supply Side - Why We Don't Have Enough Nurses

• Nurses are aging along with the rest of the population; the average nurse is in his or her late 40s; one-third of the RN population is over 50.
  
• Recruitment into nursing education programs is problematic for several reasons. For one, women, who have traditionally filled the field, have many other career options today.
  
• Colleges have not expanded because nursing education is more expensive to provide than other programs.
  
• Enrollment in baccalaureate nursing programs has declined for five consecutive years.
  
• Introduction of the lottery system into community college admissions has allowed under-prepared students to enter. Attrition rates (due to dropout and failure) have risen from 10 percent to 40 percent. Community colleges have provided 70 percent of the nurses in California.
  

Solutions

• AB 655 (Scott, D-Pasadena), which passed in 1999, requires California's higher-education community, along with health care providers, to develop a plan and budget to increase the number of nursing graduates. HASC has urged CHA to take a leadership role in this process.
  
• HASC and CHA will seek funding for nursing education in this legislative session.
  
• HASC's Nursing Shortage Task Force has developed a plan to address the problem on several fronts:
  
• Op-ed articles have been written to educate the public about this public health crisis. Hill & Knowlton is placing these pieces in appropriate media.
  
• HASC developed a resource directory of colleges willing to work with hospitals on training programs.
  
• HASC is bringing nursing educators from California State University, Los Angeles, together with interested hospitals to plan and develop appropriate nursing certificate programs.