A couple of months ago, I wrote an article for Stat Line that shared the new Bureau of Labor Statistics (BLS) information which indicated that nursing will need to grow 22.2% by 2018 in order to meet the patient needs. As we all march forward with various changes in our country, it is definitely time to stop and think about what these changes will mean to nursing. The economy, aging workers, health care reform and technology are all strong drivers of a new and different "look" that will encompass the profession.
For the past 2-3 years, many organizations have been running on a status quo basis when it comes to recruitment. Vacancy rates are low, turnover is down, census varies, acuity remains high and potential retirees continue to work. We are beginning to see a glimmer of change in some areas of the country as we begin to pull out of the recession and see brighter times ahead. For nursing, this will have a dramatic effect and we will experience it from many angles.
- Retirements-There has been a very tight labor market in the past few years due to the economy. The aging population that is still working is now cautiously planning on exiting the workforce and organizations and patients will feel the exodus of these experienced workers.
- Health care reform-With over 32 million Americans receiving insurance in the years ahead, there will be an increase in the need for health care workers. Covering preexisting medical conditions will also add more coverage, although this occurs in 2014 for adults.
- Pediatrics-The need for RNs in pediatrics will be quite noticeable for a couple of reasons. One is the preexisting medical condition coverage which begins this year for children and the other is the fact that millions more children will now have coverage due to health care reform. This will drive the increase in staffing needs at facilities around the country, especially those specializing in neonatal and pediatric care.
- Education-Clinical instructor shortages have remained throughout the last few years and are expected to continue. Educational positions pay one-half to two-thirds of the salary that an RN makes in a clinical setting so instructors are very difficult to recruit and retain. Both pay and clinical site issues will need to be addressed in the very near future in order for training to continue at the pace we need.
- Surgery-OR nurses tend to be some of the most experienced nurses in any organization and often have the most retirement eligible staff of any department. As you do your workforce planning, take a close look at OR because this group will begin exiting the workforce as the economy recovers and OR training programs will need to be run on an ongoing basis.
- Wellness-With the healthy focus on wellness in today's world, more and more programs and staff are needed in clinics, smoking cessation and other areas targeted at keeping patients well.
- Advanced Practice Nurses-The increased need for nurse practitioners, midwives and nurse anesthetists will also be driven by retirements, health care reform and wellness programs. In addition, these advanced practice RNs offer a cost effective professional that adds tremendous value to patient care.
- Geriatrics/long term care-The over 65 age group will grow by 13 million people between 2008 and 2018 and this increase will add to the need for RNs in geriatrics and LTC.
- Oncology and hospice-An increase in oncology and hospice is another area where we will see an increased need for RNs. The drivers include the aging population and their needs coupled with the increased technology and pharmacology that has helped add years to many patients' lives.
- Home care-RNs in home care will also increase as this specialty is the fastest growing sector within health care and, according to the BLS, is due to increase at a rate of 3.9% per year.
Although all of the above points may not be relevant to your organization, some of them will be. These changes will need to drive a different strategy in human resources on how an organization recruits and retains employees. It is our job to be pro-active, knowledgeable of these changes and strategic enough to meet the needs of the next decade.