Is the RN shortage over—for good? Experts say no

NEJM: Nurses who joined workforce during recession expected to exit

Although RN shortages have been less pronounced in recent years, an article in NEJM warns that the nurse workforce expansion is a temporary bubble that likely will deflate within the next several years.

The authors highlighted the "countercyclical nature of the health care industry, in which job gains occur faster in recessionary than in nonrecessionary periods." Based on Current Population Survey data, the researchers reported that the number of full-time RNs increased by 386,000 from 2005 to 2010, and that more than one-third of that increase could be attributed to the unemployment rate, which climbed from 5.1% in 2005 to 9.6% in 2010.

  • The HR Investment Center has found similar through its benchmarking initiative. The Center's 2011 National Report on staffing, released this week, also shows rising turnover and vacancy rates that could foreshadow a return to the shortage conditions of the 1990s and early 2000s.

Researchers wrote that during the recent recession, nurses tended to fill vacancies because of personal finance concerns and fewer opportunities in other fields. For example, they noted that about seven in 10 RNs are married women, who in an economic downturn might rejoin the workforce as full-time employees to bolster their household income.

According to the authors:

  • The unemployment rate is expected to decrease to 6.1% by 2015, likely causing the RN workforce to contract.
  • About 118,000 full-time nurses will leave the profession by 2015, causing the overall workforce to grow by only 109,000 RNs across the time period.
  • While the number of young people entering the workforce rose across the last 10 years, the ramifications are not expected to manifest until after 2020.

"Thus it seems likely that growth in the demand for RNs over the next few years will outstrip the projected growth in the workforce, leading to renewed shortages of RNs in the near term," the authors concude.

The authors wrote that the potential shortages could reduce access to care, increase health costs, and threaten health reform implementation. "Therefore, plans to counter the reemergence of a post-recession shortage and to use existing RNs—both incoming and outgoing—as efficiently and effectively as possible should be a priority for policymakers" (Staiger, NEJM, 3/21 [subscription required]; Ostrow, Bloomberg, 3/22;, 3/26).

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