BenefitsEmployee Engagement

Nursing a Problem

A survey of the largest health profession tells a lot about Obamacare. First of a series, leading to our May 1-2 forum in Philadelphia.

By Marcia Faller
The 2012 Survey of Registered Nurses: Job Satisfaction, Career Pattern and Trajectories explores current career plans and trends, satisfaction levels, and professional concerns for registered nurses (RNs). In the next one to three years, a considerable number of nurses may pursue employment outside of nursing, shift to part-time roles, retire, or otherwise modify their career paths in some way, according to this report. As the economy continues to recover, issues such as nursing retention and turnover within healthcare facilities will be essential in planning for future nurse staffing.
Therefore, it is important to know how nurses truly perceive their profession. Their candid feelings, expressed in these survey results, might influence their peers and the next generation of nurses.

AMN Healthcare conducted its annual 2012 Survey of Registered Nurses to answer these and related questions. The survey inquiries mirror those asked in the 2011 Survey of Registered Nurses, and include a few new components. Data from previous surveys conducted in 2010 and 2011 are compared to the 2012 data in this report, unveiling some remarkable findings.
The 2012 survey offers a snapshot of current job satisfaction levels among nurses and also indicates how the economic recovery could affect future career trajectories. The data suggest how nurses currently view the quality of nursing care, and whether they believe healthcare reform will help address the predicted nursing shortage.
These results are offered as an information resource for healthcare industry leaders, policymakers, academics, staffing professionals, analysts, and others who follow clinical staffing and supply trends.
The following data points provide background describing the current nursing supply and demand situation:

  • Nursing is the nation’s largest healthcare profession, with more than 3.1 million RNs nationwide.
  • Of all licensed RNs, 2.6 million or 84.8 percent are employed in nursing. That means about 500,000 licensed nurses don’t work in the nursing field, but potentially could do so.
  • The nation’s ability to train new nurses to replace retiring nurses is significantly compromised by the limited number of faculty members at nurse training programs.
  • According to the American Association of Colleges of Nursing (AACN), U.S. nursing schools turned away 58,327 qualified applicants from entry-level baccalaureate nursing programs in 2011 (up from 52,115 in 2010) due to insufficient numbers of faculty, clinical sites, classrooms, clinical preceptors and budget constraints.
  • Almost two-thirds of the nursing schools cited faculty shortages as a reason for not accepting all qualified applicants.
  • AACN reported that there was a 5.1 percent enrollment increase in entry-level baccalaureate programs in nursing in 2011, but this increase is not sufficient to meet the projected demand for nursing services.
  • The Patient Protection and Affordable Care Act (PPACA) of 2010 is projected to provide 32 million Americans with access to healthcare services.
  • In July 2010, the Tri-Council for Nursing cautioned about declaring an end to the nursing shortage. The economic downturn led to an easing of the shortage in many parts of the country, but the Tri-Council noted that the limitations of the nation’s education system will slow the graduation of RNs. That, coupled with the passage of PPACA, is projected to increase demand for nursing services.
  • According to the projections released by the Bureau of Labor Statistics (BLS), registered nurses top the list of the 10 occupations with the largest projected job growth in the years between 2002 and 2012. Although RNs have ranked among the top 10 growth occupations in the past, this is the first time in recent history that RNs have ranked first.
  • The total job openings, which include job growth and the net replacement of nurses, will be more than 1.1 million. This growth, coupled with current trends of nurses retiring or leaving the profession and few new nurses, could lead to a nursing shortage of more than one million nurses by the end of this decade.
  • Current projections for 2025 indicate a shortage of 260,000 registered nurses according to The Recent Surge in Nurse Employment: Causes and Implications by Dr. Peter Buerhaus, June 2009. A shortage of this magnitude would be twice as large as any nursing shortage experienced in this country since the mid 1960s.


Key Findings
AMN Healthcare’s 2012 Survey of Registered Nurses was conducted following an economic recession and in the midst of an economic upswing, albeit not an aggressive recovery. In addition, the first parts of the PPACA of 2010 were being implemented and more fully understood.
The survey reflects how RNs modified career plans due to the recession and how they have begun to respond to the economic recovery. In addition, the survey addresses registered nurses’ perceptions of the impact of healthcare reform on the nursing shortage.

  • Less than one-fifth (17 percent) of nurses plan to seek a new place
  • of employment as the economy recovers, a decline from the 24 percent who said they would seek a new place of employment in the 2011 survey.
  • RNs are still more likely to be employed by a hospital where there
  • is permanent employment. However, down by 7 percent (total of 57 percent) from 2011. Thirty-one percent of nurses plan to take steps in the next one to three years that would take them out of nursing altogether (by retiring or seeking non-nursing jobs) or reduce the volume of clinical work they do (by switching to part-time or less demanding roles).
  • Sixty-six percent report that they will continue as they are, which is a significant rise from 55 percent last year.
  • A little less than half (40 percent) report they either would not recommend nursing as a career to young people or were not sure that they would.
  • Ninety-one percent of nurses are satisfied with their careers, up significantly from 2011.
  • Yet 44 percent would either hesitate about becoming a nurse or choose another career entirely if they were making such a professional choice today:
  • – 38 percent (age 19-39) in 2012 as opposed to 34 percent in 2011.
  • – 44 percent (age 40-54) in 2012 as opposed to 49 percent in 2011.
  • – 48 percent (age 50+) in 2012 as opposed to 45 percent in 2011.
  • Four percent plan to work as travel nurses in the next one to three years, compared to 14 percent who said that in 2011.
  • Forty percent of nurses will pursue further education in nursing in the next 1-3 years.


Trends and Observations
AMN Healthcare’s 2012 Survey of Registered Nursesis the third annual survey designed to explore how nurses currently feel about their profession and to evaluate their future career plans.

Responses to the 2012 survey indicate that roughly nine out of 10 nurses (91 percent) are satisfied with their choice of a career; 27 percent are not satisfied with their particular jobs. Nurses are holding strong overall in their career choice, but consider their current job not a good match for them. That compares to 74 percent who were pleased with their career choice in the previous survey, and 42 percent not satisfied with their particular jobs.
Overall, from 2011 to 2012, there has been a significant improvement in both career satisfaction and intent to stay in the current job. Should the economy continue to improve, nearly one-third (29 percent) of nurses said they would alter their career plans, either change employers, work as travel nurses, take steps that would reduce the volume of clinical work they do, or leave patient-care settings altogether. In the 2011 survey, almost half (42 percent) said they would alter their career plans. In addition, 32 percent of nurses suggested that, if they have their way, they will not be in their current job one year from now. That is up slightly from 30 percent in the 2011 survey.
The 2012 survey results show a much-improved sense of satisfaction with both career and job, but with a consistent one-third of nurses wanting to move on to something different in the near future. In light of these findings, healthcare facilities should continue their vigilance in the areas of nurse retention and nurse job satisfaction, particularly as the economy begins to improve.
AMN Healthcare’s 2012 Survey of Registered Nurses suggests that many RNs today are preparing to make a job move as the economy improves. Seventeen percent surveyed say that will seek a new place of employment as the economy continues to recover. Close to one-third said that during the next one to three years they plan to make a career change by switching to a less demanding nursing position, working as a travel nurse, switching to part-time, retiring, or taking other steps.
Of significant concern, 5 percent up from 3 percent in 2011, say they are likely to retire now that the economy is beginning to recover. More specifically, 5 percent of nurses permanently employed in a hospital setting indicate they plan to retire in the next one to three years. With the higher levels of dissatisfaction seen in the older age brackets of this survey, this could indicate even larger numbers of defections.
Some results indicate certain positive implications such as 66 percent (up from 56 percent) of nurses will continue in their profession for the next 1-3 years. Also, 91 percent are satisfied overall with their choice of nursing as a career. Nevertheless, 32 percent of those nurses—if they have their way—will not be working in their current position a year from now.
The following results stand out from the 2012 survey:
• Job satisfaction is on the upswing, but still concerning.
• A significant number plan to retire or scale back hours.
• Many nurses are working due to economic reasons and feel very strongly that healthcare reform does not provide a mechanism that will ensure an adequate supply of qualified nurses.
• Nearly half of nurses worry that their current job negatively impacts their health.
• One in five nurses plans to change employers.
• Almost half of nurses will return to advance their education in nursing.
Comparing responses from the 2011 survey to the 2012, continues to point out that nurses have several areas of dissatisfaction, and that healthcare facilities must continue to refine their nurse recruitment and retention strategies as well as consider alternative staffing options in order to meet their patient care objectives.
Marcia Faller, RN, PhD, joined AMN Healthcare in 1989 and currently serves as senior vice president of operations and chief clinical officer.
Register today for the HRO Today Forum that will take place on April 30th – May 2nd in Philadelphia, Pennsylvania and get the insight that you need to find out what Obamacare means for your business.

Tags: Benefits, Engaged Workforce, HRO Today Global

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