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Joanne Spetz, University of California, San Francisco

The Present & Future of California’s Registered Nurse Labor Market: Shortages, Surpluses, and Surprising Trends. Joanne Spetz, University of California, San Francisco Deloras Jones, California Institute for Nursing and Health Care September 29, 2011 . The market, it is a-changin’….

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Joanne Spetz, University of California, San Francisco

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  1. The Present & Future of California’s Registered Nurse Labor Market: Shortages, Surpluses, and Surprising Trends Joanne Spetz, University of California, San Francisco Deloras Jones, California Institute for Nursing and Health Care September 29, 2011

  2. The market, it is a-changin’…. Is the shortage over? Does California have a surplus of RNs? Will health care providers be able to hire all the RNs needed now and in the long term?

  3. Goals for this webinar Learn how employers perceive the current RN labor market Link employer perceptions with recent data on RN employment and education Compare regions of California with a newly updated “report card” Forecast future supply and demand Review next steps for understanding California’s RN labor market

  4. The collaboration • Betty Irene Moore Nursing Initiative • California Institute for Nursing and Health Care • Institute for Health Policy Studies, University of California, San Francisco • Hospital Association of Southern California Acknowledgements & thanks to… • California Hospital Association • Hospital Council of Northern & Central California • Hospital Association of San Diego & Imperial Counties • UCSF Staff & Interns: Dennis Keane, Tim Bates, Lela Chu, Jessica Lin • Nikki West at CINHC

  5. What is going on in our RN labor market? • More than a decade of severe shortage, 1998-2008 • Reports that new graduates cannot find jobs 2009-now • Stories that nurses are not retiring when expected • Shortages in some regions Context: Ongoing recession, high unemployment, severe regional differences

  6. Goals for this webinar Learn how employers perceive the current RN labor market Link employer perceptions with recent data on RN employment and education Compare regions of California with a newly updated “report card” Forecast future supply and demand Review next steps for understanding California’s RN labor market

  7. Survey of Nurse Employers, Fall 2010 Collaboration between UCSF, CINHC, and HASC Email survey with option to return paper survey via fax or email Questions based on previous CINHC survey and National Forum of State Nursing Centers “Minimum Demand Data Set” recommendations Follow-up short survey conducted Spring 2011

  8. Perceptions of employers, fall 2010

  9. Differences across regions, Fall 2010 & Spring 2011 Lower number = more shortage

  10. Rural versus urban perceptions Lower number = more shortage

  11. Differences by hospital size Lower number = more shortage

  12. Change in difficulty recruiting, compared to last year, Fall 2010

  13. Change in difficulty recruiting, compared to last quarter, Spring 2011

  14. Share of budgeted positions filled, Fall 2010

  15. Per diem, traveler, and agency use Traveler RN share rose to 2.9% in Spring 2011

  16. Turnover & hiring

  17. Hiring of newly graduated RNs

  18. New graduate training programs 67.4% have a formal training program 80.4% developed program internally Most common capacity is 20-30 new grads (up to 60 grads) Most common length is 12 weeks (up to 24 weeks)

  19. Clinical areas for new graduate training

  20. Staff RN Vacancies, Fall 2010 & Spring 2011 Estimated 1,772 vacancies for new RN graduates in Fall 2010

  21. Hiring expectations for 2011, from Fall 2010

  22. Average expected change in hiring, Spring 2011 vs. Summer 2011

  23. Planned employment growth for 2011 & 2012, from Fall 2010 These data are for respondents, not all California hospitals

  24. New graduate hiring plans, 2010-2011 Average growth of 12% expected

  25. Reasons for planned changes in new graduate hiring, Fall 2010

  26. Reasons for expected change in hiring

  27. Goals for this webinar Learn how employers perceive the current RN labor market Link employer perceptions with recent data on RN employment and education Compare regions of California with a newly updated “report card” Forecast future supply and demand Review next steps for understanding California’s RN labor market

  28. Employment rates by age, 2008 & 2010 Source: California Board of Registered Nursing Survey of RNs, 2010

  29. Share of RNs working in multiple jobs, 2008 & 2010 Source: California Board of Registered Nursing Survey of RNs, 2010

  30. Reasons for not working in nursing% important or very important Source: California Board of Registered Nursing Survey of RNs, 2010

  31. Nurse earnings over time Source: California Board of Registered Nursing Survey of RNs, 2010

  32. Job satisfaction over time Source: California Board of Registered Nursing Survey of RNs, 2010

  33. Future plans of RNs Source: California Board of Registered Nursing Survey of RNs, 2010

  34. RN Graduations are expected to drop in 2012-2013 Source: California Board of Registered Nursing Annual Schools Report, 2009-2010

  35. Goals for this webinar Learn how employers perceive the current RN labor market Link employer perceptions with recent data on RN employment and education Compare regions of California with a newly updated “report card” Forecast future supply and demand Review next steps for understanding California’s RN labor market

  36. CA MSA Report Card: RN Jobs per capita • 2004 Report Card of RN jobs/capita replicated with 2010 data • Comparison of the RN workforce in different areas of the state…measurement of “density’ of RN jobs • Comparison of CA RN workforce to the rest of the country • Useful for regional planning

  37. Methodology • Formula: # RN Jobs x 100,000 = RN jobs/100,000 population • Measurement: based on data from Bureau of Labor Statistics & US Census Bureau • Rpt card values (letter grade): grading rubric constructed based on S.D. from median of RN jobs/capita of 50 states + D.C. (198 jobs = 1 S.D.) • Letter grade given to 23 MSA • Represents # of RN jobs NOT # of RNs working

  38. Grading Rubric

  39. Results • National average RN jobs/capita = 860 (C) • CA received a D with RN jobs ratio = 644 • 2 MSAs = or > Nat’l average (SF and Redding) • 4 MSAs = Fs with RN job ratio < 462/capita • 10 MSAs = D • Most MSAs retained same grade as in 2004; 5 improved; 5 dropped their grade • Although CA RN job ratio increased by 22 jobs/capita, CA ranking relative to the rest of the country remained the same, as the rest of the country also added RN jobs

  40. Letter grade by States

  41. CA Letter Grades by P/MSA

  42. Distribution of CA Letter Grades

  43. Goals for this webinar Learn how employers perceive the current RN labor market Link employer perceptions with recent data on RN employment and education Compare regions of California with a newly updated “report card” Forecast future supply and demand Review next steps for understanding California’s RN labor market

  44. Board of Registered Nursing Forecasts of Supply Nurses with Active Licenses Living in California Outflow of nurses Inflow of nurses Share of nurses who work, and how much they work Full-time equivalent supply of RNs

  45. The range of supply forecasts (RNs living in California) Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011

  46. Variation in FTE employment with assumptions about work and retirement Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011

  47. Forecast of Full-time Equivalent RNs per 100,000 population Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011

  48. What is demand? National benchmarks: Employed RNs per 100,000 Bureau of Labor Statistics, forecast of 2018 demand Growth based on current hospital employment & expected growth in patient days Potential impact of PPACA

  49. Forecasts of RN demand Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011

  50. Best supply and demand forecasts for RNs, 2009-2030 Source: California Board of Registered Nursing Forecasts of the RN Workforce, 2011

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