Nursing Shortage Persists In Florida Despite Recession
Florida now has one of the highest unemployment rates in the nation – 11.5 percent as of November 2009, yet a new report released this month by the Florida Center for Nursing found that Florida's nursing education programs continued to turn away vast numbers of qualified applicants even while health care employers were also forecasting considerable growth in nursing positions.
The Florida Center for Nursing conducted a survey of nurse employers in six industry groups from July through September 2009 in order to determine their current and future demand for nursing personnel as well as the impact of the economic recession on nurse employment.
All hospitals, psychiatric hospitals, skilled nursing facilities (nursing homes), home health agencies, public health departments, and hospices in Florida were asked about their 2009 nursing vacancies and growth projections through 2012. Employers were asked about vacancies, turnover, future demand for nurses, recruiting difficulty encountered over the past year, and how the current economic recession has affected their nurse staffing and hiring practices.
The resulting Workforce Demand in Nursing-Intensive Healthcare Settings report indicated that despite the current recession, employers reported higher than expected vacancies, turnover, and projected growth in nursing positions. The estimated number of vacant positions as of June 30, 2009 was approximately 6,800 RNs, 1,400 LPNs, and 4,000 CNAs.
Full-time equivalent (FTE) position vacancy rates for RNs were highest within skilled nursing facilities (6.8%), hospices (7.0%), and home health agencies (8.6%). Home health agencies also reported high vacancy rates for LPNs (8.8%) and certified nursing assistants (CNAs, 6.7%). Psychiatric hospitals reported a CNA vacancy rate of 8.9 percent.
These figures reflect a substantial need for nursing personnel in Florida, despite the recession, and they are likely underestimates of the true number of nursing vacancies because not all nurse employers (such as physicians’ offices or prisons) were included in the study.
Employers reported substantial unmet need for budgeted positions. Seventy percent of public health departments reported needing additional budget lines for RNs, as did 55 percent of psychiatric hospitals. Thirty-five percent of hospitals reported needing positions for direct care RNs. Thus, while vacancy rates have declined in these groups, the number of budgeted positions may not be keeping pace with perceived need within these industries.
The skill mix of nurses employed varied by industry group. Within hospitals, 78.1 percent of the nursing staff were RNs, 4.9 percent were LPNs and 16.3 percent were CNAs. Public health department nurse employees were also predominantly RNs. Hospices and psychiatric hospitals had a similar nursing skill mix, almost half of their nursing employees were RNs and over 30 percent were CNAs. Approximately one percent of the nursing staff of hospitals and psychiatric hospitals are Advanced Registered Nurse Practitioners (ARNPs).
Even though growth is difficult to predict in the current economic climate, respondents reported that they did anticipate growth in new positions through 2011. Percentage growth in budgeted positions varies widely by industry. By 2010, hospitals expect to increase their RN staffs by 2.2 percent. In contrast, home health agencies expect to increase their RN staffs by 35 percent. Expected growth in nursing positions through 2011 is estimated to be about 8,200 RN positions, 3,100 LPN positions, and 5,000 CNA positions.
Most Difficult Nursing Positions To Fill
Nursing Administrators and Supervisor positions were deemed most difficult to fill by four out of the five surveyed industry groups, nurse practitioner positions were difficult to fill among all groups. Infection control nurses were the most difficult to fill specialty in public health and hospice. In hospitals, cath lab nurses and adult critical care nurses were also difficult to fill positions. SNFs needed rehabilitation nurses, minimum dataset nurses, and administrators. Although the number of psychiatric hospital respondents was quite small, they reported Psychiatric/Behavioral RNs and LPNs were difficult positions to fill.
Top Five Growth Specialties Over the Next Two Years
The top five specialties for which growth in budgeted positions is expected over the next two years are as follows: Staff RNs will be needed by SNFs, home health agencies, public health agencies, and hospices. All of these groups, with the exception of public health, also expect to increase the employment of CNAs and LPNs. Public health departments also will need nurse practitioners, case managers, community outreach and school nurses. Because they offer more specialized care, hospitals were given a longer list of staff nursing positions. Many expected growth for adult and pediatric critical care and emergency nurses. Psychiatric hospitals also reported a need for psychiatric RNs.
Although the nursing shortage has eased a bit with the current recession, a greater shortage looms in the near future. Once the recession abates, older nurses will retire and those who rejoined the profession may decide to leave as well. At the same time, an aging population will begin to demand more health care. Therefore, the nursing shortage is likely to intensify over the coming decade. An estimated 40 percent of Florida’s nurses are nearing retirement age, and the center suggests there are not enough nurses coming up through the ranks to replace them.
The Bureau of Labor Statistics (BLS) projects that demand for RNs will increase more than any other type of worker through 2016, with more than new 587,000 RN positions projected during this time in the United States.6 Hence, we expect long-term demand for nurses to increase in response to population trends.
The healthcare industry continues to grow and remains a strong source of new jobs, even in an economic recession, as evidenced by the projected demand for nurses over the next two years. Indeed, RN employment has increased nationwide during the recession.
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