Transcript Brunell - LIFE at UCF

The State of Nursing in Florida:
Today and in the Future
Mary Lou Brunell, RN, MSN
Executive Director
10/15/2013
Visit us at: www.FLCenterForNursing.org
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Objectives
1. Describe the current nurse workforce.
2. Identify factors affecting the demand for an
adequate, qualified nurse workforce.
3. Predict the likelihood of having an
adequate, qualified nurse workforce to
meet future consumer demand.
4. Examine potential interventions to assure
an adequate, qualified nurse workforce for
today’s and tomorrow’s needs.
10/15/2013
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The Nurse Workforce – What is it?
 Licensed Practical Nurses (LPN)
 Registered Nurses (RN)
 Advanced Practice Nurses (APN)
Who are eligible for employment with a clear and active
license (without disciplinary or other limitation).
AND
Who choose to work in the practice of nursing.
10/15/2013
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Licensed Practical Nurses
 Promotes wellness, maintenance of good health, and
illness prevention
 Provides direct patient care and observation, and
administers medications and treatments under the
direction of a registered nurse or licensed physician
10/15/2013
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Registered Nurse
 Assesses, monitors, and evaluates patient health status
using knowledge of scientific principles and clinical
judgment
 Anticipates risks and prepared to intervene to prevent or at
least minimize medical complications
 Educates patients, families, and communities about health
promotion and disease prevention
 Coordinates care
 Administers medications and treatments prescribed by an
advanced practice nurse or licenses physician
10/15/2013
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Advance Practice Nurse
 Independently evaluates and manages patients under an
established protocol with a licensed physician or dentist
 Four APN roles
1. Advanced Registered Nurse Practitioner: Manages the care of
patients with acute and chronic medical and psychiatric conditions
2. Certified Nurse Midwife: Provides well-women care and manages
patient during labor and delivery
3. Certified Registered Nurse Anesthetist: selects and administers
regional and general anesthetic agents and oversees patient recovery
4. Clinical Nurse Specialist: Assesses and manages health status of
individuals and families – educator, coordinator, consultant
10/15/2013
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Successful Planning
 To meet consumer needs we must know
the numbers
• Supply of Nurses
• Demand for Services
 If Supply ≠ Demand
 Shortage
 Need to know for today and the future
10/15/2013
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Supply of Today vs. Supply of Tomorrow
 Age of nurse population
• Anticipating retirements
• Projecting work longevity
 Historical trends projected forward
• Anticipated turnover / loss from profession
• Anticipated new nurse graduates
 Forecasting Models
• Predict supply
10/15/2013
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Florida Center for Nursing
 Established in law (FS 464.0195) 2001
 Purpose – to address issues related to the
nursing shortage in Florida
 Overseen by 16 member Board appointed
through the Governor’s Office
 Vision
To be the definitive source for information,
research, and strategies addressing the
dynamic nurse workforce needs in Florida.
10/15/2013
Visit us at: www.FLCenterForNursing.org
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Nurse Workforce Information
The nurse data “trifecta”:
• Nurse Supply Data – licensure and renewal
survey data analyzed biennially (consistent
with renewal cycle)
• Nurse Demand Data – employer surveys of 6
industries conducted and analyze biennially
(odd years)
• Nurse Education Data – LPN / RN prelicensure and graduate programs surveyed
and analyzed annually
These data elements permit forecasting
10/15/2013
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Florida Nurse Supply as of January 2012
All Licensees
250,000
200,000
Potential Workforce
Estimated Working
251,113
194,959
167,266
150,000
100,000
75,161
50,000
61,324
17,508 14,103
12,809
50,208
0
RN
10/15/2013
APN
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LPN
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Age of Florida’s Working Nurses
35%
30%
25%
20%
15%
RN
10%
ARNP/CNS
5%
0%
21-30
10/15/2013
31-40
41-50
51-60
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61 and older
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RN Work Status in Percent, 2010-2011
4%
3%
Column1
2%
Employed as Nurse
5%
Not Seeking Work
Retired with Active
License
86%
Seeking Work as Nurse
N/A
10/15/2013
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FTE RN Vacancy Rates by Industry as of 6/30/2011
10/15/2013
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Trend in FT Faculty Vacancy Rates, 2007-2012
10/15/2013
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Do we know demand?
 Actual survey of Florida nurse employers (2011)
• Current Need = 8,994 RN vacancies
• Future Growth = 6,746 RN positions
 Population Estimates
• Growth / In-Migration
• Age (Increasing age = Increasing Demand
10/15/2013
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Trend in Number of New Graduate Nurses 2007-2012
8,000
ADN programs
Pre-licensure BSN Programs
7,000
5,603
6,000
5,000
4,000
3,000
2,000
5,640
5,701
7,264
6,250
4,134
1,906
1,904
2,031
2,189
2,258
2,523
1,000
2007
10/15/2013
2008
2009
2010
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2011
2012
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Florida’s Registered Nurse Forecast
RN FTE Supply
RN FTE Demand
240,000
220,000
- 50,321
200,000
180,000
160,000
140,000
2010
10/15/2013
2015
2020
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2025
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National Predictions
Researchers predict a national nursing
shortage of between
300,000 and 1,000,000 by 2030
Source: Jurasheck, Zhang, Ranganathan, Lin. (2012). United States
Registered Nurse Workforce Report Card and Shortage Forecast.
Public Health Resources. Paper 149.
10/15/2013
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Factors Effecting Supply & Demand
 Low Supply
• Aging nurses  retirements &/or reduced work
• Poor work environments   turnover
• Barriers to education expansion
 High Need
• Population growth
• Aging population   demand
• Expanded health care access
10/15/2013
Increased need
Employment opportunities in new areas
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Solutions: Education Capacity Issues
 Faculty shortage
• Competitive salaries
• Incentives to return to school (scholarships,
loan forgiveness, stipends)
• Academic funding challenges
 Clinical Capacity
• Use of Simulation
• Nurse Internships
• Day/time flexibility
10/15/2013
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Solutions: Work Environment Issues
 Nurse Residency Programs
• School to Work transition
• Change in practice setting
-
Anticipate  acute care beds
Anticipate  long-term care, hospice, and home
health
 Value the contribution of all nurses
• Decision making involvement
• Leadership appointments
• Participate in policy decisions
10/15/2013
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 New Models of Care Delivery
• Nurses practice to full extent of education
and experience with strong support system
• Address increasing cost while improving
safety and outcomes
• Accommodate the aging nurse population
thus extending nurses’ work life
10/15/2013
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Solution: Increasing Diversity
 Greater reflection of general population 
greater ability to meet consumers needs
 Gender – increase proportion of men
US – 50%
Nursing – 9.1%
 Ethnicity/Race – improve diversity of
nursing faculty to improve student diversity
US – 37% minority
10/15/2013
Nurse Faculty – 12.6%
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Challenges
 Need political support
 Need funding allocations / reimbursement
 Need industry buy-in
 Need support of health provider colleagues
 Need consumer support
 Need ACTION!!
10/15/2013
Visit us at: www.FLCenterForNursing.org
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QUESTIONS??