Building an Improved Infrastructure for Collection & Analysis of Nursing Workforce

As the general population continues to age and grow, the nursing workforce is aging alongside. Approximately half of the current nursing workforce is apart of the baby boomer generation (Mion). RNs are eligible to retire at age 55, which will affect the majority of “baby boomer” nurses between 2005 and 2010 (Mion). According to the Nursing Management Aging Workforce Survey in 2006, “55% of surveyed nurses reported their intention to retire between 2011 and 2020” (Nursing Shortage). The demand for skilled nurses is growing at an exponential rate. According to information from the U.S. Department of Health and Human Services, the supply of nurses has been

“United States Registered Nurse Workforce Report Card and Shortage Forecast.” American Journal of Medical Quality. January 2012

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

“Registered Nurses represents the largest profession within the U.S. Health workforce” (nursingeconomics.net). The need for registered nurses will continue to grow and the RN with the strongest skill set will be chosen for the job over a candidate who only has formal

The Oklahoma Board of Nursing (OBN) provides information to the public about the services of the Board of Nursing (OBN, n.d.). The purpose of the OBN is to “safeguard the public’s health by ensuring that licensed nurses are qualified and competent to practice” (OBN, n.d.). The public has access to the OBN to inquire on current licensed nurses, Nurse Practice Act, and guidelines about nursing care (OBN, n.d.). The American Nurses Association (ANA) is the “only full-service professional organization” that represents registered nurses’ interest through associations and partners (ANA, 2014). Their mission is “nurses advancing our profession to improve health for all” (ANA, 2014). They promote nursing practice by setting high standards, promoting nurses’ rights, leading a realistic outlook of nursing, and “by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public” (ANA, 2014). The National League for Nursing (NLN) is an organization for any nursing-related faculty offering “faculty development programs, networking opportunities, testing and assessment, nursing research grants, and public policy” (NLN, 2013). Their mission is to “promote excellence in nursing education to build a strong and diverse nursing workforce to advance the nations health” (NLN, 2013).

Over the past few decades, many drastic changes occurred in U.S health care delivery.   Our current healthcare trends demand nurses to take more active role in the health care decisions in hospital setting, long term care setting and in community healthcare setting. Since “nursing is based upon a body of knowledge that is always changing with new discoveries and innovation” Potter and Perry (2005), nursing profession is compelled to grow from being just a traditional bedside nurse. IOM’s future of nursing report which is released in 2010 calls nurses to be “more highly educated, diverse nursing workforce”.

The Robert Wood Johnson Foundation (RWJF) has just released a new study highlighting the steps 12 states are taking to prevent a looming crisis in nursing. Experts predict the United States could be short more than 260,000 nurses by 2025 and the study authors say state-level partnerships must take the lead in addressing the problem. The scarce supply and shortage of nursing staff has become a matter of sincere concern for healthcare organizations across the nation. The demand for healthcare services is increasing and requires healthcare organizations to employ qualified and well trained nursing staff.

While the US has more nurses and physicians than ever before, upcoming retirements and a dysfunctional workplace are creating clinical shortages that can become more severe than the industry can bear (Woods, D. 2009). According to research, half of all nurses working today were born during the baby-boomer years. Therefore, the workforce is aging at a rapid rate. As such, in efforts to prevent a mass exodus from the profession, healthcare organizations leaders are exploring innovative ways to keep experienced nurses (Larson, J, 2009). The average age of registered nurses has risen from 41 in 2002 to 48 in 2006(Bolton-Burnes L. 2007). Even more troubling, in 2006, 45% of hospital-employed RNs

Implementation of the Affordable Care Act (ACA) has afforded many individuals the opportunity to obtain health insurance, and many of the newly insured are seeking medical services at the same time a primary care provider shortage is unraveling. This is a great time to be a nurse practitioner, as we will be expected to fill the primary care provider shortage gaps. Upon successful completion of this graduate nurse practitioner program, my main focus will be shifted towards obtaining certification in order to be eligible for reimbursement from the Centers for Medicare and Medicaid Services (CMS).

The nursing shortage began in the 1940’s during the World War II and has not changed over many decades. Predominantly females staffed the nursing field until the 1980-1990’s era. That is when the nursing profession was regarded as a less attractive career as other professions opened up to women that were once ruled by males. Between the 1990-2000’s, the shortage of nurses happened as a result of the implementation of managed care. The government and private insurer reimbursements declined and health care cost dramatically increased. Since reimbursements were reduced hospitals and health care corporations had to reduce staff in order to manage budgets. The nursing shortage of today is considered plentiful and complex (Huston, 2014).

"In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) began a two-year study initiative to respond, the need to assess and transform the nursing profession."("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010).An interdisciplinary committee was put together to report the nations issues impacting health care. Recommendations were set forth by the IOM in a way to improve and restructure the nursing profession to fit the future of the medical field. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010) The recommendation from the committee starts with an action-oriented blueprint for the future of nursing also to identify matters of medical care, research, education. (AJN, American Journal of Nursing: 2010). The Affordable Healthcare ACT (ACA) of 2010 introduced new changes to United States healthcare system. These changes were the improvement of research and evidence-based practice, health awareness, prevention screenings, and community-based wellness promotion and applied. (Affordable Care Act, 2010) Before the IOM’s action-oriented blueprint nurses came up against barriers that prevented them from being able to the start to make those transformations. Today nurses have the potential to overcome obstacles by leading innovative strategies to transform nursing education, practice, and leadership. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010)

The nursing shortage is an accumulation of multiple factors. The four primary contributions to the shortage include the aging registered nurse workforce, declining nursing school enrollments, the changing work climate, and the poor image of nursing (Love et al., 2006, p. 558). When it comes to the aging workforce, approximately one-third of the nursing workforce was over 50 years of age in 2000 and that fraction has increased to two-fifths in 2014 (Nevidjon and Erickson, 2001). Over half of registered nurses intend to retire between 2011 and 2020

The second guideline outlines the need for nurses with higher degrees and competencies. This pursuit of higher education must be seamless. The third suggestion stresses the need to be equal partners in designing the future of healthcare. Nurses must be part of the solution to health care reform. Fourthly, there is a need for accurate numbers of health care workers available. With this data accurate projections can be made. These facts must be provided on a state level as well as regional (Institute of Medicine, 2010). For the nursing workforce, the IOM Future of Nursing report is of great importance.

An article in the Upstate Business Journal discusses why the raising of hospital standards for nurses could leave South Carolina in a nursing shortage. Hospitals in South Carolina and other states are requiring their nurses to have a Bachelor’s of Science in Nursing (BSN) or return to school within a specific amount of time to obtain their BSN. Hospitals are making this switch because studies have shown that more nurses within a hospital system with a four year degree or higher, increases positive patient outcomes. Unfortunately for South Carolina, this switch could decrease the amount of qualified nurses in their state. SC does not currently have the educational capacity to educate this increase number of nurses returning for advanced

According to Paller (2012), the nursing shortage in different countries for example the United States tends not to be the only growing problem, but has also become a complex one. Nursing shortage and nurse's turnover has become the worsening predicament in the health care industry in the United