Visit us at: The State of Nursing in Florida: Today and in the Future Mary Lou Brunell, RN, MSN...

Visit us at: www.FLCenterForNursing.org

The State of Nursing in Florida:Today and in the FutureMary Lou Brunell, RN, MSN

Executive Director

10/15/2013 1


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 2

Visit us at: www.FLCenterForNursing.org10/15/2013 3

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.


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


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


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


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

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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

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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.

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Nurse Workforce InformationThe 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 pre-licensure and graduate programs surveyed and analyzed annually

These data elements permit forecasting

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Florida Nurse Supply as of January 2012

251,113

17,508

75,161

194,959

14,103

61,324

167,266

12,809

50,208

0

50,000

100,000

150,000

200,000

250,000

RN APN LPN

All Licensees Potential Workforce Estimated Working


Age of Florida’s Working Nurses


RN Work Status in Percent, 2010-2011

86%

5%

4%3% 2%

Column1

Employed as Nurse

Not Seeking Work

Retired with ActiveLicense

Seeking Work as Nurse

N/A


FTE RN Vacancy Rates by Industry as of 6/30/2011


Trend in FT Faculty Vacancy Rates, 2007-2012


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

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Trend in Number of New Graduate Nurses 2007-2012


Florida’s Registered Nurse Forecast

140,000

160,000

180,000

200,000

220,000

240,000

2010 2015 2020 2025

RN FTE Supply RN FTE Demand

- 50,321


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.

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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

- 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

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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

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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

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Solution: Increasing Diversity

Greater reflection of general population greater ability to meet consumers needs

Gender – increase proportion of menUS – 50% Nursing – 9.1%

Ethnicity/Race – improve diversity of nursing faculty to improve student diversityUS – 37% minority 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!!

QUESTIONS??

Visit us at: The State of Nursing in Florida: Today and in the Future Mary Lou Brunell, RN, MSN...

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