The 2015 National Nursing Workforce Survey

Executive Summary T he National Council of State Boards of Nursing has partnered for the second time with The National Forum of State Nursing Workforce Centers to conduct the only national-level survey specifically focused on the U.S. nursing workforce. The National Nursing Workforce Survey, first conducted in 2013, generates information on the supply of nurses in the United States, information that is critical to planning for well-prepared and well-educated nurses in sufficient numbers to meet the health care needs of the nation, ensuring a safe, diverse, accessible, and effective health care system. In addition to providing a portrait of the current state of the nursing workforce, the data from this study facilitate the following: ⦁ Examination of national workforce trends. The current survey data can be compared with data from previous Nursing Workforce surveys, including the 2013 study mentioned above, and the Health Resources and Services Administration (HRSA) nursing surveys (conducted from 1990 to 2008). Also, trends can be ascertained by a look at this year’s data only; for example, this year’s data concerning age and year licensed provide an idea of how the workforce will change as nurses retire. ⦁ State-level analysis. Each board of nursing and state nursing workforce center will be provided their state’s data for further analyses that can help employers, educators, and others in developing policies and initiatives impacting the supply of nurses in their state. ⦁ Further research. The national survey generates a broad data set from which important substudies or analyses can be conducted. As of June 2015, the total number of active registered nurse (RN) licenses held was 4,378,273 and active licensed practical/ vocational nurse (LPN/VN) licenses held was 1,030,080. These numbers include approximately 12% who hold multiple licenses; these individuals were removed prior to sampling. Over 260,000 individual RNs and LPN/VNs were randomly selected from the study sample to participate in the survey (140,154 RNs and 120,793 LPN/VNs). Nurses throughout the United States with active licenses were asked to report on their age, gender, race, education, employment, and other characteristics. Participants received an announcement postcard in late June of 2015 and received their first survey in early July. Participants could submit their responses via mail or online until the survey closed on September 15th. In total, 78,739 nurses (46,476 RNs and 32,263 LPN/VNs) responded to the survey. A formal nonresponse analysis was conducted and weighting was used in the analysis process to adjust the distribution across states, age, and gender. Selected Results From the Survey Size of the Nurse Workforce As of June 2015, an estimated 3,852,881 individuals held an active RN license (up from 3,530,174 in 2013) in the United States and its territories, representing an increase of 322,707 RN licensees from 2013; an estimated 906,471 individuals held an LPN/ VN license in the United States and its territories. Respondents had been licensed for an average of 20.9 years (M, 19, SD 14.8); 81.1% of RNs and 77% of LPN/VNs were employed in nursing. Only 5.4% of RNs were initially licensed as an RN or LPN/ VN outside of the United States (2.6% in the Philippines; 0.5% in Canada, and 2.0% in other countries). An examination of the type of license currently held by RNs revealed that 8.6% held an advanced practice registered nurse (APRN) license and, of those, 70.4% were licensed as a nurse practitioner. Education of RNs and LPN/VNs Evidence on the academic progression of RNs has been steadily accumulating over the past few years. When asked to indicate highest level of education, 65% of respondents in the current study indicated that they had obtained a baccalaureate or higher degree, up from 61% in 2013. The current study also found an increase in the percentage of respondents with a BSN as their initial nursing education. Specifically, in 2013, 36% indicated a BSN as their initial nursing education, while in 2015, 39.0% indicated this. Additionally, in the current study, almost 42% of RNs held either a BSN (39.0%) or graduate degree (3.0%) as their initial credential. Newly licensed RNs, those licensed from 2013 to 2015, were more likely to have obtained a BSN as their initial education (48.6%) versus RNs licensed prior to 2000 (34.8%). Volume 7/Issue 1 Supplement April 2016 S5 More than two-thirds of LPN/VNs indicated their highest level of education was a vocational/practical certificate in nursing; about 6% have gone on to obtain further education beyond this certificate. The vast majority (95.1%) were educated in the United States. The 4.9% of LPN/VNs who were educated outside the United States tended to have achieved a higher level of education—17.6% of foreign-educated LPN/VNs held BSN degrees, compared to 0.3% for U.S.-educated LPN/VNs. Employment Status The study revealed 81.1% of RN licensees were actively employed in nursing and of those, 62.9% worked full time. In 2013, 85% of RNs were actively employed, with 60% employed full time. The current study shows that the percentage of those younger than age 30 who are working in nursing is consistent with 2013 data. However, in the 50-and-older age cohort, the current study shows a drop-off in percentage employed in nursing when compared to 2013 data. For instance, in 2013, 47% of those age 65 and older were employed in nursing; in 2015, 40.1% were employed in nursing. Hospitals remain the most common employment setting for RNs, at 54% (down from 56% in 2013 and down from HRSA’s 62% in 2008). Therefore, although numbers of RNs are increasing, fewer are working in hospitals. Overall, 77% of LPN/VNs were employed in nursing. However, data indicate that LPN/VNs older than age 60 were less likely to be employed in nursing, as compared to the younger-than-30 age cohort. The most common primary care setting of LPN/ VN respondents was nursing home/extended care (30%), followed by home health (15%) and hospitals (approximately 11%). The “work setting” for both RNs and LPN/VNs is changing, as patient care is no longer confined within the walls o