2014 Survey of Registered Nurses

Joanne Spetz, PhD

Lela Chu, BS

Zachary Levin, BS

Ulrike Muench, PhD, RN

Dennis Keane, MPH

June 4, 2015

BRN Surveys of RNs - background

BRN required to collect and report data on the state’s RN workforce every 2 years

Surveys conducted:

• Sporadically – 1990, 1993, 1997

• Regularly – 2004, 2006, 2008, 2010, 2012, 2014

Survey of RNs with active licenses, all years

• Survey of RNs with inactive/lapsed licenses, 2004-10

These data feed into forecasts of RN supply published by the BRN

UCSF has been the contractor since 2006

Survey of RNs, 2014

10,000 active RNs

• Same sample size as last survey

Mailed April 4, 2014

• Paper survey with online option

Multiple reminders

• Postcard 2-3 weeks after first mailing

• Re-mailing to non-respondents 2 weeks later

• 2 more postcards

Data collection ended September 4, 2014

57% response rate (similar to 2012)

Share of RNs that works in nursing

82.6% 89.3%

84.2% 87.5% 86.7% 86.9% 87.4% 85.1% 83.4%

17.4% 10.7%

15.8% 12.5% 13.3% 13.1% 12.6% 14.9% 16.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1993 1997 2004 2006 2008 2010 2012 2014

Employed in nursing Not employed in nursing

14.6% of working nurses have more than one RN job.

Share of RNs employed in nursing by age

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

< 30years

30-34years

35-39years

40-44years

45-49years

50-54years

55-59years

60-64years

65+years

2006 2008 2010 2012 2014

Ages of working RNs Average ages

1990 – 42.9

1993 – 43.6

1997 – 44.6

2004 – 47.6

2006 – 47.1

2008 – 47.2

2010 – 46.3

2012 – 46.1

2014 – 46.7

0%

5%

10%

15%

20%

25%

Under30

30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 orolder

1990

1997

2004

2008

2014

Gender of working RNs

94.6% 94.2% 92.6% 92.6% 89.5% 85.7% 89.3% 88.4% 88.2%

5.4% 5.8% 7.4% 7.4% 10.5% 14.4% 10.7% 11.6% 11.8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1993 1997 2004 2006 2008 2010 2012 2014

Female Male

Gender of RNs by age group

88.3% 83.8% 86.2% 87.2% 93.3%

11.0% 16.0% 12.6% 12.4% 6.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Under 35years

35-44years

45-54years

55-64years

65+ years

Male

Female

8

Racial/ethnic mix of working RNs

77.2% 64.5% 61.5% 58.6%

51.6%

15.9% 18.2% 18.0% 20.3%

12.7% 6.9% 7.1% 8.6% 8.6%

3.7% 4.9% 7.5% 7.5% 6.7%

1.2% 2.4% 2.9% 2.8%

7.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1997 2004 2008 2014

Mixed/Other

Native Am.

Hispanic

Black

Asian / P.I.

Filipino

White

Racial/ethnic mix of RNs, by age group

44.7% 38.3%

52.6% 65.9% 71.3%

18.9% 27.9%

15.4%

15.2% 9.9% 14.4% 9.6% 8.7%

4.5% 6.3% 9.7% 9.1% 7.6% 3.8%

1.4% 8.9% 9.3% 10.3% 5.4% 4.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Mixed/Other

Native Am.

Hispanic

Black

Asian / P.I.

Filipino

White

Initial nursing education for working RNs

20.9% are

internationally-

educated

32.3% 28.1% 23.6% 18.5% 15.7% 14.2% 11.1% 10.3% 8.7%

39.0% 43.0% 44.3% 47.3% 47.3% 46.8% 45.0% 45.8% 45.0%

28.6% 28.6% 31.7% 33.4% 35.5% 37.5% 39.1% 39.0% 41.0%

0%

20%

40%

60%

80%

100%

1990 1993 1997 2004 2006 2008 2010 2012 2014

Diploma program Associate degree

Baccalaureate degree Master's or Doctorate Degree

30 unit program

Highest level of nursing education of working RNs

26.6% 22.9% 18.4% 13.7% 9.6% 9.5% 8.4% 7.0% 5.4%

33.9% 38.7% 36.7% 39.7%

36.3% 36.7% 38.5% 39.8% 33.2%

33.6% 33.7% 38.0% 38.1%

40.9% 41.6% 41.7% 42.3% 44.9%

5.8% 5.6% 6.8% 8.5% 13.2% 12.2% 11.5% 10.9% 16.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1993 1997 2004 2006 2008 2010 2012 2014

Diploma program Associate degree

Baccalaureate degree Master's or Doctorate Degree

Job titles of RNs for primary positions

62.6% 62.1% 61.2% 59.8% 50.8%

16.6%

17.2% 16.3% 14.6% 18.8% 13.0%

2.7% 5.6% 5.6% 5.3% 7.1%

8.8% 7.7% 7.5% 8.6% 4.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1997 2006 2010 2014

Other

Case manager/UR/QI

Educator

NP/CNM/CRNA

Clinical nursespecialist

Management/chargenurse

Staff nurse + chargenurse

Direct patient care/staff nurse

Work settings of RNs for primary nursing position

67.9% 60.2% 60.9% 64.4% 66.8%

5.6% 7.1% 4.4%

3.8% 8.5%

11.8% 9.0%

10.8% 9.3% 5.4%

7.5% 14.2% 18.5% 17.4% 14.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1997 2004 2008 2014

Other

Ambulatory care

Public/communityhealth agency

Home health

Skilled nursing

Acute hospital

2.4% work for a temporary/traveling agency

Departments within hospitals for hospital-employed RNs

55.6% 56.3% 53.4% 53.6% 50.5%

4.8% 5.5% 7.8% 7.9% 10.1%

0.0% 0.7% 0.4% 0.0% 4.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1997 2004 2008 2014

Other type ofhospital dept.

Ancillary unit inhospital

Ambulatory caredept. in hospital

Nursing home unitwithin hospital

Acute carehospital unit

Use of information technology in primary nursing job, 2014

92% 93% 76% 71%

53%

89%

8% 7% 24% 29%

47%

11%

0%

20%

40%

60%

80%

100%

No

Yes

Average income from all nursing positions

$31,504

$42,163 $45,073

$59,937

$73,542

$81,428 $82,134

$89,940 $93,911

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000

1990 1993 1997 2004 2006 2008 2010 2012 2014

Highest job satisfaction ratings

Interactions with patients

Nursing profession overall

Feeling that work is meaningful

Job overall

Relations with other non-nursing staff

Teamwork between coworkers was in the top 5 in 2012, but was replaced by Nursing profession overall in 2014.

Lowest job satisfaction ratings

Involvement in policy and management decisions

Amount of paperwork required

Non-nursing tasks required

Employer-supported education/training programs

Quality of preceptor/mentor programs

Relations with agency/registry nurses was in the bottom 5 in 2012 but was replaced with employer-supported education training programs in 2014.

Largest changes in job satisfaction, 2012-2014

Improved:

• Leadership from nursing administration

• Amount of paperwork required

• Opportunities for advancement

• Relations with physicians

Worsened:

• Support of other nurses with whom you work

• Adequacy of RN staffing where you work

• Quality of preceptor and mentor programs

• Adequacy of clerical support services

Changes in employment setting in past year

Percent of

RNs who

experienced

a change,

2012

Percent of

RNs who

experienced

a change,

2014

Added secondary nursing job 14.3% 18.1%

Added secondary non-nursing job 1.2% 2.0%

Stopped secondary nursing job * 8.9%

Stopped secondary non-nursing job * 2.0%

Not working as RN now, but was earlier this year 6.5% 4.4%

Working as an RN now, but was not working

earlier this year 7.5% 7.4%

New Position, Same Employer 29.5% 27.4%

Same Position, New Employer 14.3% 11.8%

New Position, New Employer 20.6% 27.0%

Other 17.2% 6.8%

Changes in hours worked in past year

Percent of RNs who

experienced a

change, 2012

Percent of RNs who

experienced a

change, 2014

Did not work in past year 19.8% 17.3%

Increase in hours, imposed

by employer 11.0% 13.6%

Increase in hours, by choice 28.9% 28.1%

Decrease in hours, imposed

by employer 14.1% 12.6%

Decrease in hours, by choice 21.4% 28.7%

Other 11.1% 18.1%

Reasons for employment changes

Reasons for changes in work status, employer, or position:

• Desire to use skills or learn new skills

• Salary

• Stress on the job

• Benefits

• Other family responsibilities

Reasons for changes in work hours:

• Salary

• Other family responsibilities

• Desire to use skills or learn new skills

• Benefits

Plans for next 5 years for working RNs

14.6% 9.7% 14.0% 15.5% 11.5% 14.4% 16.0%

6.7% 8.5%

7.2% 10.1% 13.1% 11.5% 11.2%

32.7% 24.7% 22.1%

19.8% 15.2%

21.0% 19.9%

46.1% 57.1% 56.7% 54.6% 60.2%

53.1% 53.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1990 1997 2004 2008 2010 2012 2014Leave nursing/retire Increase hours

Reduce hours Work as much as now

Employment status of active RNs who do not have a nursing job

22.7% 33.9%

25.4% 26.9% 27.5% 26.3%

77.3% 66.1%

74.6% 73.1% 72.4% 73.7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2004 2006 2008 2010 2012 2014

Working outside nursing Not working outside nursing

“Very important” reasons for not having RN job

Family responsibilities (33.5%)

Non-job-related illness/injury (20.0%)

Childcare responsibilities (18.2%)

Moving to a different area (15.8%)

Travel (14.5%)

Retirement (14.4%)

Increase between 2012 and 2014 in the share who said they are not working because they were laid off (5.9% in 2012 and 11.9% in 2014)

Decreases in the shares reporting that it was difficult to find a nursing position or to find a desired position

Intentions of non-retired RNs not working in nursing (5 years)

4.7%

4.4%

20.3%

23.0%

15.9%

30.1%

19.8%

14.1%

13.8%

15.4%

15.6%

33.7%

32.8%

33.1%

41.3%

16.0%

12.9%

6.8%

7.5%

6.0%

33.7%

29.1%

26.1%

22.6%

6.0%

0% 20% 40% 60% 80% 100%

2006

2008

2010

2012

2014

Currently seeking employment in nursingPlan to return to nursing in the futureRetiredDefinitely will not return to nursing, but not retiredUndecided at this time

Summary of key findings

Age distribution is fairly “flat” – similar numbers in each age group

Diversity of nursing workforce is slowly increasing

Employment settings have been relatively stable

• More hospital-employed RNs in ambulatory care

More than 60% of RNs have a BSN or higher degree

Summary of key findings

Employment rate dropped again in 2014

• Dropped to 83.4% in 2014, from 87.4% in 2010

• Fewer RNs hold multiple jobs

Employment rates for younger RNs still lower than historic averages

Fewer nurses want to increase hours of work

• A higher share is planning to retire within 5 years

Salaries are continuing to rise

Job satisfaction dropped in many areas