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Snapshot of Mississippi’s Nursing Workforce
Debbie Logan, MHA, RN Sheila Keller, PhD
Objectives
• Understanding national nursing recruitment and retention practices
• Knowledge of Mississippi nursing vacancy, turnover, and salaries
• Nursing graduate earning and retention in healthcare employment
• Job satisfaction and intent to leave for RN and LPNs
Nursing Workforce
• According to the National Center for Health Workforce Analysis within HRSA, approximately 2.8 million registered nurses (RNs) are currently working in nursing in the United States.
Nursing Workforce Distribution in Rural and Urban Areas
Rural444,688
Rural165,980 Rural
52,153,208
Urban2,379,953
Urban524,058 Urban
254,590,000
0%
20%
40%
60%
80%
100%
RNs LPNs U.S. Population
Nurses per 100,000 Residents in Rural and Urban Areas
The per Capita RN Workforce, Ranked by State
IdahoHawaii
CaliforniaNew Mexico
OklahomaAlaska
VirginiaWashington
ColoradoMichigan
South CarolinaArkansas
North CarolinaMaryland
IndianaNew York
West VirginiaNew Hampshire
TennesseeWisconsin
OhioPennsylvaniaNorth DakotaRhode Island
NebraskaSouth Dakota
0 200 400 600 800 1,000 1,200 1,400
The U.S. Nursing Workforce: Trends in Supply and Education, HRSA
Figure 4. The per Capita LPN Workforce, Ranked by State
OregonAlaska
NevadaWashingtonNew Mexico
CaliforniaIllinois
MontanaIdaho
New JerseyVermont
North CarolinaSouth Carolina
KentuckyTexas
ConnecticutFlorida
AlabamaSouth Dakota
VirginiaPennsylvania
OhioMississippiOklahomaTennessee
North Dakota
0 50 100 150 200 250 300 350 400 450
National Shortage
• Over the next 20 years, the average age of the RN will increase and the size of the workforce will plateau as large numbers of RNs retire.
• Because demand for RNs is expected to increase during this time, a large and prolonged shortage of nurses is expected to hit the US.
Nursing Shortage??
• Over the past decade, the average age of employed RNs has increased by nearly two years, from 42.7 years in 2000 to 44.6 years in 2010.
• America is seeing vast increases in the number of people over 65. This age group has many medical and health needs, and will put a strain on our health system.
• Recent reforms in healthcare will give millions of people access to the healthcare system. More nurses and health professionals are needed in response.
• These factors, combined with an anticipated strengthening of the economy, will create a renewed critical shortage for nurses.
• A shortage of RN’s is projected to spread across the country through 2030.
• US is projected to experience a shortage of RN’s that is expected to intensify as Baby Boomers age and the need for health care grows (AACN).
RN Retirement Tsunami is expected Economy has forced delay of retirement in many RNs
• Near the end of 2013 the U.S. Department of
Labor Bureau of Labor Statistics (BLS) updated its Employment Projections 2012-2022.
• By 2022 total employment of RNs and APRNs will increase by 574,400 jobs. In fact, with RN retirements also in the mix, the nation will need to have produced 1.13 million new RNs by 2022 to fill those jobs.
• There are a number of other issues that must be addressed to avoid the return of a catastrophic nurse shortage.
• Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform.
• Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services.
• “The nursing pipeline, measured by the annual number of individuals who pass national nurse licensing exams, grew substantially from 2001 to 2011. Understanding the supply and distribution of nurses is key to ensuring access to care and an effective health care system.” – ( The U.S. Nursing Workforce: Trends in Supply and Education, 2013)
• A 2.6% enrollment in nursing schools was reported in 2013, but at that rate it is not enough to meet the projected demand of nursing services with more than 32 million gaining access to health care through the Affordable Care Act.
Growth in NCLEX-RN First-Time Test Takers, by Bachelor’s and Non-Bachelor’s Degree Status, 2001 to 2011
Total Number and Percentage of NCLEX-RN First-Time Test Takers, by Bachelor’s and Non-Bachelor’s Degree
Status, 2001 vs. 2011
NCLEX-PN Passers, 2001 to 2011
Licensed RNs Graduating With BSN Qualification, 2007 to 2011
Master’s and Doctoral Graduates, 2007 to 2011
Figure 26. Nurse Practitioner Graduates, 2001 to 2011
Mississippi’s Nursing Workforce
• There are 29,016 RN’s reported working in Mississippi
• A reported 9,719 LPN’s working in Mississippi– This represents 980.6 RN’s per 100,000
Mississippians and 328.5 LPN’s per 100,00 Mississippians.
National Growth in Full-Time Nurse Salaries
Mississippi Salary Survey• Salary data reveals 2015 staff nurses
RN salaries in Mississippi hospitals and clinics range from $39,561 to $68,432/year.
• Upper level RN management salaries range from $50,000 to $100,000/year.
• LPN salaries in Mississippi hospitals and clinics are reported to range from $ 28,246 - $41,912/year.
Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report
Mississippi RN Salaries• Staff Nurse• Clinic Nurse• LTC Nurse• Nurse Manager• Director of Nursing• Infection Control
Nurse• Nurse Educator• Nurse Practitioner• CRNA
$42,099 - $68,432$39,561 - $61,505$41,724 - $62,545$58,760 - $90,043$50,000 - $75,000$47,424 - $71,656$47,444 - $74,710
$85,841 - $129,979 $120,619 - $183,268
Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report
Mississippi LPN Salaries
• LPN• LPN Clinic • LTC LPN
$28,246 - $41,912$27,580 -
$40,268$30,971 -
$41,641
Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report
Recruitment and Retention
Factors Impacting Nursing Workforce Recruitment and
Retention• Literature review revealed key obstacles:
• Nurses leaving the workforce due to age
• Rural difficulties in attracting nurses
• Educational preparation issues and concerns related to faculty shortage
• Increased use of non-licensed personnel by employers
– Retention
• Work load intensity
• Staffing ratio issues
• Lack of empowerment
• Use of travel nurses in rural settings who were made more
• Salaries and benefits
• Lack of support for educational advancement
Brewer, Zayas, Kahn and Sienkiewicz (2006), Nooney, Unruh, and Yore (2010), Laschinger, Leiter, Day, Gilin (2009), Tallman & Brning (2005), Chenoweth, Jeon, Merlyn & Broadaty (2010), Kovner, Brewer, Fiarchild, Poornima, Kim & Djukic (2007)
Factors Impacting Nursing Workforce Recruitment and
Retention• Survey of newly licensed nurses
found: • 41% indicated would change jobs if free to • Associate degree nurses more apt to change
jobs than new bachelor degree nurses • Job orientation was found to be a factor with
a wide variation in the type received. • 6% reported receiving no orientation at all.
» by Chenoweth, Jeon, Melryn and Broday (2010)
Mississippi Recruitment and Retention
• Recent survey of some Mississippi Delta RN’s indicated the most important recruitment factors:– Pay– Hours– Benefits– Greater support for nursing
(MS Delta Area Nursing Workforce Study, 2014)
29% (8)2014
RN Hospital Turnover Rates
by Public
Health Districts
17% (9)
22% (11) 17% (10)
14% (6)
25% (15)20% (18)
21% (11)
19% (11)
Copyright © 2014 by Mississippi Office of Nursing Workforce
Statewide Turnover Rates
2004 24.0%2005 21.7%2006 21.9%
2007 18.9% 2008 18.2%2009 14.1%2010 14.9%2011 14.7%2012 14.2%2013 20.6%2014 20.4%
2011 - 4.5%2012 - 9.8%2013 - 3.9%2014 -6.9%
2011 - 9.9%2012 - 7.5%2012 - 7.3%2014 - 7.9%
2011 - 4.7%2012 - 6.5%2013 - 7.7%2014 - 8.6%
2011 - 5.4%2012 - 3.3%2013 - 4.3%2014 - 2.2%
2011 - 3.6%2012 - 3.5%2013 - 3.2%2014 - 6.5%
2011 - 1.7%2012 - 2.6%2013 - 2.9%2014 - 2.7%
2011 - 2.6%2012 - 3.6%2013 - 3.8%2014 - 3.3%
2011 - 4.8%2012 - 1.6%2013 - 2.5%2014 - 2.9%
2011 - 3.7%2012 - 2.8%2013 - 5.0%2014 - 4.6%
Hospital RNVacancy
Rates by
PublicHealth
DistrictsStatewide RN Vacancy Rates
2007 9.1%2008 6.4%2009 5.0%2010 4.3%2011 4.3%2012 4.9%2013 5.3%
2014 5.8% MONW,2014
Copyright © 2014 by Mississippi Office of Nursing Workforce
National Average RN turnover rate 13.9% (Hodes Group, 2005)
RN –6.9% (59)LPN – 1.1% (1)Anc – 6.6% (17)
RN – 7.9% (54)LPN – 3.7% (7)Anc – 3.7% (11)
RN – 8.6% (334)LPN – 5.1% (10)Anc – 12.4% (111)
RN – 2.2% (12)LPN – 3.2% (3)Anc – 4.0% (4)
RN – 6.5% (151)LPN – 0.7% (1)Anc – 4.5% (34)
RN – 2.7% (43)LPN – 2.4% (6)Anc – 4.1% (26)
RN – 3.3% (44)LPN – 13.9% (21)Anc – 2.3% (14)
RN – 2.9% (23)LPN – 5.5% (5)Anc – 2.8% (7)
RN – 4.6% (75)LPN – 2.5% (3)Anc – 7.9% (28)2014
Hospital Staff RN, LPN & Ancillary Vacancy Rates
(FTEs) by
Public Health Districts
Statewide Vacancy Rates
2014 2013
Staff RN 5.8% (793) 5.3%
LPN 4.3% (56) 4.5%
Ancillary 6.0% (252) 6.5%
Copyright © 2014 by Mississippi Office of Nursing Workforce
RN – 2.55% (4.0)LPN – 3.25% (8.0)Anc – 7.1% (38.8)
RN – 9.10% (14.8)LPN – 5.21% (15.0)Anc – 5.53% (41.0)
RN – 5.23% (23.0)LPN – 8.53% (57.5)Anc – 14.26% (201.0)
RN – 2.26% (3.0)LPN – 2.94% (6.0)Anc – 5.27% (23.0)
RN – 3.73% (11.0)LPN – 6.71% (23.0)Anc – 5.94% (39.0)
RN – 2.70% (5.0)LPN – 5.47% (21.0)Anc – 5.14% (34.3)
RN – 6.84% (17.0)LPN – 4.85% (15.0)Anc – 9.90% (84.0)
RN – 2.10% (4.0)LPN – 1.98% (5.5)Anc – 2.27% (18.0)
RN – 1.88% (5.3)LPN – 2.01% (10.0)Anc – 4.79% (77.5)
2015Long Term Care
RN, LPN & Ancillary
Vacancy Rates (FTEs) by
PublicHealth Districts Statewide Vacancy
Rates
2015 2014
RN 4.20% (87.0) 4.77%
LPN 5.00% (161.0) 5.44%
Ancillary 7.21% (556.5) 7.32%
Mississippi LTC RN Vacancy and Demand RN Vacancy and Demand
01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'
-2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
6.0%
10.5%
15.0%
13.4%
11.9%
12.9% 13.1%
7.4%
6.6%
4.7%4.8%
3.4%
4.1%4.8%
4.2%
8.3%
9.9%
9.3%
5.7%
3.2%
10.8%
5.3%
4.3%
-0.6%
3.5%
5.4%
3.6%
3.3%
5.2%
3.2%
RN Vacancy Rate
N=173 N=185 N=163 N=183 N=186 N=186 N=183 N=201 N=207 N=202 N=210 N=207 N=208 N=202 N=204
87.0 FTEs
65.0 FTEs
Mississippi LTC LPN Vacancy and Demand
01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'
-4%
-2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
8.9%
13.3%
15.0%
15.0%
12.5%
12.6%
11.0%
8.3%
6.2%
4.8%
4.9%4.5%
5.4%
5.4%5.0%
6.4%
8.0%7.5%
6.3%
4.8% 5.2%
2.9%
-1.2%
0.6%
-2.4%
1.0%
2.5%
2.2%
2.8% 2.3%
LPN Vacancy Rate
Predicted Increase in Demand over 2 Yrs
N=172 N=183 N=161 N=182 N=182 N=186 N=179 N=199 N=203 N=196 N=201 N=207 N=203 N=202 N=202
161.0 FTEs
70.3 FTEs
Mississippi LTC Ancillary Vacancy and Demand
01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'
-4%
-2%
0%
2%
4%
6%
8%
10%
7.3%
5.0%5.7%
6.7%
6.5%
8.0% 8.1%
8.6%
8.0%
4.6%
6.2%
5.1%
6.3%
7.3%
7.2%7.1%
3.3%
5.1%5.4%
7.1%
2.6%
3.7%
0.3%
-1.8%
-1.2%
2.4%
3.1%
2.4%
3.8%
2.9%
Ancillary Vacancy Rate Predicted Increase in Demand over 2 Yrs
N=163 N=172 N=153 N=174 N=175 N=178 N=170 N=186 N=188 N=178 N=189 N=205 N=188 N=202 N=202
556.5 FTEs
219.0 FTEs
Alice: Would you tell me, please, which way I ought to go from here?
The Cat: That depends a good deal on where you want to get to
Alice: I don't much care where.
The Cat: Then it doesn't much matter which way you go.
Alice in Wonderland
What’s next?
How do You Keepyour Bucket Full?
SUSTAINABILITY OF A SUCCESSFUL RECRUITMENTRETENTION PROGRAM
Our goals: an up-to-date for education/training for faculty
and clinical staff increase in number of clinical staff returning to
school for BSN and MSN opportunities for health care facilities to recruit
and retain students clinical education for students and faculty
impacting patient outcomes and safety statewide DEU implementation and extern
programs available for students in all schools in Mississippi
QUESTIONS??