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Will the RN Workforce Weather the Retirement of the Baby Boomers?

Auerbach, David I. PhD*; Buerhaus, Peter I. PhD, RN, FAAN; Staiger, Douglas O. PhD‡,§

doi: 10.1097/MLR.0000000000000415
Original Articles

Importance: After forecasts made more than a decade ago suggested dire nursing shortages, enrollment in nursing schools doubled. The implications of this unprecedented change for the nursing workforce have not yet been fully explored.

Objective: To forecast the size and age distribution of the nursing workforce to the year 2030 and to compare to demand recently projected by the Health Resources and Services Agency.

Design: A retrospective cohort analysis of employment trends by birth year and age were used to project age and employment of registered nurses (RNs) through 2030.

Setting: Data on employed RNs from the United States Bureau of the Census Current Population Survey (1979–2000, N=72,222) and American Community Survey (2001–2013, N=342,712).

Participants: RNs between the ages of 23 and 69 years.

Main Outcome Measure: Annual full-time equivalent (FTE) employment of RNs in total and by single year of age.

Results: Annual retirements from the nursing workforce will accelerate from 20,000 a decade ago to near 80,000 in the next decade as baby boomer RNs continue to age. We project that this outflow will be more than offset by continued strong entry of new RNs into the workforce. Overall, we project that the registered nursing workforce will increase from roughly 2.7 million FTE RNs in 2013 to 3.3 million in 2030. We also find that the workforce will reach its peak average age in 2015 at 44.4. This increase in workforce size, which was not expected in forecasts made a decade ago, is contingent on new entry into nursing continuing at its current rate. Even then, supply would still fall short of demand as recently projected by the Health Resources and Services Agency in the year 2025 by 128,000 RNs (4%).

Conclusions: The unexpected surge of entry of new RNs into the workforce will lead to continued net growth of the nursing workforce, both in absolute FTE and FTE per capita. While this growth may not be sufficient to meet demand, such projections are uncertain in the face of a rapidly evolving health care delivery system.

*External Adjunct Faculty, Vanderbilt University Medical Center, Newton MA

Department of Health Policy, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN

Department of Economics, Dartmouth College, Hanover, NH

§National Bureau of Economic Research, Cambridge, MA

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Supported by a grant from the Gordon and Betty Moore Foundation.

Presented at Denver in June, 2015, at the following conference entitled, “State of the Nursing Workforce in an Era of Health Care Reform: Data, Trends, and New Collaborations.” http://healthworkforcestudies.com/event/conference-state-of-the-nursing-workforce-in-an-era-of-health-care-reform-data-trends-and-new-collaborations/.

The authors declare no conflict of interest.

Reprints: David I. Auerbach, PhD, External Adjunct Faculty, Vanderbilt University Medical Center, 200 Church St #3, Newton, MA 02458. E-mail: davea@alum.mit.edu.

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