The State of Nursing in Florida Today and

The State of Nursing in Florida: Today and in the Future Mary Lou Brunell, RN, MSN Executive Director 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 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 Visit us at: www. FLCenter. For. Nursing. org 2

The Nurse Workforce – What is it? h Licensed Practical Nurses (LPN) h Registered Nurses (RN) h 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. 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 3

Licensed Practical Nurses h Promotes wellness, maintenance of good health, and illness prevention h Provides direct patient care and observation, and administers medications and treatments under the direction of a registered nurse or licensed physician 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 4

Registered Nurse h Assesses, monitors, and evaluates patient health status using knowledge of scientific principles and clinical judgment h Anticipates risks and prepared to intervene to prevent or at least minimize medical complications h Educates patients, families, and communities about health promotion and disease prevention h Coordinates care h Administers medications and treatments prescribed by an advanced practice nurse or licenses physician 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 5

Advance Practice Nurse h Independently evaluates and manages patients under an established protocol with a licensed physician or dentist h 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 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 6

Successful Planning h To meet consumer needs we must know the numbers • Supply of Nurses • Demand for Services h If Supply ≠ Demand Shortage h Need to know for today and the future 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 7

Supply of Today vs. Supply of Tomorrow h Age of nurse population • Anticipating retirements • Projecting work longevity h Historical trends projected forward • Anticipated turnover / loss from profession • Anticipated new nurse graduates h Forecasting Models • Predict supply 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 8

Florida Center for Nursing h Established in law (FS 464. 0195) 2001 h Purpose – to address issues related to the nursing shortage in Florida h Overseen by 16 member Board appointed through the Governor’s Office h Vision To be the definitive source for information, research, and strategies addressing the dynamic nurse workforce needs in Florida. 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 9

Nurse Workforce Information The 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 analyze biennially (odd years) • Nurse Education Data – LPN / RN prelicensure and graduate programs surveyed analyzed annually These data elements permit forecasting 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 10

Florida Nurse Supply as of January 2012 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 11

Age of Florida’s Working Nurses 35% 30% 25% 20% 15% RN 10% ARNP/CNS 5% 0% 21 -30 10/15/2013 31 -40 41 -50 51 -60 Visit us at: www. FLCenter. For. Nursing. org 61 and older 12

RN Work Status in Percent, 2010 -2011 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 13

FTE RN Vacancy Rates by Industry as of 6/30/2011 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 14

Trend in FT Faculty Vacancy Rates, 2007 -2012 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 15

Do we know demand? h Actual survey of Florida nurse employers (2011) • Current Need = 8, 994 RN vacancies • Future Growth = 6, 746 RN positions h Population Estimates • Growth / In-Migration • Age (Increasing age = Increasing Demand 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 16

Trend in Number of New Graduate Nurses 2007 -2012 8, 000 ADN programs 7, 000 5, 603 6, 000 5, 000 4, 000 3, 000 2, 000 7, 264 Pre-licensure BSN Programs 5, 640 5, 701 6, 250 4, 134 1, 906 1, 904 2, 031 2, 189 2, 258 2, 523 1, 000 10/15/2013 2007 2008 2009 2010 Visit us at: www. FLCenter. For. Nursing. org 2011 2012 17

Florida’s Registered Nurse Forecast 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 18

National Predictions Researchers predict a national nursing shortage of between 300, 000 and 1, 000 by 2030 Source: Jurasheck, Zhang, Ranganathan, Lin. (2012). United States Registered Nurse Workforce Report Card and Shortage Forecast. Public Health Resources. Paper 149. 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 19

Factors Effecting Supply & Demand h Low Supply • Aging nurses retirements &/or reduced work • Poor work environments turnover • Barriers to education expansion h High Need • Population growth • Aging population demand • Expanded health care access - Increased need - Employment opportunities in new areas 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 20

Solutions: Education Capacity Issues h Faculty shortage • Competitive salaries • Incentives to return to school (scholarships, loan forgiveness, stipends) • Academic funding challenges h Clinical Capacity • Use of Simulation • Nurse Internships • Day/time flexibility 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 21

Solutions: Work Environment Issues h Nurse Residency Programs • School to Work transition • Change in practice setting - Anticipate acute care beds - Anticipate long-term care, hospice, and home health h Value the contribution of all nurses • Decision making involvement • Leadership appointments • Participate in policy decisions 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 22

h 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 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 23

Solution: Increasing Diversity h Greater reflection of general population greater ability to meet consumers needs h Gender – increase proportion of men US – 50% Nursing – 9. 1% h Ethnicity/Race – improve diversity of nursing faculty to improve student diversity US – 37% minority 10/15/2013 Nurse Faculty – 12. 6% Visit us at: www. FLCenter. For. Nursing. org 24

Challenges h Need political support h Need funding allocations / reimbursement h Need industry buy-in h Need support of health provider colleagues h Need consumer support h Need ACTION!! 10/15/2013 Visit us at: www. FLCenter. For. Nursing. org 25

QUESTIONS? ?