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JAMA cites aging RN workforce for future shortage 


CHICAGO - The nation's registered nurse (RN) workforce is aging significantly and the number of full-time equivalent RNs per capita is forecast to peak around the year 2007 and decline steadily thereafter, according to an article in the June 14 issue of The Journal of the American Medical Association (JAMA).

Peter I. Buerhaus, Ph.D., R.N., from the Vanderbilt University School of Nursing, Nashville, Tenn., and colleagues, conducted a study of employment trends of recent groups of RNs over their lifetime based on U.S. Bureau of the Census Current Population Surveys between 1973 and 1998. Recent workforce trends were used to forecast future age and employment of RNs. The researchers found the average age of working RNs increased by 4.5 years between 1983 and 1998. The number of full-time equivalent RNs observed in recent groups has been
approximately 35 percent lower than that observed at similar ages for groups that entered the labor market 20 years earlier. 

"Over the next two decades, this trend will lead to a further aging of the RN workforce because the largest cohorts of RNs will be between age 50 and 69 years," the researchers write. "Within the next 10 years, the average age of RNs is forecast to be 45.4 years, an increase of 3.5 years over the current age, with more than 40 percent of the RN workforce expected to be older than 50 years. ...By the year 2020, the RN workforce is forecast to be roughly the same size as it is today, declining nearly 20 percent below projected RN workforce requirements."

The authors explain that the aging of the RN workforce has resulted from the expansion of career opportunities for young women and a decrease in the number of young women choosing nursing as a career.

Women continue to make up more than 90 percent of the RN workforce. 

The authors believe that long-term strategies to increase RN supply are needed.  As shortages develop during the next 20 years, it can be expected that RN wages will rise and working conditions will be improved to attract more women and men to choose nursing as a career.

Yet, these effects will occur slowly, and employers may have to rely on controversial strategies, such as substituting other personnel for RNs and hiring nurses from other countries.  The authors recommend that employers and nursing leaders plan now how best to use the increasingly scarce supply of RNs to deliver patient care in the future.

"The impending decline in the supply of RNs will come at a time when the first of 78 million baby boomers begin to retire and enroll in the Medicare program in 2010," the authors write.  "Because RNs are vital in ensuring access to and quality of health care, it is critical that policy makers understand, and develop appropriate responses to, the implications of a rapidly aging RN workforce."