Tuesday, June 3, 2008

Arizona Faces Registered Nurse Shortage

Arizona will need approx. 49,000 new registered nurses (RNs) by the year 2017, according to The Arizona RN Shortage: 2007 Results, the first report published by the recently launched HealthWorks, the Arizona Healthcare Workforce Data Center established by the Healthcare Institute at the Arizona Hospital & Healthcare Association (AzHHA).

“Nurses are the foundation of a healthcare system & these staggering numbers demonstrate there is much to be done in order to fortify that foundation,” said James Puffenburger, FACHE, AzHHA Board of Directors & president/chief executive officer, Northern Arizona Healthcare. “It’s my hope, & the hope of AzHHA’s Healthcare Institute, that this ground-breaking study will be used to formulate solutions to Arizona’s critical statewide shortage of registered nurses.”

The Data Center is the first ever to forecast Arizona’s future needs for RNs. It revealed major factors contributing to the shortage including:

* Arizona’s rapidly growing population.
* the significant number Arizona RNs who are nearing retirement.

Of the approx. 49,000 RNs Arizona will need by 2017:

* 20,000 will be needed to keep pace with the state’s growing population as well as to close the gap between Arizona’s current average ratio of 681 RNs per 100,000 residents & the U.S. average ratio of 825 RNs per 100,000 residents.

* 10,000 RNs will be required to replace retiring RNs as one-third of the state’s RNs are older than 55.
*19,000 RNs - 3.5% annually - will be needed to account for the profession’s attrition rate.

The RN Shortage: Its Impact on Our State & Its Counties
According to the Health Resources & Services Administration (HRSA) - the federal agency responsible for tracking the health professions shortage in the U.S. - Arizona ranks well below the national average for RNs per 100,000 population. HRSA’s study, The Registered Nurse Population National Sample Survey of Registered Nurses, is published every 4 years & has served as a barometer of state-by-state RN needs throughout the nation.

“The Data Center study demonstrates what has been of concern to the healthcare community for some time: that the national RN average - which has been Arizona’s target - is woefully inadequate for our state’s growing population,” said Adda Alexander, RN, MBA, AzHHA’s executive vice president.

The Data Center study also revealed county-by-county variations, with 12 of the state’s 15 counties falling below the national average of RNs per 100,000 population. Three Arizona counties - Coconino, Pima, & Yavapai - exceed the national average & are still facing shortages of RNs. Maricopa County is close to exceeding the national average. “Even counties that exceed or are close to the national average for RNs per 100,000 population are in desperate need of these professionals,” said Richard Polheber, a member of AzHHA’s Healthcare Institute Advisory Board & chief executive officer, Carondelet Holy Cross Hospital-Nogales.

Arizona’s RN shortage is coupled with rapid population growth. According to the U.S. Census Bureau, in 2007 Arizona was the nation’s second fastest growing state. Additionally, the state’s population soared approx. 20% from April 2000 to July 2006. The U.S. population grew 6% during those same years.

The Education Bottleneck: APNE’s Success Still Not Enough to Address Arizona’s Growing Population
Another factor contributing to Arizona’s nursing shortage is insufficient capacity in the state’s nursing education programs. According to the 2007 Annual Report of the Arizona State Board of Nursing, 2,693 qualified applicants were not admitted to RN programs in 2007. The Data Center report projects that Arizona’s nursing education programs would need to graduate an additional 2,235 RNs each year through 2017 just to keep pace with the state’s population growth.

In 2005, Senator Carolyn Allen (R-Scottsdale) & Governor Janet Napolitano backed Senate Bill (SB) 1517, also known as Arizona’s Partnership for Nursing Education (APNE). This legislation appropriated a total of $20 million over 5 years to double the capacity of Arizona’s college & university nursing education programs by increasing the number of nurse education faculty. The call to double nursing education program capacity actually began in 2002, when the Arizona Legislature passed SB1260 which required the state’s community colleges & public universities to double their nursing program enrollments in 5 years (2007).

Between 2002 & 2007, Arizona’s RN graduation rate increased 108%, according to statistics gathered by the Arizona State Board of Nursing. In 2002, 1,133 RNs graduated from Arizona nursing programs & in 2007, the programs graduated 2,364 RNs, thereby doubling the graduates from all RN nursing education programs in the 5 years allotted by SB 1260.

“I am pleased with the progress that has been made, but continue to be very concerned about how this nursing shortage affects Arizonans,” said Governor Janet Napolitano. “Just this year I issued an Executive Order directing the Arizona Department of Commerce to develop a healthcare workforce plan that addresses healthcare education & training, identifies the specific types of professionals needed & recommends an equitable distribution of healthcare professionals across the state’s geographic regions.”

AzHHA and its leadership agree with this assessment & continue to work on strategies to address Arizona’s healthcare workforce shortage.

“Given the capacity of Arizona’s nursing education programs & the current number of such programs, it would be extremely difficult to graduate enough RNs to keep pace with both Arizona’s population growth & the anticipated RN retirement rate,” said Sharon Gardner, chair of AzHHA’s Healthcare Institute & vice president, Human Resources for Yuma Regional Medical Center. “HCI is confident this Data Center report will ignite the innovative spirit that has helped address this issue in the past.”

The Data Center: Arming Decision Makers with Information
The Data Center will continue to provide Arizona’s healthcare leaders with the data they need to make critical
workforce decisions & to track the impact of solutions that are implemented. In 2008-09, the Data Center will issue reports on Arizona’s shortage of:

* RNs.
* licensed practical nurses.
* nurse practitioners.
* pharmacists.
* pharmacy technicians.