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The nursing shortage -- long a concern among health care professionals, academics and policymakers -- appears to be over for now, thanks to a surge in nurse employment during the recession. But the shortage is likely to spike again in the near future, as the economy improves and the health care system requires nurses in greater numbers.
That's according to "Registered Nurse Labor Supply and the Recession -- Are We in a Bubble?" a March 21 report in the New England Journal of Medicine. The authors note that job gains were steady in the health care industry overall during the economic downturn, bucking national trends. During the 18-month recession, which officially started in December 2007, the health field added 428,000 jobs, while the national economy lost 7.5 million jobs.
Registered nurses saw especially large job gains. In 2007 and 2008, hospital employment of registered nurses rose by an estimated 243,000 jobs (or full-time equivalents). That's the biggest increase during any two-year period in the last 40 years. "Because of this increase at the beginning of the recession," the authors write, "the decade-long national shortage of RNs appears to have ended."
What was behind the sudden swell in the ranks of RNs? The report credits several factors. Unlike other less essential services, health care doesn't experience falling demand just because the economy is suffering. At the same time, many nurses who had stopped working or cut their hours headed back to the workforce, driven by economic uncertainty. The 70 percent of registered nurses who are married women may have gone back to work or picked up extra hours to stabilize their household economies.
So if you're a nurse who has struggled to find work in recent years, it may have been because many of the positions were filled by experienced nurses hanging onto their jobs during uncertain times. But the report points out that if the economy continues to improve over the next few years, these same nurses will probably quit or scale back their hours.
The report's authors, Douglas O. Staiger, David I. Auerbach and Peter I. Buerhaus, created a workforce model to predict whether nurses are likely to leave the workforce in significant numbers once the economy gets better. They found that the "substantial expansion in the RN workforce is largely a temporary bubble that is likely to deflate during the next several years."
Demand in coming years will also be driven by retirement of baby-boom generation nurses, the aging population and (if it passes court challenges) health care reform, since the number of people seeking health care is likely to grow if the law succeeds in providing health coverage for an estimated 32 million uninsured.
The authors point out that nursing schools have been producing graduates in growing numbers during the last decade, but they still may not meet the demand over the long term. "Employers and workforce policymakers should not be lulled into complacency by the current absence of a nursing shortage," they write. "Instead, they should anticipate that the current positive effect of a weak economy on the RN labor supply is likely to evaporate as the economy improves and that shortages will reemerge."
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