Category Archives: Medical, Nursing & Dental Workforce
A regional analysis of the nursing workforce finds that the South and Midwest have a greater supply of registered nurses (RNs) available to fill positions when nurses retire or leave the workforce than other regions. The study, published in Nursing Economic$, found the South and Midwest have more young nurses to replace fewer older nurses than the Northeast and West.
“Expanding the size of the future RN workforce requires the number of entrants flowing into the workforce to exceed the number of nurses flowing out of the workforce,” the authors write.
In addition to surveying the age structure of the RN workforce, researchers used projection models to predict the nurses per capita in each region through 2030. They predict the South and Midwest will continue to see higher growth of RNs to U.S. residents than the Northeast and West.
The findings can help guide national and state health workforce planners, employers, educators, and others who are developing policies and initiatives to address nursing supply in their states, the study says. States in relatively slower RN growth regions might consider actions to recruit more entrants into the nursing workforce, increase efforts to educate policy-makers about their RN age structure, and examine their nursing education capacity.
The research was conducted by Peter Buerhaus, PhD, RN, FAAN, David Auerbach, PhD, MS, Douglas Staiger, PhD, and Ulrike Muench, PhD, RN.
While policy-makers in Washington and in state capitals across the nation have been embroiled in a debate over health care reform, many aspects of the health care system have been evolving in response to economic and demographic pressures. The latest issue of the Robert Wood Johnson Foundation’s ongoing Charting Nursing’s Future (CNF) series of policy briefs highlights a number of examples of that evolution, all related to nurses’ changing role in primary care.
The Institute of Medicine’s landmark report, The Future of Nursing: Leading Change Advancing Health, noted that nurses “are poised to help bridge the gap between coverage and access, to coordinate increasingly complex care for a wide range of patients, to fulfill their potential as primary care providers to the full extent of their education and training, and to enable the full economic value of their contributions across practice settings to be realized.” In fact, as the CNF brief points out, “Nurses are already leading the way in keeping patients healthy, managing their diseases, and reducing their use of costly hospital care by increasing the availability and scope of primary care services.”
Last week, NPR aired a story examining the prognosis for primary care providers in the United States. The country will have tens of thousands fewer health care providers than it needs to care for its the population by 2015, and the shortage is expected to hit rural and underserved areas especially hard.
Part of the problem, the story reports, is that medical students—often saddled with massive student loan debt—are choosing specialties over primary care and family medicine. In addition to higher salaries, specialties allow more schedule flexibility and predictability, and less stress. The nursing workforce, too, has a looming shortage. Many nurses are close to retirement, and a shortage of nurse faculty is making it difficult for nursing schools to educate the next generation.
Provisions of the Affordable Care Act may help alleviate the shortage in the areas most hard-hit, by providing loan forgiveness or other incentives for providers who practice primary care in underserved areas. “A lot of the money in the Affordable Care Act went to beef up programs that train primary care providers, not just doctors but nurse practitioners, physician assistants, what we call mid-level providers,” Julie Rovner, NPR health policy correspondent, said. Primary care “doesn’t necessarily have to be provided by someone with an MD after their name… [There are] lots of studies that say good primary care can be delivered by people like nurse practitioners, by physician assistants, by nurses.”
The show also took calls from listeners—a neurologist, a recent nursing school graduate, a surgical subspecialist, and a nurse practitioner, among them.
Listen to the NPR story or read the transcript here.
Comilla Sasson, MD, MS, is an attending physician at the University of Colorado Hospital and Assistant Professor in the Department of Emergency Medicine at the University of Colorado. Sasson was a Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Michigan from 2007 to 2010.
I wasn’t even supposed to work that night. I had finished a long day of meetings, and found out at 6:30 pm that my colleague, who had called in sick twice in 40 years, had influenza and he knew it was best not to expose Emergency Department (ED) patients to it. After he called, I remember thinking, “Well, I can just power through until 8 am. Nothing too bad happens on Thursday nights.”
The night began as many other nights do in our ED. Twenty-five of our 50 beds were taken up by inpatients who were waiting for hospital beds to open up. The ED was completely full, with another 10 patients in the waiting room. “Another one of those nights,” I groaned to myself. We were already on “divert” status, meaning that ambulances would bypass our hospital and go to others in town. This should be a relatively easy night, right?
Until we received the call over the dispatch radio at approximately 12:30 am: Shooting at a theater in Aurora. Hopefully the paramedics remembered we were already at capacity and took the patients elsewhere. Nine minutes later, we received a frantic phone call from one of the policemen on scene: Multiple shooting victims and Aurora Police Department just received permission to transport patients to hospitals in the backs of police cars instead of waiting for ambulances. That’s when we realized this was not a gang fight with one or two victims, this was something different.
The first police car showed up at 1:06 am. We raced out to the ambulance bay and started removing patients from the back of the car. The police car looked like a crime scene, with blood splattered throughout. As we were pulling the first two victims out of the car, another police car showed up. And another. And another. In total, we received nine police cars and one ambulance within 45 minutes. Looking out into our ambulance bay with police lights flashing, I realized, this is not like any other shooting I have been involved in. This is radically different.
In a month when national employment data were largely unchanged, the U.S. Bureau of Labor Statistics reports that the health care industry added nearly 33,000 jobs in May, continuing as a strong and growing field. Over the year, health care employment has risen by 340,000 jobs.
Employment in ambulatory care services accounted for the majority of the new jobs in the industry (23,000). That growth was seen mostly in physicians’ offices (9,900), home care services (6,900) and outpatient care centers (4,600).
Demand for health care employees remains strong. Nurse.com reports that data from Wanted Analytics finds that employers posted more than 620,000 online job ads for health care careers in May, an increase of 5 percent from a year prior.
Human Capital News Roundup: Soda taxes, suicide-prevention training, the environmental justice movement, and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:
Michigan Radio reports on a study led by RWJF Clinical Scholars alumnus Aasim Padela, MD, MSc, that examined discrimination against American Muslims in health care settings and what providers can do to better meet the cultural needs of these patients. Read a post Padela wrote for the RWJF Human Capital Blog about the study.
A study co-authored by RWJF Harold Amos Medical Faculty Development Program alumnus Esteban Burchard, MD, MPH, finds that African American and Latino children whose mothers smoked during pregnancy are much more likely to suffer from acute asthma symptoms in their teen years than are children whose mothers did not smoke, Medical News Today reports.
The Robert Wood Johnson Foundation (RWJF), NPR and the Harvard School of Public Health commissioned a poll to better understand Americans’ experiences and attitudes related to the cost and quality of their medical care. Released on May 21st, Sick in America found that many Americans who experienced a serious illness or injury in the past 12 months are concerned about the financial costs of medical care, and struggle to ensure that their care is appropriate. Nearly nine in ten respondents (87 percent) think the cost of care is a serious problem for the country.
In addition to surveying the public, the poll examined sick Americans’ experiences and perceptions. “Sick Americans” (27 percent of adults surveyed) were defined as those who said they had a serious illness, medical condition, injury, or disability requiring a lot of medical care or who had been hospitalized overnight in the past 12 months. A quarter of sick Americans said a doctor, nurse, or other health professional did not provide all the needed information about their treatment or prescriptions – or they had to see multiple medical professionals, and no single doctor understood or kept track of all the different aspects of their medical issues and treatments (23 percent). Three in 10 hospitalized Americans said there was poor communication among the doctors, nurses, and other health care professionals involved in their care.
In addition, 34 percent of patients who were hospitalized for at least one night in the past year said “nurses weren’t available when needed or didn't respond quickly to requests for help.”
To learn more, NPR published a call-out to nurses on its Facebook page. It was a non-scientific way to gather information, NPR notes, but the response from nurses was significant. “We received hundreds of responses and read them all: piles of stories about nurses feeling overworked, getting no breaks, no lunches and barely enough time to go to the bathroom. Even worse, many nurses say breaks and lunchtimes are figured into their salaries and deducted, whether they take them or not,” NPR reported on Morning Edition.
The poll also found that consumers see a shortage of nurses and physicians as one of the problems with the quality of health care in the country today. Of the one-third of total respondents who were asked about major reasons for quality problem, 35 percent identified “not enough doctors or nurses in hospitals or medical offices” as a major problem.
This is the first in a series of blog posts introducing programs that are part of the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio. Funded by RWJF, the Summer Medical and Dental Education Program (SMDEP) offers intensive and personalized medical and dental school preparation to freshman and sophomore college students from underrepresented groups and disadvantaged backgrounds. The goal is to help them overcome barriers to medical or dental school.
Meet 26-year-old Carmen Young, a May 2012 graduate of the University of Louisville, School of Medicine who begins her obstetrics and gynecology residency at St. Mary’s Hospital in St. Louis this summer. Her 8th grade commitment—from dream to destination—has been realized with a boost from the Summer Medical and Dental Education Program (SMDEP). Carmen pledges to build a practice that improves outcomes for Black mothers and their babies.
Meet Adrienne Perry, 23, whose eyes were opened to the vast oral health problems faced by adults and children during a trip to Guatemala. That trip, coupled with six weeks of intensive classes through SMDEP, awakened the third-year Howard University School of Dentistry student to similar oral health gaps faced by people in urban communities surrounding her campus in Washington, D.C. When she gets her degree, this Conyers, Georgia native plans to address the oral health crisis among underserved communities both here and abroad. Today, just 12 percent of the nation’s dentists are from minority populations.
And meet Drew Gehring, 24, from rural Garrison, North Dakota. He also participated in SMDEP and was inspired to dive into research probing the causes of colon cancer, hoping to contribute to curing the disease.
SMDEP gave these and other students from economically disadvantaged or medically underserved communities a jumpstart to open educational opportunities and clear career paths to medicine or dentistry. They are among the more than 20,000 alumni of the program.
Human Capital News Roundup: Genome sequencing of tumors, Medicare physician fees, cervical cancer among Latinas, and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) scholars, fellows and grantees. Some recent examples:
Alejandra Casillas, MD, MPH, an RWJF Clinical Scholar, spoke to New America Media about why Latinas have the highest rates of cervical cancer. Many women don’t go to the doctor as much as recommended because of a cultural belief that their families come first, Casillas says, so raising awareness among men could help encourage more women to get Pap tests.
Healthcare Finance News reports on The Primary Care Team: Learning from Effective Ambulatory Practices (the LEAP Project), a recently launched RWJF initiative designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce. Learn more about the LEAP Project and read an RWJF Human Capital Blog post about it.
A team led by scientists from the Broad Institute and Dana-Farber Cancer Institute—including RWJF Harold Amos Medical Faculty Development Program alumnus Levi Garraway, MD, PhD—has sequenced the genomes of 25 metastatic melanoma tumors, MediLexicon reports. The first high-resolution views of the genomic landscape are published online in the journal Nature.
RWJF Scholar in Health Policy Research and political scientist Brendan Nyhan, PhD, gave comments to NPR’s Morning Edition about the political landscape, discussing why and how voters reject facts about the political parties or politicians to whom they are loyal. Nyhan’s ongoing research suggests that people may be better able to deal with cognitive dissonance—“the psychological experience of having to hold inconsistent ideas in one's head”—if they are first given an image or ego boost.
By 2020, nearly one in nine jobs in the United States will be in the health care sector, according to new research from the Center for Health Workforce Studies at the University at Albany, State University of New York. The industry is expected to add 4.2 million jobs during that time, growing at twice the rate of the overall economy.
The United States will need nearly 7.5 million health care workers to fill new and existing jobs, the report says, including 1.2 million registered nurses (RNs). The largest job growth is expected among RNs, home health aides, and personal care aides.
“With an aging health care professional workforce, we will not only see new job growth but also openings in existing positions as workers retire or leave for other job opportunities," Robert Martiniano, principal author of the report, said in a news release.
The report also found that the majority of jobs (63 percent) are expected to be concentrated in ambulatory care (non-institutional settings).
The analysis is based on data from the biennial U.S. Bureau of Labor Statistics 10-year (2010-2020) occupational and industry projections for employment.
Read a news release about the study.