The Nursing Labor Market in California: Still in Surplus? May 2013 - PowerPoint PPT Presentation

The Nursing Labor Market in California: Still in Surplus? May 2013

Today’s presenters • Joanne Spetz – Professor at the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco • Teri Hollingsworth – Vice President, Human Resources Services, Hospital Association of Southern California • Judee Berg – Executive Director of the California Institute for Nursing & Health Care 2

Goals for this webinar • Learn how Chief Nursing Officers perceive the current RN labor market • Track the latest hospital vacancy and turnover data • Understand how recently-graduated nurses are faring • Link employer and nurse perceptions with recent data on RN employment and education • Measure the impact of enrollment trends on forecasts of future supply and demand • Identify next steps for ensuring an adequate nurse supply 3

The collaboration • Betty Irene Moore Nursing Initiative • Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco • California Institute for Nursing & Health Care • Hospital Association of Southern California Acknowledgements & thanks to… – California Hospital Association – Hospital Council of Northern & Central California – Hospital Association of San Diego & Imperial Counties – UCSF Staff & Interns: Tim Bates, Lela Chu, Jessica Lin, Dennis Keane, Fletcher Munksgard, Glenda Tam 4

What is going on in our RN labor market? • More than a decade of severe shortage, 1998-2008 • Reports of nurse surplus 2009-now Context: Ongoing recession, high unemployment, severe regional differences 5

Goals for this webinar • Learn how Chief Nursing Officers perceive the current RN labor market • Track the latest hospital vacancy and turnover data • Understand how recently-graduated nurses are faring • Link employer and nurse perceptions with recent data on RN employment and education • Measure the impact of enrollment trends on forecasts of future supply and demand • Identify next steps for ensuring an adequate nurse supply 6

Survey of Chief Nursing Officers • Fielded by UCSF • Funded by Gordon & Betty Moore Foundation • Web-based survey with option to return paper survey via fax or email • Questions based on previous CINHC survey and National Forum of State Nursing Centers “Minimum Demand Data Set” recommendations • Five surveys conducted – Fall 2010, Spring 2011, Fall 2011, Spring 2012, Fall 2012 – Spring surveys & Fall 2012 conducted solely for CNOs – Fall 2010 and 2011 included HR data 7

Perceptions of employers 0% 20% 40% 60% 80% 100% 0.5% 2012 45.0% 19.7% 17.0% 12.4% 5.5% 2.0% 4.6% 2011 43.0% 6.6% 23.2% 20.5% 5.0% 5.0% 2010 29.4% 11.3% 25.6% 23.8% High demand: difficult to fill open positions Moderate demand: some difficulty filling open positions Demand is in balance with supply Demand is less than supply available Demand is much less than supply available Other 8

Differences across regions 2.9 California 3.2 2012 3.4 3.0 Southern Border 3.1 2011 3.5 2.2 2010 Inland Empire 3.0 3.3 2.8 Los Angeles 3.1 3.2 2.6 2.7 Central California 3.1 3.2 San Francisco Bay Area 3.7 3.9 3.0 Sacramento & Northern CA 3.2 2.9 1 2 3 4 5 Lower number = more shortage 9

Rural versus urban perceptions 5.0 2010 2011 2012 4.5 4.0 3.5 3.33 3.15 2.9 3.0 2.82 2.71 2.6 2.5 2.0 1.5 1.0 Rural Non-rural Lower number = more shortage 10

Differences by hospital size 5.0 2010 2011 2012 4.5 4.00 4.0 3.50 3.50 3.48 3.5 Average ranking 3.28 3.04 3.03 3.00 2.88 3.0 2.83 2.62 2.71 2.5 2.0 1.5 1.0 Less 100 - 150 - 200 - 300 - 400 or than 149 199 299 399 more 100 # of Licensed Beds Lower number = more shortage 11

Change in difficulty recruiting, compared to last year, Fall 2012 100% 11.7% 90% 23.7% 27.3% 28.0% 80% 70% 60% 62.1% 50% 61.6% Less difficult 71.6% 40% 72.1% About the same 30% More difficult 20% 26.2% 10% 0.6% 10.4% 4.6% 0% 12

Change in RN employment in the past year 100% 90% 22.1% 23.6% 23.0% 28.3% 33.7% 80% 70% 60% 47.0% 49.1% 50% 55.4% Decreased 59.9% 40% 48.8% employment 30% No change 20% 34.3% 27.3% 22.5% 10% 14.1% Increased 11.5% 0% employment 13

Changes experienced in past year 0 20 40 60 80 100 120 140 Budget constraints Fewer RN retirements than… Reduction in census Less turnover of staff Decrease in use of… Current staff working more shifts Current staff converting PT to… Hiring freeze Increase in use of… Less foreign recruitment Number of responses (217 maximum possible) 14

Foreign recruitment, 2010-2012 8% 6.7% 7% 6% 5% 4.0% 4% 3% 1.9% 2% 1% 0% 2010 2011 2012 15

Hiring of newly graduated RNs, Fall 2012 100% 8.0% 8.7% 9.8% 90% 6.7% 9.4% 12.6% 80% 70% Do not hire ever 60% 50% Normally hire, but not this year 84.6% 82.6% 40% 77.6% Hired this year 30% 20% 10% 0% 2010 2011 2012 16

Hiring requirements and preferences, Fall 2011 & 2012 21.6% No experience required 21.2% 55.5% Specific type of experience 52.3% Baccalaureate degree 67.9% preferred 69.5% Baccalaureate degree 7.3% required 4.6% Minimum experience 53.7% requirement 52.3% 0% 20% 40% 60% 80% 2012 2011 Care experience most often needed in critical care, OR, ED, L&D 17

New graduate training programs, Fall 2012 100% • 71% had a 90% 29.3% 32.6% residency in 2012 80% 38.6% 70% • 82% developed 60% program internally 50% • Most common 40% capacity is 20-30 70.7% 67.4% 30% 61.4% new grads 20% • Most common 10% length is 12 weeks 0% 2010 2011 2012 Residency No residency 18

Hiring expectations 100% 75% 50.0% 51.6% 67.8% No change 50% Hire fewer than last year 18.6% 17.2% Hire more than last year 8.7% 25% 31.4% 31.2% 23.5% 0% 2010-2011 2011-2012 2012-2013 19

Reasons for expected increasing employment 0 10 20 30 40 50 60 Increase in census Increase in bed capacity Decrease in use of traveler/contract RNs More RN retirements than expected Care model redesign Number of responses (67 maximum possible) 20

Reasons for expected decreasing employment 0 5 10 15 20 25 30 35 Reduction in census Less turnover of staff Hiring freeze Fewer RN retirements than expected Budget constraints Current staff working more shifts Number of responses (37 maximum possible) 21

Hiring expectations for new graduates 100% 75% 55.4% 59.7% No change 50% Decrease hiring Increase hiring 22.3% 18.7% 25% 22.3% 21.6% 0% 2011-2012 2012-2013 22

Goals for this webinar • Learn how Chief Nursing Officers perceive the current RN labor market • Track the latest hospital vacancy and turnover data • Understand how recently-graduated nurses are faring • Link employer and nurse perceptions with recent data on RN employment and education • Measure the impact of enrollment trends on forecasts of future supply and demand • Identify next steps for ensuring an adequate nurse supply 23

Turnover & hiring of full-time personnel, Fall 2012 4.0% 3.8% 3.7% 3.7% 3.5% 3.5% 2.9% 3.0% 2.5% 2.4% 2.5% 2.1% 2.0% 1.5% 1.5% 1.0% Staff RNs 0.5% Other RNs New RN grads 0.0% LVNs Separations Hiring Aides 24

Percent of new hires that were new graduates, Fall 2012 35% 32.0% 30% 26.0% 25% 20% 15% 10% 6.0% 5% 0% Full-time Part-time Overall 25

Per diem, traveler, and agency use 20% 15% RNs 2010 RNs 2011 10% RNs 2012 LVNs 2010 LVNs 2011 5% LVNs 2012 0% Per diem Traveler Agency 26

RN Vacancies, 2010-2012 4.5% 4.0% 4.0% 3.8% 3.4% 3.5% 3.0% 2.5% Fall 2010 Fall 2011 2.0% Fall 2012 1.5% 1.0% 0.5% 0.0% All RNs 27

Vacancy rates by position, Fall 2012 8% 7.1% 7% 5.9% 6% 4.9% 5% 3.7% 4% 2.9% 3% 2% 1% 0% Staff RNs Other RNs New RN LVNs Aides Grads 28

Vacancy rates by part-time and full- time status, Fall 2012 10% 9.5% 9% 8.0% 8% 6.7% 7% 5.8% 6% 4.7% 5% Full-time 4.1% 4% 3.5% Part-time 2.6% 3% 2.1% 1.9% 2% 1% 0% Staff Other New RN LVNs Aides RNs RNs Grads 29

Goals for this webinar • Learn how Chief Nursing Officers perceive the current RN labor market • Track the latest hospital vacancy and turnover data • Understand how recently-graduated nurses are faring • Link employer and nurse perceptions with recent data on RN employment and education • Measure the impact of enrollment trends on forecasts of future supply and demand • Identify next steps for ensuring an adequate nurse supply 30

New RN Graduate Hiring Survey • Statewide survey of new grads conducted in fall of 2012 • Collaborators: – CINHC – UCLA School of Nursing – Board of Registered Nursing – Association of California Nurse Leaders – California Student Nurses Association • Random selection of >5,000 newly licensed RNs in CA between September 2011-August 2012 – Sample was mailed letters with invitation to complete web-based survey

Findings from the 2012 New RN Graduate Hiring Survey • 46% were not yet employed as an RN – Consistent with survey from National Student Nurses Association in Sept 2011 – 45% unemployed – American Association of Colleges of Nursing survey in 2012 (BSN degree only) – 43% unemployed