I spaced out completely yesterday while posting on the national data on schools that produce the most nurses. I didn't include similar data for Minnesota.
We'll make up for that today with a few graphics.
Below is data on students who completed a two year or four year RN track program in 2009 at a Minnesota-based college. The numbers come from the federal IPEDS database.
I focused on those two degree programs because they're the most likely to produce new nurses that add to the supply. (Some bachelor's programs target working nurses moving up the degree ladder and so don't add to supply.)
Here are the Minnesota institutions producing the most two year RN graduates:
And here are the major four year institutions:
(Thanks to Josh Wright from the research firm EMSI for pulling the IPEDS Minnesota data together for us.)
Here's a look from the Minnesota Office of Higher Education on the growth of bachelor's and associate's degree graduates from RN programs. It shows about a 50 percent increase in annual graduates over four years, from 2004 to 2008.
That jump has come in years (even before the recession) when statewide RN vacancies were relatively flat -- and then took a dramatic dive.
There's no doubt the recession is to blame for Minnesota RN vacancies falling off a cliff in 2009.
Demand for new nurses in Minnesota will bounce back. But when does that happen? How will it affect the job choices for nurses, especially graduates from two year programs, in the short run?
The clock is ticking on a potential Twin Cities nurses strike on July 6. The hospitals and nurses haven't been able to come to an agreement. A major sticking point in the negotiations is that the nurses union want hospitals to limit the number of patients nurses are required to care for during a shift. The hospitals are wary of agreeing to specific staffing ratios, especially since there are so many known-unknowns (to use Donald Rumsfeld's famous phrase) with the health care reform law.
Still, it makes intuitive sense that high nurse staffing ratios would be associated with better patient care and outcomes. A number of studies on the issue suggest that there's some insight to that common sense notion.
But an intriguing new study published by the National Bureau of Economic Research comes to a more skeptical conclusion. In The Effect of Hospital Nurse Staffing on Patient Health Outcomes: Evidence from California's Minimum Staffing Regulation, economists Andrew Cook (Resolution Economics LLC), Martin Gaynor (Carnegie Mellon), Melvin Stephens, Jr. (University of Michigan) and Lowell Taylor (Carnegie Mellon) look at the impact of California's 1999 Assembly Bill 394. It mandated maximum levels of patients per nurse in hospitals. The mandate went into effect in 2004 after several years of study and negotiation.
The scholars found that California's staffing requirement succeeded in decreasing the patient/nurse ratio in hospitals that didn't meet the standard before the law was enacted. However, they found no evidence that the higher staffing ratios improved patient safety at these hospitals. "Our empirical results suggest that a mandate reducing patient/nurse rations, on its own, need not lead to improved patient safety," they write. "This is not to say, though that nurse staffing decisions are unimportant as a component in a hospitals's overall strategy for ensuring high patient safety."
In other words, management and basic strategy matters.
To be sure, studies like this are never definitive. The data is always incomplete and flawed by definition. It's extremely difficult to establish cause and effect no matter how hard the scholars try. This isn't a criticism of the scholars. It's in the nature of the beast and the scholars are very forthright about the limitations of their study. Still, California's experience provides a real world case study and it's disappointing the results weren't better--that is, from a patients perspective.
It's worth noting that another NBER study found a dismaying but suggestive short-term patient consequences from a strike. I posted on that earlier.