Posted at 1:09 PM on June 28, 2010
by Paul Tosto
Filed under: Health care
If you've been following our rolling discussion on the supply of nurses from the college systems in Minnesota and the nation, you'll know that Josh Wright from the economic research group EMSI has been generating some very cool data.
Number one? Excelsior College, a distance learning and online university, which has become the largest nursing school in the country .
Excelsior is based in Albany, NY, but the college says one in 10 students pursuing an associate degree in nursing in the U.S. was enrolled in its school.
School number two? University of Phoenix, which has a program tailored for RNs seeing to earn a bachelor's.
Click on the chart below to examine the rest of the EMSI research.
My point? The market for new nurses is more complex than I realized when I first asked, What's the right number of nurses?
While I've been thinking in terms of supply of nurses from Minnesota colleges, the reality is this is a national and increasingly international business. Nurses are being trained in big numbers in schools across the country, tied only in a basic way to geography, making it.even harder to understand if we have an oversupply.
Thoughts and questions:
1.) What's the fate of two-year degree students? Do they get jobs, how long does it take and do they get the RN jobs they want (hospitals)?
Do they choose jobs in assisted care facilities for less pay and flexibility? There's a need there so that's not necessarily a bad thing, unless you were in mid-life and went back to college thinking a well paying, super-flexible hospital nursing job awaited and what you got wasn't as well paying or as flexible as what you left.
We're starting to see those concerns show up in the media. Here's a story from Lancaster, PA.
2.) How good are the colleges and the industry at managing supply? Like airlines that overbook because they know a certain percentage of fliers will not show, how good are the colleges and the industry at figuring a rate of students who won't pass their gateway exams into nursing or who'll become RNs but won't practice?
There's a legitimate argument that what I view as oversupply, the industry and colleges view as acceptable since a percentage of those new completers won't stay in nursing.
Still, if you take the national and international view, there are a lot more new nurses coming in to the U.S. market that there is projected demand.
Take a look at the NCLEX, the gateway exam to get a registered nursing job in the U.S.
Data collected by the National Council of State Boards of Nursing (.pdf page 19) show a total of 132,940 U.S. students passing the NCLEX exam for the first time in fiscal 2009. That's significantly higher than the 105,020 annual national need EMSI projects.
Now add in the number internationally educated students who took the NCLEX exam for the first time or repeated and you get a total of 148,266 nurses who passed the exam and are able to enter the health system work force as RNs.
So if the U.S. going forward needs 100,000 to 110,000 new nurses each year and if we have 148,000 total US and international students passing the NCLEX for the first time, every year....
I still can't reconcile that data.