Snapshot of Mississippi’s Nursing Workforce

Debbie Logan, MHA, RN Sheila Keller, PhD

Objectives

• Understanding national nursing recruitment and retention practices

• Knowledge of Mississippi nursing vacancy, turnover, and salaries

• Nursing graduate earning and retention in healthcare employment

• Job satisfaction and intent to leave for RN and LPNs

Nursing Workforce

• According to the National Center for Health Workforce Analysis within HRSA, approximately 2.8 million registered nurses (RNs) are currently working in nursing in the United States.

Nursing Workforce Distribution in Rural and Urban Areas

Rural444,688

Rural165,980 Rural

52,153,208

Urban2,379,953

Urban524,058 Urban

254,590,000

0%

20%

40%

60%

80%

100%

RNs LPNs U.S. Population

Nurses per 100,000 Residents in Rural and Urban Areas

The per Capita RN Workforce, Ranked by State

IdahoHawaii

CaliforniaNew Mexico

OklahomaAlaska

VirginiaWashington

ColoradoMichigan

South CarolinaArkansas

North CarolinaMaryland

IndianaNew York

West VirginiaNew Hampshire

TennesseeWisconsin

OhioPennsylvaniaNorth DakotaRhode Island

NebraskaSouth Dakota

0 200 400 600 800 1,000 1,200 1,400

The U.S. Nursing Workforce: Trends in Supply and Education, HRSA

Figure 4. The per Capita LPN Workforce, Ranked by State

OregonAlaska

NevadaWashingtonNew Mexico

CaliforniaIllinois

MontanaIdaho

New JerseyVermont

North CarolinaSouth Carolina

KentuckyTexas

ConnecticutFlorida

AlabamaSouth Dakota

VirginiaPennsylvania

OhioMississippiOklahomaTennessee

North Dakota

0 50 100 150 200 250 300 350 400 450

National Shortage

• Over the next 20 years, the average age of the RN will increase and the size of the workforce will plateau as large numbers of RNs retire.

• Because demand for RNs is expected to increase during this time, a large and prolonged shortage of nurses is expected to hit the US.

Nursing Shortage??

• Over the past decade, the average age of employed RNs has increased by nearly two years, from 42.7 years in 2000 to 44.6 years in 2010.

• America is seeing vast increases in the number of people over 65. This age group has many medical and health needs, and will put a strain on our health system.

• Recent reforms in healthcare will give millions of people access to the healthcare system. More nurses and health professionals are needed in response.

• These factors, combined with an anticipated strengthening of the economy, will create a renewed critical shortage for nurses.

• A shortage of RN’s is projected to spread across the country through 2030.

• US is projected to experience a shortage of RN’s that is expected to intensify as Baby Boomers age and the need for health care grows (AACN).

RN Retirement Tsunami is expected Economy has forced delay of retirement in many RNs

• Near the end of 2013 the U.S. Department of

Labor Bureau of Labor Statistics (BLS) updated its Employment Projections 2012-2022.  

• By 2022 total employment of RNs and APRNs will increase by 574,400 jobs.  In fact, with RN retirements also in the mix, the nation will need to have produced 1.13 million new RNs by 2022 to fill those jobs. 

• There are a number of other issues that must be addressed to avoid the return of a catastrophic nurse shortage.

• Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform.

• Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services.

• “The nursing pipeline, measured by the annual number of individuals who pass national nurse licensing exams, grew substantially from 2001 to 2011. Understanding the supply and distribution of nurses is key to ensuring access to care and an effective health care system.” – ( The U.S. Nursing Workforce: Trends in Supply and Education, 2013)

• A 2.6% enrollment in nursing schools was reported in 2013, but at that rate it is not enough to meet the projected demand of nursing services with more than 32 million gaining access to health care through the Affordable Care Act.

Growth in NCLEX-RN First-Time Test Takers, by Bachelor’s and Non-Bachelor’s Degree Status, 2001 to 2011

Total Number and Percentage of NCLEX-RN First-Time Test Takers, by Bachelor’s and Non-Bachelor’s Degree

Status, 2001 vs. 2011

NCLEX-PN Passers, 2001 to 2011

Licensed RNs Graduating With BSN Qualification, 2007 to 2011

Master’s and Doctoral Graduates, 2007 to 2011

Figure 26. Nurse Practitioner Graduates, 2001 to 2011

Mississippi’s Nursing Workforce

• There are 29,016 RN’s reported working in Mississippi

• A reported 9,719 LPN’s working in Mississippi– This represents 980.6 RN’s per 100,000

Mississippians and 328.5 LPN’s per 100,00 Mississippians.

National Growth in Full-Time Nurse Salaries

Mississippi Salary Survey• Salary data reveals 2015 staff nurses

RN salaries in Mississippi hospitals and clinics range from $39,561 to $68,432/year.

• Upper level RN management salaries range from $50,000 to $100,000/year.

• LPN salaries in Mississippi hospitals and clinics are reported to range from $ 28,246 - $41,912/year.

Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report

Mississippi RN Salaries• Staff Nurse• Clinic Nurse• LTC Nurse• Nurse Manager• Director of Nursing• Infection Control

Nurse• Nurse Educator• Nurse Practitioner• CRNA

$42,099 - $68,432$39,561 - $61,505$41,724 - $62,545$58,760 - $90,043$50,000 - $75,000$47,424 - $71,656$47,444 - $74,710

$85,841 - $129,979 $120,619 - $183,268

Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report

Mississippi LPN Salaries

• LPN• LPN Clinic • LTC LPN

$28,246 - $41,912$27,580 -

$40,268$30,971 -

$41,641

Mississippi Hospital Association, Health, Research & Educational Foundation, 2015 Salary Survey Report

Recruitment and Retention

Factors Impacting Nursing Workforce Recruitment and

Retention• Literature review revealed key obstacles:

• Nurses leaving the workforce due to age

• Rural difficulties in attracting nurses

• Educational preparation issues and concerns related to faculty shortage

• Increased use of non-licensed personnel by employers

– Retention

• Work load intensity

• Staffing ratio issues

• Lack of empowerment

• Use of travel nurses in rural settings who were made more

• Salaries and benefits

• Lack of support for educational advancement

Brewer, Zayas, Kahn and Sienkiewicz (2006), Nooney, Unruh, and Yore (2010), Laschinger, Leiter, Day, Gilin (2009), Tallman & Brning (2005), Chenoweth, Jeon, Merlyn & Broadaty (2010), Kovner, Brewer, Fiarchild, Poornima, Kim & Djukic (2007)

Factors Impacting Nursing Workforce Recruitment and

Retention• Survey of newly licensed nurses

found: • 41% indicated would change jobs if free to • Associate degree nurses more apt to change

jobs than new bachelor degree nurses • Job orientation was found to be a factor with

a wide variation in the type received. • 6% reported receiving no orientation at all.

» by Chenoweth, Jeon, Melryn and Broday (2010)

Mississippi Recruitment and Retention

• Recent survey of some Mississippi Delta RN’s indicated the most important recruitment factors:– Pay– Hours– Benefits– Greater support for nursing

(MS Delta Area Nursing Workforce Study, 2014)

29% (8)2014

RN Hospital Turnover Rates

by Public

Health Districts

17% (9)

22% (11) 17% (10)

14% (6)

25% (15)20% (18)

21% (11)

19% (11)

Copyright © 2014 by Mississippi Office of Nursing Workforce

Statewide Turnover Rates

2004 24.0%2005 21.7%2006 21.9%

2007 18.9% 2008 18.2%2009 14.1%2010 14.9%2011 14.7%2012 14.2%2013 20.6%2014 20.4%

2011 - 4.5%2012 - 9.8%2013 - 3.9%2014 -6.9%

2011 - 9.9%2012 - 7.5%2012 - 7.3%2014 - 7.9%

2011 - 4.7%2012 - 6.5%2013 - 7.7%2014 - 8.6%

2011 - 5.4%2012 - 3.3%2013 - 4.3%2014 - 2.2%

2011 - 3.6%2012 - 3.5%2013 - 3.2%2014 - 6.5%

2011 - 1.7%2012 - 2.6%2013 - 2.9%2014 - 2.7%

2011 - 2.6%2012 - 3.6%2013 - 3.8%2014 - 3.3%

2011 - 4.8%2012 - 1.6%2013 - 2.5%2014 - 2.9%

2011 - 3.7%2012 - 2.8%2013 - 5.0%2014 - 4.6%

Hospital RNVacancy

Rates by

PublicHealth

DistrictsStatewide RN Vacancy Rates

2007 9.1%2008 6.4%2009 5.0%2010 4.3%2011 4.3%2012 4.9%2013 5.3%

2014 5.8% MONW,2014

Copyright © 2014 by Mississippi Office of Nursing Workforce

National Average RN turnover rate 13.9% (Hodes Group, 2005)

RN –6.9% (59)LPN – 1.1% (1)Anc – 6.6% (17)

RN – 7.9% (54)LPN – 3.7% (7)Anc – 3.7% (11)

RN – 8.6% (334)LPN – 5.1% (10)Anc – 12.4% (111)

RN – 2.2% (12)LPN – 3.2% (3)Anc – 4.0% (4)

RN – 6.5% (151)LPN – 0.7% (1)Anc – 4.5% (34)

RN – 2.7% (43)LPN – 2.4% (6)Anc – 4.1% (26)

RN – 3.3% (44)LPN – 13.9% (21)Anc – 2.3% (14)

RN – 2.9% (23)LPN – 5.5% (5)Anc – 2.8% (7)

RN – 4.6% (75)LPN – 2.5% (3)Anc – 7.9% (28)2014

Hospital Staff RN, LPN & Ancillary Vacancy Rates

(FTEs) by

Public Health Districts

Statewide Vacancy Rates

2014 2013

Staff RN 5.8% (793) 5.3%

LPN 4.3% (56) 4.5%

Ancillary 6.0% (252) 6.5%

Copyright © 2014 by Mississippi Office of Nursing Workforce

RN – 2.55% (4.0)LPN – 3.25% (8.0)Anc – 7.1% (38.8)

RN – 9.10% (14.8)LPN – 5.21% (15.0)Anc – 5.53% (41.0)

RN – 5.23% (23.0)LPN – 8.53% (57.5)Anc – 14.26% (201.0)

RN – 2.26% (3.0)LPN – 2.94% (6.0)Anc – 5.27% (23.0)

RN – 3.73% (11.0)LPN – 6.71% (23.0)Anc – 5.94% (39.0)

RN – 2.70% (5.0)LPN – 5.47% (21.0)Anc – 5.14% (34.3)

RN – 6.84% (17.0)LPN – 4.85% (15.0)Anc – 9.90% (84.0)

RN – 2.10% (4.0)LPN – 1.98% (5.5)Anc – 2.27% (18.0)

RN – 1.88% (5.3)LPN – 2.01% (10.0)Anc – 4.79% (77.5)

2015Long Term Care

RN, LPN & Ancillary

Vacancy Rates (FTEs) by

PublicHealth Districts Statewide Vacancy

Rates

2015 2014

RN 4.20% (87.0) 4.77%

LPN 5.00% (161.0) 5.44%

Ancillary 7.21% (556.5) 7.32%

Mississippi LTC RN Vacancy and Demand RN Vacancy and Demand

01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'

-2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

6.0%

10.5%

15.0%

13.4%

11.9%

12.9% 13.1%

7.4%

6.6%

4.7%4.8%

3.4%

4.1%4.8%

4.2%

8.3%

9.9%

9.3%

5.7%

3.2%

10.8%

5.3%

4.3%

-0.6%

3.5%

5.4%

3.6%

3.3%

5.2%

3.2%

RN Vacancy Rate

N=173 N=185 N=163 N=183 N=186 N=186 N=183 N=201 N=207 N=202 N=210 N=207 N=208 N=202 N=204

87.0 FTEs

65.0 FTEs

Mississippi LTC LPN Vacancy and Demand

01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'

-4%

-2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

8.9%

13.3%

15.0%

15.0%

12.5%

12.6%

11.0%

8.3%

6.2%

4.8%

4.9%4.5%

5.4%

5.4%5.0%

6.4%

8.0%7.5%

6.3%

4.8% 5.2%

2.9%

-1.2%

0.6%

-2.4%

1.0%

2.5%

2.2%

2.8% 2.3%

LPN Vacancy Rate

Predicted Increase in Demand over 2 Yrs

N=172 N=183 N=161 N=182 N=182 N=186 N=179 N=199 N=203 N=196 N=201 N=207 N=203 N=202 N=202

161.0 FTEs

70.3 FTEs

Mississippi LTC Ancillary Vacancy and Demand

01' 02' 03' 04' 05' 06' 07' 08' 09' 10' 11' 12' 13' 14' 15'

-4%

-2%

0%

2%

4%

6%

8%

10%

7.3%

5.0%5.7%

6.7%

6.5%

8.0% 8.1%

8.6%

8.0%

4.6%

6.2%

5.1%

6.3%

7.3%

7.2%7.1%

3.3%

5.1%5.4%

7.1%

2.6%

3.7%

0.3%

-1.8%

-1.2%

2.4%

3.1%

2.4%

3.8%

2.9%

Ancillary Vacancy Rate Predicted Increase in Demand over 2 Yrs

N=163 N=172 N=153 N=174 N=175 N=178 N=170 N=186 N=188 N=178 N=189 N=205 N=188 N=202 N=202

556.5 FTEs

219.0 FTEs

Alice: Would you tell me, please, which way I ought to go from here?

The Cat: That depends a good deal on where you want to get to

Alice: I don't much care where.

The Cat: Then it doesn't much matter which way you go.

Alice in Wonderland

What’s next?

How do You Keepyour Bucket Full?

SUSTAINABILITY OF A SUCCESSFUL RECRUITMENTRETENTION PROGRAM

Our goals: an up-to-date for education/training for faculty

and clinical staff increase in number of clinical staff returning to

school for BSN and MSN opportunities for health care facilities to recruit

and retain students clinical education for students and faculty

impacting patient outcomes and safety statewide DEU implementation and extern

programs available for students in all schools in Mississippi

QUESTIONS??