A Report Addressing the Resources Needed to Increase the Capacity of the Kansas Board of Regents System for Educating Registered Nurses Charge from the Legislative Budget Committee

Kansas Nurse, Jan 2006

The Legislative Budget Committee expressed concern over the shortage of nurses in Kansas and recognized that the problem will only become worse as the current workforce nears retirement. As a result, the committee recommended that the Board of Regents submit a report to the Governor and the 2006 Legislature addressing the resources needed to increase the capacity in the state's higher education system for educating registered nurses by 25 percent. It was also requested that the report include a timeline for rebuilding the infrastructure to accommodate up to 250 more nursing student admissions annually.

The Kansas Board of Regents appreciates the opportunity to respond to this issue. The report begins with a background of the nursing shortage drawing upon both national and Kansas studies. The next section, Filling the Pipeline, focuses on the successful efforts of various organizations in attracting more interest in the nursing profession. Asa result of these efforts, a new problem has surfaced - postsecondary program capacity and growth, referred in the report as, Widening the Pipeline. The paper also addresses the various barriers to increasing capacity and growth. The report concludes with recommendations, projected costs, and a stated timeline for the project.

Background

The American Hospital Association's Commission on Workforce for Hospitals and Health Systems stated, "Among the many issues facing the field of health care, none is more important to its long-term future than solving the growing workforce crisis." Hospitals and other facilities that provide patient care in Kansas, as well as nationwide, are threatened by a long-term shortage of nurses. This demand for health care professionals, specifically registered nurses, is well documented. In the 2004 article by Bleich and Hewlett, entitled "Dissipating the 'Perfect Storm' - Responses from Nursing and the Health Care Industry to Protect the Public's Health," the authors use the metaphor of converging storms to describe the current nursing shortage. In essence, this long-term shortage is due to:

*An aging population that will require increased utilization of the health care system

* An increase in the number of retirements, in this case nurses and other health care professionals

* Fewer potential workers to replace those that are retiring

* Dissatisfaction of many in the current hospital workforce with their work due to the increasing workload and faster pace, which results in harried, dissatisfied caregivers with less time at the bedside and an increased fear of dire patient outcomes

In short, the aging population will be placing greater demands on the health care system at the same time many health professionals will be retiring. In addition, the population is becoming more ethnically diverse and minorities continue to be underrepresented in the health care workforce. This issue has become more prevalent in recent years with an increase in the Hispanic population, as well as the elderly in many rural areas of Kansas.

The U.S. Department of Labor has identified Registered Nursing as one of the top occupations in terms of job growth through the year 2012. According to a U.S. Department of Health and Human Services study, by 2010 the shortage of qualified health care workers is expected to reach 12 percent nationally, and by 2020 this shortage is projected to grow to 29 percent. This translates to a need for 1,101,000 more registered nurses nationally to meet the demand by the year 2012.

The outlook in Kansas is similar to the national trend. The Kansas Occupational Outlook, published by the Kansas Department of Labor in February 2005, identified the top 10 occupations for projected growth through 2010. Registered Nurse (RN) is listed second, with a projected growth of 31.2%, or 6,890 more RN positions needed by 2010 to meet the workforce demand at that time. Coupled with 4,460 RN replacements needed due to retirements in the same timeperiod, the total projected need for RNs will exceed 11,350. The need for Licensed Practical Nurses (LPN) for this same time-period is projected to be 3,370 (a number that does not include replacement positions needed due to retirements).

Although the focus of this report is to increase the capacity for educating RNs, it is also sensitive to the need of more LPNs. There are 10 generic LPN programs in Kansas and 70% of these students enter the workforce while 30% continue their education to become RNs. Obviously this benefits the RN pool; however, it reduces the supply of needed LPNs for long-term care. Long-term care is the major employer of the LPN and the LPN is the major health care provider for the growing population of elderly in Kansas.

The Kansas State Nurses Association (KSNA) conducted a study entitled, "Nursing Shortage: Environmental Assessment of Nursing Education and Faculty in Kansas" estimating a projected need of 11,390 RNs over this same time-period, which varies less than one-half percent from the Department of Labor projections.