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The Registered Nurse Population The Registered Nurse Population Findings from the 2008 National Sample Survey of Registered Nurses September 2010 U.S. Department of Health and Human Services Health Resources and Services Administration The Registered Nurse Population Findings from the 2008 National Sample Survey of Registered Nurses September 2010 U.S. Department of Health and Human Services Health Resources and Services Administration Preface The U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), is the principal Federal agency responsible for the evaluation and development of the nursing workforce in the United States. HRSA’s Bureau of Health Professions (BHPr) works to appraise and improve the U.S. nursing workforce with the goal of ensuring there are enough qualified nurses to meet the Nation’s health needs. To do this, BHPr reviews the supply, composition, and distribution of nurses on the national and State levels. To that end, BHPr commissioned the National Sample Survey of Registered Nurses (NSSRN). This publication is the report of the ninth NSSRN representing data collected about registered nurses (RNs) holding active nursing licenses as of March 2008. As with previous iterations of the NSSRN, this report is available to all primary stakeholders involved in health care planning and evaluation as well as the public. The 2008 NSSRN public use files and code book are available to researchers and analysts and can be accessed at http://bhpr.hrsa.gov/healthworkforce/rnsurvey/ default.htm. The 2008 NSSRN was developed for the U.S. Department of Health and Human Services, Health Resources and Services Administration under contract with Westat. The study was overseen by BHPr and funded through the Division of Nursing. The first national survey was conducted in 1977; HRSA has conducted this national survey every 4 years since 1980. Data from these periodic surveys provide the basis for evaluating trends and projection of the future supply of nursing resources at the national and State levels. The NSSRN is the cornerstone of nursing workforce data. It is the principal data source used for disseminating information to the Federal Government, researchers, and the public on the nursing workforce. It provides essential information for performing supply-demand projections of nursing requirements and foreseen shortages. Periodic monitoring of the number and characteristics of the registered nurse population is vital to effectively maintain an up-to-date picture of the RN population and to assess the future availability of this critical resource. For example, previous surveys were integral in identifying the shortages of RNs that occurred at the end of the 1980s and then reappeared around 2000. The NSSRN is the Nation’s most extensive and comprehensive source of statistical data on all individuals in the United States that hold active RN licenses, whether they are currently practicing iii Preface nursing or not. The survey assesses the number of RNs; their educational background; employment setting, position, and specialty areas; job satisfaction; and salaries. In addition, the survey also identifies the geographic distribution of nurses throughout the United States, as well as the personal composition of the U.S. nursing workforce in terms of gender, racial/ethnic background, age, and family structure. iv Table of Contents Chapter Page Preface .................................................................................................................. iii Executive Summary ............................................................................................ xxvii Introduction ........................................................................................................ xxxvii 1 Survey Methods .................................................................................................. 1-1 1.1 Summary ................................................................................................. 1-1 1.2 2008 Questionnaire ............................................................................... 1-3 1.3 Sample Design ....................................................................................... 1-4 1.4 Data Collection Methods ..................................................................... 1-5 1.5 Sample Performance ............................................................................. 1-6 1.6 Imputation ............................................................................................. 1-7 1.7 Sample Weighting ................................................................................. 1-9 1.7.1 Overview of the Weighting Process .................................. 1-9 1.7.2 Implications of Weighting for NSSRN Data Users ....................................................................................... 1-9 2 Education and Licensing of Registered Nurses ............................................. 2-1 2.1 Introduction ........................................................................................... 2-1 2.2 Initial Nursing Education .................................................................... 2-1 2.3 Age at Graduation ................................................................................. 2-2 2.4 Sources of Financing ............................................................................ 2-3 2.5 Education and Experience Prior to Initial Nursing Education ............................................................................................... 2-5 2.6 Nursing Licensure ................................................................................. 2-6 2.7 Degrees Obtained After Initial Nursing Education ......................... 2-7 2.8 Currently Enrolled Students ................................................................ 2-11 2.9 Emergency Preparedness ..................................................................... 2-12 2.10 Certifications .......................................................................................... 2-13 3 The Employment of Registered Nurses .......................................................... 3-1 3.1 Introduction ........................................................................................... 3-1 3.2 Nursing Workforce Size ....................................................................... 3-1 3.3 Employment and Age........................................................................... 3-3 3.4 Employment and Education ............................................................... 3-5 3.5 Employment Settings ........................................................................... 3-7 v Contents (continued) Chapter Page 3.5.1 Employment Setting Trends ............................................... 3-11 3.5.2 Employment Settings and Age ........................................... 3-11 3.5.3 Employment Settings and Education ................................ 3-13 3.6 Job Titles ................................................................................................ 3-14 3.6.1 Job Titles and Employment Settings ................................. 3-15 3.6.2 Job Titles and Experience ................................................... 3-16 3.6.3 Job Titles and Education ..................................................... 3-16 3.7 Secondary Nursing Jobs ....................................................................... 3-17 3.8 Supply of Registered Nurses ............................................................... 3-19 3.8.1 Hours and Weeks Worked and Age Group ..................... 3-24 3.8.2 Hours and Weeks Worked and Highest Education ............................................................................... 3-24 3.8.3 On-Call Work ........................................................................ 3-25 3.8.4 Overtime Work ..................................................................... 3-25 3.8.5 Hours Worked and Employment Setting ......................... 3-26 3.8.6 Hours Worked and Job Title .............................................. 3-28 3.9 Employment Settings and Level of Care ........................................... 3-29 3.9.1 Education and Areas of Clinical Specialty ........................ 3-31 3.10 Composition of Nursing Work ........................................................... 3-33 3.10.1 Composition of Work and Job Title .................................. 3-34 3.10.2 Composition of Work and Education ............................... 3-34 3.11 Temporary and Travel Work ............................................................... 3-36 3.12 Crossing State Lines and Compact States ......................................... 3-37 3.13 Unionization in Principal Nursing Positions .................................... 3-37 3.14 Earnings of Registered Nurses ............................................................ 3-38 3.14.1 Earnings and Job Titles ....................................................... 3-40 3.14.2 Earnings and Employment Setting .................................... 3-41 3.14.3 Earnings From Secondary Jobs .......................................... 3-41 3.14.4 Earnings and Experience ..................................................... 3-42 3.14.5 Earnings and Education ...................................................... 3-42 3.15 Job Satisfaction ...................................................................................... 3-43 3.15.1 Job Satisfaction and Employment Setting ........................ 3-45 3.15.2 Job Satisfaction and Job Titles
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