Preface -- Acknowledgments -- About the authors -- Section 1. Introduction and overview -- 1. Introduction and overview -- Focus on registered nurses -- Economic perspective -- Ominous outlook -- Overview of book -- section 1. Introduction and overview -- section 2. Factors that influence the demand for RNs -- section 3. Factors that influence the supply of RNs -- section 4. Shortages of hospital RNs, impact on quality, and RN working conditions -- section 5. Implications and recommendations -- Data on the nursing workforce -- Current population survey (CPS) -- National sample survey of registered nurses (NSSRN) -- Privately funded national surveys -- A final comment -- Appendix 1-1. Detailed information about data sources -- Current population survey -- National sample survey of registered nurses (NSSRN) -- National surveys conducted for the Johnson & Johnson campaign for nursing's future -- Resources -- References -- 2. Key trends in the healthcare industry and the nursing workforce -- Overview of the health care system and RN employment -- RN employment -- Labor force characteristics of RNs -- Participation in the workforce, hours worked, and key demographic characteristics -- Earnings of registered nurses -- Educational preparation -- Comparing key trends between RNs and other professions -- Chapter summary -- References -- 3. A brief primer on demand and supply -- The demand for labor -- The supply of labor -- Equilibrium in a competitive labor market -- Equilibrium when multiple markets compete for the same type of labor -- Labor market shortage as disequilibrium -- Chapter summary -- Section 2. Factors that influence the demand for RNs -- 4. The demand for health care and the derived demand for registered nurses -- Society's demand for health care -- Changes in the health, size, and age composition of the population -- Sociocultural characteristics -- Economic factors -- Changes in the organization of the health care system -- Technology -- Healthcare organizations' demand for registered nurses -- Factors that determine organizations' demand for RNs -- Projections of the future demand for nurses -- BLS projections to 2014 -- HRSA's projections through 2020 -- Chapter summary -- References -- 5. Managed care and the nurse labor market -- Overview of managed care -- The impact of managed care on the demand for registered nurses -- Identifying states that are early adopters of managed care -- Trends in the employment and earnings of nurses in early adopter and laggard states -- Trends in the employment of RNs by sector in early adopter and laggard states -- Chapter summary -- References -- Section 3. Factors that influence the supply of RNs -- 6. The short-run supply of registered nurses -- Economic and noneconomic factors that determine the short-run supply of RNs -- Economic factors impacting RNs' decisions to participate in the nurse labor market and number of hours worked -- Impact of noneconomic factors on the short-run labor supply of RNs -- Changes in hospital RN employment associated with RN wages and nonwage income -- RN employment changes in "bust" versus "boom" years -- Recent changes in RN employment -- Changing composition of the RN workforce in the United States -- Increasing proportion of foreign-born RNs -- An aging RN workforce -- Chapter summary -- References -- 7. The long-run supply of registered nurses -- Overview of trends in nursing education -- Factors that determine the long-run supply of RNs -- Changes in the population -- Changes in societal preferences for a career in nursing (the cohort effect) -- Influence of RN's age (age effects) -- Alternative sources of RNs -- Economic factors and the decision to become an RN -- Number and capacity of nursing education programs -- Previous projections of the long-run supply of RNs : 2000 to 2020 -- Overview of authors' 2000 projection model and estimates of the long-run supply of RNs through 2020 -- Overview of HRSA's 2002 projection model and estimates of the long-run supply of RNs through 2020 -- Chapter summary -- Appendix 7-1. The influence of economic factors in determining the choice of nursing education programs and expanding the RN workforce -- References -- 8. Changing preferences for a career in nursing -- Data on career choices of young people -- Declining interest in nursing -- Explanations for the decline in interest in nursing -- What is behind the recent rise in interest in nursing? -- Chapter summary -- References -- 9. Associate degree graduates and the rapidly aging registered nurse workforce -- Rise in associate degree graduates -- Explaining the increase in the percentage of associate degree RN graduates -- Changing patterns of ages of graduates -- Cohort effects as an explanation for patterns and trends observed for associate degree graduates -- Older age of new graduates -- Chapter summary -- References -- 10. Forecast of the supply and age of registered nurses through 2025 -- Overview of forecasting model and key results -- Components of our forecast model -- Cohort, population, and age effects -- Prior workforce supply model and forecasts -- Updating our forecast -- Age and supply forecasts through 2025 -- Implications of the resurgence of the 1970s cohorts -- Chapter summary -- Appendix 10-1. How the projection model was estimated -- Estimating the model -- Forecasting using the model -- Incorporating recent changes in age effects -- References -- Section 4. Shortages of hospital RNs, impact on quality, and RN working conditions -- 11. Shortages of registered nurses : then and now -- Defining, explaining, and measuring hospital shortages of RNs -- Economic definition of a hospital RN shortage (and surplus) -- Measuring hospital RN shortages -- The development of hospital RN shortages in the United States -- Inflexible RN wages and hospital RN shortages in the 1960s and 1970s -- Demand-driven RN shortages in the 1980s -- The RN labor market in the 1990s : another shock in demand -- Deterioration in hospital RN working conditions -- Influence of a changing age composition of the RN workforce in the development of the current shortage of RNs -- Aging RN workforce -- RN shortages in intensive care units and operating rooms -- Changes in RN wages and reported hospital vacancy rates : 2002 to 2006 -- Chapter summary -- Appendix 11-1. Why hospitals are often slow to increase RN wages when experiencing a shortage of RNs -- Hospitals might not realize a shortage exists -- Hospitals do not know how much to raise wages -- Fear that raising wages might actually decrease employment -- Less costly alternatives -- Collusion among hospitals -- References -- 12. Impact of the current shortage of hospital registered nurses -- Overview of the quality and safety improvement environment -- Development of a national movement to improve quality and safety -- Patient outcomes associated with hospital nurse staffing -- Complexity of studies of hospital nurse staffing and patient outcomes -- Summary of results of hospital nurse staffing studies and patient outcomes -- Impact of the current shortage of hospital RNs : perceptions of physicians, RNs, and hospital executives -- Surveys of RNs, physicians, hospital CEOs, and hospital CNOs -- Survey findings -- Chapter summary -- References -- 13. Registered nurses' perceptions of the hospital workplace environment, 2002 to 2006 -- Overview of national RN surveys -- Survey themes and data -- Characteristics of RN samples -- Survey results -- Prevalence, severity, and impact of the current hospital RN shortage -- Causes of the nursing shortage and RNs' views of how to solve the shortage -- Characteristics of the hospital work environment -- Job and career satisfaction -- Likelihood of advising a career in nursing -- Chapter summary -- References -- Section 5. Implications and recommendations -- 14. Long-term implications of an aging RN workforce -- The aging RN workforce and its impact on the future supply of RNs -- The growing demand for health care and its impact on the future demand for RNs -- The unprecedented shortage of RNs that is on the horizon -- Implications for hospitals and other employers of RNs -- Implications for quality, safety, and access to care -- Implications for RNs themselves -- Implications for nursing education programs -- Chapter summary -- References -- 15. Strategies to ensure a better future for the RN workforce -- Transition policy strategies -- Transition demand side strategies -- Transition supply side strategies -- Transition policies involving RN wages -- Long-run policies -- Reducing barriers to enter the nursing profession in the United States -- Nursing as an undervalued social benefit -- Chapter summary -- References -- Index.
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