Nursing in New Jersey and the Economic Downturn

The economic downturn is creating a profound new challenge for the state, as nurses and nurse faculty temporarily postpone retirement; non-working nurses with spouses who have lost jobs return to work; and part-time nurses seek more hours.¹ While all of this creates a temporary respite, there is a danger that it will mask the severity of the looming shortage and lead some to inaccurately conclude that there is no need to take action. The facts tell another story:

• There is a seven percent vacancy rate for nurse faculty in New Jersey.² With the economic crisis worsening, institutions may choose to eliminate vacant positions, which would exacerbate the faculty shortage in the future. Nurse faculty position cuts will result in fewer students being accepted into nursing schools, including graduate programs that would educate the next generation of nurse faculty. 
• The nurse workforce is also aging. The average age of a nurse in New Jersey is 50.³ Though some report temporarily postponing retirement out of necessity in the current economic climate, fifteen percent of RNs in the state are expected to retire in the next five years.⁴ (For more information on nurse demographics in New Jersey, go to the New Jersey Nursing at a Glance: 2009 Fact Sheet.) 
• An aging population requiring treatment for chronic conditions will increase the need for nurses. In a March 2008 study, demand for RNs was projected to increase by two to three percent each year.⁵ Short term remedies employed to address the current economic crisis, such as cutting nurse faculty positions, are likely to exacerbate the nursing shortage over time. If prospective nursing students are turned away from schools because of space or faculty limitations, it does not bode well for the state's ability to meet its future health care needs. 
• The American Hospital Association reports that hospitals are either planning, or considering, large layoffs of staff including nurses, in order to weather the economic crisis.⁶ However, in an article published in CNNMoney.com on February 27, 2009, the CEOs of two of the nation's largest healthcare systems - Tenet Healthcare and HCA, Inc. – confirmed the strong need for more registered nurses even as hospitals are reducing their use of nursing staffing companies. Tenet's CEO said: "Anyone with a nursing degree in this country does not have to worry about having a job."⁷
• According to a November 2008 report from the American Hospital Association, hospitals are treating fewer patients because many people are delaying procedures or not seeking care due to a loss of insurance and the high cost of health care.⁸ Under the current economic conditions, this situation will only worsen, because nurses and other health professionals may see patients who are sicker and need more urgent care. 
• Bureau of Labor data from May 9, 2009 show that health care employment grew nationally by 17,000 in April. Job gains in health care have averaged 17,000 per month thus far in 2009, down from an average of 30,000 per month during 2008.⁹

1. Dr. Peter Buerhaus, Journal of the American Medical Association (JAMA), November 26, 2008.
2. Dickson, Geri, Situation Critical: Closing the Nurse Supply Gap in New Jersey, The New Jersey Collaborating Center for Nursing, Rutgers University, February 2009.
3. Dickson, Geri, Situation Critical: Closing the Nurse Supply Gap in New Jersey, The New Jersey Collaborating Center for Nursing, Rutgers University, February 2009.
4. Dickson, Geri, Situation Critical: Closing the Nurse Supply Gap in New Jersey, The New Jersey Collaborating Center for Nursing, Rutgers University, February 2009.
5. Dr. Peter Buerhaus et. al. The Future of the Nursing Workforce in the United States: Data, Trends and Implications. March 2008.
6. American Hospital Association, The Economic Crisis: Impact on Hospitals, November 2008
7. American Association of Colleges of Nursing, “Talking Points: Impact of the Economy on the Nursing Shortage,” March 12, 2009 http://www.aacn.nche.edu/Media/pdf/TalkingPoints.pdf
8. American Hospital Association, The Economic Crisis: Impact on Hospitals, November 2008
9. Bureau of Labor Statistics, Employment Situation Summary, May 8, 2009.