Home
Becoming a nurse
Student Nurse/LNA Externship
Re-Entry Information
Lifetime Professional
Development
Clinical Teaching Awards
Research & Reports
Experienced Nurse Retention
Nursing Faculty Recruitment
Hospital Nursing Pilot Study 2003
WHY WAS THIS SURVEY DONE?
One factor in assuring access to quality health care for all Vermonters is an ongoing understanding of the state’s health workforce resources. To this end, the Office of Nursing Workforce Research, Planning and Development created the Health Workforce Assessment Team (HWAT)1. This team was charged to develop a new system to assess Vermont’s health care workforce, including new ways to measure the state’s need for various health care positions. The following is a report of the 2003 pilot survey of the state’s 16 hospitals. Adjustments will be made to the survey instrument based on this pilot study.
WHO WAS SURVEYED?
In February 2003, the Vermont Health Workforce Survey was sent to hospital nurse executives. This contact person was asked to participate in the data collection with assistance from human resources and other department heads. Follow-up postcards, letters, telephone calls and replacement surveys were used to assure a high response rate. The response rate was 94% (15 of 16 hospitals responded).
WHAT WAS LEARNED?
Vacancy rates2 vary according to nursing position in the hospital setting.
| Statewide Vacancy Rate | % (Range) |
| Nurse Practitioner/ Physician Assistant | 21% (0-31%) |
| Clinical Nurse Specialist | 16% (0-31%) |
| Nurse Anesthetist | 14% (0-50%) |
| Registered Nurse* | 12% (0-24%) |
| Licensed Practical Nurse | 8% (0-50%) |
| Nurse Managers | 8% (0-25%) |
| Nursing Assistant | 1% (0-34%) |
| Nurse Midwife | 0% (0%) |
| * The need for RNs (assessed by CNO) was greater than budgeted FTEs in 50% of hospitals. A need for RNs with specialized skills was identified by 80% of the hospitals. | |
Turnover rates vary according to nursing position in the home health setting.
| Statewide Turnover Rate | % (Range) |
| Licensed Nursing Assistant | 29% (0-55%) |
| Nurse Anesthetist | 17% (0-100%) |
| Licensed Practical Nurse | 16% (0-40%) |
| Registered Nurse | 13% (0-26%) |
| Nurse Practitioner/ Physician Assistant | 13% (0-100%) |
| Nurse Midwife | 9% (0-25%) |
| Nurse Manager | 9% (0-50%) |
| Clinical Nurse Specialist | 0% (0%) |
RECRUITMENT INCENTIVES:
Traveling nurses were used by 8 hospitals for a total cost of $9.4 million and they occupied 7% of the budgeted staff nurse and CRNA positions
| Most needed RN specialties and # weeks needed to fill position* | |
| 1. Critical/intensive care** | (22 weeks) |
| 2. Operating room** | (15 weeks) |
| 3. Emergency room** | (21 weeks) |
| 4. Managers/educators | (20 weeks) |
| 5. Obstetrics** | (17 weeks) |
| 6. Psychiatric | (19 weeks) |
| 7. Pediatric |
(16 weeks) |
| *Mean
weeks needed to fill position by hospitals reporting difficulty.
**More than 50% of hospitals report this position difficult to fill. |
|
| IMPACT OF SHORTAGES | Never |
Several times a year |
Monthly |
Weekly |
Daily |
Missing or n/a |
| Curtailed plans for acquiring new technology |
93% |
7% |
||||
| Reduced number of staffed beds |
33% |
33% |
7% |
7% |
20% |
|
| Emergency department overcrowding |
20% |
33% |
20% |
13% |
13% |
|
| Diverted emergency department patients |
40% |
47% |
13% |
|||
| Delayed or diverted admissions |
20% |
40% |
20% |
7% |
13% |
|
| Reduced service hours |
67% |
20% |
7% |
7% |
||
| Increased wait times to surgery |
47% |
27% |
7% |
20% |
||
| Cancelled surgeries |
53% |
27% |
20% |
|||
| Delayed hospital discharges |
47% |
7% |
13% |
13% |
20% |
|
| Shortened lengths of stay |
67% |
33% |
||||
| Mandatory staff overtime |
73% |
7% |
13% |
7% |
||
| Decreased patient satisfaction |
60% |
20% |
20% |
|||
| Increased patient complaints |
20% |
40% |
20% |
20% |
||
| Decreased staff satisfaction |
53% |
7% |
20% |
7% |
13% |
|
| Curtailed plans for facility expansion |
Yes 7% |
No 73% |
20% |
|||
| Discontinued clinical programs |
No 93% |
7% |
CONSEQUENCE OF THE AGING WORKFORCE:
Percent Fulltime by Nurse Position
As the RN workforce ages, more nurses may be cutting back their hours
per week.
Conclusions
In September 2002, the AACN reported that the annual nurse vacancy rate an U.S. hospitals is 13%, and that one in seven hospitals has an RN vacancy rate over 20%4. The range of vacancy rates at Vermont’s hospitals (0-24%) indicates that the nursing shortage is significant in some Vermont hospitals. In addition, only 57% of hospital RNs are working full time. This may decrease hospital cost for benefits, but may create more underinsured workers. High turnover rates lead to increased expenditures on recruitment, orientation, and traveling nurses to fill the gaps. Continued attention must be paid to the preparation of nurses with specialized skills. At this time, the largest impact of the nursing shortage is in the areas of staff satisfaction, patient satisfaction and complaints, diverted emergency room patients and overcrowding, and delayed or diverted admissions. Ongoing assessment of the impact of the shortage on quality of care is also necessary.
