1. Visit us at: www.FLCenterForNursing.org The State of Nursing in Florida: Today and in the Future Mary Lou Brunell, RN, MSN Executive Director 10/15/20131

2. Visit us at: www.FLCenterForNursing.org Objectives 1.Describe the current nurse workforce. 2.Identify factors affecting the demand for an adequate, qualified nurse workforce. 3.Predict the likelihood of having an adequate, qualified nurse workforce to meet future consumer demand. 4.Examine potential interventions to assure an adequate, qualified nurse workforce for today’s and tomorrow’s needs. 10/15/20132

3. Visit us at: www.FLCenterForNursing.org 10/15/20133 The Nurse Workforce – What is it?  Licensed Practical Nurses (LPN)  Registered Nurses (RN)  Advanced Practice Nurses (APN) Who are eligible for employment with a clear and active license (without disciplinary or other limitation). AND Who choose to work in the practice of nursing.

4. Visit us at: www.FLCenterForNursing.org 10/15/20134 Licensed Practical Nurses  Promotes wellness, maintenance of good health, and illness prevention  Provides direct patient care and observation, and administers medications and treatments under the direction of a registered nurse or licensed physician

5. Visit us at: www.FLCenterForNursing.org 10/15/20135 Registered Nurse  Assesses, monitors, and evaluates patient health status using knowledge of scientific principles and clinical judgment  Anticipates risks and prepared to intervene to prevent or at least minimize medical complications  Educates patients, families, and communities about health promotion and disease prevention  Coordinates care  Administers medications and treatments prescribed by an advanced practice nurse or licenses physician

6. Visit us at: www.FLCenterForNursing.org 10/15/20136 Advance Practice Nurse  Independently evaluates and manages patients under an established protocol with a licensed physician or dentist  Four APN roles 1.Advanced Registered Nurse Practitioner: Manages the care of patients with acute and chronic medical and psychiatric conditions 2.Certified Nurse Midwife: Provides well-women care and manages patient during labor and delivery 3.Certified Registered Nurse Anesthetist: selects and administers regional and general anesthetic agents and oversees patient recovery 4.Clinical Nurse Specialist: Assesses and manages health status of individuals and families – educator, coordinator, consultant

7. Visit us at: www.FLCenterForNursing.org Successful Planning  To meet consumer needs we must know the numbers Supply of Nurses Demand for Services  If Supply ≠ Demand  Shortage  Need to know for today and the future 10/15/20137

8. Visit us at: www.FLCenterForNursing.org Supply of Today vs. Supply of Tomorrow  Age of nurse population Anticipating retirements Projecting work longevity  Historical trends projected forward Anticipated turnover / loss from profession Anticipated new nurse graduates  Forecasting Models Predict supply 10/15/20138

9. Visit us at: www.FLCenterForNursing.org Florida Center for Nursing  Established in law (FS 464.0195) 2001  Purpose – to address issues related to the nursing shortage in Florida  Overseen by 16 member Board appointed through the Governor’s Office  Vision To be the definitive source for information, research, and strategies addressing the dynamic nurse workforce needs in Florida. 10/15/20139

10. Visit us at: www.FLCenterForNursing.org Nurse Workforce Information The nurse data “trifecta”: Nurse Supply Data – licensure and renewal survey data analyzed biennially (consistent with renewal cycle) Nurse Demand Data – employer surveys of 6 industries conducted and analyze biennially (odd years) Nurse Education Data – LPN / RN pre- licensure and graduate programs surveyed and analyzed annually These data elements permit forecasting 10/15/201310

11. Visit us at: www.FLCenterForNursing.org 10/15/201311 Florida Nurse Supply as of January 2012

12. Visit us at: www.FLCenterForNursing.org 10/15/201312 Age of Florida’s Working Nurses

13. Visit us at: www.FLCenterForNursing.org 10/15/201313 RN Work Status in Percent, 2010-2011

14. Visit us at: www.FLCenterForNursing.org 10/15/201314 FTE RN Vacancy Rates by Industry as of 6/30/2011

15. Visit us at: www.FLCenterForNursing.org 10/15/201315 Trend in FT Faculty Vacancy Rates, 2007-2012

16. Visit us at: www.FLCenterForNursing.org Do we know demand?  Actual survey of Florida nurse employers (2011) Current Need = 8,994 RN vacancies Future Growth = 6,746 RN positions  Population Estimates Growth / In-Migration Age (Increasing age = Increasing Demand 10/15/201316

17. Visit us at: www.FLCenterForNursing.org 10/15/201317 Trend in Number of New Graduate Nurses 2007-2012

18. Visit us at: www.FLCenterForNursing.org 10/15/201318 Florida’s Registered Nurse Forecast

19. Visit us at: www.FLCenterForNursing.org National Predictions Researchers predict a national nursing shortage of between 300,000 and 1,000,000 by 2030 Source: Jurasheck, Zhang, Ranganathan, Lin. (2012). United States Registered Nurse Workforce Report Card and Shortage Forecast. Public Health Resources. Paper 149. 10/15/201319

20. Visit us at: www.FLCenterForNursing.org Factors Effecting Supply & Demand  Low Supply Aging nurses  retirements &/or reduced work Poor work environments   turnover Barriers to education expansion  High Need Population growth Aging population   demand Expanded health care access - Increased need - Employment opportunities in new areas 10/15/201320

21. Visit us at: www.FLCenterForNursing.org Solutions: Education Capacity Issues  Faculty shortage Competitive salaries Incentives to return to school (scholarships, loan forgiveness, stipends) Academic funding challenges  Clinical Capacity Use of Simulation Nurse Internships Day/time flexibility 10/15/201321

22. Visit us at: www.FLCenterForNursing.org Solutions: Work Environment Issues  Nurse Residency Programs School to Work transition Change in practice setting - Anticipate  acute care beds - Anticipate  long-term care, hospice, and home health  Value the contribution of all nurses Decision making involvement Leadership appointments Participate in policy decisions 10/15/201322

23. Visit us at: www.FLCenterForNursing.org  New Models of Care Delivery Nurses practice to full extent of education and experience with strong support system Address increasing cost while improving safety and outcomes Accommodate the aging nurse population thus extending nurses’ work life 10/15/201323

24. Visit us at: www.FLCenterForNursing.org Solution: Increasing Diversity  Greater reflection of general population  greater ability to meet consumers needs  Gender – increase proportion of men US – 50%Nursing – 9.1%  Ethnicity/Race – improve diversity of nursing faculty to improve student diversity US – 37% minorityNurse Faculty – 12.6% 10/15/201324

25. Visit us at: www.FLCenterForNursing.org 10/15/201325 Challenges  Need political support  Need funding allocations / reimbursement  Need industry buy-in  Need support of health provider colleagues  Need consumer support  Need ACTION!!

26. QUESTIONS??