Magazine article Nursing Economics

The Impact of Economic Recession on Registered Nurse Workforce Supply in California

Magazine article Nursing Economics

The Impact of Economic Recession on Registered Nurse Workforce Supply in California

Article excerpt

Asevere economic recession, from December 2007 to December 2010, considerably reduced employment in most sectors in the United States (Wood, 2011), as presented in Figure 1 (U.S. Bureau of Labor Statistics [BLS], 2008a, 2010a, 2013a). This figure shows employment in the 15 largest occupations in the United States declined 4.6%, on average, between 2008 and 2010 (during the recession), but increased an average of 3.3% between 2010 and 2012 as the economy started to recover. One major exception to this pattern was registered nurses (RNs), for whom employment increased by 4.4% between 2008 and 2010, but declined by 0.8% between 2010 and 2012. Similar discrepancies in employment trends between RNs and other occupations were also observed in California. As presented in Figure 2, the number of employed RNs decreased only 0.2% during the recession period, while the employment in the 15 largest occupations decreased 5.2% on average. When the economy recovered after 2010, employment of California RNs increased by 4.1%, which was lower than the average increase of 5.3% among the 15 largest occupations (BLS, 2008b, 2010b, 2013b). During this recession period, the RN workforce shortage was mitigated, at least in the short-term (Buerhaus, 2009).

Research identified various noneconomic as well as economic predictors of RN workforce supply. Factors associated with higher RN supply include younger age, better working conditions, lower demand for RNs' time for childrearing (Brewer et al., 2006) and high job satisfaction (Buerhaus, Staiger, & Auerbach, 2009; Sochalski, 2002). Household income has a negative association with RN supply (Antonazzo, Scott, Skatun, & Elliott, 2003), particularly during an economic recession (Buerhaus, 2009; Buerhaus, Auerbach, & Staiger, 2007; Buerhaus Staiger et al., 2009); this association may differ by age or marital status (Antonazzo et al., 2003). In most studies, RNs' hourly wage level has little or no effect on the RN work supply (Antonazzo et al., 2003; Chiha & Link, 2003; Tellez, Spetz, Seago, Harrington, & Kitchener, 2009).

Prior research documented an increase in RN supply during the most recent recession in the United States. It was estimated the number of full-time equivalent employed RNs increased by 386,000 between 2005 and 2010, and more than one-third of this increase could be attributed to the increase in unemployment rates among other occupations during the recession (Buerhaus, Auerbach, & Staiger, 2009; Staiger, Auerbach, & Buerhaus, 2012). Tellez, Neronde, and Wong (2013) conducted a descriptive analysis of California data from 2006 through 2010 finding RN employment levels remained high throughout this period, and that RN earnings increased. However, to the best of our knowledge, no study has examined the impact of the recession on the factors that predict short-run RN workforce supply. This gap in the literature could be partly due to the lack of nationally representative data. The National Sample Survey of Registered Nurses (NSSRN), the most widely used nationally representative data set, was suspended after 2008.

This study uses data from the biennial Survey of Registered Nurses conducted by the California Board of Registered Nursing (CA-BRN) (Spetz, Keane, Chu, & Blash, 2013; Spetz, Keane, & Herrera, 2011; Tellez et al., 2009) to examine whether there were changes in the predictors of RN employment over the course of the most recent recession. Using data from 2008, 2010, and 2012, four hypotheses were tested: (a) Older RNs became more likely to work in 2010 (the most severe recession time) than in 2008, compared to younger RNs; (b) RNs' employment decisions were less sensitive to the hourly wage in 2010 than in 2008; (c) RNs' employment decisions became less sensitive to non-nursing household income in 2010 than in 2008; and (d) these patterns reversed between 2010 and 2012.


Datasets. Data were analyzed from the 2008, 2010, and 2012 CA-BRN surveys, which are designed to describe licensed RNs in California. …

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