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The traditional means of nurse recruitment are simply not effective in today's environment. In fact, these factors are expected to increase demand for nurses by as much 23 percent by the year 2006:
- 80 million baby boomers approaching high health care utilization years;
- Increasing life expectancy;
- Growth in the 65+ population cohort increasing to 40 million by 2010;
- Greater nursing specialization.
On the supply side as many as 50 percent (2.1 million) of all nurses will be retired by the year 2006 while the pipeline of replacements is expected to be much less than needed. Factors affecting the supply slide include:
- Fewer nursing applicants, down 21 percent from 1996 to 1998;
- Managed Care has affected case mix—shifting more to outpatient settings and concentrating severity of case mix in acute care hospitals, translating to more demanding and riskier environments;
- High average nurses' age (44), and as the average age increases, many are taking earlier retirement;
- Agency pay nurse differentials are strangling hospitals' bottom lines, costing as much as 2x full time staff.
In the meantime, HR Departments are under siege and taxed to keep up:
- Spending has increased dramatically, but . . .
- Returns have decreased via traditional recruitment means.
Further exacerbating the situation, hospitals are losing nurses out the back door with nurse defections up to 20-30 percent in many hospitals:
- Capital is being frozen in many hospitals because of the managed care effect—tightening the bottom line;
- The nursing work environment is being threatened with nurse/patient ratios being stretched, and general facility upkeep in decline;
- Resulting in more and more nurses looking for a way out.
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