Sep 16, 2010

The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses

The Size of the RN Population

There were an estimated 3,063,162 licensed registered nurses living in the United States, as of March 2008. This is an increase of 5.3 percent from March 2004, representing a net growth of 153,806 RNs. An estimated 444,668 RNs received their first U.S. license from 2004 through 2008, and thus approximately 291,000 RNs allowed their U.S. licenses to lapse, possibly indicating that the substantial retirements that have been anticipated may have begun.

Initial Education of Registered Nurses

The most commonly reported initial nursing education of RNs in the United States is the Associate Degree in Nursing (ADN), representing 45.4 percent of nurses. Bachelor’s or graduate degrees were received by 34.2 percent of RNs, and 20.4 percent received their initial education in hospital-based diploma programs. The average age of RNs who graduated from their initial nursing education program is rising. More than 21 percent of RNs earned an academic degree prior to their initial nursing degree. Nearly two-thirds of RNs reported working in a health occupation prior to their initial nursing education.

Highest Education Preparation of Registered Nurses

After initial licensure, RNs can obtain additional academic degrees in nursing or nursing-related fields. In 2008, half of the RN population had a bachelor’s or higher degree in nursing or a nursing-related field, while the other half’s highest education level was a diploma or an ADN.

Employment of Registered Nurses

In 2008, an estimated 2,596,399 RNs were employed in nursing, representing 84.8 percent of licensed RNs. This was the highest rate of nursing employment since the NSSRN commenced in 1977. There also has been the first increase in full-time employment since 1996, rising from 58.4 percent of RNs in 2004 to 63.2 percent in 2008. Among nurses under 50 years old, 90 percent or more are employed in nursing positions; this percentage drops to less than half of RNs over age 65.

Hospitals remain the most common employment setting for RNs in the United States, increasing from 57.4 percent in 2004 to 62.2 percent of employed RNs in 2008. The increase in this percentage is the first increase since 1984. While nearly 90 percent of RNs under 25 years old work in hospitals, less than 53 percent of RNs age 55 and older work in hospitals.

Fewer than half of nurses with master’s degrees work in hospitals; more than 18 percent are in ambulatory care settings and nearly 12 percent are in academic education.

The most common job title of RNs in the United States is “staff nurse,” or its equivalent (66.3 percent). Between 2004 and 2008, the proportion of staff RNs increased by 2.2 percent. Just under 20 percent of RNs with graduate degrees are staff RNs, compared with 72.8 percent of those without a graduate degree. The next most common job title in 2008 included management and administration titles (12.5 percent).

Many registered nurses hold more than one job in nursing. Overall, about 12 percent of RNs who have a full-time primary nursing position and 14 percent of those with part-time primary positions have additional nursing positions.

More than half of RNs work at least 40 hours per week in their principal nursing position, and another 24.2 percent work 32 to 39 hours per week. A total of 19.1 percent of RNs report that they worked on-call or could have been called to work (on “standby”) during a typical work week in their principal nursing positions. Among RNs employed in nursing positions, 27.5 percent report that they worked overtime averaging 7.5 hours per week and received pay for such work.

Earnings and Satisfaction of Registered Nurses

Average annual earnings for RNs employed full-time in 2008 were $66,973, rising 15.9 percent since the 2004 average of $57,785. When annual earnings are adjusted for inflation to 1980 dollars, earnings in 2008 increased only 1.7 percent from average inflation-adjusted 2004 earnings. The highest earnings were reported by nurse anesthetists (NAs), who averaged $135,776 per year. Staff nurses earned $61,706 per year, on average. Registered nurses with graduate degrees earned an average of at least $20,000 more than did RNs with other levels of education.

In 2008, 29.3 percent of RNs reported that they were extremely satisfied and a further 51.8 percent reported being moderately satisfied with their principal nursing position. This compares with 2004 rates of satisfaction of 27.5 percent and 50.5 percent, respectively.

Only 11.1 percent were dissatisfied in 2008, as compared with 13.8 percent in 2004. The highest rates of being moderately or extremely satisfied were reported by registered nurses working in academic education programs (86.6 percent), while the lowest rate of being either moderately or extremely satisfied was reported by nurses in nursing homes/extended care (74.5 percent).

Job Changes and Future Employment Plans

Nearly 80 percent of RNs were employed in nursing in both 2007 and 2008, while 12.3 percent were not employed in nursing in either year. Nearly 3 percent were employed in nursing in 2007, but not in 2008, and conversely, 2.4 percent returned to employment in 2008. Of those who were employed in 2007 but not in 2008, 27.3 percent (24,430) reported that they stopped working due to retirement. Among nurses who worked full-time in 2007, 11.6 percent changed to a different employer by 2008. Another 6.5 percent of these RNs worked with the same employer, but held a different position. More than 73 percent of RNs reported that they changed positions or employers due at least in part to workplace issues, such as lack of good management or inadequate staffing. Personal career reasons, such as interest in another position or improved pay or benefits, were a factor in job changes for 37.5 percent of nurses. Nearly 30 percent of nurses changed jobs at least in part due to personal family reasons.

The percentage of employed RNs who intended to leave nursing within 3 years is quite small, at 3 percent or fewer, among nurses under 55 years old. Among RNs 55 and older who worked in nursing in 2008, 12.5 percent intended to leave the nursing profession within 3 years and another 8.9 percent intended to leave their current nursing jobs and were unsure if they will remain in nursing afterward.