Executive Summary

Recent data from Florida hospitals reflect a continued easing of the state's nursing shortage. However, hospitals reported difficulty in filling the more specialized nursing positions and selected shifts. These challenges will likely remain as hospitals' need for nurses grows due to greater demands for hospital services. Although hospitals have focused on their retention and recruitment efforts, the need for nurses continues to exceed the supply. The National Center for Health Workforce Analysis projects by 2020, Florida will need 61,000 more nurses than will be available. Enrollments in nursing schools will not produce enough graduates to replace the nurses that will soon retire from active practice.. Long-term solutions are necessary to ensure there are enough nurses to care for Florida's aging population.

Results from the Florida Hospital Association's (FHA) annual nurse staffing survey are:

• One-in-ten (9.9%) of the registered nursing positions in Florida hospitals were vacant in February 2003. While the data indicate some improvements, the nursing shortage is still at a critical level. Based on our sample of hospitals, we estimate there were 6,200 vacant RN positions when the survey was conducted in February 2003.

• Hospitals on the West Coast (Tampa Bay to Naples) experienced the greatest shortage with a 15.8% RN vacancy rate. The Panhandle hospitals reported the most improvement with the RN vacancy rate falling from 14.3% in 2002 to 8.3% in 2003.

• Stepdown/telemetry, adult critical care, and medical/surgical were nursing areas with the highest vacancy rates. Hospitals reported a 16% vacancy rate for stepdown/telemetry RN positions, 12.5% for adult critical care, and 12.1% for medical/surgical RNs.

• The turnover rate, i.e. percentage of nurses leaving the hospital during the year, fell dramatically to 12.4%, a 44% decline from the rate reported in 2002. This may be an indication that hospital retention strategies were having an impact. Turnover rates were highest for psychiatric and licensed practical nurses.

• One-third of the hospitals responding indicated taking longer than 90 days to fill any vacant nursing position. Adult critical care and evening/night shifts were the hardest positions to fill.

• Hospitals participating in the FHA survey incurred costs of $186.5 million during 2002 associated with filling vacant nursing positions through overtime, temporary, and part-time staff. Overtime was the most common method used to fill vacant positions, followed by per diem/in-house nursing pools, contract nurses, and temporary agencies.

• Hospitals offered a variety of financial incentives to recruit nurses including referral fees to existing employees or sign-on, relocation or start-up bonuses. Hospitals offered enhanced benefits to attract nurses including continuing education, graduate nurse training programs and scholarships.

• Sixty-two percent of the responding hospitals were recruiting foreign nurses to fill vacant positions, with most recruiting in the Philippines.

• Emergency department overcrowding was the most common impact of the nursing shortage on hospitals. One-fourth of the participating hospitals reported they had experienced increased patient complaints and ER diversions due to the nursing shortage.

State and federal legislation passed during 2002 should help fund nurse training programs and other initiatives to attract more students into the nursing profession. Hospitals are actively involved in nursing education programs, providing scholarships to students in nursing school, and enhancing the image of nursing. Local, state, and federal efforts must continue to increase the supply of nurses to meet the needs of Florida's population in the future. Despite improvements in the nurse vacancy rate in hospitals, Florida faces a long-term challenge of ensuring an adequate supply of nurses to care for an expanding and aging population.

Staff resources:
Kim Streit, VP/Health Care Research and Information, (407) 841-6230, kims@fha.org
Rich Rasmussen, VP/Strategic Communications, (850) 222-9800, Rich@fha.org.

Press Release

Nursing Survey Results