Archive ScienceWatch



David I. Auerbach talks with and answers a few questions about this month's New Hot Paper in the field of Social Sciences, general.
Auerbach Article Title: Better late than never: Workforce supply implications of later entry into nursing
Authors: Auerbach, DI;Buerhaus, PI;Stalger, DO
Volume: 26
Issue: 1
Page: 178-185
Year: JAN-FEB 2007
* Congress Budget Off, Hlth & Human Resources Div, Washington, DC USA.
* Congress Budget Off, Hlth & Human Resources Div, Washington, DC USA.
(addresses have been truncated)

 Why do you think your paper is highly cited?

The fate of health care provision in the US (especially hospital care) rests heavily on the shoulders of the more than 2.5 million registered nurses. When we don't have enough nurses, quality of care suffers—and since health care is far from a typical "market" in the economic sense, we don't expect imbalances of supply and demand to quickly work themselves out via the invisible hand.

Impending shortages such as those predicted by our forecast models are cause for concern among patients, policymakers, and nurses themselves. Because nursing is such a large profession, primarily employing women, there is also a great deal of general interest in nursing issues from a labor market and general economy point of view—almost everyone either knows a nurse, is a nurse, or has had contact with one recently.

 Does it describe a new discovery, methodology, or synthesis of knowledge?

Our paper discusses emerging trends not yet described—we use the most recent data in a novel way, combined with a novel forecast model. The most interesting trend discussed is the emergence of a new group of people entering the nursing profession—women in their mid to late 20s who may have started out in other careers and who have switched to nursing as a stable career with secure employment prospects. This trend may also be linked to a decline in manufacturing jobs or to the economic prospects of many of their current or potential spouses.

 Would you summarize the significance of your paper in layman's terms?

This paper is significant because it captures the trend discussed above in a forecast model. We document this trend for the first time—that people are much less likely to enter the nursing profession directly from high school than in the past, but many are turning to nursing as a second career. While this trend does not appear strong enough yet to reverse large pending shortages as baby-boomer nurses retire in the next decade (reported in our earlier work), it is something to watch carefully.

 How did you become involved in this research, and were there any problems along the way?

I became involved in this work in 1997 as a Ph.D. student as a result of a single idea combined with a single data innovation (both from the mind of Professor Douglas Staiger of the Dartmouth College Department of Economics and one of my two co-authors; the other is Peter Buerhaus, Director of the Center for Interdisciplinary Health Workforce Studies at Vanderbilt University). The idea was to use the annual Current Population Survey (CPS) to track labor market trends of nurses. This had not been tried before, as only specialized, infrequent nurse surveys had been used for this purpose.

We found the CPS to have a large enough sample of nurses (some 3,000 per year since the 1970s) to allow for the application of a common labor economics model describing a workforce in terms of cohort, age, and period effects to the nurse labor market. The model forecast the future workforce much more accurately than other leading models.

 Where do you see your research leading in the future?

We have recently published a book The Future of the Nursing Workforce in the United States: Data, trends, and implications, with Jones and Bartlett publishers. We hope to reach a large audience with this book which describes the current workforce and trends that have led to what we observe today and where we think things are going in the future. Importantly, the book ends with two chapters discussing strategies and recommendations for how to best accommodate and even to reverse future projected shortages. With no action, these shortages could significantly hamper the quality of health care in the US.

 Do you foresee any social or political implications for your research?

As noted above, we hope to reach a wide audience, including policymakers and decision-makers with our research which projects a dire future if we do not begin to make adjustments today. One of these adjustments, for example, that would help lessen future shortages would be to try to remove barriers for entry into the nursing profession that apparently exist for both men in general and also particularly for members of the Hispanic population, who are underrepresented across nursing programs at all levels and whose ranks remain disproportionately small compared to the growth in the Hispanic population.

David Auerbach
Principal Analyst
Health & Human Resources Division
Congressional Budget Office
Washington, DC, USA

NOTE: The views expressed in this article are those of the author and should not be interpreted as those of the Congressional Budget Office.


Keywords: nursing, health care provision, nursing profession, baby-boomer nurses, retire, labor market trends, current population survey, cps, health care in the us.

2008 : May 2008 - New Hot Papers : David I. Auerbach