The Changing Demographics of Nursing

The face of nursing has been changing over the last 50 years. Women who a half a century ago would only work as nurses until they married are now ending up as nursing managers and administrators, moving out of the practice field. But still, it has been noted that the age of the nursing workforce has increased over the last quarter of a century, and fewer younger people are entering the nursing profession. In fact, at the time of the survey by the Bureau of Health Professions in 1997, baby boomers (those born between 1947 and 1962) were the largest component of the nursing workforce and at the current time, only nine percent of registered nurses are younger than 30 years of age (Santucci, 2004). If this trend continues, then it would mean that the need for nursing would increase by as much as 22% between the years 1998 and 2008.

The demographics of nursing are changing as to the working environment as well. While hospitals employ about 60% of all nurses, the nurses who work in hospitals are likely to be younger, mostly due to the strain of physically demanding work and the shift work involved. While the hospitals tend to produce recruiting programs more focused on younger nurses, this also means that there is the need to promote relationships between the different generations of nurses. Problems in workplaces are the most often cited issues when it comes to job turnover rates among nurses. And the flow of younger nurses toward the hospital setting also means that the number of new graduate nurses being hired into the nursing pool is getting higher. This, in turn, results in a greater number of rather inexperienced new nurses in positions that may be better filled by experienced nurses.

In order to answer this problem, residency programs have been developed for new graduate nurses, to provide orientation to the specialty areas such as critical care, medical/surgical and psychiatry.

These residency programs appear to do much to help the new nurses address the challenges they face in their new positions. Green and Puetzer (2002) clearly define in their article the issues surrounding the importance of effective recruitment, efficient training and ultimate retention of experienced nursing staff. A structured mentoring and precepting program appears to be key to all three of these issues and shows that while the schools prepare the nurses for the basics, mentoring programs are the most effective in the workplace. Without residency programs, there is a significant degree of turnover in the nursing staff, which leads to poor clinical are and burnout.

A study by Bowles and Candela in 2005 reviewed involved the experiences of recent RN graduates in their first jobs (Bowles and Candela, 2005). The study was meant to determine new graduate perceptions of first jobs and why they left them if they had. The results showed that 30% of new graduates left their positions within one year, and 57% had left their first positions within 2 years. Issues cited for leaving consisted of patient care problems, unsafe nurse to patient ratios, and stress associated with the acuity of the patients. Other significant issues (22%) noted a lack of support on the part of management, as well as a lack of guidance and a sensation of being given too much responsibility for patient care as compared to the nurse’s level of comfort and experience. This review showed that RNs in the first year of work tend to leave their first position at a much higher rate than RNs who are in second or subsequent positions. It would appear from this study that to improve RN retention one must consider the development of orientation and mentoring programs. This would improve work environments and reduce stress levels.

There is a limited availability of preceptors. This often causes nurse interns multiple preceptor assignments that cause a problem with educational continuity, follow through on assignments and progress assessments, as well as preceptor burnout.