Projected Registered Nurse Workforce
in Hawai’i 2005 - 2020January 2007 (download pdf file)

Summary & Introduction | I. Nursing Supply Model | II. Nursing Demand Model

III. Projecting RN Shortage | IV. Limitations | V. Recommendations

VI. Conclusions | VII. References

III. Projecting RN Shortage using the NSM and NDM

The NSM and NDM models, as identified previously were developed independent of each other. However, the variables FTE RN supply and FTE RN demand generated from the models allows for creation of a new dataset to project estimates of FTE RN shortage.

A. The Projection of Hawai’i FTE RN Shortage

i. Previous Projections of FTE RN Shortage

A number of forecast projections have been carried out at the national level using the state level data captured from the 1996 and 2000 National Sample Surveys of Registered Nurses (NSSRN). However, as highlighted by the developers of the models, the smaller populated states are highly likely to display error in estimates due to small sample sizes.

After the release of the report ‘Projected Supply, Demand and Shortages of Registered Nurses: 2000-2020’ in July of 2002. Hawai’i State representatives reported concerns with the accuracy of the projections. After discussions, the estimates for growth in Hawai’i supply were revised downward after adjustments for migration and initial graduates. ⁴ However, RN demand was left unchanged from previous projections. These projections were also reported in the “Hawai’i Health in the Balance: A Report on the State of the Nursing Workforce”. ⁵

The 2004 data reflect baseline FTE RN supply and demand projections. Both the NSM and NDM models, in this scenario, use NSSRN to estimate the number of RNs employed in the base year. The NSM uses the 2000 NSSRN to estimate supply of RNs by age, education level, and state. While the NDM uses the 1996 NSSRN to estimate FTE RNs by setting and state. Both baseline projections use the U.S. Census Bureau population data which constitutes a key determinant of projected demand for FTE RNs in the baseline scenario. These estimates reveal the greatest FTE RN shortage over time. ⁶

The current 2006 estimates use 2004-05 survey data of new RN graduates from statewide nursing programs and estimates of licensed nurses in the state (1996- 2006). In addition to CDC projections that reflect a smaller growth in Hawai’i’s population. The data continues to demonstrate that nursing supply will grow slowly. However nursing demand is less than previously projected.

Figure 3.1 demonstrate variation and range in the projected shortages of FTE RNs in 2003, 2004 and 2006.

Figure 3.1 Comparison in Hawai’i’s Projected Shortage of FTE Registered Nurses in 2003, 2004 & 2006

Table 3.1 highlights there is little difference between the three FTE RN supply projections. However, there are marked differences between the demand projections. For the current RN demand estimates adjusted for reduced population growth, reduced proportion of women aged 20-44, and the actual numbers of new RN graduates indicate the employer demand for RNs will also be smaller than previously forecasted. The current supply and demand estimates continue to indicate that there will be a growing shortage of registered nurses over the next fifteen years (Figure 3.1).

Table 3.1 Comparisons of Nursing Estimates 2003, 2004 & 2006

Figure 3.2 illustrates that the increase in nursing supply will be small while the demand for RNs will continue to increase. One of the prominent factors in the widening gap between supply and demand of Hawai’i’s RNs over the next fifteen years will be the increase in retirement by nurses over 50 years of age.

Figure 3.2 Projected FTE Supply and Demand 2006 to 2020

B. Estimates of Registered Nurses Supply and Demand

Utilizing data generated from the NSM and NDM it was possible to project estimates of FTE RN shortage from 2006 to 2020. Figure 3.3 shows that in 2006, Hawai’i experienced a shortage of 960 RNs, which is estimated to grow to approximately 2,220 by 2016 and to 2,670 RNs by 2020.

Figure 3.3 Projected Hawai’i FTE RN Shortages, 2006 to 2020

C. Projected FTE Registered Nurses Supply, Demand and Shortages

Between 2006 and 2020, demand for RNs in Hawai’i is expected to grow by 28%, while supply of RNs is expected to grow by 8.9%. In relative terms, the shortfall in demand will increase from about 11 percent to 24 percent as shown in Table 3.2.

Table 3.2 Projected Hawai’i FTE RN Supply, Demand, and Shortages