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Annual Report
Registered Nurse Survey '07
Nurse Staffing &
Patient Outcomes
Projected RN Workforce in Hawaii 2005 - 2020
Nursing Education Programs
2005 - 2006
Nursing Education & Practice
Hawaii's Health in the
Balance: A Report on the
State of the Nursing Workforce

Hawaii State Center for Nursing

2528 McCarthy Mall
Webster Hall 432
Honolulu, Hawaii 96822 - Map -

Ph: (808) 956-5211
Fax: (808) 956-3257


Projected Registered Nurse Workforce
in Hawai’i 2005 - 2020
January 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


V. Recommendations


By 2020, the Hawai’i State Center for Nursing projects a shortage of approximately 2,670 registered nurses in Hawai’i. Nationwide, the Health Resources and Services Administration (HRSA) estimates indicate there will be a shortage of more than 1 million registered nurses by 2020. 6 The broad set of complex and interwoven factors driving the shortage are impacting healthcare at a micro and macro level. These drivers include:


• An aging population that will require more RN managed/guided care 5,7-9 • An aging nursing workforce that will find it difficult to meet the physical demands of employment 10-12

• An inadequate supply pipeline of new nurses created by a lack of adequate nursing faculty to educate new nurses, fewer women choosing nursing as a career, and salary inequities 13

• A poor image of nursing as a professional career option, particularly for men 14- 17

• Difficulty retaining nurses in work environments perceived as unattractive and unsupportive 18-20


Trends indicate demand as well as supply factors contributing to the RN shortage will deepen as the baby boom generation consumes greater portions of healthcare services and the aging nursing workforce retires from the profession. A number of recommendations are presented for consideration.


1. Promote and support the integration of nurse education and practice

Nursing is a practice based profession. Programs that integrate education and practice may be the tipping point to generating new resources, improving education and addressing the myriad of quality and patient safety issues in the work environment.


2. Link educational opportunities and resources across the State of Hawai’i

A regional educational linkage integrated to the practice community offers providers greater opportunity for innovation. Simulation learning, shared information technology, a single uniform curriculum and shared faculty are some of the conceptual ideas proposed to revolutionize nursing in Hawai’i.


3. New graduate nurse residency programs

There is a growing body of evidence demonstrating that new nurses are not competent to work independently immediately after graduation. Evidence suggests new nurses that participate in residency programs after graduation transition into their professional role with less negative impact, are happier in their role, and are more likely to be retained by the facility.


4. Develop strategies that promote the retention of mature nurses

Create a system to develop and apply evidence based criteria for best practices focused on the retention of our aging nursing population. Strategies could include shortened working hours, adaptation of the work environment, and assignment to less physically demanding positions.


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