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Health Affairs: Millennials almost twice as likely to be registered nurses

One factor may be millennials' coming of age at a time of economic uncertainty and earnings instability.

Jeff Lagasse, Associate Editor

Baby Boomers represented the largest segment of the registered nurse workforce from 1981 to 2012, and with many of them now retiring, the profession may seem ripe for a shortage. But that's where millennials are coming to the rescue. According to new research published in Health Affairs, millennials are entering the nurse workforce at nearly double the rate that boomers once were.

That means the RN workforce will continue to grow, although the spate of boomer retirements will indeed have an impact: It is projected to slow the rate of growth in the field to 1.3 percent per year from 2015 to 2030.

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Changes in the size and age composition of the RN workforce can be attributed a number of different factors, such as demand and various economic phenomena, such as the Great Recession. The largest factor, though, is a cohort effect -- the combination of socioeconomic conditions and trends in healthcare present when people consider nursing careers, usually in their twenties. That appears to be the case with this latest trend.

It was certainly the case when boomers flocked to nursing en masse. The study showed that women born shortly after World War II entered nursing in record numbers, partly because other professions were somewhat closed to them. So the RNs who were part of the baby boomer generation dominated the field by 1981.

It's not yet entirely clear why millennials have expressed such strong interest in nursing, but this trend, combined with the delay in boomer retirement wrought by the Great Recession, seems to have avoided the nursing shortfall that had been projected.

The numbers are significant. By the time the first members of the MIllennial generation reached age 33, there were 760,000 mIllennial full-time equivalent RNs, compared to 400,000 in generation X at the equivalent point in time. One factor, according to the research, may be mIllennials' coming of age at a time of economic uncertainty and earnings instability. Another may be the generation's general tendency to be drawn to meaningful work, with opportunities to learn and grow.

Among the findings are that those born in the late 1980s were 65 percent more likely to become an RN compared to those born in 1955. Overall, an average Millennial has been 186 percent more likely to become an RN than an average Baby Boomer. The number of younger RNs dipped to a low of 440,000 in 2000 before nearly doubling to 834,000 in 2015, although data from the past few years indicates this swelling has plateaued -- hence boomers' retirement factoring into the slow rate of overall growth projected over the next several years.

Overall, the researchers expect the nurse workforce to grow 36 percent to just over 4 million RNs between 2015 and 2030 (a 1.3 percent growth rate), although the Health Resources and Services Administration estimated that demand would increase about 1.5 percent between 2012 and 2025, slightly above the study's estimates.

If interest in nursing wanes among younger members of the later-Millennial generation or the following generation, researchers predict the field will once again be characterized by a "pig in the python" work cycle, with the bulk of the workforce marching toward retirement at the same time; this was seen with the Baby Boomers, and the upsurge in Millennial interest is seen as the main factor counteracting this trend's propensity to create a shortage.

These workforce patterns, the authors said, are happening in a dynamic healthcare environment. Whether the projected number of RNs will be adequate to meet demands will depend on several factors, including changing patterns of care that have led to reductions in inpatient utilization in many organizations.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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