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Nursing_Shortage_2011.pdf

March 2011 The Florida Nursing Shortage 1

The economic recession has temporarily

resolved the nursing shortage in Florida.

Presently, the supply and demand of nurses

(both RNs and LPNs) is close to

equilibrium, resulting in a tight labor market

particularly for new graduates. As a result of

the recession, hospitals have laid-off

employees and delayed hiring new

employees, employee turnover has

decreased, nurses working part-time have

increased their hours at work, while others

have delayed their retirement plans or

returned to work to support their families.

As the economy slowly improves, we can

expect these economic drivers will shift:

some employees will reduce their hours at

work, others will resume their retirement

plans and leave the workforce, and the aging

population will need more healthcare – all of

which will lead to gradual increased hiring

of more nurses.

Florida’s nurse workforce status and the

predicted future nursing shortage is affected

by a confluence of demographic effects: an

aging population requiring more health care,

simultaneous retirements of large numbers

of Baby Boomers in the nurse workforce,

and projected state population increases.

Factors that will increase the number of

people seeking access to healthcare include:

1) increased focus on primary prevention of

chronic diseases and utilization of

preventive screening procedures, 2) demand

for elective surgeries will resume as the

recession ends, and 3) the uninsured will

gain access to healthcare as a component of

healthcare reform. As the health industry

moves from the traditional illness model to

an emphasis on health promotion and

primary care, an increase in nurse

practitioners will be needed. Thus,

implementation of healthcare reform will

also play a key role in nurse employment.

The Florida Center for Nursing (Center)

predicts demand for nurses will increase

sharply beginning in 2014, coinciding with

full implementation of healthcare reform.

Complicating these demographic and

market-related shifts are limitations in the

ability to expand nursing education

programs and problems retaining nurses in

the Florida nurse workforce. As a

consequence, the Center’s forecasts of nurse

supply and demand predicted that by 2025

there will be a shortage of more than 50,000

RN full-time equivalents (FTEs) and more

than 12,500 LPN FTEs. 1 (The Center does

not calculate forecasts for ARNPs because

the forecast models used are not designed

for this purpose and the Center’s surveys of

nurse employers focus on industries which

employ mainly RNs and LPNs. However,

the Center does have supply, demand, and

education data for ARNPs.)

This paper reviews the most current data

available on various elements of the nurse

workforce in Florida, including nurse supply

and demand, nursing education capacity,

and nurse retention and turnover. The

information presented here comes from

original research conducted by the Florida

Center for Nursing and is available on our

website. The following points summarize

the highlights of our recent work:

Although there are over 187,000 RNs in Florida’s potential nurse workforce (an

active license, Florida address, no

disciplinary restrictions) the Center

estimates that approximately 160,303

(85.5%) are actually working in nursing

in Florida. Among the potential LPN

The Florida Nursing Shortage

March 2011

March 2011 The Florida Nursing Shortage 2

workforce, an estimated 83.3 percent are

working as LPNs in Florida.

About 80 percent of RNs were working more than 36 hours per week in 2009, a

figure that is higher than national

estimates of full-time RN employment in

2008 and is likely due to the recent

economic downturn.

The most common employment settings for RNs were hospitals (63.8%), home

health care (7.9%), ambulatory care

facilities (4.9%), and long term care

facilities (4.6%).

Florida’s nurse supply is becoming more diverse in terms of gender and

race/ethnicity. The average age of nurses

is increasing; the average age of RNs in

January 2010 was 48.6 years.

Nearly 6,800 RN positions (full- and part-time) and 1,400 LPN positions were

vacant as of June 30, 2009. The majority

of RN vacancies were in hospitals, while

the majority of LPN vacancies were in

skilled nursing facilities.

If vacant nurse FTEs (as of 2009) were filled, the state and local tax earnings on

these salaries would be approximately

$30 million.

When surveyed by the Center in June 2009, many nurse employers expected

considerable growth in RN and LPN

employment over the next two years,

mostly in home health and hospitals.

Demand for nurses has changed in the past two years relative to the economy.

The Center predicts that demand for nurses will soar to over 50,000 RN FTEs

and over 12,500 LPN FTEs in 2025 as a

result of retiring nurses, an aging

population needing more care, and

healthcare reform implementation. These

predicted RN vacancies in 2025 translate

into an estimated $226 million in state

and local tax revenues were the positions

filled.

Nursing education programs in Florida denied admission to over 20,000

qualified applicants in Academic Year

2009-2010 – over 50 percent of the

qualified applicants to LPN, RN

associate’s degree, and RN

baccalaureate degree programs were

turned away.

The most consistently cited barriers to program expansion are limited clinical

sites, lack of funds to hire faculty, lack

of qualified applicants for faculty

positions, and lack of campus resources.

From academic year (AY) 2008-2009 to AY 2009-2010, the number of pre-

licensure graduates from ADN and BSN

programs increased by 1.1% and 7.8%

respectively. LPN programs reported a 6

percent decrease in graduates.

Solutions to the nursing shortage, while often viewed as costs, may also have

economic benefits for the state. The

salaries earned by nurses filling

currently vacant positions would

contribute to the gross state product and

state and local tax revenues. Reducing

nurse turnover also reduces costs to

employers.

Most importantly, solutions to the shortage will assure Floridians access to

an adequate, qualified, nurse workforce

to meet their health needs.

Nurse Supply

Florida’s potential nurse workforce is

comprised of those nurses who are eligible

to work as nurses in this state by virtue of

having an active license, no disciplinary

restrictions, and a Florida address. Not all

nurses in the potential nurse workforce are

actually working as a nurse. The Center

recently completed a survey of over 90

percent of all licensed nurses in Florida who

renewed their licenses in 2008 and

March 2011 The Florida Nursing Shortage 3

2009. Our Nurse Workforce Survey found

that of the potential nurse workforce, 85

percent of RNs, 90 percent of ARNPs, and

83.3 percent of LPNs were employed in the

field of nursing in Florida. 2,3

The estimated

number of working RNs is 160,303.

However, since some nurses work part-time,

the estimated number of full-time equivalent

(FTE) RNs is lower still at 143,538 (Figure

1).

About 80 percent of RNs, ARNPs, and

LPNs in Florida were working full-time (36

or more hours per week), and an estimated

849 RNs were employed in nursing for

every 100,000 Floridians. 2

Similarly, the

2008 National Sample Survey of Registered

Nurses found an estimated 74.6% of RNs

were working full-time and there were 854

employed RNs per 100,000 people

nationwide. 4 Younger nurses tend to work

more hours: the average FTE is between 0.9

and 0.94 for RNs age 21-40, but drops to 0.8

for RNs above age 60. The differences in

full-time employment estimates of state and

national data may reflect both the economic

recession (which has worsened since the

national survey was conducted) causing

nurses to increase their hours worked and

other nurses to return to work, as well as the

unique nursing needs of Florida’s

population. Future Center surveys of the RN

population in Florida will allow tracking of

these data over time so that we can examine

fluctuations in nurses’ employment

congruent with population shifts and

economic changes.

Increases in Florida’s nurse workforce hide

much volatility over the past two years. The

net number of nurses in Florida has

increased by almost 16,000 from 2008 to

2010 (Table 1). 2,3

However, during this

same time-frame, a total of 24,437 nurses

left the workforce in Florida. This workforce

volatility is seen at all levels of nurse

preparation – LPNs, RNs, and ARNPs. The

most common reasons for the losses were

failure to renew a license, no longer

living/working in Florida, license upgrades

(LPN to RN; RN to ARNP), or license is

null and void.

Figure 1. Florida’s Nurse Supply and Employment Status

238,936

187,093

160,303 143,538

68,472 57,861

48,185 42,747

15,451 12,656 11,335 10,123

0

50,000

100,000

150,000

200,000

250,000

All Licensees Potentia l

Workforce

Estima ted #

Working

Estima ted FTEs

RNs LPNs ARNPs

March 2011 The Florida Nursing Shortage 4

Table 1. Components of Net Change in the Potential Nurse Workforce, 2008-2010

RNs ARNPs LPNs Total

Total Gains to Potential Workforce 27,668 2,223 10,530 40,421

Total Losses from Potential Workforce 16,172 650 7,615 24,437

Net Change in the Potential Workforce 11,512 1,562 2,919 15,993

Nurses employment settings vary by level of

preparation. The most common employment

setting for RNs were hospitals (63.8%),

followed by home health care (7.9%) and

ambulatory care facilities (4.9%) according

to the Center’s 2009 Nurse Workforce

Survey. 2 By contrast, slightly over one-third

(37.9%) of ARNPs work in hospitals, one-

quarter (26.4%) in physician or other health

care provider offices, and 10 percent work in

ambulatory care. LPN employment shows a

different pattern, as they are employed

primarily in long term care (36.5%), home

health care (15.1%), and hospitals (14.8%). 3

Over 56 percent of Florida’s RNs have a

diploma or associate’s degree, and 36

percent have a bachelor’s degree (Figure 2).

In comparison, almost 80 percent of ARNPs

have a master’s degree and almost 4 percent

have a doctoral degree.

The diversity of Florida’s nurses is slowly

starting to reflect the diversity in Florida’s

general population. Statewide, 70.5 percent

of RNs are white as are 79.5 percent of

ARNPs and 58.5 percent of LPNs. 2,3

In

contrast, the South Florida region has a

much more diverse population which is also

reflected in their supply of nurses. In South

Florida, approximately 37 percent of RNs

are white, 25 percent are African-American,

and 23 percent are Hispanic. 5 Men are

slowly becoming a larger proportion of the

nurse workforce: almost 10 percent of RNs

and almost 15 percent of ARNPs are men. 2

Figure 2. Highest Degree Held by RNs and ARNPs Working in Nursing

5.2%

10.9%

79.9%

3.9%

ARNPs

56.6% 36.3%

6.6% 0.6%

Diploma and

Associate's

Bachelor's Degree

Master's Degree

Doctoral

RNs

March 2011 The Florida Nursing Shortage 5

Figure 3. Age Distribution for RNs, ARNPs, and LPNs in Florida

Aging of Florida’s nurse supply is a serious

concern for the future of our nurse

workforce. As older nurses leave the

workforce, fewer younger nurses are

available to replace them, and these younger

nurses also do not benefit from the

knowledge transfer and mentoring of their

more experienced nurse colleagues. In

January 2010, the average age of Florida’s

RNs was 48.6 years. 2

Although a person’s

retirement plans may fluctuate with

changing state and national economic

conditions, we should realistically expect

many older nurses to retire during the next

10 to 15 years. Only ¼ of RNs and 1/3 of

LPNs are younger than 40 years (Figure 3),

and these smaller cohorts of younger nurses

will likely be unable to compensate for the

projected personnel losses due to retirement

in the next 10 years. Based on current age

statistics and retirement projections, the

future nurse supply will become insufficient

to meet the soaring demand for healthcare of

aging Floridians.

Nurse Demand Nurse demand includes employed nurses

(demand that has been satisfied) as well as

unmet demand in the form of vacancies for

RNs and LPNs. Future demand for nurses

depends on many factors, including

population growth, nurse retirements, and

healthcare reform. As of the 30 th

of June

2009, the Center estimated that a total of

6,807 full and part-time RN positions were

vacant, as were about 1,400 LPN positions. 6

Most of the estimated RN vacancies were in

hospitals (71%), whereas the LPN vacancies

were predominately in skilled nursing

facilities (53%) and home health agencies

(26%). Demand for nurses has certainly

changed in the past two years in response to

economic changes.

Within a specific employment setting, the

position vacancy rates represent the

proportion of all FTE positions that were

vacant as of June 30, 2009 (Figure 4). FTE

vacancy rates for RNs and LPNs were

highest in home health agencies (RN: 8.6%;

LPN: 8.8%) and hospices (RN: 7.0%; LPN:

6.3%). FTE vacancy rates for RNs were

lowest in hospitals and public health

departments. LPN vacancy rates were lowest

in psychiatric hospitals, hospitals, and

skilled nursing facilities.

0%

5%

10%

15%

20%

25%

30%

35%

40%

21-30 31-40 41-50 51-60 61 or older

RNs

ARNPs

LPNs

March 2011 The Florida Nursing Shortage 6

Figure 4. FTE Position Vacancy Rates for RNs and LPNs as of 06/30/09

Filling vacant nursing positions is

economically beneficial for Florida. The

Center’s economic analysis shows that the

estimated vacant nurse FTEs in 2009

represented $30 million in estimated state

and local tax revenues that were not

collected because the positions were not

filled. 7

Based on information received from

industry in the Center’s 2009 Workforce

Survey, an estimated 8,200 new RN

positions and over 3,170 new LPN positions

may be created through 2011. 6 About 50

percent of new RN positions are expected to

be in home health agencies and 37 percent in

hospitals. Approximately 70 percent of new

LPN positions are expected to be in home

health agencies, 13 percent in skilled

nursing facilities, and 9 percent in hospitals.

Nationally, the Bureau of Labor Statistics

(BLS) predicts that the demand for RNs will

generate 581,500 new jobs by 2018 (22%

employment growth). 8 The highest

percentage of national employment growth

for RNs is forecast for physicians’ offices

(48%), which are expected to create 106,500

new jobs. (The Center does not survey

physicians’ offices or ambulatory care

centers, thus our demand and vacancy

numbers do not include data from these

industries.) National employment growth in

hospitals is expected to be about 17 percent,

which will generate 274,000 new RN jobs.

Other industries with high growth rates for

new RN jobs are home health care services

(33%), nursing care facilities (25%), and

employment services (24%). LPNs are

expected to have 21 percent employment

growth through 2018, generating 155,600

new jobs nationally. 9 LPN job creation will

be especially strong in home health care

agencies and nursing care facilities.

Within Florida, the Center’s forecast models

show that despite the recession and slowly

recovering economy, the implementation of

healthcare reform will increase demand for

RNs over the next 15 years (Figure 5). 1

Supply and demand are predicted to be close

to equilibrium from 2011-2013, then

demand is predicted to increase sharply

4.6

6.8

8.6

2.5

7.0

5.7

2.2

3.7

8.8

4.8

6.3

1.4

0

2

4

6

8

10

Hospital SNF Home

Health

Public

Health

Hospice Psychiatric

Hospital

F T

E P

o si

ti o

n V

a c a

n c y

R a

te RN LPN

March 2011 The Florida Nursing Shortage 7

Figure 5. RN FTE Supply and Demand Projections with and without Healthcare Reform

as the economy continues on a path of

recovery, baby boomer nurses retire,

Florida’s population ages, and healthcare

reform is phased in. These combined factors

are predicted to create a shortage of more

than 50,300 RN FTEs and over 12,500 LPN

FTEs by 2025. This worst-case scenario

translates into $226 million in state and local

tax revenues that will not be collected if

these positions remain vacant. 7 However,

the Center’s recent forecasts suggest that if

the rate of attrition (loss) from the RN

workforce is decreased by 2% (or 3,000

nurses per year) combined with an increase

in new graduates of 5% per year for six

years (30% total) then the predicted nursing

shortage will be eliminated by 2022. 1

Nursing Education

Nursing education programs have the

potential to aid in addressing long-term

demand for nurses by increasing their output

of new graduate nurses, but evidence

indicates that our education supply pipeline

suffers from a bottleneck that limits nursing

program expansion. The 2010 Florida

Center for Nursing Survey of Nursing

Programs found that pre-licensure RN

associate’s degree programs (ADN) denied

admission to almost 60% of qualified

applicants and Baccalaureate degree

programs (BSN) denied admission to 56%

of qualified applicants in Academic Year

(AY) 2009-2010 (Table 2). 10

LPN programs

also turned away over fifty percent of

qualified applicants. At present it is not

possible to distinguish the number of people

denied admission to nursing schools from

the number of applications declined. A

single prospective student may be denied

admission (or accepted) by more than one

school. Nonetheless, the percentage of

qualified applicants that were denied

admission to Florida nursing schools has

increased by 10% or more from last

academic year.

140,000

160,000

180,000

200,000

220,000

240,000

260,000

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

RN FTE Supply RN FTE Demand - Without HCR

RN FTE Demand - Including HCR

50,321 FTEs

March 2011 The Florida Nursing Shortage 8

Table 2. Program Capacity Measures for Pre-licensure Programs, AY 2009-2010

LPN Curriculum ADN Curriculum BSN Curriculum

# of QUALIFIED applicants 13,142 16,033 7,392

# of student SEATS 6,868 7,028 2,951

# of students ADMITTED 6,312 6,579 3,237

# of rejected applications 6,830 9,454 4,155

% of rejected applications 52.0% 59.0% 56.2%

# of NEW enrollees 5,776 6,344 2,830

# of SEATS left VACANT 1,092 684 121

Among all types of nursing programs, the

number of new enrollees to nursing

programs is smaller than the number of

students admitted. Prospective students may

often apply and be accepted to multiple

schools (thus inflating the total number of

qualified applicants), but choose only one

school in which to enroll. However, there

were also a number of vacant seats in

nursing programs – in other words, some

programs were not filled to capacity. This

may be a result of expansion restrictions,

such as a shortage of faculty or clinical

capacity limitations, which restricted the

number of students that a school could

admit.

In AY 2009-2010, Florida nursing schools

graduated 7,890 new RNs and 3,805 new

LPNs. Most of these new RNs (72%) were

from ADN programs (Figure 6). The

number of graduates from ADN and BSN

programs increased slightly (1.1% and 7.8%,

respectively), but the number of LPN

graduates decreased by 6%. A relatively

stable number of graduates over this time

period was to be expected, as the first

cohorts of students enrolled in new nursing

programs have not yet graduated. Hence,

next year we should expect an increase in

the number of graduates from the state’s

recently licensed nursing programs.

Figure 6. New Pre-Licensure Graduate Nurses, 2007-2010

3,473

4,134

1,906

3,563

5,603

1,904

4,047

5,640

2,031

3,805

5,701

2,189

0

1,000

2,000

3,000

4,000

5,000

6,000

LPN Programs RN: ADN program s RN: Pre-licensure BSN

Programs

# o

f G

r a

d u

a te

s

2007 2008 2009 2010

March 2011 The Florida Nursing Shortage 9

1,012

606

41

1,216

599

31

1,319

693

60

1,286

892

94

0

200

400

600

800

1,000

1,200

1,400

RN-BSN Programs MSN Programs Doctoral Programs

N u

m b

e r o

f G

r a

d u

a te

s

2007 2008 2009 2010

Since the October 2009 survey, the number

of post-licensure graduates has increased by

28.7 percent for MSN programs and 56.7

percent for doctoral programs (Figure 7).

Although the numeric increases for these

program types are small – 199 master’s

graduates and 34 doctoral graduates – the

increases demonstrate significant expansion,

particularly during AY 2009 - 2010. RN-

BSN programs who responded to our survey

graduated 33 fewer students in AY 2009-

2010 than in AY 2008-2009, but this is

likely an undercount of the RN-BSN

graduates as not all of these programs

responded to the Center’s education survey.

As previously mentioned, nursing education

programs reported several barriers to

program expansion. The most consistently

cited barriers are limited clinical sites for

interactive learning experiences and lack of

funds to hire faculty – cited as problems by

three-quarters of BSN programs. Lack of

qualified applicants for faculty positions

(faculty shortage) and lack of campus

resources were also cited as barriers to

expansion, particularly within BSN

programs. In contrast to pre-licensure

programs, a lack of qualified student

applicants was a significant barrier to

expansion among post-licensure programs.

Faculty vacancy rates have increased in

Florida’s nursing education programs since

AY 2008-2009. As of September 2010,

faculty vacancy rates were approximately

8.4% in LPN programs, 7.6% percent in

ADN programs, and 12.4% in BSN

programs. 10

Rising faculty vacancy rates

correlate with an increasing ratio of enrolled

students to full-time faculty positions within

all types of nursing programs. The average

age of full-time faculty members was 52.7

years in BSN programs and 51.5 years in

both ADN and LPN programs; and 16

percent of ADN and LPN faculty and almost

22 percent of BSN full-time faculty

members are over the age of 60. This age

distribution suggests that many nurse faculty

may retire in the next 10 years, increasing

the severity of the already existing faculty

shortage and causing a subsequent reduction

in program capacity.

Figure 7. Post-Licensure Graduate Nurses, 2007-2010

March 2011 The Florida Nursing Shortage 10

Nurse Retention and

Turnover

The recession has further affected the

nursing profession by decreasing turnover

rates, as nurses are more likely to remain

with their current employer in uncertain

economic times. During Fiscal Year (FY)

2008-2009, median turnover rates for RNs

were approximately 14 percent in hospitals,

with a high of 31 percent in skilled nursing

facilities (Figure 8). 6 LPN turnover was

highest within skilled nursing facilities and

hospices. Although these turnover rates are

high, they have decreased in most industries

since our previous nurse employer survey in

FY 2006-2007. Turnover rates are certainly

impacted by the economy, and data from the

Center’s next survey of nurse employers in

the summer of 2011 will provide updated

nurse turnover information.

Excessive turnover is costly for employers

as they incur expenses related to recruiting

and hiring, lost productivity, increased

payments for overtime or agency personnel,

and possibly compromised quality of care.

The Center estimated the cost of nurse

turnover in Florida during FY 2008-2009 to

be $1.4 billion. 7 Clearly, if nurse turnover

were decreased, the facility-level cost

savings could lead to higher-quality, less

expensive health care.

Complementary to reducing turnover,

emphasis must be placed on retaining the

nurse workforce. Considerations of the

effects of aging on the nurse workforce are

critical to improve retention of this cohort of

nurses - for the experiential knowledge they

contribute to the quality of care delivered,

and for their contributions to the

professional development of novice nurses.

Challenges to be addressed include the

physical requirements of nursing practice,

accommodations for diminished vision (e.g.:

improved lighting, larger fonts), and a desire

to reduce hours worked. Improving the work

environment and providing for a healthy

work-life balance will demonstrate that

employers value the contributions of multi-

generational nurses.

14.3%

30.6%

18.2% 20.3%

8.7%

15.0% 15.2%

29.2%

0.0%

27.0%

0.0%

22.5%

0%

5%

10%

15%

20%

25%

30%

35%

Hospita ls Skilled

Nursing

Home Hea lth Hospice Public Hea lth Psychia tric

Hospita l

RN LPN

Figure 8. RN and LPN Median Turnover Rates by Employment Setting, FY 2008-2009

March 2011 The Florida Nursing Shortage 11

Conclusions: Current and

Long-Term Drivers of the

Nurse Workforce

Presently, the supply and demand for nurses

in Florida is near equilibrium, as a result of

the many dynamic elements of the

prolonged economic recession. One major

factor affecting the current and future nurse

supply is the aging Baby Boomer nurse

workforce. Approximately 50 percent of

RNs in Florida are over 50 years of age, and

we can anticipate that as the economy

recovers, many RNs who returned to work

or had been delaying retirement will leave

the workforce within the next 10-15 years.

Only 26.5 percent of RNs in the nursing

workforce are younger than age 40, and this

group cannot fill the potentially large

number of vacancies that will be left by

retiring nurses. Two foremost drivers of the

future demand for nurses are the aging of the

US population and the implementation of

healthcare reform, which will emphasize

primary prevention and increase access to

healthcare. Nurses are, and will continue to

be, the largest component of the health

workforce. Thus we should keep in mind

that the current easing of the nursing

shortage is temporary, and we must continue

to work towards developing and

implementing long-term strategies to create

a sustainable nurse workforce for Florida.

Creating a sustainable nurse workforce

involves increasing the long-term supply of

nurses through targeted expansion of

nursing programs in areas of the state where

they are most needed, and retaining

currently employed nurses. Nursing program

expansion cannot be accomplished without

addressing the problems of clinical capacity

limitations and nursing faculty shortages.

Increased use of simulation technologies can

create opportunities for safe, effective

clinical learning experiences. Nursing

faculty positions must be made more

attractive to those considering a career in

nursing education, including receiving

market-competitive salaries. Furthermore,

improvements in nurses’ work environment,

such as ergonomic designs, shared

governance, role and work redesign, and

staffing at appropriate levels, are strategies

employers can use to retain their nurse

workforce.

The Center also recommends continued data

collection from nurses, nurse employers, and

nursing education programs. Through

continued study of what types of nurses

Florida has, where they work, what nurse

employers need, and changes in the nursing

education pipeline, the state and employers

can develop and evaluate specific

interventions for a sustainable nursing

workforce. In essence, continued data

collection can help the state course-correct

so that resources are expended in the most

efficient way to resolve the shortage.

Resolving the nursing shortage and creating

a sustainable nursing workforce has clear

benefits for patients and all Floridians.

The Florida Center for Nursing, as your

definitive source of information on the

nursing workforce, will continue to collect

the data needed to describe the current (and

future) supply and demand for nurses. We

look forward to being your partner in

resolving Florida’s nursing shortage.

March 2011 The Florida Nursing Shortage 12

References

1. Florida Center for Nursing. (2010). RN and LPN Supply and Demand Forecasts, 2010- 2025: Florida’s Projected Nursing Shortage in View of the Recession and Healthcare

Reform. Accessed: March 7, 2011 from:

http://www.flcenterfornursing.org/files/2010_Shortage_Forecast.pdf.

2. Florida Center for Nursing. (2010). Florida’s RN and ARNP Supply: Growth, Demographics, and Employment Characteristics. Accessed May 10, 2010 from

http://www.flcenterfornursing.org/files/RN_Supply_2010.pdf.

3. Florida Center for Nursing. (2010). Florida’s LPN Supply: Growth, Demographics, and Employment Characteristics. Accessed May 10, 2010 from

http://www.flcenterfornursing.org/files/LPN_Supply_2010.pdf.

4. U.S. Department of Health and Human Services, Health Resources and Services Administration (2010). The Registered Nurse Population: Initial Findings from the 2008

National Sample Survey of Registered Nurses. Accessed: May 18, 2010 from

http://bhpr.hrsa.gov/healthworkforce/rnsurvey/.

5. Florida Center for Nursing. Unpublished data. April 2010. 6. Florida Center for Nursing. (2010). Workforce Demand in Nursing Intensive Healthcare

Settings: 2009 Vacancies and 2010 Growth Projections. Accessed May 10, 2010 from

http://www.flcenterfornursing.org/files/ 2010_Demand_Report.pdf

7. Florida Center for Nursing. (2010). The Economic Impact of Florida’s Nursing Workforce. Accessed: March 7, 2011 from:

http://www.flcenterfornursing.org/files/Econ_Impact_2010.pdf.

8. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Registered Nurses. Accessed: June 7, 2010 from:

http://www.bls.gov/oco/ocos083.htm.

9. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Licensed Practical and Licensed Vocational Nurses. Accessed: June 7,

2010 from: http://www.bls.gov/oco/ocos102.htm.

10. Florida Center for Nursing. (2011). Florida’s Nursing Education and Nurse Faculty Supply and Demand: 2010 Survey Results. Accessed: March 7, 2011 from:

http://www.flcenterfornursing.org/files/2011_Education_Report.pdf.