Nurses in the workforce may be wondering what the future holds for their careers.
Will a shortage of nurses continue, particularly in specific geographic areas? Will new restrictions or requirements be placed on novice nurses hoping to enter the field? Will experienced nurses, who might have delayed retirement, start exiting the profession, leaving gaps in knowledge and skill that can’t readily be filled?
What do experts in the field predict for nursing in five years? In ten?
How much will the profession of nursing change in that time?
Nurses express concern over a shortage of trained professionals, but experts in the field have expressed the opinion that shortages may begin to wane as we grow closer to the years 2020-20304. Nursing leaders have been meeting to study factors that affect the levels of nurses entering and leaving the profession annually, and although many have predicted a dire shortage since the year 2000, those predictions have not come to fruition. In fact, shortages have begun to appear only in isolated geographic areas within the United States, and within specific specialties, as opposed to the profession in general.
Data in 2015 predicted a nursing shortfall of only around 4% by 2025, based on several factors in the United States economy, the most significant issue proved to be the Great Recession, which kept far more nurses working than they planned. Researchers from Montana State University and Dartmouth College also found the recession drew new students into the nursing profession in increasing numbers across the country, bulking up the strength of the RN workforce. Statistics began to change for nursing data by 2015, for as 40% of working nurses proved older than 50, that trend is expected to edge down over the next 10 to 15 years as newer and younger nurses begin to enter the workforce.3
By 2030, the overall number of working nurses is anticipated to be ~ 3.3. million, with new RN entrants, nearly offsetting expected RN retirements, but researchers at Montana State University and Dartmouth warn that current rates of enrollment must remain consistent for that to be true. Nursing enrollments have already begun to dip from the highs that were driven by the panic of the year 2000 when projections of severe shortages were running high. Nurses are expected to leave the workforce in numbers around 80,000/year by 2020.3
What is currently happening in the workforce is a high concentration of newer nurses in metropolitan areas, where jobs may be difficult to obtain. Jobs in specialty areas are trickier to fill, especially those requiring experienced or certified nurses, especially geriatric, pediatric, and neurology fields. Behavioral health, sexual assault, substance abuse, prosthetics, and trauma specialties are also challenging to fill. Nursing jobs in acute care hospitals will remain the most competitive.
Aside from the number of nurses available in the next five to ten years, colleagues must be wondering about a vision for the future, for as the IOM (now the National Academy of Medicine, NAM) published how they hoped to see nursing unfold by 2020, nursing leaders realize they have not met all the goals within those published guidelines. Clearly, much progress has been made.1
Nearly ten years ago, the IOM (NAM) published the landmark report, Future of Nursing: Leading Change, Advancing Health, “which included recommendations designed to improve access to high-quality patient care.” The IOM report really became a roadmap to nursing excellence, where nurses could function to improve and advance health. With the IOM’s publication as a roadmap, BSN nurses increased from 49% in 2010 to 56% by 2017.1
The number of RN to BSN graduates rose from 22,531 in 2010 to 62,725 in 2017. The number of U.S. nurses with a doctoral degree has tripled from 2010 to 2017, and multiple states are in the process of allowing APRN’s to practice to the full extent of their education and training. In 2016, the U.S. Department of Veteran’s Affairs allowed APRN’s to practice without restrictions at federal facilities. Additionally, greater than 5,000 nurses sit on the boards of hospitals within the United States, which is more than halfway to the goal of 10,000 nurses set by the IOM report.1
Future goals for the next five to ten years include further recognition of the BSN in 10 (signed into law in New York State in December 2017), which will encourage more states to move towards BSN preparation in the nursing workforce. Additional goals will be to encourage diversity in nursing, as well as attracting more men into the nursing field, and strengthening participation on hospital boards.1
As nurses head into the future, one of the more immediate concerns is the actual work of performing the job of nursing; will the job become easier? Will nurses be able to execute tasks more readily, or spend less time in documentation? These are legitimate concerns for nearly every professional in the field. Advances in artificial intelligence may provide dramatic changes in documentation for nurses in the next five years, with smartwatches or small computers that can synchronize (or recognize) conversation to databases that document in real-time, not unlike what we observe with scribes at this time.
The field of technology in healthcare is also booming. Whether it is a sheet of luminous “skin” that demonstrates exactly where difficult veins may be located (for intravenous starts), called EchoNous, or an FDA-approved stethoscope that can capture and analyze heart and lung sounds via Bluetooth technology, the world of artificial intelligence is about to significantly “empower healthcare providers worldwide by providing real-time data and clinical interpretation”, according to Dr. John Sperling of Mayo Clinic. Products such as these could change care at the bedside as well as communication and time to intervention.2
3D printers are also changing the world of patient care, whether it is through epilepsy pills that can be printed in layers to readily dissolve or bio-printed liver tissues. Within a decade, it is suggested that whole solid organs such as livers, hearts, and kidneys might be able to be printed for patients requiring a transplant. Already, a company in the U.S., as well as one in Madrid, has developed the prototype of a 3D printer that can create synthetic skin for burn patients. Imagine the possibilities!2
So, where will nurses be in five years, or even ten? They will be working in a field with younger colleagues than those they work with today. They might be seeking metropolitan, specialty, acute care positions, among a more diverse group of colleagues, including more males in the field, as well as more nurses of color.
The nurses will be trained in artificial intelligence, and skilled at utilizing new tools, whether it is devices that link maneuvers through Bluetooth or Wi-Fi to document patient care and collaborate interdisciplinary support in real-time. Scheduling additional staff will easily be accomplished both onsite and off, through mobile access. Life will still be busy, it may still be challenging, but the profession won’t be static. In a word, it will be exciting!
- Americannursetoday.com “Future of nursing 2020-2030: Extending the vision.” ANA on the Frontline, May 7, 2019.
- Blog.diversitynursing.com “The future of nursing technology is exciting.” Bettencourt, E., June 5, 2018.
- Fiercehealthcare.com “Nursing shortage in 2025 will be smaller than projected.” Bird, J., September 22, 2015.
- Nationalacademies.org “The future of nursing 2020-2030.” Consensus Study. Study updates and agenda for 11-20-2019 open meeting.