Articles : Nursing

   Nursing Fact Sheet

07/16/05 by AACN






Misconceptions about nursing have contributed to misinformation about the profession in the media. Journalists should know these facts:

Nursing is the nation's largest health care profession, with more than 2.7 million registered nurses nationwide. Of all licensed RNs, 2.2 million, or 81.7 percent, are employed in nursing. 1


Nursing students account for more than half (52 percent) of all health professions students in the United States. 2


Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation's long-term care.


Most health care services involve some form of care by nurses. In 1980, 66 percent of all employed RNs worked in hospitals. By 2000, that number had declined to 59 percent as more health care moved to sites beyond the hospital and nurses increased their ranks in a wide range of other settings, including private practices, health maintenance organizations, public health agencies, primary care clinics, home health care, nursing homes, outpatient surgicenters, nursing-school-operated nursing centers, insurance and managed care companies, schools, mental health agencies, hospices, the military, industry, nursing education, and health care research. 3


Though often working collaboratively, nursing does not "assist" medicine or other fields. Nursing operates independent of, not auxiliary to, medicine and other disciplines. Nurses' roles range from direct patient care and case management to establishing nursing practice standards, developing quality assurance procedures, and directing complex nursing care systems.


With more than four times as many RNs in the United States as physicians, nursing delivers an extended array of health care services, including primary and preventive care by advanced nurse practitioners in such areas as pediatrics, family health, women's health, and gerontological care. Nursing's scope also includes services by certified nurse-midwives and nurse anesthetists, as well as care in cardiac, oncology, neonatal, neurological, and obstetric/gynecological nursing and other advanced clinical specialties.


The primary pathway to professional nursing, as compared to technical-level practice, is the four-year Bachelor of Science degree in nursing (BSN). Registered nurses are prepared either through a BSN program; a two- to three-year associate degree in nursing program; or a three-year hospital training program, receiving a hospital diploma. All take the same state licensing exam. (The number of diploma programs has declined steadily -- to less than 10 percent of all basic RN education programs -- as nursing education has shifted from hospital-operated instruction into the college and university system.)


To meet the more complex demands of today's health care environment, a federal advisory panel has recommended that at least two-thirds of the basic nurse workforce hold baccalaureate or higher degrees in nursing by 2010. 4 Aware of the need, RNs are seeking the BSN degree in increasing numbers. In 1980, almost 55 percent of employed registered nurses held a hospital diploma as their highest educational credential, 22 percent held the bachelor's degree, and 18 percent an associate degree. By 2000, a diploma was the highest educational credential for only 22.3 percent of employed RNs, while the number with bachelor's degrees as their highest education had climbed to 32.7 percent, with 34.3 percent holding an associate degree as their top academic preparation. 5 In 2003, 9,856 RNs with diplomas or associate degrees graduated from BSN programs. 6


In 2000, 9.6 percent and 0.6 percent of employed RNs, respectively, held a master's or doctoral degree as their highest educational preparation. 7 However, the demand for master's- and doctorally prepared nurses for advanced practice, clinical specialties, teaching, and research roles far outstrips the supply.


According to the U.S. Bureau of Labor Statistics, Registered Nursing is the occupation with the largest job growth from 2002 - 2012. 8 Other federal projections indicate that by 2020, the U.S. nursing shortage will grow to more than 800,000 registered nurses. 9 Even as health care continues to shift beyond the hospital to more community-based primary care and other outpatient sites, federal projections say the rising complexity of acute care will see demand for RNs in hospitals climb by 36 percent by 2020. 10
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The American Association of Colleges of Nursing is the national voice for university and four-year-college education programs in nursing. Representing 575 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, databank, publications, and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice.



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REFERENCES

1. Division of Nursing. (March 2000). The Registered Nurse Population: Findings from the National Sample Survey of Registered Nurses. Washington, DC: U.S. Department of Health and Human Services.


2. Health Resources and Services Administration. (September 1992). Health Personnel in the United States, 1991: Eighth Report to Congress, p. 215 and other tables. Washington, DC: U.S. Department of Health and Human Services.


3. See Note 1.


4. National Advisory Council on Nurse Education and Practice. (October 1996). Report to the Secretary of the Department of Health and Human Services on the Basic Registered Nurse Workforce. Washington, DC: U.S. Department of Health and Human Services, Division of Nursing.

5. See Note 1.


6. American Association of Colleges of Nursing (2004). 2003-2004 Enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: Author.


7. See Note 1.


8. Hecker, D.E. (2004). Occupational Employment Projections to 2012. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics.


9. Health Resources and Services Administration, Bureau of Health Professions. (2002). Projected Supply, Demand and Shortages of Registered Nurses: 2000-2020. Washington, DC: U.S. Department of Health and Human Services.


10. See Note 4.