Trends in the Experiences of Hospital-Employed Registered Nurses: Results From Three National Surveys

Peter I. Buerhaus, PhD, RN, FAAN; Karen Donelan, ScD; Beth T. Ulrich, EdD, RN, FACHE, FAAN; Catherine Desroches, Dr.P.H.; Robert Dittus, MD, MPH

Disclosures

Nurs Econ. 2007;25(2):69-79. 

In This Article

Survey Data and Methods

Data for this analysis come from national random sample surveys of RNs conducted in 2002, 2004, and 2006. Each of the surveys were designed, pre-tested, and analyzed by our research team, and took respondents approximately 20 minutes to complete. Institutional review board approvals were obtained for using data from each survey, and we collaborated with Harris Interactive who conducted the fieldwork for each survey. Complete descriptions of the methodology for the 2002 and 2004 surveys were published previously (Buerhaus, Donelan, Norman, Ulrich, & Dittus, 2005).

2002 National Survey of Registered Nurses

This survey was funded by NurseWeek, a national weekly nursing publication and continuing education company, and by the American Organization of Nurse Executives. From October 24, 2001 through March 13, 2002, Harris Interactive mailed the eight-page questionnaire to a nationally representative sample of 7,600 RNs who were randomly selected from a list of all RNs licensed to practice in the United States. Response enhancements included continuing education credits valued at $35 and the opportunity to be entered into a lottery drawing for one of three travel vouchers for work-related travel. A total of 4,108 RNs completed the survey for a response rate of 55% (177 of the 7,600 were determined to be ineligible). The data were weighted by age and region to reflect the distribution of RNs as reported in the federal government's 2000 Nation al Sample Survey of Registered Nurses in the United States. For the analysis reported here, we used a subset of the data that represents all hospital employed RNs who provide direct patient care (n=1,442).

2004 National Survey of Registered Nurses

The 2004 national survey of RNs was funded by Johnson & Johnson and Nursing Spectrum (which had acquired NurseWeek). The survey contained many of the same questions used in the earlier 2002 survey, and included several different questions aimed at exploring new areas and probing certain aspects of the workplace environment in greater depth.

From May 11 through July 12, 2004, Harris Interactive mailed the eight-page questionnaire to a random sample of 3,500 RNs drawn from the previously referenced Nursing Spectrum national database. Respondents were given the option of responding at a secure Web site or by mail, and up to five mailings were sent to non-responders to encourage participation. Response enhancement incentives included 2 hours of continuing education courses valued at $35 and the opportunity to be entered into a lottery drawing for vouchers redeemable for travel to professional conferences. Following exclusion of cases of retired nurses or those not working at the time of the survey, we obtained a 53% response rate among eligible respondents and 1,697 usable responses. The data were weighted by age and region to reflect the distribution of RNs as reported in the federal government's 2000 National Sample Survey of Registered Nurses in the United States. For the analysis reported here, we use a subset of the data that represents all hospital-employed RNs who provide direct patient care (n=657).

2006 National Survey of Registered Nurses

The 2006 survey was funded by Johnson & Johnson and Nursing Spectrum. From May 24 through July 26, 2006, Harris Interactive mailed the eight-page questionnaire to a random sample of 3,436 RNs that was drawn once again from the Nursing Spectrum national data base. Given prior low response to the online option in this population, the survey was conducted only by mail. Up to five mailings were sent to non-responders to encourage participation. Response enhancement incentives included 2 hours of continuing education courses valued at $35 and the opportunity to be entered into a lottery drawing for vouchers redeemable for travel to professional conferences. Following exclusion of cases of retired nurses or those not working at the time of the survey, we obtained a 52% response rate among eligible respondents and 1,392 responses were usable for analysis.

For this survey we elected not to weight the data according to the federal government's 2000 National Sample Survey of the Population of Registered Nurses. Our sample was deemed to be representative by region. More importantly, the age distribution of respondents reflected differences from the federal government's 2000 survey, but were consistent with an analysis of more recent U.S. Bureau of Census data reported by Buerhaus, Auerbach, and Staiger (2007) in this issue of the journal (see page 59). We determined that it was best not to use weights from previous government national surveys if, in fact, those weights would mask a true change in the characteristics of the nursing workforce (at the time of this analysis, only preliminary findings from the federal government's 2004 National Survey of the Population of Registered Nurses in the United States were available, including information on the weights used by this government survey). For the analysis reported here, we use a subset of the data that represents all hospital-employed RNs who provide direct patient care (n=617).

Characteristics of National Random Sample Surveys of RNs

In each of the three surveys, most hospital-employed RNs providing direct patient care are white and female, and clear majorities are married and work in hospitals located in urban and suburban areas (see Table 1 ). More than two-thirds are over the age of 35, with more RNs between the ages of 35 and 49 years than any other age category. The average age of RNs employed in hospitals shot up in 2006, reaching 48 years, an in crease of 9 years from the average age of 39 years for hospital-employed RNs reported in 2004. As explained by Buerhaus, Auerbach, and Staiger (2007), this increase is attributed to the re-entry into the workforce of approximately 180,000 RNs over the age of 50 between 2003 and 2005. Table 1 also shows that RN self-reports of their health has fluctuated, with 29% rating their health as "excellent" in both 2002 and 2006, and across the three surveys, roughly 40% of RNs rated their health as "very good," approximately 20% as "good," and less than 5% as "fair" or "poor."

Essentially the same percentage (38%) of RNs reported an associate or baccalaureate degree as the highest nursing degree received; fewer RNs in 2004 (11%) compared to 2002 (19%) reported a diploma certificate as their highest nursing education. In 2006, the mean days worked per week rose slightly to 3.7, and nearly the same proportion of RNs reported they worked 0 to 3 days as those who reported working 4 to 5 days per week. Although the mean hours worked per week fell slightly in 2006 compared to 2004, overtime hours increased by nearly 1 hour per week during this same period. In 2006, RNs reported an average hourly wage of $32.10 for a regularly scheduled shift, a sharp increase (over 18%, not adjusted for inflation) from the $27.10 RNs reported earning in 2004. Finally, across the three surveys most RNs reported their total annual income from working as a hospital-employed nurse ranged between $25,000 and $75,000.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....