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Nursing students at Ivy Tech Community College.
Editor’s note: This is an excerpt from an article in the October/November edition of the Community College Journal, the bimonthly magazine of the American Association of Community Colleges.
As health care providers, patients and employers adjust to national health care law changes, which promise to extend medical coverage to 30 million previously uninsured Americans, community colleges are gearing up to keep pace with rising economic and societal demands for medical and allied health professionals.
Even before the U.S. Supreme Court ruling on the Affordable Care Act, the health care industry accounted for nearly 19 percent of all spending in the nation’s economy, and 13 percent of all jobs. Nurses, doctors and allied and support staff account for two-thirds of workers in this sector—and community colleges train more than half of the entire health care workforce.
Demand on the rise
By 2020, there will be 1.2 million job openings for registered nurses (RNs), including 470,000 openings for RNs with associate degrees. There will be 370,000 job openings for licensed practical nurses (LPNs) and licensed vocational nurses (LVNs)—134,000 of which will be for LPNs and LVNs with associate degrees. Other categories include dental hygienists (105,000 projected jobs, including 51,000 for those with associate degrees), emergency medical technicians and paramedics (121,000 projected jobs, including 32,000 for those with associate degrees), and pharmacy technicians (166,000 projected jobs, including 34,000 for those with associate degrees).
Support professionals will also be in high demand. Over the next seven years, the U.S. economy will add 838,000 jobs for home health care aides (91,000 of which will require at least an associate degree), 496,000 jobs for nursing orderlies and attendants (103,000 of which will require at least an associate degree), 244,000 jobs for medical assistants (61,000 of which will require an associate degree) and 154,000 jobs for dental assistants (38,000 of which will require at least an associate degree).
DataPoints: New registered nurses
By 2020, 91 percent of the health care market will be in nursing, allied or support care. Allied health care will account for roughly 3.4 million jobs, or 27 percent of all health care occupations. Combined with health care support staff, these two sectors will account for 64 percent of all health care occupations. Doctors and nurses combined will account for 1.2 million and 3.5 million jobs, respectively, totaling 36 percent of all health care occupations in the same time frame.
Ramping up enrollment
Who will train all these workers? Over the past two decades, community college market share in the provision of health care credentials has declined 5 percent, from 37 percent in 1986 to 32 percent in 2010. During the same period, the market share of community colleges offering sub-baccalaureate health care credentials declined by 45 percent.
Nursing programs adjusting to 'degree creep' trend
Private for-profit institutions have picked up the slack. Between 1986 and 2010, the share of health care workers trained at such institutions rose from 1 percent to 29 percent, and the share of sub-baccalaureate health care credentials received at private for-profit schools increased from 1 percent to 49 percent.
This trend indicates a significant mismatch between job training and job availability. Private for-profit schools are churning out graduates trained for health care support and paraprofessional occupations—the lower end of the pay scale—while a declining share of nurses (60 percent) entering the field today are community college graduates.
Breaking down the training market
Nurses, the backbone of community college health care training programs, make up the largest group of licensed health care professionals in the country. Historical data from the U.S. Department of Health and Human Services’ Health Resources and Services Administration show that the field has expanded steadily since the 1980s, thanks to a number of factors, including aging baby boomers, rising disposable income, increased health coverage, and changing health care delivery models.
La. hospitals help fund college nursing program
It comes as no surprise that the nursing profession offers some of the best opportunities for qualified job seekers, with the largest projected new-job totals of any single health occupation and an annual median wage ($64,690) nearly double that of all other such occupations, according to the Bureau of Labor Statistics. Of the top-10 health care occupations with the highest expected job growth, nursing is also the best paid.
But community nursing programs are expensive to run, and it is a challenge to find qualified teachers with master’s degrees in nursing who are willing to take a pay cut to teach, as opposed to working in direct care. Compounding matters is a trend in the profession toward higher training standards.
A gap in training options
Despite an increased need for more and better-trained nurses, there has been little or no corresponding increase in higher education training options for these workers.
Associate-degree programs have always graduated more RNs than bachelor’s-degree programs (BSN), but that disparity is wider today than it was in the past.
In 1980, 2 percent more RNs graduated from associate-degree programs than from baccalaureate programs. In 2008, the gap had widened to 9 percent.
At the same time, more nurses than ever have a four-year bachelor’s degree.
A new wave of health care training facilities
This growth seems due in large part to an increasing number of RNs already in the field upgrading their skills by completing bachelor’s-degree programs. Enrollment and graduation data from the American Association of Colleges of Nursing supports this interpretation, showing that between 2007 and 2011, the number of students in RN-to-BSN programs increased by 73 percent, compared with a 17 percent increase for generic (entry-level) baccalaureate nursing students over the same time period.
Position also plays a role in the average wage RNs can expect to earn. Nurse anesthetists, for example, command the highest salaries, with a real annual mean wage of $141,052. Nurse practitioners and nurse midwives are next, followed by RNs in management and administrative roles, with real annual mean wages of $76,212 and $76,102, respectively. RNs with no official title had the lowest real annual mean wage, at $36,185.
Carnevale is director and research professor of the Georgetown University Center on Education and the Workforce. Smith is a research professor and senior economist at the center.
Copyright ©2014 American Association of Community Colleges