2011 Indiana Registered Nurse Licensure Survey Report

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2011 Indiana Registered Nurse

Licensure Survey Report

Produced by:

The Indiana Center for Health Workforce Studies

Bowen Research Center, Department of Family Medicine

Indiana University School of Medicine

In collaboration with the:

Indiana Area Health Education Centers Program

February 2013

Authors:

Zachary T. Sheff, MPH

Komal Kochhar, MBBS, MHA

Terrell W. Zollinger, DrPH I N D I A N A A H E C I N D I A N A A H E C N E T W O R KN E T W O R K Stands for Jobs

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2011 Indiana Registered Nurse

Licensure Survey Report

Produced by:

The Indiana Center for Health Workforce Studies

Bowen Research Center, Department of Family Medicine

Indiana University School of Medicine

In collaboration with the

Indiana Area Health Education Centers Program

February 2013

Zachary T. Sheff, MPH

Komal Kochhar, MBBS, MHA Terrell W. Zollinger, DrPH

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Acknowledgements

We would like to extend our gratitude to all dedicated individuals who provided valuable and timely assistance to us during this project. Preparing this report required the assistance, cooperation, and effort of many individuals and agency staff. The survey data and additional data elements were provided by the Indiana Professional Licensing Agency through the Indiana State Department of Health.

An advisory committee provided direction and insights to the data analysis and report generation:

Biff Williams, PhD., Professor and Dean, Indiana State University, College of Nursing, Health, and Human Services

Elizabeth Kiefner Crawford, Director, Nurse Licensing Board, Indiana Professional Licensing Agency

Jennifer Bruner, Staff Attorney, Indiana State Department of Health Kimberly Harper, MS, RN, Executive Director, Indiana Center for Nursing Marcia Plant Jackson, FNP, Director, Health Policy, Coalition of Advanced

Practice Nurses of Indiana

The cooperation and support of the Indiana State Department of Health was

instrumental in obtaining the survey data and interpreting it. The authors are grateful for the financial support received from the Indiana Area Health Education Centers Program to produce this report.

Zachary T. Sheff, MPH Komal Kochhar, MBBS, MHA Terrell W. Zollinger, DrPH

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Table of Contents

Executive Summary ... 1

Introduction ... 1

Responses to the 2011 Indiana Registered Nurse Survey ... 1

Nursing Faculty ... 1

Advanced Practice Nurses ... 2

Principal Practice Location ... 2

Trends in the Registered Nurse Workforce ... 2

Conclusions ... 3

Chapter 1: Introduction ... 4

Methods ... 4

Inclusion and Exclusion Criteria ... 5

Weighting for County Level Data ... 7

Calculation of FTE for Maps ... 8

Response Rate ... 10

Data Analysis ... 11

Limitations of the Survey ... 11

Chapter 2: Responses to the 2011 Indiana Registered Nurse Survey ... 12

Demographic Composition ... 12

Education Characteristics ... 17

Professional Characteristics ... 20

Chapter 3: Nursing Faculty ... 31

Demographic Composition ... 31

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Chapter 4: Advanced Practice Nurses ... 34

Demographic Composition ... 34

Educational Characteristics ... 36

Primary vs. Non-Primary Care Nurse Practitioners ... 37

Chapter 5: Principal Practice Location ... 39

Chapter 6: Trends in the Registered Nurse Workforce ... 51

Chapter 7: Conclusions ... 54

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Executive Summary

Introduction

A total of 98,235 registered nurse licenses were issued or renewed in 2011. The survey on which this report is based was offered to licensees during the licensure process and received a response rate of 90.7 percent. Of the 80,429 registered nurses who responded to the survey 54,588 were actively practicing in Indiana and 53,591 met the criteria for inclusion in analysis.

Responses to the 2011 Indiana Registered Nurse Survey

The majority of respondents were white (94.0%), non-Hispanic (98.2%) females (94.6%) between the ages of 45 and 54 (27.1%). Nearly one-half (45.1%) of respondents held an Associate degree as their highest credential in nursing. Another 38.7 percent held a Bachelor’s degree. Less than one-tenth (8.4%) of the registered nurse workforce completed training as an advanced practice nurse. The most common work setting among respondents was as a staff nurse or direct care nurse (54.6%) at a non-federal, short-term, non-psychiatric hospital (41.4%) in an urban county (85.9%). The most common medical specialties in which respondents

practiced were surgery (10.7%) and critical care (8.2%).

Nursing Faculty

There were 971 respondents who indicated that they currently worked as a faculty member of a nurse training program. Nursing faculty were demographically similar to the rest of the registered nurse workforce, but differed in their educational background. Only 8.8 percent of the entire registered nurse workforce held a Master’s degree and less than one percent (0.5%) of the workforce held a doctorate. Over one-half (52.0%) of nursing faculty held a Master’s degree and 14.7 percent held a doctorate.

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Advanced Practice Nurses

There were 3,222 respondents currently working as an advanced practice nurse. Advanced practice nurses include clinical nurse specialists, nurse anesthetists, nurse

practitioners, and nurse midwives. Nurse practitioners accounted for two-thirds (68.1%) of advanced practice nurses and were evenly split between primary care and non-primary care roles. Advanced practice nurses were demographically similar to the overall registered nurse population (except nurse anesthetists who were evenly split between males and females). Advanced practice nurses had a much higher proportion of respondents who held a Master’s or doctorate degree (76.9% compared to 8.8% of all registered nurses). Non-primary care nurse practitioners were more likely to work full-time compared to primary care nurse practitioners (84.0% vs. 73.9%, respectively).

Principal Practice Location

As expected, counties with larger populations had the highest number of registered nurse FTEs and advanced practice nurse FTEs. Urban counties tended to have higher numbers of registered nurse FTEs. The proportion of registered nurses in each county holding a

Bachelor’s degree or higher ranged from 18.7% (Sullivan County) to 62.3% (Marion County).

Trends in the Registered Nurse Workforce

The number of registered nurses who renewed their license in Indiana as well as the number of registered nurses who are actively practicing in Indiana has been increasing since 1997 and peaked in 2007. After a decline in 2009 it appears to be rising again in 2011. Since 1997 the majority of registered nurses were between the ages of 31 and 44. The most commonly held degree in each year since 1997 has been an Associate degree in nursing followed closely by Bachelor’s degrees. The proportion of the registered nurse workforce holding a Master’s degree has doubled over this time period.

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Conclusions

The Indiana registered nurse workforce is primarily composed of white, non-Hispanic females between the ages of 45 and 54. Associate and Bachelor’s degrees were the most commonly held credentials, but the proportion of respondents holding a Master’s degree has doubled since 1997. Nursing faculty and advanced practice nurses were demographically identical to the overall registered nurse population, but were more likely to hold a Master’s or doctorate degree. The majority of respondents worked as staff or direct care nurses in non-federal, short-term, non-psychiatric hospitals in urban counties.

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Chapter 1: Introduction

Having an accurate understanding of the personal and professional characteristics of registered nurses licensed in Indiana is critical to develop and manage effective programs to recruit and retain registered nurses where they are most needed in the State. The purpose of this report is to provide those data. The findings from this report may be used to identify registered nurse shortage areas, develop more recruitment and retention strategies, and plan additional locations for training registered nurses within the state.

The Indiana State Department of Health (ISDH) and the Indiana Professional Licensing Agency (IPLA) collaborated in implementing the Indiana Registered Nurse Licensure Surveys. In 1997 and 2001, licenses were renewed by mail and an accompanying paper questionnaire was included. Beginning in 2003, IPLA began electronic license renewals. Since then, all Indiana registered nurses who renewed their license electronically were asked to complete an electronic survey instrument.

The 2011 Indiana Registered Nurse Licensure Survey instrument included items to address current work status, principal practice location, principal position, activities performed in the principal practice location, practice setting, average hours worked, current education level, and plans for obtaining future degrees. A copy of the 2011 2011 Indiana Registered Nurse Licensure Survey instrument is included in Appendix 1.

This report summarizes the responses to the 2011 Indiana Registered Nurse Licensure Survey and compares the results from the current survey to the results of the prior registered nurse surveys (1997, 2001, 2005, 2007, and 2009). Due to the low response rate of 66.3 percent, the 2003 survey results are generally not reported because of the possibility of a non-response bias.

Methods

The data used to generate this report were extracted from the 2011 Indiana Registered Nurse Licensure Survey dataset collected by the ISDH and the registered nurse license dataset maintained by the IPLA. The 2011 Indiana Registered Nurse Licensure Survey instrument

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included questions on current work status, principle practice location, activities performed in the principle practice location, position title, specialty, principal practice setting, average hours worked, and demographic information. The data provided by the IPLA included date of birth for all licensed registered nurses who were practicing in Indiana at the time of the survey. The datasets were merged in order to match the respondents’ approximate age to his or her survey responses. The datasets were merged by matching the license number of each physician using SAS 9.3 and age was calculated using September 30, 2011 as a reference point since surveys were completed from August 31, 2011 through October 31, 2011. The merged dataset was then used to filter the records to include only the respondents who met the inclusion criteria.

Inclusion and Exclusion Criteria

The merged dataset was filtered initially to include only registered nurses with an active or probationary license and who reported an Indiana address for their primary practice

location. Almost all of the respondents who reported Indiana as their primary practice location held an active Indiana license (refer to Table 1.1).

Table 1.1 Current License Status

Physician License Status Number Percent

Active 54,588 99.6

Probation 150 0.3

Other 90 0.2

Total 54,828 100

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The dataset was further refined by work status. Only those registered nurses who were currently practicing in Indiana were included in the analysis. Registered nurses who were actively working in a position other than nursing, working only on a non-paid basis, retired, temporarily inactive, currently unemployed, or practicing outside Indiana were excluded from the analyses. A total of 53,591 registered nurses (98.4%) were selected for inclusion (refer to Table 1.2).

Table 1.2 Current Work Status*

Registered Nurse Work Status Number Percent Excluded from Dataset Actively working in paid health care position, but not in

nursing 498 0.9

Actively working, but not in nursing or health care 32 0.1

Working in nursing ONLY on a non-paid basis 84 0.2

Retired or permanently inactive as a nurse 42 0.1

Temporarily inactive as a nurse 67 0.1

Unemployed and seeking work as a nurse in Indiana 168 0.3

Total Excluded from Dataset 891 1.6

Included in Dataset

Actively working in a paid position related to nursing 53,591 98.4

Total Included in Dataset 53,591 98.4

Total Indiana-based Survey Respondents 54,482 100.0

No Response Given 344

*These numbers represent survey respondents only.

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Table 1.3 includes the work status of registered nurses in previous years’ reports (2005 – 2009) to provide a comparison from year to year. In each year a large proportion of Indiana-based RNs were included in the analysis.

Table 1.3 Current Work Status (2005 – 2009)*

2005 2007 2009 Registered Nurse Work Status Num Pct Num Pct Num Pct Excluded from Dataset Actively working in paid health care position, but

not in nursing 1,337 2.9 1,442 2.7 1,121 2.1

Actively working, but not in nursing or health care 526 1.1 719 1.3 101 0.2

Working in nursing ONLY on a non-paid basis 452 1.0 571 1.1 358 0.7

Retired or permanently inactive as a nurse 174 0.4 1,378 2.5 148 0.3

Temporarily inactive as a nurse 409 0.9 2,309 4.3 300 0.6

Unemployed and seeking work as a nurse in Indiana 220 0.5 616 1.1 452 0.9

Total Excluded from Dataset 3,118 6.7 7,035 13.0 2,480 4.7

Included in Dataset

Actively working in a paid position related to nursing 43,164 93.3 47,169 87.0 50,682 95.3

Total Included in Dataset 43,164 93.3 47,169 87.0 50,682 95.3

Total Indiana-based Survey Respondents 46,282 100.0 54,204 100.0 53,162 100.0

No Response Given 147 150 363

*These numbers represent survey respondents only.

Weighting for County Level Data

A key component of identifying potential health profession shortage areas is determining the number of existing professionals in each county. Two strategies were

employed to create an accurate measure of the availability of registered nurses in each county. First, rather than performing a simple headcount of registered nurses in each county, the number of full-time equivalent (FTE) registered nurses was calculated for each county. The method for calculating and defining FTEs is discussed below. After FTEs for each county were calculated, the second strategy used to ensure an accurate estimate was to weight the FTEs in each county. The estimated number of registered nurse FTEs in each county was calculated by

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summing the number of respondent FTE in each county of principle practice location, then assigning a weight of 90.2 percent to the sum. The weight was determined by calculating the proportion of registered nurses who renewed their license electronically and responded to the survey (n = 88,650) to the total number of registered nurse license renewals (n = 98,235) (refer to Table 1.4). Thus, the counts of registered nurse FTEs are estimates of the actual number of registered nurses in each county and not the number of respondents in each county. The

estimated number of registered nurse FTEs per county also does not necessarily reflect the

total number of practicing RNs, but the number of RN FTEs available to serve the community at large.

Table 1.4 Weighting for County Data

Weighting for County Level Data Number Percent

Renewed electronically and responded to the survey 80,429 81.9

Total Nurse License Renewals in 2011 98,235

Calculation of FTE for Maps

The data shown on maps are registered nurse FTEs rather than a simple headcount because not all respondents indicated that they worked full-time in patient care activities. Thus, measuring the number of registered nurse FTEs per county provides a more accurate picture of the availability of registered nurses for the communities of each county. Each

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respondent had an FTE assigned to them based on their survey response indicating the average number of weekly hours spent in patient care or in professional duties (refer to Table 1.5). While the weighted headcount of registered nurses is not used in maps, the estimated headcount of registered nurses in each county is included in the county-by-county tables in Chapter 5.

Table 1.5 FTE Definition for Registered Nurses

Average Number of Weekly Hours Spent in ALL Nursing

Related Activities FTE

1 - 19 0.5

20 - 35 0.75

36 - 40 1

41 or more 1

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Response Rate

Although only registered nurses who met the inclusion criteria were included in the analysis of this report, the denominator used for determining the survey response rate was based on the total number of registered nurses who renewed their licenses electronically in 2011 (refer to Table 1.6). The response rate for the survey was calculated by dividing the number of registered nurses who renewed their license electronically and responded to at least one question on the survey by the total number of electronic renewals. The response rate for those who had the opportunity to take the survey was 90.7 percent. Table 1.7 shows the response rate for previous years’ surveys as a comparison. Each year had a high proportion of responders with the exception of 2003 (66.3%), therefore data from each year (except for 2003) are included in the analyses when the survey question was asked in each year to visualize trends in the registered nurse workforce.

Table 1.6 Survey Response Rate

Survey Response Rate Number Percent

Renewed electronically and responded to the survey 80,429 90.7

Total Electronic Renewals 88,650

Table 1.7 Survey Response Rate (1997 – 2003)

1997* 2001* 2003** Survey Response Rate Num Pct Num Pct Num Pct

Renewed electronically and responded to the survey 62,230 89 68,258 93.6 47,495 66.3

Total Electronic Renewals 69,893 72,928 71,585

*Indiana Registered Nurse Survey Databook 1997 (& 2001), Indiana Health Care Professional Development Commission. ** 2009 Indiana Registered Nurse Survey Report, Indiana Center for Health Workforce Studies, Indiana Area Health Education Centers Program.

Table 1.7 Survey Response Rate (2005 – 2009) (Cont’d.)

2005** 2007** 2009** Survey Response Rate Num Pct Num Pct Num Pct

Renewed electronically and responded to the survey 56,670 79.8 66,451 81.2 81,976 92.3

Total Electronic Renewals 70,982 81,786 88,852

*Indiana Registered Nurse Survey Databook 1997 (& 2001), Indiana Health Care Professional Development Commission. ** 2009 Indiana Registered Nurse Survey Report, Indiana Center for Health Workforce Studies, Indiana Area Health Education Centers Program.

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Data Analysis

Frequency and cross-tabulation analyses were performed to describe the characteristics of the registered nurses within Indiana. The data were coded in Microsoft Excel 2007® and

analyzed using SAS 9.3 and IBM SPSS Statistics 20. Graphic Information Systems (GIS) maps were developed to illustrate the estimated number of registered nurse FTEs per Indiana county, the ratio of registered nurse FTEs per 100,000 residents, and delineate rural and non-rural counties. Rural counties were defined by the United States Department of Agriculture as non-metropolitan counties and were designated by hash marks on the map. The GIS maps were designed in ArcGIS™ 9.3. Data from 2011 also was compared to data collected in previous surveys of registered nurses from 1997, 2001, 2005, 2007, and 2009 for variables that matched.

Limitations of the Survey

The survey instrument used in 2011 is shown in Appendix 1. Several changes were implemented in the 2011 survey instrument in response to discussions with members of the advisory board. Some questions have been added and others re-worded to obtain more precise information. As a result, the 2011 data may not be fully comparable to data from previous years. Only those registered nurses who participated in the licensure survey were included in the data analysis. In 2011 there was a 81.9 percent response rate; therefore there is only a small possibility of non-response bias.

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Chapter 2: Responses to the 2011 Indiana Registered Nurse Licensure

Survey

This chapter summarizes responses to items on the 2011 Indiana Registered Nurse Licensure Survey. Responses from the 1997, 2001, 2005, 2007, and 2009 surveys are also summarized for those items that matched the 2011 survey instrument. Caution should be taken when making generalizations about all Indiana RNs. The responses from previous surveys have been taken from the 2009 Registered Nurse Licensure Survey Report. The data shown may not

be representative of all licensed registered nurses in Indiana since registered nurses who renewed their license by paper, as well as those who did not respond to the electronic survey are not included in these results. Each table shows the number of valid and missing responses to each survey item and the percentage of valid responses. The tables and text describe the responses to the survey.

Demographic Composition

The demographics shown include age, gender, race, and ethnicity of survey

respondents. The age distribution of respondents from 2005 to 2011 is provided in Table 2.1. Demographic questions were not asked in 2007. In 2011, the majority of respondents were between the ages of 45 and 54 (27.1%). However, respondents’ ages were distributed relatively evenly among age groups under 65 years old. A small proportion of respondents (4.1%) were over 65 years old. From year to year, the distribution of respondents’ ages has remained relatively unchanged.

Table 2.1 Age of Respondents (2005 – 2011)

2005 2007 2009 2011 Age Groups Num Percent Num Percent Num Percent Num Percent

Under 35 9,782 22.9 10,828 22.3 11,152 22.1 13,178 24.6 35-44 11,761 27.5 12,847 26.5 12,295 24.3 11,556 21.6 45-54 14,312 33.5 15,636 32.2 15,113 29.9 14,486 27.1 55-64 6,150 14.4 8,050 16.6 9,951 19.7 12,067 22.6 65 or older 766 1.8 1,182 2.4 2,048 4.1 2,192 4.1 Total 42,771 100.0 48,543 100.0 50,559 100.0 53,479 100.0 No Response Given 390 407 123 112 12 | P a g e

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The gender of respondents from 1997 to 2011 are provided in Table 2.2. In each year the vast majority of respondents were female. This trend continued in 2011 in which 94.6 percent of respondents were female.

Table 2.2 Gender of Respondents (1997 – 2005)

1997 2001 2005 Gender Num Percent Num Percent Num Percent

Female 36,572 96.3 43,192 95.7 40,619 94.9

Male 1,403 3.7 1,951 4.3 2,182 5.1

Total 37,975 100 45,143 100 42,801 100

No Response Given 746 472 360

Table 2.2 Gender of Respondents (2007 – 2011) (Cont’d.)

2007 2009 2011 Gender Num Percent Num Percent Num Percent

Female n/a n/a 46,946 94.9 49,628 94.6

Male n/a n/a 2,534 5.1 2,838 5.4

Total n/a n/a 49,480 100 52,466 100.0

No Response Given 1,202 1,125

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Table 2.3 displays the racial and ethnic demographics for the population of Indiana to provide a comparison with the demographics of the registered nurse workforce. Compared to the population of Indiana, minorities are underrepresented in the registered nurse workforce.

Table 2.3 Demographic Composition of Indiana1

Indiana Demographic Information Number Percent

White 5,467,906 84.3

Black or African-American 591,397 9.1

American Indian/Alaska Native 18,462 0.3

Asian 102,474 1.6 Asian Indian 27,598 0.4 Chinese 22,553 0.3 Filipino 10,652 0.2 Japanese 4,896 0.1 Korean 10,322 0.2 Vietnamese 6,845 0.1 Other Asian 19,608 0.3 Native Hawaiian 2,348 0

Hispanic or Latino (of any race) 389,707 6

Total Population 6,483,802 100

1 Source: 2010 US Census data. http://2010.census.gov/2010census/

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Table 2.4 shows the race of survey respondents from 1997 to 2011. The majority of respondents in each year were white. This is still the case in 2011.

Table 2.4 Race of Respondents (1997 – 2005)

1997 2001 2005 Race Num Percent Num Percent Num Percent

White 36,653 95.4 42,650 94.8 40,373 94.2

Black/African American 1,011 2.6 1,344 3.0 1,233 2.9

Asian/Pacific Islander 378 1.0 453 1.0 492 1.1

American Indiana/Native Alaskan 68 0.2 73 0.2 93 0.2

Multiracial n/a n/a 155 0.3 210 0.5

Other 326 0.8 319 0.7 476 1.1

Total 38,436 100.0 44,994 100.0 42,877 100.0

No Response Given 285 621 284

Table 2.4 Race of Respondents (2007 - 2011) (Cont’d.)

2007 2009 2011 Race Num Percent Num Percent Num Percent

White n/a n/a 46,060 93.7 48,980 94.0

Black/African American n/a n/a 1,632 3.3 1,758 3.4

Asian/Pacific Islander n/a n/a 681 1.4 689 1.3

American Indiana/Native Alaskan n/a n/a 146 0.3 111 0.2

Multiracial n/a n/a n/a n/a 564 1.1

Other n/a n/a 628 1.3 n/a n/a

Total n/a n/a 49,147 100.0 52,102 100.0

No Response Given 1,535 1,489

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The ethnicity of survey respondents from 1997 to 2011 is shown in Table 2.5. In each year since 1997, less than two percent of respondents indicated that they have a Hispanic or Latino ethnicity.

Table 2.5 Ethnicity of Respondents (1997 – 2005)

1997 2001 2005 Ethnicity Num Percent Num Percent Num Percent

Hispanic or Latino 418 1.1 555 1.3 658 1.5

Not Hispanic or Latino 35,956 98.9 40,723 98.7 42,014 98.5

Total 36,374 100.0 41,278 100.0 42,672 100.0

No Response Given 2,347 4,337 489

Table 2.5 Ethnicity of Respondents (2007 – 2011) (Cont’d.)

2007 2009 2011 Ethnicity Num Percent Num Percent Num Percent

Hispanic or Latino n/a n/a 739 1.6 889 1.8

Not Hispanic or Latino n/a n/a 44,127 98.4 49,700 98.2

Total n/a n/a 44,866 100.0 50,589 100.0

No Response Given 5,816 3,002

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Education Characteristics

The data displayed in Table 2.6 represent the highest degree obtained by respondents in the registered nurse workforce from 1997 to 2011. The proportion of respondents who hold a diploma as their highest degree has decreased from 21.0 percent in 1997 to 6.9 percent in 2011. The decrease in respondents holding a diploma has corresponded with an increase in respondents seeking higher degrees. From 1997 to 2011 the proportion of respondents with a Bachelor’s degree has risen from 30.2 percent to 38.7 percent, and the proportion of

respondents with a Master’s degree has risen from 4.4 percent to 8.8 percent in that same period. In each year, the majority of respondents held an Associate degree.

Table 2.6 Highest Degree in Nursing Completed by Respondents (1997 – 2005)

1997 2001 2005 Highest Degree in Nursing Num Percent Num Percent Num Percent

Diploma 8,121 21.0 6,663 14.7 4,602 10.7 Associate 17,077 44.2 19,789 43.8 19,190 44.6 Bachelor's 11,667 30.2 15,745 34.8 15,809 36.7 Master's 1,690 4.4 2,828 6.3 3,162 7.3 Doctorate 94 0.2 172 0.4 263 0.6 Total 38,649 100.0 45,197 100.0 43,026 100.0 No Response Given 72 328 135

Table 2.6 Highest Degree in Nursing Completed by Respondents (2007 – 2011)

2007 2009 2011 Highest Degree in Nursing Num Percent Num Percent Num Percent

Diploma 4,255 9.4 4,222 8.4 3,659 6.9 Associate 20,501 45.1 22,579 45.1 23,796 45.1 Bachelor's 16,990 37.3 18,964 37.9 20,415 38.7 Master's 3,505 7.7 4,085 8.2 4,647 8.8 Doctorate 248 0.5 196 0.4 268 0.5 Total 45,499 100.0 50,046 100.0 52,785 100.0 No Response Given 3,451 636 806 17 | P a g e

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Table 2.7 shows the highest degree held by registered nurse respondents in 2011 by age group. Less than one-tenth (8.3%) of 2011 respondents under the age of 44 held a diploma as their highest degree in nursing. The majority of respondents under the age of 44 held either an Associate or Bachelor’s degree. Respondents between the ages of 55 and 64 had the largest proportion of registered nurses with a diploma (43.2% of all respondents holding a diploma as their highest degree in nursing) as well as the highest percentage of registered nurses with a doctorate (47.8% of all respondents holding a doctorate as their highest degree in nursing). The high proportion of diplomas could be due to changing trends in nursing degrees (younger respondents were more likely to hold an Associate or Bachelor’s degree). The higher

proportion of respondents holding a doctorate could be due to the amount of time it takes to complete a doctorate degree.

Table 2.7 Highest Degree in Nursing by Age Group of 2011 Respondents

Under 35 35 - 44 45 - 54 Highest Degree in Nursing Number Percent Number Percent Number Percent

Diploma 85 2.3 219 6.0 1,083 29.6 Associate 5,544 23.4 5,778 24.3 6,593 27.8 Bachelor's 6,705 32.9 4,443 21.8 5,092 25.0 Master's 599 12.9 912 19.6 1,450 31.2 Doctorate 3 1.1 24 9.0 82 30.6 Total 12,936 24.6 11,376 21.6 14,300 27.1 No Response Given 242 180 186

Table 2.7 Highest Degree in Nursing by Age Group of 2011 Respondents (Cont’d.)

55 - 64 65 and older Total Highest Degree in Nursing Number Percent Number Percent Number Percent

Diploma 1,580 43.2 688 18.8 3,655 100.0 Associate 5,138 21.6 680 2.9 23,733 100.0 Bachelor's 3,633 17.8 501 2.5 20,374 100.0 Master's 1,420 30.6 263 5.7 4,644 100.0 Doctorate 128 47.8 31 11.6 268 100.0 Total 11,899 22.6 2,163 4.1 52,674 100.0 No Response Given 168 29 917 18 | P a g e

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Table 2.8 shows the percentage of RNs that plan to pursue additional degrees in nursing in the next two years. This question was not included on the survey prior to 2009.

Respondents were allowed to choose all responses that applied. Therefore percentages may not sum to 100. The majority of respondents do not plan on pursuing additional degrees in the next two years (73.3% in 2009 and 66.0 % in 2011). The most common degree that

respondents indicated they would seek in the next two years is a Bachelor’s degree, with a similar proportion planning to pursue a Master’s degree.

Table 2.8 Additional Nursing Degrees to be Pursued by Respondents in the Next Two Years

2009 2011

Future Degrees Num Percent Num Percent

Bachelor's 6,180 13.3 8,462 17.5

Master's 5,252 11.3 8,197 17.0

Doctor of Nursing Practice (DNP) 551 1.2 1,047 2.2

Other Doctorate (PhD) 269 0.6 402 0.8

I plan on getting more than one degree 158 0.3 n/a n/a

I do not intend to pursue further nursing education 34,046 73.3 31,871 66.0

No Response Given 5,293

Table 2.9 shows the proportion of respondents who indicated that they had completed an advanced practice nursing degree since completing their initial nursing program. Nearly one-tenth (8.4%) of respondents had completed an advanced practice nursing degree.

Table 2.9 Respondents Who Completed Advanced Practice Nursing Degree Completed Advanced Practice Nursing Degree since

Graduating from Initial Nursing Program Number Percent

No 47,903 91.6

Yes 4,418 8.4

Total 52,321 100.0

No Response Given 1,270

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Professional Characteristics

The information displayed in Table 2.10 shows the principal position currently held by respondents. Over half of respondents (54.6%) held a position as a staff nurse or direct care nurse. Charge nurses/team leaders were the next most commonly held position (8.6% of respondents) followed by “other” nurses (4.5%) and those working in middle

management/administration (4.3%).

Table 2.10 Currently Held Principal Practice Position of Respondents (2011)

Current Position Number Percent

Staff Nurse or Direct Care Nurse 28,943 54.6

Charge Nurse or Team Leader 4,562 8.6

Other 2,404 4.5

Middle Management/Administration (Asst. Director,

House Supervisor) 2,278 4.3

Patient Care Coordinator, Case Manager, Discharge

Planner 1,980 3.7

Nurse Practitioner 1,970 3.7

First Line Management (Head Nurse, Floor Supervisor) 1,254 2.4

School Nurse 1,063 2.0

No position title 1,011 1.9

Senior Management/Administration (CEO, Vice President,

Nursing Executive) 996 1.9

Faculty 972 1.8

Quality Improvement Nurse, Utilization Review Nurse 751 1.4

Clinical Nurse Specialist 608 1.1

Advice/Triage Nurse 574 1.1

Staff Educator or Instructor in Clinical Setting 524 1.0

Community Health Nurse 391 0.7

Consultant 361 0.7

Instructor/Lecturer 341 0.6

Public Health Nurse 329 0.6

Patient Educator 325 0.6

Informatics Nurse 303 0.6

Certified Registered Nurse Anesthetist (CRNA) 246 0.5

Researcher 212 0.4

Surveyor/Auditor/Regulator 161 0.3

Infection Control Nurse 141 0.3

Staff Development Director 124 0.2

Legal Nurse 83 0.2

Certified Nurse-Midwife 60 0.1

Total 52,967 100.0

No Respone Given 624

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Table 2.11 shows the principal work setting of respondents. The most common work setting was non-federal, short-term (non-psychiatric) hospitals (41.4%) followed by other types of hospitals (11.8%) and nursing home/extended care facilities (5.6%).

Table 2.11 Principal Work Setting of Respondents (2011)

Work Setting at Primary Position Number Percent

Non-Federal, short-term hospital, except psychiatric 21,487 41.4

Other type of hospital 6,100 11.8

Nursing Home/Extended Care Facility - Free standing

nursing home/extended 2,922 5.6

Other 2,306 4.4

Home health agency (non-hospital based) 1,902 3.7

Non-Federal , long-term hospital, except psychiatric 1,866 3.6

Federal Government hospital 1,239 2.4

Ambulatory Care Setting - Group practice (physicians) 1,132 2.2

Ambulatory Care Setting - Ambulatory surgical center 1,063 2.0

Community/neighborhood health center 1,010 1.9

Public school system 891 1.7

Home health service unit (hospital based) 651 1.3

Ambulatory Care Setting - Hospital owned off-site clinics 621 1.2

Rural health care center 476 0.9

Ambulatory Care Setting - Partnerships (physicians) 470 0.9

Non-Federal psychiatric hospital 458 0.9

Nursing Education Program - Bachelor's Degree 440 0.8

Ambulatory Care Setting - Other 429 0.8

Community mental-health organization or facility 418 0.8

Other public or community health setting 418 0.8

Hospice 417 0.8

Nursing Home/Extended Care Facility - Other types of

extended care facility 380 0.7

Nursing Education Program - Associate's Degree 374 0.7

College or university 373 0.7

Ambulatory Care Setting - Dialysis center/clinic 362 0.7

Ambulatory Care Setting - Partnership or Group Practice

(mixed practitioners) 360 0.7

Ambulatory Care Setting - Solo practice (physicians) 333 0.6

Visiting nurse service (VNS/NA) 314 0.6

Official City or County Health Department 299 0.6

Nursing Home/Extended Care Facility - Nursing home unit

in hospital 268 0.5

Occupational Health (Employee Health Service) - Private

industry 259 0.5

Ambulatory Care Setting - Freestanding clinic (physicians) 133 0.3

Correctional Facility 130 0.3

Retirement community center 127 0.2

(27)

Table 2.11 Principal Work Setting of Respondents (2011) (Cont’d.)

Work Setting at Primary Position Number Percent

Nursing Education Program - Higher degree nursing

program 121 0.2

Official State Mental Health Agency 115 0.2

Official State Health Department 108 0.2

Nursing Education Program - LPN/LVN program 98 0.2

Nursing Education Program - Other nursing education

program 97 0.2

Home-based self-employment 90 0.2

Ambulatory Care Setting - Group practice (nurses) 79 0.2

Occupational Health (Employee Health Service) - Other 79 0.2

Combination (official/voluntary) nursing service 78 0.2

Nursing Home/Extended Care Facility - Facility for

mentally challenged 78 0.2

Ambulatory Care Setting - Freestanding clinic (nurses) 71 0.1

Private or parochial elementary or secondary school 69 0.1

Ambulatory Care Setting - Solo practice (nurses) 67 0.1

Substance abuse center/clinic 62 0.1

Other school health service 45 0.1

Planned Parenthood/Family Planning Center 38 0.1

Private duty in a home setting 37 0.1

Nursing Education Program - Diploma program (RN) 32 0.1

Ambulatory Care Setting - Partnerships (nurses) 29 0.1

Day care center 26 0.1

Ambulatory Care Setting - Health Maintenance

Organization (HMO) 23 0.0

Ambulatory Care Setting - Dental practice 9 0.0

Occupational Health (Employee Health Service) -

Government 9 0.0

Total 51,888 100.0

No Response Given 1,703

(28)

Table 2.12 displays the number of paid positions in nursing held by respondents from 2009 and 2011. The majority of registered nurses in both years held only one position (87.3% in 2009 and 87.6% in 2011).

Table 2.12 Number of Paid Positions Held by Respondents

2009 2011

Number of Positions Held in Nursing Num Percent Num Percent

1 43,757 87.3 45,751 87.6 2 5,771 11.5 5,904 11.3 3 497 1.0 460 0.9 4 or more 69 0.1 83 0.2 Total 50,094 100.0 52,198 100.0 No Response Given 588 1,393

Table 2.13 shows the additional work settings of respondents. These work settings have been grouped into broader categories. Two-fifths (40.6%) of respondents indicated that their secondary work setting was a hospital. One-third (32.3%) of respondents indicated that the question was not applicable to them.

Table 2.13 Work Setting of Other Position(s) of Respondents (2011)

Work Setting at Positions Other than Primary Position Number Percent

Hospital 19,825 40.6

Not applicable 15,811 32.3

Insurance Claims/Benefits 3,131 6.4

Ambulatory Care Setting 2,531 5.2

Other 2,414 4.9

Nursing Home/Extended Care Facility 2,237 4.6

Public or Community Health Setting 1,296 2.7

Nursing Education Program 722 1.5

School Health Service 602 1.2

Occupational Health (Employee Health Service) 258 0.5

Policy, Planning, Regulatory, or Licensing Agency 52 0.1

Total 48,879 100.0

No Response Given 7,530

(29)

Table 2.14 shows the distribution of respondents’ practice locations in urban and rural counties. The majority (85.9%) of respondents worked in urban counties.

Table 2.14 Respondents’ Practice Location by Urban and Rural Counties (2011)

Practicing in Urban or Rural County Number Percent

Rural 7,539 14.1

Urban 46,043 85.9

Total 53,582 100.0

No Response Given 9

The average number of hours per week spent in nursing related activities by

respondents in 2009 and 2011 are displayed in Table 2.15. The majority of RNs worked 36 or more hours per week in each year (73.3% in 2009 and 73.9% in 2011).

Table 2.15 Average Number of Hours per Week Spent in Nursing Related Activities by Respondents Average Hours per Week Spent in Nursing

Related Activities

2009 2011

Num Percent Num Percent

1 - 19 2,880 5.9 2,950 5.7 20 - 35 10,183 20.9 10,490 20.4 36 - 40 22,527 46.2 24,602 47.8 41 or more 13214 27.1 13,412 26.1 Total 48,804 100.0 51,454 100.0 No Response Given 1,878 2,137 24 | P a g e

(30)

Table 2.16 shows the clinical specialty in which respondents spent the majority of their time. Respondents were spread over more than 30 specialties. Surgery (10.7%) was the most common specialty followed by critical care (8.2%) and general medical surgery (7.1%).

Table 2.16 Clinical Specialty in which Respondents Spent the Majority of their Time (2011) Clinical Specialty in which Most Time is Spent at Primary

Nursing Position Number Percent

Surgery (ambulatory, pre/post-operative, post-anesthesia) 5,637 10.7

Critical Care 4,320 8.2

General Medical Surgical 3,781 7.1

Cardiac or Cardiovascular Care 3,582 6.8

Other Specialty 3,579 6.8

Long-term Care/Nursing Home 3,470 6.6

Emergency or Trauma Care 3,265 6.2

Pediatrics/Neonatal 2,887 5.5

Home Health 2,322 4.4

Obstetrics 2,157 4.1

Ambulatory Care (including primary care, outpatient, NOT

surgical) 2,129 4.0

No Patient Care 1,843 3.5

Primary Care 1,688 3.2

Psychiatric or Mental Health (Substance Abuse

Counseling) 1,626 3.1

Education 1,595 3.0

Oncology 1,584 3.0

Labor and Delivery 977 1.8

Hospice 903 1.7 No Specific Area 751 1.4 Renal/Dialysis 746 1.4 Community Health 689 1.3 Gastrointestinal 582 1.1 Public Health 553 1.0 Neurological 510 1.0 Occupational Health 443 0.8

Gynecology (Women's Health) 376 0.7

Chronic Care 270 0.5

Radiology (Diagnostic or Therapeutic) 208 0.4

Pulmonary/Respiratory 201 0.4 Infectious/Communicable Disease 180 0.3 Dermatology 63 0.1 Total 52,917 100.0 No Response Given 674 25 | P a g e

(31)

Table 2.17 displays the respondents who indicated that they are currently practicing in an advanced practice nursing role. Approximately one-third of advanced practice nurses indicated that they were a nurse practitioner in primary care (34.1%) and another third of advanced practice nurses were nurse practitioners in a field other than primary care (34.0%). A total of 3,226 respondents indicated that they were advanced practice nurses, or about 6 percent of all respondents.

Table 2.17 Respondents Currently Practicing in an Advanced Practice Nursing Role (2011) Currently Practicing in an Advanced Practice Role Number Percent

Nurse Practitioner - Primary Care (eg. School based

Clinics, Community Health) 1,099 34.1

Nurse Practitioner - Other (eg. Orthopedics, Neurology,

Acute Care, ER) 1,097 34.0

Clinical Nurse Specialist 677 21.0

Nurse Anesthetist 268 8.3

Nurse Midwife 85 2.6

Total 3,226 100.0

No Response Given 50,365

(32)

Table 2.18 displays the age distribution by degree type of registered nurses in the year 2020. Age groups are separated into two categories: those who will be less than 63 years old in 2020 and those who will be 63 years or older in 2020. These categories were chosen to

approximate the registered nurses who will be nearing retirement by 2020. Approximately one-quarter (26.2%) of respondents will be 63 years or older in 2020. The majority of

registered nurses holding both diplomas and doctorates (61.4% and 58.6%, respectively) will be over the age of 63 in 2020. The proportion of the registered nurse workforce holding a diploma is expected to continue declining as more RNs are choosing to earn an Associate or Bachelor’s degree. On the other hand, it is likely that by 2020 the number of registered nurses holding a doctorate and under 63 years old will increase as more respondents complete doctorate degrees. Refer to Table 2.8 to see a list of degrees current respondents plan to pursue in the near future.

Table 2.18 Age of Respondents in 2020 by Highest Degree in Nursing

Under 63 years old in 2020 63 or older in 2020 Total

Highest Degree Number Percent Number Percent Number Percent

Diploma 1,412 38.6 2,243 61.4 3,655 100.0 Associate 18,037 76.0 5,696 24.0 23,733 100.0 Bachelor's 16,341 80.2 4,033 19.8 20,374 100.0 Master's 2,998 64.6 1,646 35.4 4,644 100.0 Doctorate 111 41.4 157 58.6 268 100.0 Total 38,899 73.8 13,775 26.2 52,674 100.0 No Response Given 617 188 112 27 | P a g e

(33)

The estimated time until retirement of respondents in each age category are shown in Table 2.19. As expected, the majority of already retired respondents were over 65 years old and younger respondents indicated that they were further away from retirement.

Table 2.19 Respondents’ Anticipated Time to Retirement by Age Categories (2011)

Under 35 35 to 44 45 to 54 55 to 64 Over 65 Total Estimated Time to

Retirement No. % No. % No. % No. % No. % No. %

I am retired already 27 7.4 50 13.6 54 14.7 100 27.2 136 37.1 367 100.0

Less than 1 year 2 0.4 2 0.4 15 3.0 272 53.6 216 42.6 507 100.0

2 - 3 years 9 0.4 12 0.5 113 4.4 1,693 66.0 739 28.8 2,566 100.0 4 - 9 years 12 0.2 60 0.8 1,249 17.7 5,405 76.5 337 4.8 7,063 100.0 10 or more years 12,692 31.0 12,288 30.0 12,822 31.3 3,101 7.6 74 0.2 40,977 100.0 Total 12,742 24.8 12,412 24.1 14,253 27.7 10,571 20.5 1,502 2.9 51,480 100.0 No Response Given 2,111 28 | P a g e

(34)

Table 2.20 shows the primary reasons indicated by respondents who are not currently in a paid nursing position for why they are not currently employed as a registered nurse.

Respondents were allowed to choose all options that applied to their situation so percentages may not sum to 100. The most common reason was “other” which may indicate that the reasons provided on the survey instrument are not capturing the primary reasons that respondents are not currently employed in nursing positions. Alternatively, the reasons respondents are not working may be too unique to neatly classify into a list of broadly

applicable reasons. The second most common reason was career advancement out of nursing followed by family obligations.

Table 2.20 Primary Reasons for not Currently Working a Paid Nursing Position (2011) If you are not currently working in a paid nursing

position, what are the primary reasons? Number Percent

Other 127 35.6

Career Advancement/Promotion to non-nursing Position 40 11.2

Never worked in a paid RN position 39 10.9

Family Obligations 23 6.4

Disability/Illness 22 6.2

Retired 17 4.8

Burnout/Stressful Environment 16 4.5

Pursuing a Career in a Different Field 13 3.6

Relocated 13 3.6

Inadequate Pay/Benefits 8 2.2

Laid Off/Downsizing of Staff 6 1.7

No Response Given 53,234

(35)

Respondents who were not currently employed in a paid nursing position were also asked how long it had been since they had worked in a paid nursing position. Table 2.21 shows the length of time indicated by respondents. The majority of respondents who were not

currently working in a paid position indicated that they had not worked in a paid position for 10 or more years (37.4%).

Table 2.21 Time Since Working in a Paid Position in Nursing (2011) If you are not currently working in a paid nursing

position, how long has it been since you worked in a paid

position in nursing? Number Percent

Less than 1 year 202 23.5

2 - 3 years 102 11.9

4 - 9 years 125 14.5

10 or more years 322 37.4

Never worked in a paid RN position 109 12.7

Total 860 100.0

No Response Given 52,731

(36)

Chapter 3: Nursing Faculty

The results presented in this chapter show the demographic and professional

characteristics of nursing program faculty who responded to the 2005, 2007, 2009, and 2011 Indiana Registered Nurse Licensure Surveys. Respondents were asked to identify their principal position on the surveys. Only those respondents who identified their principal position as faculty in a nursing program were included in the analysis reported in this chapter.

Demographic Composition

Table 3.1 shows the ages of respondents whose principal position was in nursing faculty from 2005 to 2011. In 2011, compared to previous years, there was an increased proportion of nursing faculty under the age of 35 (16.0% in 2011 compared to an average of 6.1% in 2005 to 2009). Additionally, there was a decrease in the proportion of nursing faculty between the ages of 45 and 54 compared to previous years (26.8% in 2011 compared to an average of 39.6% in 2005 to 2009).

Table 3.1 Age of Nursing Faculty (2005 – 2011)

2005 2007 2009 2011 Age Groups Num Percent Num Percent Num Percent Num Percent

Under 35 52 7.1 43 5.1 63 6.1 155 16.0 35 - 44 120 16.4 157 18.7 165 15.9 160 16.5 45 - 54 325 44.5 326 38.8 369 35.5 260 26.8 55 - 64 211 28.9 270 32.1 365 35.1 342 35.2 Over 65 23 3.1 44 5.2 78 7.5 54 5.6 Total 731 100.0 840 100.0 1,040 100.0 971 100.0 No Response Given 2 0 1 1 31 | P a g e

(37)

The gender of respondents whose principal position was in nursing faculty from 2005 to 2011 is shown in Table 3.2. Demographic variables were not collected in 2007. The majority of nursing faculty respondents were female in each year.

Table 3.2 Gender of Nursing Faculty (2005 – 2011)

2005 2007 2009 2011 Gender Num Percent Num Percent Num Percent Num Percent

Female 712 97.1 n/a n/a 1,000 97.4 930 97.4

Male 21 2.9 n/a n/a 27 2.6 25 2.6

Total 733 100 n/a n/a 1,027 100 955 100

No Response Given 0 14 17

Tables 3.3 and 3.4 display the racial and ethnic distribution of respondents who indicated that their primary position was in nursing faculty from 2005 to 2011 (demographic variables were not collected in 2007). The majority of nursing faculty in each year were white and non-Hispanic.

Table 3.3 Race of Nursing Faculty (2005 – 2011)

2005 2007 2009 2011 Race Num % Num % Num % Num %

White 690 94.3 n/a n/a 940 92.1 872 92.3

Black/African American 27 3.7 n/a n/a 47 4.6 41 4.3

Asian/Pacific Islander 6 0.8 n/a n/a 13 1.3 15 1.6

American Indiana/Native Alaskan 2 0.3 n/a n/a 2 0.2 2 0.2

Multiracial 0 0.0 n/a n/a n/a n/a 15 1.6

Other 7 1.0 n/a n/a 19 1.9 n/a n/a

Total 732 100.0 n/a n/a 1,021 100.0 945 100.0

No Response Given 1 20 27

Table 3.4 Ethnicity of Nursing Faculty (2005 – 2011)

2005 2007 2009 2011 Ethnicity Num Percent Num Percent Num Percent Num Percent

Hispanic or Latino 8 1.1 n/a n/a 13 1.4 16 1.8

Not Hispanic or Latino 719 98.9 n/a n/a 936 98.6 896 98.2

Total 727 100.0 n/a n/a 949 100.0 912 100.0

No Response Given 6 92 60

(38)

Educational Characteristics

Table 3.5 shows the highest degree in nursing obtained by respondents who indicated that their principal position was in nursing faculty from 2005 to 2011. The proportion of nursing faculty holding an Associate degree has risen from 1.9 percent in 2005 to 15.8 percent in 2011. On the other hand, the proportion of faculty holding Bachelor’s and Master’s degrees has fallen from 20.4 percent and 61.9 percent, respectively, in 2005 to 16.4 and 52.0 percent, respectively, in 2011. The increased number of nursing faculty holding a Master’s degree in 2009 could be due to the overall higher number of nursing faculty included in the 2009 survey, but the subsequent return to the previous years’ numbers in 2011 may warrant further

analysis.

Table 3.5 Highest Degree in Nursing among Nursing Faculty (2005 – 2011)

2005 2007 2009 2011 Highest Degree in Nursing Num Percent Num Percent Num Percent Num Percent

Diploma 8 1.1 9 1.1 15 1.5 11 1.1 Associate 14 1.9 25 3.1 66 6.4 152 15.8 Bachelor's 147 20.4 184 22.8 200 19.3 158 16.4 Master's 447 61.9 487 60.4 631 61.0 500 52.0 Doctorate 106 14.7 101 12.5 122 11.8 141 14.7 Total 722 100.0 806 100.0 1,034 100.0 962 100.0 No Response Given 11 34 10 33 | P a g e

(39)

Chapter 4: Advanced Practice Nurses

This chapter presents the demographic and professional characteristics of the advanced practice nurses (APNs). Advanced practice nurses include the following specialties: nurse practitioners, clinical nurse specialists, nurse-midwives, and nurse anesthetists. Only those respondents who indicated they were currently working as an advanced practice nurse were included in the analysis reported in this chapter.

Demographic Composition

Table 4.1 shows the age distribution of each APN specialty in 2011. While clinical nurse specialists, nurse anesthetists, and nurse midwives each had approximately one-tenth of respondents (9.6%, 13.5%, and 9.4%, respectively) under age 35, nearly one-fifth (18.8%) of nurse practitioners were under 35 years old. All specialties except nurse anesthetists had the majority of respondents between 45 and 54 years old. The greatest proportion of nurse anesthetists, on the other hand, was between 35 and 44 years old.

Table 4.1 Age Distribution of Advanced Practice Nurses by Specialty (2011)

Clinical Nurse Specialist Anesthetist Nurse Practitioner Nurse Midwife Nurse Total Age Groups No. % No. % No. % No. % No. %

Under 35 65 9.6 36 13.5 413 18.8 8 9.4 522 16.2 35 - 44 132 19.5 81 30.3 541 24.7 22 25.9 776 24.1 45 - 54 234 34.6 74 27.7 703 32.0 29 34.1 1,040 32.3 55 - 64 208 30.8 59 22.1 474 21.6 21 24.7 762 23.6 65 and older 37 5.5 17 6.4 63 2.9 5 5.9 122 3.8 Total 676 100.0 267 100.0 2,194 100.0 85 100.0 3,222 100.0 No Response Given 4 34 | P a g e

(40)

The gender distribution of APNs (listed by specialty) can be found in Table 4.2. In each specialty the majority of respondents were female. Nurse anesthetists were nearly evenly split between males and females.

Table 4.2 Gender Distribution of Advanced Practice Nurses by Specialty (2011)

Clinical Nurse Specialist Nurse Anesthetist Nurse Practitioner Nurse Midwife Gender Num Percent Num Percent Num Percent Num Percent

Female 631 94.3 145 54.3 2,071 94.8 84 98.8

Male 38 5.7 122 45.7 113 5.2 1 1.2

Total 669 100.0 267 100.0 2,184 100.0 85 100.0

No Response Given 8 1 12 0

Tables 4.3 and 4.4 show the racial and ethnic distribution of APNs among respondents by specialty. The majority of respondents were white and non-Hispanic in each specialty.

Table 4.3 Racial Distribution of Advanced Practice Nurses by Specialty (2011)

Clinical Nurse Specialist Anesthetist Nurse Practitioner Nurse Nurse Midwife Race Num Percent Num Percent Num Percent Num Percent

White 625 94.1 237 89.8 2,047 94.5 78 94.0 Black/African American 21 3.2 9 3.4 61 2.8 3 3.6 Asian/Pacific Islander 14 2.1 11 4.2 30 1.4 0 0.0 American Indiana/Native Alaskan 1 0.2 2 0.8 5 0.2 0 0.0 Multiracial 3 0.5 5 1.9 24 1.1 2 2.4 Total 664 100.0 264 100.0 2,167 100.0 83 100.0 No Response Given 13 4 29 2

Table 4.4 Ethnic Distribution of Advanced Practice Nurses by Specialty (2011)

Clinical Nurse Specialist Anesthetist Nurse Practitioner Nurse Nurse Midwife Ethnicity Num Percent Num Percent Num Percent Num Percent

Hispanic or Latino 4 0.6 12 4.6 35 1.6 2 2.4 Not Hispanic or Latino 645 99.4 251 95.4 2,112 98.4 82 97.6 Total 649 100.0 263 100.0 2,147 100.0 84 100.0 No Response Given 28 5 49 1 35 | P a g e

(41)

Educational Characteristics

Table 4.5 displays the highest degree in nursing obtained by APNs listed by specialty. The majority of APNs in each specialty held a Master’s degree. This is not surprising due to the increased level of education required to enter an advanced practice nursing role.

Table 4.5 Highest Degree in Nursing by Specialty Among Advanced Practice Nurses (2011)

Clinical Nurse Specialist Anesthetist Nurse Practitioner Nurse Nurse Midwife Highest Degree in

Nursing Num Percent Num Percent Num Percent Num Percent

Diploma 30 4.4 26 9.7 18 0.8 4 4.7 Associate 164 24.3 35 13.1 81 3.8 8 9.4 Bachelor's 127 18.8 43 16.1 130 6.1 10 11.8 Master's 326 48.2 161 60.3 1,829 86.0 61 71.8 Doctorate 29 4.3 2 0.7 68 3.2 2 2.4 Total 676 100.0 267 100.0 2,126 100.0 85 100.0 No Response Given 1 1 12 0 36 | P a g e

(42)

Primary vs. Non-Primary Care Nurse Practitioners

Table 4.6 shows the average weekly hours worked by primary care nurse practitioners and non-primary care nurse practitioners. A greater proportion of primary care nurse

practitioners work less than 35 hours per week (26.1%) compared to non-primary care nurse practitioners (16.0%). Nearly identical percentages of primary and non-primary care nurse practitioners work between 35 and 40 hours per week, but a greater percentage of non-primary care nurse practitioners work 41 hours or more per week than primary care nurse practitioners (48.8% and 38.6%, respectively).

Table 4.6 Average Weekly Hours Worked by Primary Care and Non-Primary Care Nurse Practitioners Non-Primary Care Nurse Practitioners Primary Care Nurse Practitioners Hours Number Percent Number Percent

1 - 19 24 2.3 68 6.4 20 - 35 146 13.7 209 19.7 36 - 40 376 35.3 374 35.2 41 or more 520 48.8 410 38.6 Total 1,066 100.0 1061 100.0 No Response Given 31 38 37 | P a g e

(43)

The highest degree obtained by primary care and non-primary care nurse practitioners is displayed in Table 4.7. The distribution of degrees held by primary and non-primary care nurse practitioners were very similar. For both types of nurse practitioners a Master’s degree was the most commonly held highest degree. Primary care nurse practitioners had a slightly larger proportion of individuals with a doctorate versus non-primary care nurse practitioners (4.5% vs. 1.7%, respectively).

Table 4.7 Highest Degree in Nursing Held by Primary Care and Non-Primary Care Nurse Practitioners Non-Primary Care Nurse Practitioners Primary Care Nurse Practitioners Degree Number Percent Number Percent

Diploma 14 1.3 4 0.4 Associate 45 4.1 36 3.3 Bachelor's 87 8.0 101 9.2 Master's 925 84.9 904 82.6 Doctorate 19 1.7 49 4.5 Total 1,090 100.0 1,094 100.0 No Response Given 7 5 38 | P a g e

(44)

Chapter 5: Principal Practice Location

The following maps display the estimated number of registered nurse FTEs by county within the state of Indiana in 2011. The number of registered nurse FTEs in each county is based on the respondents’ principal practice location and it was adjusted (weighted) for the response rate of the 2011survey (81.9%).Thus, the counts of registered nurse FTEs used in these maps are estimates of the actual number of registered nurse FTEs in each county, and not the actual number of survey respondents in each county. For clarification on how FTEs were calculated please refer to the Methods section at the beginning of this report.

(45)

Map 5.1 shows the estimated number of registered nurse FTEs in Indiana counties. The most populous counties tended to have the most registered nurse FTEs. These counties include Allen, Bartholomew, Delaware, Elkhart, Floyd, Hamilton, Hendricks, Howard, Lake, La Porte, Madison, Marion, Monroe, Porter, St. Joseph, Tippecanoe, Vanderburgh and Vigo counties.

Map 5.1 Estimated FTEs of Registered Nurses in Indiana Counties

(46)

Map 5.2 shows the estimated number of registered nurse FTEs per 100,000 by county. Counties with the highest ratios per 100,000 included Allen, Bartholomew, Delaware, Dubois, Elkhart, Floyd, Grant, Howard, Lake, Knox, Marion, Monroe, St. Joseph, Tippecanoe,

Vanderburgh, Vigo, Warrick and Wayne counties.

Map 5.2 Estimated FTEs of Registered Nurses per 100,000 Population in Indiana Counties

(47)

Map 5.3 shows the percentage of registered nurses holding a Bachelor’s degree or higher as their highest degree in nursing for each Indiana county. Marion County had the highest percentage of registered nurses holding a Bachelor’s degree or higher (62.3%) and Sullivan County had the lowest percentage (18.7%). Counties with the highest percentages (all greater than half of registered nurses) included: Carroll, Delaware, Elkhart, Grant, Hamilton, Hendricks, Madison, and Marion.

Map 5.3 Percentage of Registered Nurses Holding a Bachelor’s Degree or Higher by County

(48)

Table 5.1 County Data for Indiana Registered Nurses

County Weighted RN FTE Weighted RN Headcount Population 2010

RN FTEs per 100,000 Population Percent of RNs Holding a Bachelor's Degree or Higher Adams 201.8 222.2 34,387 586.8 23.9 Allen 4,608.7 5,098.9 355,329 1,297.0 38.3 Bartholomew 713.7 790.0 76,794 929.3 49.3 Benton 18.3 19.5 8,854 206.9 48.3 Blackford 58.0 62.3 12,766 454.3 39.5 Boone 237.5 256.4 56,640 419.3 43.5 Brown 23.2 24.4 15,242 152.2 31.6 Carroll 32.4 37.9 20,155 160.5 56.6 Cass 293.7 310.1 38,966 753.6 40.6 Clark 846.5 912.1 110,232 767.9 44.9 Clay 86.1 95.2 26,890 320.1 36.6 Clinton 126.4 139.2 33,224 380.4 32.7 Crawford 12.5 13.4 10,713 116.8 29.3 Daviess 223.1 240.5 31,648 705.1 23.0 DeKalb 227.1 256.4 50,047 453.8 25.2 Dearborn 293.3 313.8 25,740 1,139.6 31.4 Decatur 159.0 173.4 42,223 376.7 36.4 Delaware 1,205.1 1,299.1 117,671 1,024.2 60.2 Dubois 514.0 560.4 41,889 1,227.2 39.2 Elkhart 1,576.3 1,724.1 197,559 797.9 51.0 Fayette 154.2 162.4 24,277 635.0 45.4 Floyd 893.5 960.9 74,578 1,198.0 47.1 Fountain 35.7 37.9 17,240 207.2 26.5 Franklin 35.4 39.1 23,087 153.4 33.0 Fulton 139.8 146.5 20,836 671.0 40.0 Gibson 142.2 155.1 33,503 424.6 22.7 Grant 675.5 713.1 70,061 964.2 61.7 Greene 117.8 124.5 33,165 355.3 29.1 Hamilton 2,279.3 2,528.7 274,569 830.1 59.0 Hancock 347.4 379.7 70,002 496.2 50.0 Harrison 164.5 180.7 39,364 418.0 34.1 Hendricks 957.3 1,041.5 145,448 658.1 53.4 Henry 276.9 301.6 49,462 559.7 43.0 Howard 851.3 917.0 82,752 1,028.8 44.4 Huntington 181.6 203.9 37,124 489.2 26.5 Jackson 350.4 367.5 42,376 826.9 46.3 Jasper 164.2 174.6 33,478 490.5 32.3 Jay 97.1 105.0 21,253 456.7 35.5 Jefferson 278.4 297.9 32,428 858.5 37.2 Jennings 80.0 85.5 28,525 280.4 37.8 43 | P a g e

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Table 5.1 County Data for Indiana Registered Nurses (Cont’d.)

County Weighted RN FTE Weighted RN Headcount Population 2010

RN FTEs per 100,000 Population Percent of RNs Holding a Bachelor's Degree or Higher Johnson 656.0 704.5 139,654 469.7 44.0 Knox 586.7 631.3 38,440 1,526.3 27.6 Kosciusko 387.4 427.4 77,358 500.7 34.2 LaPorte 899.0 982.9 111,467 806.5 34.6 LaGrange 105.6 119.7 37,128 284.5 37.5 Lake 4,882.8 5,357.8 496,005 984.4 46.3 Lawrence 287.5 315.0 46,134 623.3 26.0 Madison 1,029.0 1,105.0 131,636 781.7 50.8 Marion 15,241.5 16,294.3 903,393 1,687.1 62.3 Marshall 352.9 381.0 47,051 750.0 38.1 Martin 21.4 23.2 10,334 206.8 42.9 Miami 143.5 156.3 36,903 388.8 37.1 Monroe 1,269.5 1,368.7 137,974 920.1 44.7 Montgomery 163.0 177.0 38,124 427.6 33.4 Morgan 352.0 385.8 68,894 510.9 36.3 Newton 19.2 20.8 14,244 135.0 41.3 Noble 178.6 196.6 47,536 375.7 32.5 Ohio 10.7 11.0 6,128 174.3 42.9 Orange 95.8 107.4 19,840 483.1 32.5 Owen 23.5 26.9 21,575 108.9 26.0 Parke 28.4 30.5 17,339 163.7 39.8 Perry 116.6 128.2 19,338 603.0 21.5 Pike 37.5 42.7 12,845 292.3 28.5 Porter 1,133.1 1,255.2 164,343 689.5 41.4 Posey 43.7 47.6 25,910 168.5 23.1 Pulaski 78.1 85.5 13,402 583.1 36.3 Putnam 134.6 145.3 37,963 354.6 31.6 Randolph 102.3 107.4 26,171 390.7 41.7 Ripley 215.8 234.4 28,818 748.9 41.9 Rush 80.6 87.9 17,392 463.4 36.5 Scott 102.3 107.4 24,181 422.9 31.6 Shelby 252.7 271.1 44,436 568.8 41.7 Spencer 58.3 61.1 20,952 278.3 19.9 St. Joseph 2,667.0 2,884.0 266,931 999.1 47.5 Starke 74.8 80.6 23,363 320.1 22.0 Steuben 131.0 151.4 34,185 383.1 29.3 Sullivan 120.9 131.9 21,475 562.9 18.7 Switzerland 18.9 20.8 10,613 178.3 32.3 Tippecanoe 1,739.9 1,851.0 172,780 1,007.0 48.2 Tipton 108.7 117.2 15,936 681.9 48.0 44 | P a g e

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Table 5.1 County Data for Indiana Registered Nurses (Cont’d.)

County Weighted RN FTE Weighted RN Headcount Population 2010

RN FTEs per 100,000 Population Percent of RNs Holding a Bachelor's Degree or Higher Union 13.1 14.7 7,516 174.6 32.6 Vanderburgh 2,980.2 3,225.9 179,703 1,658.4 39.8 Vermillion 95.5 102.6 16,212 589.3 41.2 Vigo 1,508.5 1,599.5 107,848 1,398.8 37.1 Wabash 150.8 162.4 32,888 458.5 32.4 Warren 33.9 35.4 8,508 398.2 26.1 Warrick 788.5 859.6 59,689 1,320.9 38.1 Washington 77.5 81.8 28,262 274.3 31.6 Wayne 742.4 790.0 68,917 1,077.2 44.0 Wells 162.1 179.5 27,636 586.5 34.2 White 122.7 131.9 24,643 498.0 34.8 Whitley 126.7 145.3 33,292 380.5 23.8 45 | P a g e

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Map 5.4 shows the estimated FTEs of advanced practice nurses in each Indiana County. The distribution of advanced practice nurse FTEs is comparable to the distribution of all

registered nurse FTEs (refer to Map 5.1). The most populous counties tended to have the highest number of advanced practice nurse FTEs. These counties included: Allen, Elkhart, Hamilton, Lake, Marion, Monroe, St. Joseph, Tippecanoe, and Vanderburgh Counties.

Map 5.4 Estimated FTEs of Advanced Practice Nurses in Indiana Counties

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Map 5.5 shows the estimated number of advanced practice nurse FTEs per 100,000 population in Indiana counties. This distribution closely matched the distribution of all registered nurse FTEs per 100,000 population in Indiana counties (refer to Map 5.2). The counties with the highest ratio of advanced practice nurses to population included: Dearborn, Floyd, Knox, Marion, Monroe, Pulaski, Tippecanoe, Vanderburgh, and Vigo Counties.

Map 5.5 Estimated FTEs of Advanced Practice Nurses per 100,000 Population in Indiana Counties

Figure

Table 1.1 Current License Status

Table 1.1

Current License Status p.10
Table 2.1 Age of Respondents (2005 – 2011)

Table 2.1

Age of Respondents (2005 – 2011) p.17
Table 2.3 displays the racial and ethnic demographics for the population of Indiana to  provide a comparison with the demographics of the registered nurse workforce

Table 2.3

displays the racial and ethnic demographics for the population of Indiana to provide a comparison with the demographics of the registered nurse workforce p.19
Table 2.4 Race of Respondents (1997 – 2005)

Table 2.4

Race of Respondents (1997 – 2005) p.20
Table 2.6 Highest Degree in Nursing Completed by Respondents (2007 – 2011)

Table 2.6

Highest Degree in Nursing Completed by Respondents (2007 – 2011) p.22
Table 2.7 Highest Degree in Nursing by Age Group of 2011 Respondents

Table 2.7

Highest Degree in Nursing by Age Group of 2011 Respondents p.23
Table 2.7 shows the highest degree held by registered nurse respondents in 2011 by age  group

Table 2.7

shows the highest degree held by registered nurse respondents in 2011 by age group p.23
Table 2.8 shows the percentage of RNs that plan to pursue additional degrees in nursing  in the next two years

Table 2.8

shows the percentage of RNs that plan to pursue additional degrees in nursing in the next two years p.24
Table 2.10 Currently Held Principal Practice Position of Respondents (2011)

Table 2.10

Currently Held Principal Practice Position of Respondents (2011) p.25
Table 2.11 shows the principal work setting of respondents.  The most common work  setting was non-federal, short-term (non-psychiatric) hospitals (41.4%) followed by other types  of hospitals (11.8%) and nursing home/extended care facilities (5.6%)

Table 2.11

shows the principal work setting of respondents. The most common work setting was non-federal, short-term (non-psychiatric) hospitals (41.4%) followed by other types of hospitals (11.8%) and nursing home/extended care facilities (5.6%) p.26
Table 2.12 Number of Paid Positions Held by Respondents

Table 2.12

Number of Paid Positions Held by Respondents p.28
Table 2.14 Respondents’ Practice Location by Urban and Rural Counties (2011)

Table 2.14

Respondents’ Practice Location by Urban and Rural Counties (2011) p.29
Table 2.17 displays the respondents who indicated that they are currently practicing in  an advanced practice nursing role

Table 2.17

displays the respondents who indicated that they are currently practicing in an advanced practice nursing role p.31
Table 2.18 displays the age distribution by degree type of registered nurses in the year  2020

Table 2.18

displays the age distribution by degree type of registered nurses in the year 2020 p.32
Table 2.19 Respondents’ Anticipated Time to Retirement by Age Categories (2011)

Table 2.19

Respondents’ Anticipated Time to Retirement by Age Categories (2011) p.33
Table 2.21 Time Since Working in a Paid Position in Nursing (2011)  If you are not currently working in a paid nursing

Table 2.21

Time Since Working in a Paid Position in Nursing (2011) If you are not currently working in a paid nursing p.35
Table 3.5 shows the highest degree in nursing obtained by respondents who indicated  that their principal position was in nursing faculty from 2005 to 2011

Table 3.5

shows the highest degree in nursing obtained by respondents who indicated that their principal position was in nursing faculty from 2005 to 2011 p.38
Table 4.1 shows the age distribution of each APN specialty in 2011.  While clinical nurse  specialists, nurse anesthetists, and nurse midwives each had approximately one-tenth of  respondents (9.6%, 13.5%, and 9.4%, respectively) under age 35, nearly one-f

Table 4.1

shows the age distribution of each APN specialty in 2011. While clinical nurse specialists, nurse anesthetists, and nurse midwives each had approximately one-tenth of respondents (9.6%, 13.5%, and 9.4%, respectively) under age 35, nearly one-f p.39
Table 4.3 Racial Distribution of Advanced Practice Nurses by Specialty (2011)

Table 4.3

Racial Distribution of Advanced Practice Nurses by Specialty (2011) p.40
Table 4.5 displays the highest degree in nursing obtained by APNs listed by specialty

Table 4.5

displays the highest degree in nursing obtained by APNs listed by specialty p.41
Table 4.6 shows the average weekly hours worked by primary care nurse practitioners  and non-primary care nurse practitioners

Table 4.6

shows the average weekly hours worked by primary care nurse practitioners and non-primary care nurse practitioners p.42
Table 4.7 Highest Degree in Nursing Held by Primary Care and Non-Primary Care Nurse Practitioners

Table 4.7

Highest Degree in Nursing Held by Primary Care and Non-Primary Care Nurse Practitioners p.43
Table 5.1 County Data for Indiana Registered Nurses   County  Weighted RN FTE  Weighted RN Headcount  2010  Population  RN FTEs per 100,000 Population  Percent of RNs Holding a Bachelor's  Degree or Higher  Adams  201.8  222.2  34,387  586.8  23.9  Allen

Table 5.1

County Data for Indiana Registered Nurses County Weighted RN FTE Weighted RN Headcount 2010 Population RN FTEs per 100,000 Population Percent of RNs Holding a Bachelor's Degree or Higher Adams 201.8 222.2 34,387 586.8 23.9 Allen p.48
Table 5.1 County Data for Indiana Registered Nurses (Cont’d.)  County  Weighted RN FTE  Weighted RN Headcount  2010  Population  RN FTEs per 100,000 Population  Percent of RNs Holding a Bachelor's  Degree or Higher  Union  13.1  14.7  7,516  174.6  32.6  V

Table 5.1

County Data for Indiana Registered Nurses (Cont’d.) County Weighted RN FTE Weighted RN Headcount 2010 Population RN FTEs per 100,000 Population Percent of RNs Holding a Bachelor's Degree or Higher Union 13.1 14.7 7,516 174.6 32.6 V p.50
Table 5.2 County Data for Indiana Advanced Practice Nurses

Table 5.2

County Data for Indiana Advanced Practice Nurses p.53
Table 5.2 County Data for Indiana Advanced Practice Nurses (Cont’d.)

Table 5.2

County Data for Indiana Advanced Practice Nurses (Cont’d.) p.54
Table 5.2 County Data for Indiana Advanced Practice Nurses (Cont’d.)

Table 5.2

County Data for Indiana Advanced Practice Nurses (Cont’d.) p.55
Figure 6.1 Registered Nurses Licensed by the State of Indiana

Figure 6.1

Registered Nurses Licensed by the State of Indiana p.56
Figure 6.2 Registered Nurses Active in Indiana by Age Group

Figure 6.2

Registered Nurses Active in Indiana by Age Group p.57
Figure 6.3 Registered Nurses Active in Indiana by Highest Degree in Nursing

Figure 6.3

Registered Nurses Active in Indiana by Highest Degree in Nursing p.58

References