Advertisement
Supplement| Volume 9, ISSUE 3, SUPPLEMENT , S1-S88, October 2018

Download started.

Ok

The 2017 National Nursing Workforce Survey

DOI:https://doi.org/10.1016/S2155-8256(18)30131-5
The 2017 National Nursing Workforce Survey
Previous ArticleEditorial Advisory Board
      The 2017 National Nursing Workforce Survey

      Executive Summary

      The purpose of this study is to provide the nation with the most accurate data available on the characteristics of the U.S. nursing workforce. Since 2013, the National Council of State Boards of Nursing (NCSBN) and The National Forum of State Nursing Workforce Centers (Forum) have partnered every 2 years to conduct this national sample survey using the Forum’s Nurse Supply Minimum Data Set (MDS), a standardized survey tool designed to collect workforce data. These data will help answer some of the pressing questions asked by health care workforce researchers, policy makers, and leaders in nursing education and practice to assist in workforce planning and provide evidence for decisions impacting the future of nursing in America.
      Previously, NCSBN and the Forum reported on the state of the workforce in The 2015 National Nursing Workforce Survey. The 2015 study estimated that in the United States and its territories, 3,852,881 individuals held active registered nurse (RN) licenses, and 906,471 held an active licensed practical nurse/licensed vocational nurse (LPN/LVN) license (
      • Budden J.S.
      • Moulton P.
      • Harper K.J.
      • Brunell M.L.
      • Smiley R.
      The 2015 national nursing workforce survey.
      Journal of Nursing Regulation. 2016; 7: S1-S90
      ). Approximately 12% of these nurses held multiple licenses. The study identified an advanced practice registered nurse (APRN) workforce that appeared to be increasing in age in addition to an aging population of nurse educators. Eighty-one percent of respondents with RN licenses were actively employed in nursing and 77% of those with LPN/LVN licenses were actively employed in nursing. According to the 2015 study, hospitals were the most common employment setting for RNs (or 54% of respondents). However, the authors recognized that the work setting for both RNs and LPNs/LVNs was changing due to telehealth technologies and other factors. Demographically, the 2015 survey found that 19.5% of RN respondents and 32% of LPN/LVN respondents were from underrepresented racial and ethnic populations. The study also noted that minority populations were better represented in younger cohorts and among more recently licensed RNs. Data from this survey indicated that the median salary for males was higher than for females among both RNs and LPNs/LVNs ($72,000 versus $64,000 among RNs, and $43,200 versus $38,000 among LPNs/LVNs.

      Selected Findings From the 2017 Workforce Study

      Size of the RN and LPN/LVN Workforce

      As of December 2017, the total number of active RN licenses held was 4,639,548 and active LPN/LVN licenses held was 975,988, representing an increase by 261,275 of RN licenses (6.0%) and a decrease by 52,432 of LPN/LVN licenses (-5.1%) when compared to 2015. After adjusting for nurses with multiple licenses, the 2017 numbers correspond to approximately 3,951,001 RN licensees and 920,743 LPN/LVN licensees.

      Aging of the Workforce

      The average age of RNs is 51, which is largely consistent with previous study findings (2015 and 2013). In 2015, 12.4% of the RN respondents were 65 or older compared to 14.6% in the current study, an increase of 2.2 percentage points, which indicates a slow but steady growth of RNs that may be heading for retirement. The average age of LPNs/LVNs was 52 in 2017, a year older than in 2015. The percentage of nurses 65 and older increased from 9.9% in 2015 to 13.2% in 2017, which represents twice as much of an increase in comparison to RNs.

      Gender, Race, and Ethnic Diversity

      The percentage of male RNs (9.1%) in the 2017 workforce increased by 1.1 and 2.5 percentage points, respectively, when compared with findings from the 2015 (8.0%) and 2013 study (6.6%). Approximately 5% of RNs indicated that they were of Hispanic or Latino origin. In the current study 19.2% of the RN respondents were minorities, which includes other and two or more races: Asian (7.5%), Black/African American (6.2%), other (2.9%), and two or more races (1.7%). The percentage of nurses who identify as Asian in the current study exceeds the 5.7% represented in the U.S. population; the percentage of nurses who identify as Black/African American falls below the 13.3% in the U.S. population (U.S. Census Bureau, 2017). The LPN/LVN workforce remains relatively unchanged in terms of gender diversity between 2015 and 2017. The percentage of males in the LPN/LVN workforce increased by less than half of a percentage point from 7.5% to 7.7% between the two studies. LPNs/LVNs are more racially and ethnically diverse than their RN counterparts. Approximately 29% of LPNs/LVNs were racial minorities with the largest reporting minority group being Black/African Americans (18.5%).

      Education

      The trend toward a higher percentage of respondents pursuing a BSN degree as their initial nursing education continued in 2017 with 41.8% of the RNs reporting the BSN as the degree that qualified them for their first US nursing license, which reflects a 2.8 percentage point increase when compared to 2015 (39.0%) and a 6.3 percentage point increase when compared to 2013 (35.5%). In terms of graduate education, the number of RNs with a Master’s degree in nursing has increased from 13.8% in 2013 to 17.1% in 2017, an increase of 3.3 percentage points. Although small in terms of percentage, 1.1% of responding RNs reported having a Doctorate in Nursing Practice (DNP) as their highest level of nursing education, which is double the percent of nurses who reported having a DNP in 2015. By comparison, 83.2% of LPNs/LVNs indicated that their entry-level qualification for their first US nursing license was a vocational/practical certificate. Of those, more than three-quarters did not pursue a higher level of nursing education.

      Employment and Salary

      Nurses work settings are changing, as patient care is no longer confined to the walls of a health care facility. Hospitals were the primary employment setting for 55.7% of RNs, 54.4% in 2015, but less than the 56.5% reported in 2013. Ambulatory care setting was the second most frequently selected employment setting reported by 9.4% of RNs, followed by nursing home/extended care (4.8%), and home health (4.3%).
      The median pre-tax annual earnings for RNs in the current study increased from $60,000 in 2015 to $63,000 in 2017, which is lower than the median salary of $70,000 for RNs reported by the Bureau of Labor Statistics Occupational Outlook Handbook (2018). In the current study, responding RNs making between $80,000 and $100,000 increased by 1.6 percentage points and those making more than $100,000 increased by nearly 4 percentage points.
      Nursing home/extended care was the most common work setting for LPNs/LVNs (31.7%), followed by home health settings (14.0%), and hospitals (9.6%). These findings are consistent with results from the 2015 survey.
      The median pre-tax annual earnings for LPNs/LVNs increased from $38,000 in 2015 to $40,000 in 2017. However, it is also lower than the median pay of $45,030 reported by the
      • U.S. Bureau of Labor Statistics
      Occupational outlook handbook.
      www.bls.gov/ooh/healthcare/registered-nurses.htm
      Date: 2018
      .

      Telehealth

      Over half (54.1%) of responding RNs provided nurse services using telehealth technologies. In the current study, 45.7% provided these services across a state border compared to 39.4% in 2015, an increase of 6.3 percentage points, and 11.1% reported providing remote services to patients or clients across national borders, which is an increase of 3.4 percentage points when compared to 2015 (7.7%).
      LPNs/LVNs provided nursing services using telehealth technologies in similar proportions to RNs (54.2%). Of those providing these services, 43.9% provided services across state borders, an increase of 10.1 percentage points from 2015.

      Conclusion

      In conclusion, ongoing monitoring and evaluation of the nursing workforce are critical, as the nursing workforce will continue to undergo significant changes in the next few years. This survey represents the nursing workforce of today with the expectation that the workforce of tomorrow will be slightly younger, highly educated, with higher numbers working in the community providing primary health care and using technology and telehealth as a means to deliver health care. As the United States undergoes health system transformations, nurses, as the largest segment of the health care workforce and members of the interprofessional health care team, are in a unique position to contribute to and, in many instances, lead the transformation. This effort will require a nursing workforce with an enhanced set of knowledge and skills in relation to population health and wellness, multidisciplinary care coordination, technological advances in health care delivery, evidence-based data analytics, and quality improvement. All these elements create a picture of what will constitute the nursing workforce of the future.

      Introduction

      The National Council of State Boards of Nursing (NCSBN) and The Forum of State Nursing Workforce Centers (Forum) collaborated on the third biennial national survey of registered nurses (RNs) and licensed practical nurses/licensed vocational nurses (LPNs/LVNs) to provide an in-depth study of the national nursing workforce. The survey is designed to collect important information on the supply of RNs and LPNs/LVNs in the United States. Knowledge of the supply of nurses can be used to predict potential shortages and assist in the allocation of resources, program development, and recruitment efforts in both the health care system and education sectors. Having an adequate supply of nurses in the workforce is essential to providing safe and effective health care to the citizens of the United States.
      This study presents a national, randomized survey of 148,684 licensed RNs and 151,928 LPNs/LVNs. Data were collected between August 28, 2017, and January 15, 2018, from the 48,704 RN responders (32.8%) and the 40,272 LPN/LVN responders (26.5%). The data provides the most recent and detailed information on the current demographics, characteristics, educational attainment, employment, and trends of the U.S. RN and LPN/LVN nursing workforce as of 2017. To illustrate trends in workforce supply, the current study’s results were compared to some national nursing workforce studies that based their findings on data collected years prior to this study, as well as studies in which different data collection methods were used. Thus, the comparisons of statistics from various studies presented should be interpreted with the above considerations in mind.

      Method

      Sample

      All RNs and LPNs/LVNs with an active license in the United States and its territories were eligible candidates for survey participation. A portion of the sample was drawn from Nursys®, NCSBN’s licensure database. This database contains basic demographic and licensure information for RN and LPN/LVN licensees, with the exception of Hawaii, Louisiana (LPN), and Oklahoma licensees because at the time of the study, these states did not participate in Nursys. Additionally, Alabama, Kansas, Massachusetts, Pennsylvania, and Washington restrict the use of addresses in Nursys. These states were contacted to obtain licensee lists and addresses directly. Licensee lists and addresses were also obtained directly from the following BONs: California (RN and LPN/LVN), Michigan, New Jersey, and New York. Names and addresses of nurses living in Utah were obtained from a national mailing list. American Samoa and Missouri voluntarily chose not to participate in this survey.
      As of June 2017, the total number of active RN licenses held was 4,639,548 and active LPN/LVN licenses held was 975,988. These numbers do not include American Samoa and Missouri but do include the approximately 17% of individuals with multiple licenses. Separate RN and LPN/LVN samples stratified by state were randomly selected from the RN licensees and LPN/LVN licensees. Surveys were mailed to 153,920 RNs and 158,502 LPNs/LVNs. Table 1 and Table 2 present the sampling by jurisdiction/state. Each jurisdiction is listed with the actual number of active licenses at the time of sampling and the number of surveys that needed to be received from each jurisdiction in order to construct a 95% confidence of plus or minus 3% error. Regardless of jurisdiction size, this calculated out to be approximately 1,000 nurses per jurisdiction. To calculate the number of surveys needed to be mailed out to reach the target survey response, response rates via online and paper from the previous 2015 survey administration were used as estimates. For example, for Alaska in 2015 there was a 36% response rate for the RN survey. Given this estimated rate, 2,684 RNs in Alaska were selected to be sent a survey in order to receive the target of 977 surveys. Actual response from Alaska RNs to the current survey (i.e., the number of responses returned) was 966, very close to the target of 977.
      Table 1Number of Active RN Licenses
      JurisdictionNumber of Active RN LicensesEstimated Sample: 95% Confidence, 3% ErrorEstimated Total Response RateNumber of Surveys MailedUndeliverableNumber ReceivedNumber of ResponsesTotal Response Rate
      AK13,82997736.4%2,684492,63596636.7%
      AL79,6101,05128.1%3,740303,7101,01027.2%
      AR41,6361,04030.1%3,455673,38896728.5%
      AZ87,4201,05432.8%3,2132312,98296632.4%
      CA427,8921,06432.1%3,315743,2411,02031.5%
      CO75,4191,05234.4%3,0582532,8051,02636.6%
      CT64,8821,05035.9%2,925762,84993732.9%
      DC26,5081,02029.0%3,5171263,39196028.3%
      DE18,1111,01037.7%2,6791062,57381831.8%
      FL316,6401,06327.3%3,894893,80599326.1%
      GA132,9491,05830.0%3,5271113,4161,01829.8%
      HI27,9161,04836.6%2,8631732,69088232.8%
      IA54,4151,04639.4%2,655702,58599238.4%
      ID21,3621,01741.4%2,4571132,34492939.6%
      IL195,3991,06131.2%3,401883,3131,06932.3%
      IN111,1291,05737.7%2,8041092,69590233.5%
      KS57,9691,04736.0%2,908602,84897234.1%
      KY69,7531,05130.8%3,412343,3781,00229.7%
      LA65,9141,05028.4%3,697593,6381,09630.1%
      MA134,4051,05834.0%3,112583,05498332.2%
      MD81,3631,05331.4%3,3541143,2401,08033.3%
      ME25,0261,02236.2%2,823602,7631,06638.6%
      MI149,8641,06039.5%2,684572,6271,02739.1%
      MN109,4561,05642.3%2,496512,44597840.0%
      MS48,9071,04325.2%4,139914,0481,07326.5%
      MT16,2851,00344.3%2,2641272,13798946.3%
      NC134,7381,05836.3%2,915922,82390832.2%
      ND14,03999141.8%2,371712,3001,00543.7%
      NE29,9301,02742.5%2,4162582,15879236.7%
      NH22,7771,01837.5%2,715952,62092835.4%
      NJ124,9911,05830.5%3,469473,4221,09231.9%
      NM28,4221,02733.1%3,1031422,9611,03535.0%
      NV38,0541,03630.9%3,3531653,1881,01631.9%
      NY322,7551,06335.4%3,0032942,70970726.1%
      OH204,2811,06237.1%2,8631022,76189532.4%
      OK55,5061,04630.5%3,430693,36193527.8%
      OR60,2301,04837.4%2,8021042,6981,07539.8%
      PA220,5831,06239.8%2,668382,63093735.6%
      RI20,5291,01333.9%2,9881132,87596833.7%
      SC69,7991,05032.2%3,261953,16694029.7%
      SD18,1621,00642.4%2,373502,32394040.5%
      TN100,8171,05631.7%3,331943,23789127.5%
      TX314,9201,06327.6%3,8511313,72090624.4%
      UT33,3091,03335.3%2,92602,92673625.2%
      VA104,6671,05631.6%3,342773,2651,02531.4%
      VT14,06499638.0%2,621252,59697337.5%
      WA96,6641,05538.5%2,7401442,5961,01939.3%
      WI102,9081,05546.8%2,254322,2221,02246.0%
      WV32,6691,03330.5%3,387563,33188826.7%
      WY15,57999040.8%2,4261082,31898042.3%
      Virgin Islands1,59962125.7%1,02613589115717.6%
      Guam1,20051223.9%74512661914323.1%
      Northern Mariana Islands2,29764020.6%465973687019.0%
      TOTAL4,639,54853,78634.3%153,9205,236148,68448,70432.8%
      Table 2Number of Active LPN/LVN Licenses
      JurisdictionNumber of Active LPN/LVN LicensesEstimated Sample: 95% Confidence, 3% ErrorEstimated Total Response RateNumber of Surveys MailedUndeliverableNumber ReceivedNumber of ResponsesTotal Response Rate
      AK86544630.7%6363959714824.8%
      AL18,4861,00528.6%3,5141253,38992627.3%
      AR15,28799828.0%3,564983,46687525.2%
      AZ10,36296824.2%4,0004033,59795426.5%
      CA100,1291,05622.5%4,6931064,5871,07923.5%
      CO8,71294025.4%3,7013903,3111,01830.7%
      CT12,95698723.0%4,2912564,03587021.6%
      DC2,20576122.8%1,827331,79435719.9%
      DE3,05077427.6%2,6931452,54859423.3%
      FL64,2371,05123.9%4,3972084,18983419.9%
      GA30,8131,03524.1%4,2951054,19094722.6%
      HI3,00497830.7%2,5691892,38071330.0%
      IA10,51797232.0%3,038982,94093131.7%
      ID3,74781832.7%2,502862,41675931.4%
      IL26,8201,03025.0%4,120794,0411,10127.2%
      IN25,3851,02127.5%3,713973,61690525.0%
      KS10,63996932.3%3,0001412,85981728.6%
      KY13,83599225.4%3,906853,82193124.4%
      LA23,1601,02022.7%4,493694,42485819.4%
      MA20,4881,01825.9%3,9311353,79689623.6%
      MD12,29798323.2%4,2372114,02694923.6%
      ME2,24273033.4%2,090672,02372836.0%
      MI24,2371,02433.9%3,021822,93990430.8%
      MN22,2971,01838.3%2,658622,5961,04340.2%
      MS14,22298920.9%4,7322584,4741,04123.3%
      MT2,66379142.0%1,8831141,76977043.5%
      NC22,6051,01829.8%3,4161583,25898730.3%
      ND3,16180539.2%2,054791,97581441.2%
      NE5,84291835.6%2,5791092,47088235.7%
      NH3,13079629.8%1,379761,30334726.6%
      NJ23,4351,02125.5%4,004823,92291223.3%
      NM2,75876829.0%2,6481802,46872729.5%
      NV3,90583227.5%3,0252522,77374126.7%
      NY76,9281,05223.9%1,903801,82335619.5%
      OH54,7201,04628.8%3,6321633,4691,01729.3%
      OK16,8081,01226.1%3,8771933,68479021.4%
      OR5,38188429.0%3,0481512,89786029.7%
      PA53,9891,04534.9%2,994682,92689430.6%
      RI2,00869127.4%1,873961,77748027.0%
      SC12,68298027.2%3,6031553,44885624.8%
      SD2,61775335.8%2,103622,04173235.9%
      TN30,2161,03125.3%4,0751003,97592623.3%
      TX105,6551,05623.7%4,4562104,24690021.2%
      UT2,83476929.3%2,62502,62555321.1%
      VA27,7451,02822.6%4,5491574,3921,00322.8%
      VT2,37969931.2%1,868601,80847126.1%
      WA11,51397830.8%3,1752692,90683628.8%
      WI13,16699942.7%2,340232,31792139.7%
      WV7,96894221.0%4,486764,41096421.9%
      WY1,46558735.6%9605390730733.8%
      Virgin Islands17014113.1%132131191714.3%
      Guam5614631.1%154251292317.8%
      Northern Mariana Islands1975410.5%40337821.6%
      TOTAL975,98846,42528.0%158,5026,574151,92840,27226.5%

      Survey Instrument and Materials

      NCSBN and the Forum currently use the Nurse Supply Minimum Data Set (MDS), which was approved in 2009 after an intensive process of consensus-building and data compilation, to collect data on the nursing workforce at the state level. Because of the evolution and transformation of health care and nursing that have taken place since 2009, in 2015 the Forum made the decision to revisit the Supply MDS. Throughout 2015, the Forum’s Research Committee undertook the task of reviewing the Supply MDS to ensure that the elements included were still relevant. This review included an assessment of items that were currently being collected by states and national organizations in their supply data collection efforts. The revised elements of this assessment were subject to review by members of the research committee as well as review and approval of all Forum member executive directors. Additionally, the Forum solicited comment on the proposed changes to the Supply MDS from national organizations and health care workforce researchers. Feedback received was incorporated into the updated version of the Supply MDS, which was ratified by the Forum in 2016.
      Data were collected between August 28, 2017, and January 15, 2018. The survey was a four-page Scantron® fillable document with 31 questions. Data elements from the latest revision of the Forum’s Supply MDS were incorporated, resulting in the following changes to the survey between the 2015 and 2017 waves of data collection:
      • •
        Ethnicity was asked separately from race
      • •
        Highest level of nursing education and highest level of non-nursing education were asked separately
      • •
        Response options for employment status, employment setting, and employment specialty were added, deleted, or revised.

      Procedure

      Western Institutional Review Board granted approval for the current study. A unique identification number was generated and assigned to each sampled participant. The identification was only to be used to record that the survey had been returned. This helped prevent unnecessary and expensive duplicate mailings to those selected to participate in the study. Also, a unique access code identifier was used for the online survey option. Electronic versions of the data were kept on department-secured servers through the end of the project. NCSBN’s research staff, three key members of the Forum, and key personnel at Scantron had initial access to the identifiable data. Scantron no longer has access to the identifiable data.
      Once materials were developed and the sampling file was complete, surveys were distributed over a 20-week period that included the following steps:
      • •
        Week 1: An announcement letter was sent to all nurses selected to participate (except for those in Utah, whose sampling process was delayed). The letter included a URL and access code to take the survey online.
      • •
        Week 2: Nurses with email addresses were sent a link to take the survey online. For nurses without email addresses, a cover letter and paper survey were mailed via first class U.S. mail.
      • •
        Week 3: Nurses with email addresses were sent a reminder to take the survey online.
      • •
        Week 4: Nurses with email addresses were sent a second reminder to take the survey.
      • •
        Week 5: For nurses who had not responded, a cover letter and paper survey were mailed via first class U.S. mail.
      • •
        Week 7: Because the sampling process was delayed in Utah, as a supplemental mailing, nurses in this state were mailed a cover letter via first class U.S. mail, which included a URL and access code and a quick response code to take the survey online.
      • •
        Week 8: For nurses who still had not responded, an additional cover letter and paper survey were mailed via first class U.S. mail. This mailing included the nurses in Utah.
      • •
        Week 13: For nurses in Utah who still had not responded, an additional cover letter and paper survey were mailed via first class U.S. mail.
      • •
        Week 20: Deadline for receipt of all surveys.
      Once the survey was closed, the final data file was compiled separately for RNs and LPNs/LVNs.

      Analysis

      At the close of the survey, 48,704 of 148,684 successfully delivered RN surveys were returned, for a response rate of 32.8%; 40,272 of 151,928 successfully delivered LPN/LVN surveys were returned, for a response rate of 26.5%. A formal nonresponse bias analysis was conducted immediately following the close of the survey. An analysis of basic demographic data (i.e., gender, age, and race/ethnicity) for all RN licensees sampled from the Nursys database was used to compare survey respondents to survey nonrespondents. Results revealed the following groups of nurses may have been slightly overrepresented in both the RN and LPN/LVN samples: White/Caucasian, female, and age 50 or older. Because of missing or incomplete data on race/ethnicity, only gender and age were used to make nonresponse weighting adjustments. Additionally, since sampling was stratified by state, to prevent smaller states from being overrepresented in the overall analysis, a weighting variable was constructed to adjust for differing nursing population sizes across states. A description of this process can be found in Appendices A and B.
      To help the readers get an accurate and comprehensive view of the statistics drawn from the sample, the number of actual valid answers to each question is reported for every table. Missing data were not imputed; hence, the presented statistics represent the actual responses from participants who responded to each respective survey item. If a participant did not respond to a certain item, they were not part of the analysis for that item. Additionally, some tables display data for all responding nurse licensees while other tables display data for employed nurses. If a table is specific to nurses employed in nursing, it is explicitly stated. The data for Utah nurses was sampled from a file of nurses living in Utah. This differs from the data collected for the rest of the jurisdictions, which were sampled from files of nurses licensed in those jurisdictions. Many tables include bar graphs to help you easily visualize and comprehend the data presented.

      Population Estimate

      For each question on the survey, frequencies are shown that reflect the nonresponse weighting adjustments. For some of the questions, an additional set of frequencies are shown that display the data scaled up to reflect estimates of the nursing population in the subgroup identified. For example, the 354,449 males reported in the 2017 column of Table 3 reflect the number of male respondents adjusted to the population level of number of RNs after the nonresponse weighting adjustments were made to the survey results and after adjusting the population number to account for nurses having licenses in multiple states.
      Table 3Gender Distribution of Nurses—RN
      Weighted Sample Values
      2013 (n = 40,364.5)2015 (n = 43,330.9)2017 (n = 48,084.9)
      nPercentnPercentnPercent
      Male2,678.96.6%3,459.68.0%4,369.39.1%
      Female37,685.693.4%39,871.492.0%43,715.590.9%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      Male221,4166.6%277,5428.0%354,4499.1%
      Female3,114,76793.4%3,198,65092.0%3,546,32090.9%
      The adjustments for multiple licenses were derived from data in the Nursys database in February 2018. At that time, the database contained 4,726,967 RN licenses, which corresponded to 4,025,446 unique RNs. This produced an RN adjustment factor of 4,025,446/4,726,967 = 0.851592, which when applied to the 4,639,548 licenses in the RN sample frame (see Table 1) produced an estimate of 3,951,001 unique RNs in 2017.
      For LPNs/LVNs, the February 2018 database contained 971,386 licenses, which corresponded to 920,013 unique LPNs/LVNs. This produced an LPN/LVN adjustment factor of 920,013/971,386 = 0.947114, which when applied to the 975,988 licenses in the LPN/LVN sample frame (see Table 2) produced an estimate of 920,743 unique LPNs/LVNs in 2017. Supplement

      Registered Nurse Results

      Gender

      While the nursing workforce continues to be predominately female (90.9%), the proportion of respondents who were male increased 2.5 percentage points from 2013 to 2017. See Table 3.

      Race/Ethnicity

      Nearly 81% of responding RNs were White/Caucasian. An additional 7.5% identified as Asian, 6.2% identified as Black/African American, 2.9% identified as other, and 1.7% identified as two or more races. See Table 4.
      Table 4Race/Ethnicity—RN
      Weighted Sample Values
      20152017
      (n = 45,989.3)percent(n = 47,966.3)percent
      American Indian or Alaska Native198.50.4%176.00.4%
      Asian3,053.06.6%3,605.67.5%
      Black/ African American2,549.95.5%2,995.96.2%
      Native Hawaiian or other Pacific Islander171.80.4%226.30.5%
      White/Caucasian37,003.080.5%38,766.180.8%
      Other390.80.8%1,367.82.9%
      Two or more races968.42.1%828.51.7%
      Estimated Population Values
      20152017
      freqpercentfreqpercent
      American Indian or Alaska Native13,6180.4%14,2760.4%
      Asian209,4846.6%292,4977.5%
      Black/ African American174,9655.5%243,0326.2%
      Native Hawaiian or other Pacific Islander11,7870.4%18,3620.5%
      White/Caucasian2,539,01380.5%3,144,81280.8%
      Other26,8150.8%110,9602.9%
      Two or more races77,687<0.1%67,2141.7%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.
      One of the changes to the 2017 survey included the modification of the race and ethnicity items. Previously, race and ethnicity categories were listed in one question. The question was modified, so that ethnicity and race are now two separate questions. Respondents were first asked whether they were of Hispanic or Latino origin and then asked to identify their race. Anyone who selected more than one race category was recoded into the two or more races category. RNs indicating that they were of Hispanic or Latino origin increased by 1.9 percentage points between 2013 and 2017. See Table 5.
      Table 5Ethnicity of Hispanic or Latino Origin—RN
      Weighted Sample Values
      2013 (n = 41,876.0)2015 (n = 45,989.3)2017 (n = 47,965.6)
      nPercentnPercentnPercent
      Hispanic or Latino origin1,406.63.4%1,654.03.6%2,528.15.3%
      Not of Hispanic or Latino origin40,469.596.6%44,335.396.4%45,324.594.7%
      Estimated Population Values
      2013 (n = 41,876.0)2015 (n = 45,989.3)2017 (n = 47,965.6)
      Hispanic or Latino origin116,2573.4%132,6923.6%205,0865.3%
      Not of Hispanic or Latino origin3,344,85796.6%3,556,76496.4%3,676,84494.7%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.

      Race/ethnicity by gender

      Race/ethnicity groups with the highest percent of males are Hispanic/Latino (15.9%), Asian (15.7%), and Native Hawaiian or other Pacific Islander groups (15.2%). These groups had a substantially higher percent of males than the overall average (9.1%). See Table 6.
      Table 6Race/Ethnicity by Gender—RN
      Weighted Sample Values
      MaleFemalen
      American Indian or Alaska Native22.6136.5159.1
      14.2%85.8%
      Asian560.43,001.23,561.6
      15.7%84.3%
      Black/African American241.32,683.72,925.0
      8.2%91.8%
      Native Hawaiian or other Pacific Islander30.0167.0197.0
      15.2%84.8%
      White/Caucasian2,915.334,219.637,134.9
      7.9%92.1%
      Hispanic/Latino of any race400.32,120.12,520.4
      15.9%84.1%
      Other85.6563.9649.6
      13.2%86.8%
      Two or more races91.3618.1709.4
      12.9%87.1%
      Total4,346.843,510.247,857.0
      9.1%90.9%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.

      Age

      In 2017, the median age of RN respondents was 53 years. This is unchanged from the median age of RN respondents in 2015, which was also 53 years, and only a year older than the median age of 52 from 2013.
      As shown in Table 7, 50.9% of respondents were age 50 or older, which is consistent with the results from 2015 when 50% of respondents were age 50 or older. There was a 2.2 percentage point increase between 2015 and 2017 for respondents reporting that they were age 65 or older.
      Table 7Age Distribution—RN
      Weighted Sample Values
      2013 (n = 34,793.9)2015 (n = 41,258.6)2017 (n = 47,527.3)
      AgenPercentnPercentnPercent
      <302,997.98.6%3,905.29.5%4,594.59.7%
      30-342,615.47.5%4,098.09.9%4,762.810.0%
      35-392,784.08.0%3,928.19.5%4,390.69.2%
      40-443,088.68.9%4,200.710.2%4,356.79.2%
      45-493,379.39.7%4,398.210.7%5,250.711.1%
      50-544,652.613.4%4,724.811.5%4,914.910.3%
      55-595,887.716.9%5,622.413.6%5,834.412.3%
      60-644,570.113.1%5,254.912.7%6,489.813.7%
      ≥ 654,818.413.9%5,126.312.4%6,932.914.6%
      Estimated Population Values
      201320152017
      AgeFreqPercentFreqPercentFreqPercent
      <30247,7788.6%313,2919.5%372,7169.7%
      30-34216,1647.5%328,7599.9%386,37410.0%
      35-39230,0988.0%315,1279.5%356,1759.2%
      40-44255,2818.9%337,00010.2%353,4309.2%
      45-49279,3059.7%352,84310.7%425,95311.1%
      50-54384,54313.4%379,04111.5%398,71210.3%
      55-59486,62516.9%451,05113.6%473,30312.3%
      60-64377,72413.1%421,57412.7%526,46813.7%
      ≥ 65398,24713.9%411,25612.4%562,41414.6%

      Age by gender

      Among older age-groups (ages 50+), women comprise a much higher proportion of the population than younger age-groups (ages 30-49). See Table 8.
      Table 8Age Distribution by Gender—RN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      Male387.4540.9413.4471.7704.7401.6454.0493.1407.04,273.9
      9.1%12.7%9.7%11.0%16.5%9.4%10.6%11.5%9.5%
      Female4,165.14,198.43,956.73,857.44,504.24,444.45,325.35,922.56,433.842,807.9
      9.7%9.8%9.2%9.0%10.5%10.4%12.4%13.8%15.0%
      Total4,552.54,739.34,370.14,329.15,208.94,846.05,779.36,415.66,840.947,081.8
      9.7%10.1%9.3%9.2%11.1%10.3%12.3%13.6%14.5%

      Age by race/ethnicity

      The proportion of Hispanic/Latinos in the RN workforce has become progressively larger as new nurses have entered the workforce. Among those RNs 65 and older, only 7.3% are Hispanic/Latino compared to 13.9% of those under 30. This indicates an increase in the overall diversity of the nursing population. See Table 9.
      Table 9Age Distribution by Race/Ethnicity—RN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      American Indian or Alaska Native12.18.815.116.220.215.617.724.025.9155.6
      7.8%5.7%9.7%10.4%13.0%10.0%11.4%15.4%16.6%
      Asian385.5443.3339.2442.2626.9274.6308.7410.0292.53,522.9
      10.9%12.6%9.6%12.6%17.8%7.8%8.8%11.6%8.3%
      Black/African American184.1256.7373.2361.6418.8348.8290.4252.7384.52,870.9
      6.4%8.9%13.0%12.6%14.6%12.1%10.1%8.8%13.4%
      Native Hawaiian or other Pacific Islander13.646.412.620.819.022.318.423.018.4194.5
      7.0%23.9%6.5%10.7%9.8%11.5%9.5%11.8%9.5%
      White/Caucasian3,468.33,484.13,153.93,086.93,657.73,815.94,775.35,364.15,746.436,552.6
      9.5%9.5%8.6%8.4%10.0%10.4%13.1%14.7%15.7%
      Hispanic/Latino of any race343.0345.9322.1301.4289.8243.6237.3200.1179.42,462.6
      13.9%14.0%13.1%12.2%11.8%9.9%9.6%8.1%7.3%
      Other34.337.877.451.468.163.160.9107.7128.7629.5
      5.4%6.0%12.3%8.2%10.8%10.0%9.7%17.1%20.4%
      Two or more races105.4117.675.249.596.964.778.846.461.7696.2
      15.1%16.9%10.8%7.1%13.9%9.3%11.3%6.7%8.9%
      Total4,546.24,740.74,368.74,329.95,197.54,848.55,787.56,428.26,837.547,084.8
      9.7%10.1%9.3%9.2%11.0%10.3%12.3%13.7%14.5%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.

      Education

      Type of nursing degree or credential for first U.S. nursing license

      The percentage of nurses reporting the baccalaureate as the nursing degree that qualified them for their first U.S. nursing license increased by 6.3 percentage points between 2013 and 2017. The percent of respondents who initially received a diploma or associate degree decreased by 7.2 percentage points. See Table 10.
      Table 10Type of Nursing Degree or Credential for First U.S. Nursing License—RN
      Weighted Sample Values
      2013 (n = 41,792.7)2015 (n = 45,818.9)2017 (n = 47,650.0)
      nPercentnPercentnPercent
      Vocational/practical certificate1,993.84.7%2,442.15.3%2,850.66.0%
      Diploma7,364.617.4%6,539.314.3%5,708.112.0%
      Associate degree16,152.038.2%17,625.938.5%17,332.536.4%
      Baccalaureate degree15,019.535.5%17,853.439.0%19,922.741.8%
      Master’s degree1,218.02.9%1,297.92.8%1,836.03.9%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      Vocational/practical certificate164,7934.7%195,9165.3%231,2476.0%
      Diploma608,69217.4%524,60714.3%463,06012.0%
      Associate degree1,334,98738.2%1,414,02038.5%1,406,06236.4%
      Baccalaureate degree1,241,37935.5%1,432,27139.%1,616,18641.8%
      Master’s degree100,6732.9%104,1212.8%148,9423.9%
      Type of nursing degree or credential for first U.S. nursing license by age. Two degrees are more associated with older RNs: diploma (almost 40% age 65 and over) and associate degree (12.3% age 65 and over). Increasingly, a baccalaureate is more common in younger age-groups as the educational qualifier for the nurse’s initial licensure (15.6% age < 30). This indicates that the workforce is becoming increasingly educated. See Table 11.
      Table 11Type of Nursing Degree or Credential for First U.S. Nursing License by Age—RN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      Vocational/practical certificate90.6226.7245.2244.7327.9309.7420.0437.2510.22,812.4
      3.2%8.1%8.7%8.7%11.7%11.0%14.9%15.5%18.1%
      Diploma79.9113.0194.4176.0316.0520.7745.41,200.32,201.75,547.5
      1.4%2.0%3.5%3.2%5.7%9.4%13.4%21.6%39.7%
      Associate degree1,255.31,546.71,688.01,770.92,102.31,923.52,228.42,398.42,097.917,011.4
      7.4%9.1%9.9%10.4%12.4%11.3%13.1%14.1%12.3%
      Baccalaureate degree3,040.12,602.62,010.91,898.62,187.41,871.22,110.42,089.61,732.919,543.8
      15.6%13.3%10.3%9.7%11.2%9.6%10.8%10.7%8.9%
      Master’s degree80.8221.5191.3198.3218.8214.0208.5248.9194.01,776.1
      4.5%12.5%10.8%11.2%12.3%12.0%11.7%14.0%10.9%
      Total4,549.44,719.94,345.84,294.25,169.34,853.25,745.06,391.06,748.846,816.7
      9.7%10.1%9.3%9.2%11.0%10.4%12.3%13.7%14.4%

      Highest level of nursing education

      Previous iterations of this survey asked for the highest level of education with both nursing and non-nursing degrees combined into one question. The 2017 survey asked two separate questions: highest level of nursing education and highest level of non-nursing education. Due to this change, direct comparisons to 2013 and 2015 are not available for non-nursing education. In terms of highest level of nursing education, 64.1% of respondents indicated they had a baccalaureate or higher degree in nursing.
      By comparison, the Center to Champion Nursing in America’s Campaign for Action Dashboard reported that in 2016, 54% of nurses had a baccalaureate or higher degree in nursing (Campaign Progress, 1027).
      A mere 1.1% of responding RNs reported a Doctorate in Nursing Practice (DNP) as their highest level of nursing education. While still a small percentage, this is double the percent of nurses who reported the degree type in 2015 and double the number of nurses with a PhD. See Table 12.
      Table 12Highest Level of Nursing Education—RN
      Weighted Sample Values
      2013 (n = 35,016.5)2015 (n = 38,625.9)2017 (n = 48,140.7)
      nPercentnPercentnPercent
      Diploma4,319.412.3%3,551.39.2%3,547.77.4%
      Associate degree11,331.632.3%11,608.830.0%13,729.128.5%
      Baccalaureate degree14,097.040.2%16,762.543.4%21,744.145.2%
      Master’s degree4,846.013.8%6,085.115.7%8,238.317.1%
      Doctoral degree—PhD217.00.6%340.20.9%284.10.6%
      Doctoral degree—DNP142.50.4%239.10.6%551.21.1%
      Doctoral degree—nursing other62.90.2%39.00.1%46.10.1%
      Note. In the 2013 and 2015 surveys, a single question “What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.
      Highest level of nursing education by gender. Of those with a DNP, 14.0% are men. Conversely, the vast majority of those with a diploma as their highest level of education are women (96.1%). See Table 13.
      Table 13Highest Level of Nursing Education by Gender—RN
      Weighted Sample Values
      MaleFemalen
      Diploma137.93,395.33,533.3
      3.9%96.1%
      Associate degree1,407.012,228.613,635.6
      10.3%89.7%
      Baccalaureate degree1,977.519,639.121,616.6
      9.1%90.9%
      Master’s degree725.07,440.98,165.9
      8.9%91.1%
      Doctoral degree—PhD17.5261.9279.4
      6.3%93.7%
      Doctoral degree—DNP76.9472.5549.4
      14.0%86.0%
      Doctoral degree—nursing other1.944.246.0
      4.1%95.9%
      Total4,347.743,488.447,836.1
      9.1%90.9%
      Note. In the 2013 and 2015 surveys, a single question ``What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.
      Highest level of nursing education by race. Across all-groups, the most common highest level of education is a baccalaureate, except for American Indian or Alaska Native (45.5% associate degree). Asian nurses are much more likely to have a baccalaureate degree (65.6%) as compared to the overall population (45.2%). See Table 14.
      Table 14Highest Level of Nursing Education by Race—RN
      Weighted Sample Values
      Vocational/Practical CertificateDiplomaAssociate DegreeBaccalaureate DegreeMaster’s DegreeDoctoral degree PhDDoctoral degree DNPDoctoral degree nursing othern
      American Indian or Alaska Native0.05.372.054.924.80.60.60.0158.3
      0.0%3.4%45.5%34.7%15.7%0.4%0.4%0.0%
      Asian0.0178.8460.32,338.9534.927.224.10.53,564.6
      0.0%5.0%12.9%65.6%15.0%0.8%0.7%0.0%
      Black/African American0.675.8805.21,458.0510.517.348.71.82,917.8
      0.0%2.6%27.6%50.0%17.5%0.6%1.7%0.1%
      Native Hawaiian or other Pacific Islander0.09.938.7113.439.60.10.30.0201.9
      0.0%4.9%19.2%56.1%19.6%0.0%0.1%0.0%
      White/Caucasian7.93,130.811,046.615,774.06,437.6221.3458.642.637,119.3
      0.0%8.4%29.8%42.5%17.3%0.6%1.2%0.1%
      Hispanic/Latino of any race1.480.4849.51,204.6369.28.612.10.62,526.4
      0.1%3.2%33.6%47.7%14.6%0.3%0.5%0.0%
      Other0.035.2174.9285.9141.01.11.20.0639.4
      0.0%5.5%27.4%44.7%22.1%0.2%0.2%0.0%
      Two or more races0.018.4186.1368.6125.51.44.80.0704.9
      0.0%2.6%26.4%52.3%17.8%0.2%0.7%0.0%
      Total9.93,534.713,633.321,598.28,183.0277.5550.645.447,832.6
      0.0%7.4%28.5%45.2%17.1%0.6%1.2%0.1%
      Note. In the 2013 and 2015 surveys, a single question ``What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.
      Highest level of nursing education by age. Almost half of individuals whose highest level of education is a diploma are older than age 65. Conversely, among those with a baccalaureate, the highest percentage are young nurses (15.4% < 30 years old). See Table 15.
      Table 15Highest Level of Nursing Education by Age—RN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      Diploma32.739.691.775.8142.2277.8472.6781.11,541.03,454.6
      0.9%1.1%2.7%2.2%4.1%8.0%13.7%22.6%44.6%
      Associate degree898.31,142.71,204.01,291.51,585.61,541.81,854.22,023.71,912.113,453.9
      6.7%8.5%8.9%9.6%11.8%11.5%13.8%15.0%14.2%
      Baccalaureate degree3,281.72,618.72,092.92,070.22,471.72,131.12,335.82,275.82,018.221,296.1
      15.4%12.3%9.8%9.7%11.6%10.0%11.0%10.7%9.5%
      Master’s degree344.1853.1909.7836.3917.6840.8992.71,182.01,189.08,065.4
      4.3%10.6%11.3%10.4%11.4%10.4%12.3%14.7%14.7%
      Doctoral degree—PhD0.36.011.813.722.322.240.678.879.7275.2
      0.1%2.2%4.3%5.0%8.1%8.1%14.7%28.6%28.9%
      Doctoral degree—DNP22.289.566.140.460.970.089.776.024.3539.0
      4.1%16.6%12.3%7.5%11.3%13.0%16.6%14.1%4.5%
      Doctoral degree—nursing other0.00.90.00.65.83.72.97.423.244.6
      0.0%2.0%0.0%1.3%13.0%8.3%6.5%16.6%52.1%
      Total4,579.34,750.74,376.54,328.55,207.04,887.55,789.06,427.86,791.047,137.3
      9.7%10.1%9.3%9.2%11.0%10.4%12.3%13.6%14.4%
      Note. In the 2013 and 2015 survey, a single question ``What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.

      Highest level of non-nursing education

      Approximately 40% of RN respondents reported an additional degree in a non-nursing discipline. Of those, 35.3% reported an associate level non-nursing degree, 45.8% reported a baccalaureate level non-nursing degree, and an additional 18.9% reported a graduate-level non-nursing degree. See Table 16.
      Table 16Highest Level of Non-Nursing Education—RN
      Weighted Sample Values
      2017 (n = 19,904.5)
      nPercent
      Associate degree7,025.935.3%
      Baccalaureate degree9,115.445.8%
      Master’s degree3,150.815.8%
      Doctoral degree612.43.1%
      Note. In the 2013 and 2015 surveys, a single question ``What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.

      Licensure

      Type of license currently held

      Respondents were asked to select all of the nursing licenses that they currently hold. Less than 1% of responding RNs also held an LPN/LVN license, while 10.0% held an APRN credential. The percentage of responding RNs who held an APRN credential increased by 1.4 percentage points from 2015 to 2017. See Table 17.
      Table 17Type of License Currently Held—RN
      Weighted Sample Values
      2013 (n = 41,658.3)2015 (n = 46,047.8)2017 (n = 48,128.0)
      nPercentnPercentnPercent
      RN39,521.694.9%43,730.295.0%45,971.395.5%
      LPN215.90.5%330.80.7%386.20.8%
      APRN3,046.47.3%3,974.78.6%4,788.610.0%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      RN3,266,51494.9%3,508,21995.0%3,729,31895.5%
      LPN17,8450.5%26,5340.7%31,3280.8%
      APRN251,7887.3%318,8708.6%388,46110.0%
      Note. Respondents were asked to select all that apply.

      Number of years licensed

      RN respondents to the 2017 survey were licensed for a median 21 years. Nearly one-third of respondents (32.9%) were licensed for 10 years or less. An additional 19.7% were licensed between 11 and 20 years. These proportions are consistent with those from 2015, 33.5% and 19.5%, respectively. See Table 18.
      Table 18Number of Years Licensed—RN
      Weighted Sample Values
      2013 (n = 37,655.3)2015 (n = 39,771.5)2017 (n = 46,757.6)
      nPercentnPercentnPercent
      0-10 years9,845.526.2%13,307.333.5%15,397.632.9%
      11-20 years7,156.219.0%7,753.419.5%9,217.719.7%
      21-30 years7,340.519.5%6,855.817.2%8,121.617.4%
      31-40 years8,213.021.8%7,311.418.4%8,226.117.6%
      > 40 years5,100.013.5%4,543.711.4%5,794.612.4%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqpercent
      0-10 years813,74726.2%1,067,56933.5%1,249,09632.9%
      11-20 years591,47219.0%622,00919.5%747,76719.7%
      21-30 years606,70119.5%549,99717.2%658,84417.4%
      31-40 years678,81821.8%586,54718.4%667,32617.6%
      > 40 years421,52513.5%364,51111.4%470,07312.4%

      Initially licensed in the United States

      In 2017, respondents were asked whether they were licensed in the United States initially. This question differs slightly from 2013 and 2015, when respondents were asked in what country they were initially licensed. In 2017, 95.1% of respondents were initially licensed in the United States. This is consistent with results from 2015 (94.6%) and 2013 (95.0%). See Table 19.
      Table 19Initially Licensed in the United States—RN
      Weighted Sample Values
      2013 (n = 40,393.1)2015 (n = 45,304.6)2017 (n = 48,095.0)
      nPercentnPercentnPercent
      No2,027.75.0%2,444.25.4%2,380.34.9%
      Yes38,365.495.0%42,860.494.6%45,714.795.1%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      No167,5905.0%196,0865.4%193,0974.9%
      Yes3,170,95495.0%3,438,44194.6%3,708,50195.1%
      Note. In the 2013 and 2015 surveys, respondents were asked “In what country were you initially licensed as an RN or LPN?” In 2017, respondents were asked whether they were initially licensed as an RN or LPN in the United States.

      Credentialed to practice as an APRN

      Respondents were asked whether they were credentialed in their state as an APRN enabling them to practice in any of the 4 APRN roles, including NP, CNS, CRNA, or CNM. A large number of respondents (88.0%) indicated they were not credentialed as an APRN. This represents a lower proportion than in 2015 or 2013 (89.7% and 90.8% respectively). In 2017, 8.5% reported being credentialed as a nurse practitioner compared to 7.2% in 2015. See Table 20.
      Table 20Credentialed to Practice as an APRN
      Weighted Sample Values
      2013 (n = 40,053.2)2015 (n = 43,045.0)2017 (n = 47,713.6)
      nPercentnPercentnPercent
      NP2,266.45.7%3,129.47.2%4,067.18.5%
      CNS1,243.13.1%576.81.3%983.52.1%
      CRNA509.11.3%571.91.3%728.71.5%
      CNM159.30.4%167.70.4%242.00.5%
      Not APRN credentialed35,875.390.8%38,599.389.7%42,960.088.0%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      NP187,3255.7%251,0537.2%329,9338.5%
      CNS102,7413.1%46,2751.3%79,7872.1%
      CRNA42,0781.3%45,8791.3%59,1141.5%
      CNM13,1650.4%13,4520.4%19,6360.5%
      Not APRN credentialed2,965,14590.8%3,096,59589.7%3,407,49888.0%
      Note. Respondents were asked to select all that apply. NP = nurse practitioner; CNS = clinical nurse specialist; CRNA = certified registered nurse anesthetist; CNM = certified nurse midwife.

      Employment

      Employment status

      The vast majority of responding RNs (84.6%) were actively employed in nursing and 65.4% were employed in nursing full time. This represents a continued increase in the proportion of RNs working full time from 2015 (62.9%) and 2013 (60.4%). See Table 21.
      Table 21Employment Status—RN
      Weighted Sample Values
      2013 (n = 42,145.6)2015 (n = 46,210.2)2017 (n = 48,146.9)
      nPercentnPercentnPercent
      Actively employed in nursing full time25,447.360.4%29,088.562.9%31,476.665.4%
      Actively employed in nursing part time6,276.114.9%6,088.013.2%5,820.912.1%
      Actively employed in nursing per diem3,069.57.3%3,675.28.0%3,424.97.1%
      Actively employed, non-nursing full time1,713.04.1%1,576.13.4%1,108.92.3%
      Actively employed, non-nursing part time1,169.02.8%850.81.8%605.71.3%
      Actively employed, non-nursing per diem512.71.2%377.70.8%267.50.6%
      Working in nursing as a volunteer810.61.9%564.51.2%645.61.3%
      Unemployed, seeking work as a nurse1,144.42.7%1,070.72.3%1,030.22.1%
      Unemployed, not seeking work as a nurse1,463.33.5%1,611.63.5%1,616.23.4%
      Retired4,755.111.3%4,993.710.8%4,916.910.2%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      Actively employed in nursing full time2,103,25460.4%2,333,60662.9%2,553,46765.4%
      Actively employed in nursing part time518,72714.9%488,40513.2%472,20412.1%
      Actively employed in nursing per diem253,6967.3%294,8378.0%277,8347.1%
      Actively employed, non-nursing full time141,5834.1%126,4453.4%89,9562.3%
      Actively employed, non-nursing part time96,6162.8%68,2551.8%49,1391.3%
      Actively employed, non-nursing per diem42,3791.2%30,2980.8%21,7020.6%
      Working in nursing as a volunteer66,9961.9%45,2881.2%52,3741.3%
      Unemployed, seeking work as a nurse94,5872.7%85,8962.3%83,5732.1%
      Unemployed, not seeking work as a nurse120,9453.5%129,2873.5%131,1143.4%
      Retired393,01411.3%400,61310.8%398,87110.2%
      Note. Respondents were asked to select all that apply.

      Reasons for being unemployed

      Respondents were asked to select all the reasons for being unemployed. Taking care of home and family was the most frequently selected reason for being unemployed by 47.8% of respondents. The proportion of RNs who indicated that they were unemployed because they experienced difficulty in finding a nursing position were similar in 2015 (15.5%) and 2017 (15.4%). See Table 22.
      Table 22Reasons for Being Unemployed—RN
      Weighted Sample Values
      2013 (n = 2,549.0)2015 (n = 2,272.4)2017 (n = 2,567.2)
      nPercentnPercentnPercent
      Taking care of home and family1,258.749.4%1,137.350.0%1,226.847.8%
      Disabled486.219.1%298.513.1%347.613.5%
      Inadequate salary58.42.3%48.22.1%73.72.9%
      School195.47.7%143.16.3%186.07.2%
      Difficulty in finding a nursing position672.126.4%352.015.5%395.015.4%
      Other774.830.4%557.424.5%758.929.6%
      Note. Respondents were asked to select all that apply.

      Number of positions currently held

      Respondents were asked to identify the number of positions in which they were currently employed as a nurse. The majority of respondents (83.3%) reported holding just one position as a nurse, which represents a 1.6 percentage point decrease when compared to 2015. The percentage of nurses who reported working in two positions increased from 12.8% in 2015 to 13.9% in 2017. The percentage of respondents who indicated that they held three or more positions in nursing also increased slightly from 2.4% in 2015 to 2.8% in 2017. See Table 23.
      Table 23Number of Positions Currently Held—RN
      Weighted Sample Values
      2013 (n = 33,264.5)2015 (n = 37,114.2)2017 (n = 39,414.3)
      nPercentnPercentnPercent
      128,069.184.4%31,499.384.9%32,827.283.3%
      24,434.613.3%4,744.012.8%5,496.713.9%
      3 or more760.82.3%870.82.4%1,090.52.8%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      12,319,94984.4%2,527,01084.9%2,663,03083.3%
      2366,52213.3%380,58512.8%445,90513.9%
      3 or more62,8832.3%69,8612.4%88,4632.8%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Number of hours worked during a typical week in all nursing positions

      Hours worked categories were recoded for the 2017 report. Over half (58.6%) of responding RNs reported working 32 to 40 hours in a typical week in all positions. This is consistent with the results from the 2015 survey (58.4%) and only 2.1 percentage points higher than 2013 (56.5%). The second most frequently reported category was 41 to 50 hours (15.8%). This represents a slight decrease from 2015 (16.4%) and 2013 (16.2%). See Table 24.
      Table 24Number of Hours Worked During a Typical Week in All Nursing Positions—RN
      Weighted Sample Values
      2013 (n = 32,645.8)2015 (n = 36,327.6)2017 (n = 39,293.3)
      nPercentnPercentnPercent
      1-151,808.95.5%1,697.74.7%1,903.74.8%
      16-231,695.45.2%1,655.74.6%1,728.14.4%
      24-313,397.710.4%3,536.99.8%3,765.09.6%
      32-4018,434.156.5%21,174.358.4%23,012.658.6%
      41-505,289.316.2%5,957.316.4%6,198.015.8%
      51-601,369.54.2%1,636.94.5%1,851.34.7%
      61 or more651.02.0%578.81.6%834.72.1%
      Estimated Population Values
      201320152017
      FreqPercentFreqPercentFreqPercent
      1-15149,5065.5%136,2004.7%154,4344.8%
      16-23140,1245.2%132,8264.6%140,1904.4%
      24-31280,82510.4%283,7459.8%305,4269.6%
      32-401,523,60056.5%1,698,69258.4%1,866,84158.6%
      41-50437,17116.2%477,91816.4%502,79615.8%
      51-60113,1924.2%131,3184.5%150,1804.7%
      61 or more53,8032.%46,4321.6%67,7122.1%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Primary nursing practice position setting

      In the 2017 survey, response options related to primary and secondary practice setting were slightly modified. Hospice and dialysis center were added as new categories. Of those who responded to the question, 55.7% indicated that a hospital was their primary nursing practice. This represents an increase of 1.3 percentage points from 2015 but still fewer than the 56.5% of respondents that selected this setting in 2013. Ambulatory care setting was the second most frequently selected setting by 9.4% of RNs, followed by nursing home/extended care setting selected by 4.8%, and home health selected by 4.3%. Each of the remaining settings were selected by fewer than 3% of the responding nurses. Additionally, 9.8% of respondents selected other. See Table 25.
      Table 25Primary Nursing Practice Position Setting—RN
      Weighted Sample Values
      2013 (n = 34,238.0)2015 (n = 37,372.1)2017 (n = 38,870.1)
      npercentnpercentnpercent
      Hospital19,343.556.5%20,311.954.4%21,646.555.7%
      Nursing home/extended care2,210.86.5%1,807.24.8%1,859.74.8%
      Assisted living facility------233.30.6%211.20.5%
      Home health2,057.76.0%2,288.06.1%1,685.94.3%
      Hospice------------757.81.9%
      Correctional facility229.00.7%259.60.7%294.80.8%
      School of nursing1,011.93.0%1,357.03.6%1,028.92.6%
      Public health609.21.8%595.41.6%539.31.4%
      Dialysis center------------493.61.3%
      Community health739.92.2%786.92.1%780.82.0%
      School health service1,145.93.3%1,092.82.9%1,025.32.6%
      Occupational health224.10.7%250.30.7%292.60.8%
      Ambulatory care setting2,994.48.7%4,201.111.2%3,649.29.4%
      Insurance claims/benefits477.21.4%673.71.8%694.11.8%
      Policy/planning/regulatory/licensing agency152.30.4%148.70.4%86.90.2%
      Other3,042.18.9%3,366.39.0%3,823.69.8%
      Estimated Population Values
      201320152017
      freqpercentfreqpercentfreqpercent
      Hospital1,598,76856.5%1,629,50654.4%1,756,02155.7%
      Nursing home/extended care182,7246.5%144,9824.8%150,8654.8%
      Assisted living facility------18,7180.6%17,1320.5%
      Home health170,0696.0%183,5536.1%136,7654.3%
      Hospice------------61,4711.9%
      Correctional facility18,9300.7%20,8280.7%23,9180.8%
      School of nursing83,6373.0%108,8633.6%83,4662.6%
      Public health50,3541.8%47,7631.6%43,7481.4%
      Dialysis center------------40,0401.3%
      Community health61,1502.2%63,1282.1%63,3372.0%
      School health service94,7083.3%87,6662.9%83,1782.6%
      Occupational health18,5190.7%20,0800.7%23,7360.8%
      Ambulatory care setting247,4958.7%337,02811.2%296,0309.4%
      Insurance claims/benefits39,4451.4%54,0461.8%56,3061.8%
      Policy/planning/regulatory/licensing agency12,5860.4%11,9300.4%7,0500.2%
      Other251,4388.9%270,0579.0%310,1789.8%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Salary includes overtime and bonuses, but does not include sign-on bonuses.

      Primary nursing position title

      As in 2015, 58.0% of 2017 respondents indicated that the title that most closely corresponds to their primary nursing position was that of staff nurse. Advanced practice registered nurse was the second most frequently selected position by 10.1% of respondents. This represents an increase from 8.1% in 2015. Between 2013 and 2017, there was a 3.0 percentage point decrease in respondents who indicated that their primary practice position was nurse manager. RNs selecting case manager as their primary position (6.4%) was in alignment with what was reported in 2015 (6.7%). The percentage of respondents who selected nurse faculty/educator increased slightly from 3.8% in 2015 to 4.0% in 2017. Each of the remaining positions were selected by less than 2% of the responding nurses. Additionally, 9.1% of respondents selected other–health related and 0.4% selected other–non-health related. See Table 26.
      Table 26Primary Nursing Position Title—RN
      Weighted Sample Values
      2013 (n = 34,356.6)2015 (n = 37,711.1)2017 (n = 39,063.1)
      npercentnpercentnpercent
      Consultant772.52.2%672.41.8%577.41.5%
      Nurse researcher251.30.7%247.20.7%235.90.6%
      Nurse executive834.42.4%881.42.3%725.31.9%
      Nurse manager3,792.011.0%3,045.88.1%3,126.28.0%
      Nurse faculty/educator1,105.43.2%1,422.23.8%1,558.24.0%
      Advanced practice registered nurse2,531.47.4%3,069.18.1%3,946.110.1%
      Staff nurse21,902.163.7%21,920.758.1%22,673.058.0%
      Case manager------2,524.86.7%2,519.26.4%
      Other–health related3,068.98.9%3,685.19.8%3,561.99.1%
      Other–non-health related98.70.3%242.50.6%139.70.4%
      Estimated Population Values
      201320152017
      freqpercentfreqpercentfreqpercent
      Consultant63,8462.2%53,9441.8%46,8441.5%
      Nurse researcher20,7700.7%19,8300.7%19,1390.6%
      Nurse executive68,9622.4%70,7062.3%58,8361.9%
      Nurse manager313,41811.0%244,3438.1%253,6098.0%
      Nurse faculty/educator91,3603.2%114,0993.8%126,4084.0%
      Advanced practice registered nurse209,2227.4%246,2148.1%320,12110.1%
      Staff nurse1,810,23863.7%1,758,57358.1%1,839,29458.0%
      Case manager------202,5466.7%204,3686.4%
      Other–health related253,6478.9%295,6379.8%288,9509.1%
      Other–non-health related8,1550.3%19,4530.6%11,3320.4%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Salary includes overtime and bonuses, but does not include sign-on bonuses.

      Primary nursing position specialty

      Response options related to primary and secondary practice specialty were also modified. Adult health and family health were separated into two categories, cardiology was added as a category, and other was separated into other–clinical and other–non-clinical. Primary care, genetics, informatics, neurology/neurosurgical, orthopedic, radiology, urology, and telehealth were all removed from the list of categories.
      In the current study, 14% of RNs reported their primary practice specialty was acute care/critical care compared to 11.4% in 2015. The second most frequently selected specialty was medical-surgical; 8.5% of RN respondents selected this specialty in 2017 compared to 10.1% in 2015. Perioperative was the third most frequently selected specialty by 5.8% of 2017 respondents. RNs selecting other specialties (14.1%) represented a decrease from 17.0% in 2015. See Table 27.
      Table 27Primary Nursing Position Specialty—RN
      Weighted Sample Values
      2013 (n = 33,516.5)2015 (n = 36,424.1)2017 (n = 37,484.3)
      nPercentnPercentnPercent
      Acute care/critical care5,789.017.3%4,159.111.4%5,239.214.0%
      Adult health871.92.6%756.12.1%1,447.13.9%
      Family health------------1,243.43.3%
      Anesthesia654.32.0%549.91.5%705.51.9%
      Cardiology------------1,291.03.4%
      Community335.01.0%356.71.0%386.61.0%
      Geriatric/gerontology1,988.85.9%1,754.74.8%1,918.55.1%
      Home health1,515.34.5%1,604.04.4%1,360.13.6%
      Maternal-child health/obstetrics1,662.25.0%1,633.94.5%1,778.14.7%
      Medical-surgical4,248.612.7%3,695.710.1%3,203.18.5%
      Nephrology------476.41.3%555.71.5%
      Occupational health333.41.0%280.70.8%339.80.9%
      Oncology952.72.8%1,044.02.9%1,046.92.8%
      Palliative care/hospice498.91.5%529.11.5%643.31.7%
      Pediatrics1,995.86.0%1,570.34.3%1,774.14.7%
      Neonatal------808.42.2%809.52.2%
      Perioperative------2,195.76.0%2,187.75.8%
      Public health510.61.5%466.01.3%472.31.3%
      Psychiatric/mental health/substance abuse1,340.54.0%1,418.43.9%1,534.14.1%
      Rehabilitation691.42.1%717.32.0%725.41.9%
      School health1,097.23.3%1,025.12.8%945.52.5%
      Emergency/trauma566.01.7%2,026.75.6%2,027.35.4%
      Women’s health651.31.9%651.71.8%567.11.5%
      Other–clinical specialties------------4,507.712.0%
      Other–non-clinical specialties------------775.12.1%
      Other6,568.419.6%6,200.817.0%------
      Primary care1,340.52.6%1,092.53.0%------
      Genetics------40.60.1%------
      Informatics------318.20.9%------
      Neurology/neurosurgical------337.10.9%------
      Orthopedic------436.11.2%------
      Radiology------191.20.5%------
      Urology------87.50.2%------
      Telehealth288.51.2%------------
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing practice position setting

      A little more than a third of RN respondents (36.0%) identified their secondary nursing position setting as being in a hospital. This has consistently been the most frequently selected secondary practice position setting over the past three surveys. The second most frequently selected setting for secondary nursing positions was ambulatory care (9.1%), followed by home health (9.0%) and nursing home/extended care (7.4%). This is slightly different than in 2015, when the top three most frequently selected categories for this question were hospitals (33.5%), home health (11.8%), and school of nursing (10.7%), and similar to the top settings reported for primary practice positions. See Table 28.
      Table 28Secondary Nursing Practice Position Setting—RN
      Weighted Sample Values
      2013 (n = 4,415.5)2015 (n = 4,877.3)2017 (n = 6,153.3)
      nPercentnPercentnPercent
      Hospital1,061.524.0%1,632.633.5%2,213.436.0%
      Nursing home/extended care502.911.4%277.25.7%456.77.4%
      Assisted living facility------58.91.2%58.41.0%
      Home health560.512.7%577.511.8%555.79.0%
      Hospice------------185.93.0%
      Correctional facility52.11.2%72.21.5%68.31.1%
      School of nursing439.710.0%519.710.7%493.68.0%
      Public health66.81.5%38.10.8%89.21.5%
      Dialysis center------------87.71.4%
      Community health188.04.3%191.13.9%209.63.4%
      School health service191.34.3%171.73.5%173.02.8%
      Occupational health90.22.0%39.00.8%57.10.9%
      Ambulatory care setting506.711.5%451.29.3%556.79.1%
      Insurance claims/benefits38.80.9%39.40.8%51.70.8%
      Policy/planning/regulatory/licensing agency19.00.4%6.10.1%7.10.1%
      Other698.015.8%802.516.5%889.314.5%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing position title

      The most frequently selected position title that corresponds to secondary nursing practice position was staff nurse (55.8%), followed by advanced practice registered nurse (12.1%), and nurse faculty/educator (9.8%). The percentage of respondents who selected advanced practice registered nurse increased from 2015 to 2017. About 10% of respondents selected another category in both 2015 and 2017. See Table 29.
      Table 29Secondary Nursing Position Title—RN
      Weighted Sample Values
      2013 (n = 5,370.9)2015 (n = 4,857.8)2017 (n = 6,145.9)
      nPercentnPercentnPercent
      Consultant244.24.6%216.04.5%201.23.3%
      Nurse researcher41.60.8%28.90.6%36.20.6%
      Nurse executive77.01.4%46.61.0%34.60.6%
      Nurse manager301.15.6%143.23.0%235.43.8%
      Nurse faculty/educator469.48.7%482.09.9%601.59.8%
      Advanced practice registered nurse520.69.7%521.810.7%743.012.1%
      Staff nurse3,050.756.8%2,767.957.0%3,430.855.8%
      Case manager------157.83.4%256.34.2%
      Other–health related628.111.7%475.09.8%573.79.3%
      Other–non-health related38.10.7%18.60.4%33.30.5%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing position specialty

      Approximately 10% of respondents (10.2%) reported acute care/critical care as the specialty for their secondary nursing position. The second most frequently selected specialty was medical-surgical (7.7%) followed by geriatric/gerontology (7.4%). See Table 30.
      Table 30Secondary Nursing Position Specialty—RN
      Weighted Sample Values
      2013 (n = 5,285.6)2015 (n = 4,791.1)2017 (n = 5,895.2)
      nPercentnPercentnPercent
      Acute care/critical care673.112.7%386.28.1%602.610.2%
      Adult health187.53.6%124.72.6%309.05.2%
      Family health------------149.12.5%
      Anesthesia115.22.2%76.21.6%161.22.7%
      Cardiology------------119.82.0%
      Community120.52.3%72.11.5%116.22.0%
      Geriatric/gerontology421.18.0%295.76.2%433.27.4%
      Home health414.27.8%404.48.4%378.96.4%
      Maternal-child health/obstetrics234.44.4%182.83.8%168.72.9%
      Medical-surgical485.99.2%324.56.8%451.57.7%
      Nephrology------37.90.8%112.61.9%
      Occupational health86.41.6%44.20.9%59.01.0%
      Oncology83.41.6%37.50.8%66.61.1%
      Palliative care/hospice83.61.6%55.91.2%140.72.4%
      Pediatrics243.04.6%219.64.6%242.74.1%
      Neonatal------87.51.8%86.31.5%
      Perioperative------227.14.7%269.84.6%
      Public health81.01.5%46.21.0%87.41.5%
      Psychiatric/mental health/substance abuse237.84.5%265.75.5%317.45.4%
      Rehabilitation121.52.3%109.72.3%150.32.6%
      School health200.03.8%177.73.7%146.02.5%
      Emergency/trauma98.11.9%291.56.1%375.16.4%
      Women’s health68.01.3%53.11.1%79.81.4%
      Other–clinical specialties------------714.412.1%
      Other–non-clinical specialties------------156.92.7%
      Other1,155.421.9%1,033.721.6%------
      Primary care134.72.6%144.73.0%------
      Genetics------11.00.2%------
      Informatics------20.00.4%------
      Neurology/neurosurgical------21.00.4%------
      Orthopedic------21.50.5%------
      Radiology------13.90.3%------
      Urology------5.20.1%------
      Telehealth40.90.8%------------
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Salary/Earnings

      2016 pre-tax annual earnings from primary nursing position

      The median pre-tax annual earnings for responding RNs increased from $60,000 in 2015 to $63,000 in 2017. Categorically, the percentage of respondents earning less than $40,000 annually decreased by 2.7 percentage points, the percentage making between $40,000 and $60,000 decreased by 2.9 percentage points, while those making between $80,000 and $100,000 increased by 1.6 percentage points and those making more than $100,000 increased by nearly 4 percentage points. See Table 31.
      Table 31Annual Earnings—RN
      Weighted Sample Values
      2015 (n = 32,455.7)2017 (n = 35,745.6)
      nPercentnPercent
      Less than $40,0004,711.314.5%4,217.811.8%
      $40,000 to $59,9998,436.826.0%8,243.423.1%
      $60,000 to $79,9999,202.028.4%10,213.328.6%
      $80,000 to $99,9995,279.816.3%6,386.317.9%
      $100,000 or more4,825.714.9%6,684.818.7%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Less than $40,000377,96414.5%342,16011.8%
      $40,000 to $59,999676,83726.0%668,72923.1%
      $60,000 to $79,999738,22428.4%828,53028.6%
      $80,000 to $99,999423,56816.3%518,07117.9%
      $100,000 or more387,13614.9%542,29218.7%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Salary includes overtime and bonuses, but does not include sign-on bonuses. APRNs were included in the RN salary tables.

      Earnings by gender and specialty

      Looking across all the specialties, the specialty with the highest median salary is anesthesia ($170,000 overall). Across nearly all specialties, men have a higher median salary than women, except for oncology. See Table 32.
      Table 32Median Annual Earnings by Gender and Specialty—RN
      MaleFemaleTotal
      Acute care/critical care$76,000$70,000$70,000
      5603,4203,980
      Adult health$81,496$73,685$75,000
      979841,081
      Family health$100,000$82,800$84,250
      751,0881,163
      Anesthesia$185,500$156,200$170,000
      204344548
      Cardiology$73,000$70,000$70,000
      104843947
      Community$76,200$70,000$70,500
      25256281
      Geriatric/gerontology$68,000$67,000$67,000
      1071,6011,708
      Home health$68,000$67,000$68,000
      629411,003
      Maternal-child health/obstetrics$76,500$67,633$68,000
      61,2971,303
      Medical-surgical$70,000$62,000$63,000
      1972,3012,498
      Nephrology$80,000$74,000$75,000
      49418467
      Occupational health$81,500$80,000$80,000
      24242266
      Oncology$64,432$73,000$72,000
      31757788
      Palliative care/hospice$70,860$66,500$67,000
      26432458
      Pediatrics$74,000$67,000$67,000
      401,1131,153
      Neonatal$80,000$73,000$73,000
      16595611
      Perioperative$84,000$72,000$72,550
      1611,4741,635
      Public health$67,500$64,490$65,000
      24422446
      Psychiatric/mental health/substance abuse$80,000$70,000$72,000
      1851,0541,239
      Rehabilitation$70,000$65,000$65,000
      55474529
      School health$53,000$50,000$50,000
      14723737
      Emergency/trauma$75,000$70,000$70,000
      2821,2741,556
      Women’s health---$70,000$70,000
      0410410
      Total$80,000$70,000
      2,65126,496
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by highest education

      Upper-level degrees show large increases in median salary, with the highest of $104,000 for those with a DNP as their highest degree. See Table 33.
      Table 33Median Annual Earnings by Highest Education—RN
      Median Salaryn
      Diploma$72,9001,358
      Associate degree$63,0008,303
      Baccalaureate degree$68,00012,714
      Master’s degree$95,0004,999
      Doctoral degree—PhD$100,000200
      Doctoral degree—DNP$104,000413
      Doctoral degree—nursing other$96,00037
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by state

      Median earnings rose in most states. The highest median earnings were for RNs practicing in California ($88,000), Hawaii ($85,000), New York ($80,000), and Oregon ($80,000). The lowest median earnings were for RNs practicing in South Dakota ($54,000) and Iowa ($58,000). See Table 34.
      Table 34Median Annual Earnings in Primary Nursing Position by State(s) Where Currently Practicing—RN
      20152017
      Alabama$55,000$60,000
      Alaska$70,000$76,000
      Arizona$69,000$70,500
      Arkansas$56,000$61,605
      California$90,000$88,000
      Colorado$63,000$65,000
      Connecticut$75,000$75,000
      Delaware$71,000$71,900
      District of Columbia$75,000$79,000
      Florida$60,000$65,500
      Georgia$64,000$68,000
      Hawaii$82,000$85,000
      Idaho$60,000$62,000
      Illinois$65,000$67,000
      Indiana$53,000$64,000
      Iowa$51,662$58,000
      Kansas$54,000$64,000
      Kentucky$60,000$64,000
      Louisiana$60,000$65,000
      Maine$60,000$63,000
      Maryland$70,000$74,466
      Massachusetts$75,633$76,000
      Michigan$60,000$67,000
      Minnesota$64,870$66,000
      Mississippi$58,000$60,000
      Montana$58,000$60,000
      Nebraska$54,000$60,000
      Nevada$72,000$77,000
      New Hampshire$64,000$66,500
      New Jersey$76,000$75,915
      New Mexico$62,000$69,500
      New York$77,000$80,000
      North Carolina$58,890$61,000
      North Dakota$54,000$60,000
      Ohio$58,000$65,000
      Oklahoma$58,326$64,000
      Oregon$75,000$80,000
      Pennsylvania$62,000$70,000
      Rhode Island$70,000$70,000
      South Carolina$57,000$64,000
      South Dakota$51,000$54,000
      Tennessee$55,000$62,000
      Texas$68,700$72,000
      Utah$53,000$65,000
      Vermont$62,000$61,000
      Virginia$60,000$69,000
      Washington$70,000$75,000
      West Virginia$55,000$62,000
      Wisconsin$60,000$63,000
      Wyoming$64,000$65,000
      American Samoa$48,000$71,000
      Guam$52,000$60,000
      Northern Mariana Islands$35,000$41,600
      Virgin Islands$62,000$74,950
      Note. Medians are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by years licensed and age

      For all age-groups, there is a steady increase in median salary as number of years licensed increases. Conversely, there is no clear trend upward as nurses age, which indicates that years licensed is more important than age when predicting salary increases. See Table 35.
      Table 35Median Annual Earnings by Years Licensed and Age—RN
      Licensed 0-1 YearsLicensed 2-5 YearsLicensed 6-10 YearsLicensed 11+ YearsTotal
      < 30$50,000$55,000$63,000$78,000$55,000
      1,1511,88843313,473
      30-34$50,000$60,000$66,250$70,000$62,000
      3119131,3575683,149
      35-39$55,000$60,000$67,000$72,000$67,000
      1795497071,4672,902
      40-44$54,000$60,000$67,000$75,000$70,000
      1263914581,9792,954
      45-49$52,000$60,000$68,000$78,000$74,000
      873243592,5223,292
      50-54$52,880$58,000$66,000$79,200$75,000
      662012783,1273,672
      55-59$52,500$59,000$68,000$79,500$78,000
      281121834,1614,484
      60-64$50,000$60,000$63,628$80,000$80,000
      749973,9364,089
      ≥ 65$60,000$68,500$71,000$78,000$78,000
      68161,6721,702
      Total$50,000$58,000$66,000$78,000
      1,9614,4353,88819,433
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by APRNs

      Certified registered nurse anesthetists have the highest median salary ($171,000). All APRN certified nurses have a substantially higher median salary than the overall population ($63,000). See Table 36.
      Table 36Median Earnings by APRNs
      Median Salaryn
      CNP$100,0002,982
      CNS$88,000644
      CRNA$171,000557
      CNM$97,750186
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing. CNP = certified nurse practitioner; CNS = clinical nurse specialist; CRNA = certified nurse anesthetist; CNM = certified nurse midwife.

      Telehealth Utilization

      Percent of time providing telehealth

      Survey findings revealed that 54.1% of responding RNs indicated they were providing nursing services remotely in 2017 compared to 48.8% in 2015. The 31.7% of RN respondents who were spending up to 25% of their time providing services remotely was similar to the 31.4% who indicated such in 2015. Approximately 10% of responding RNs indicated that they spend from 76% to 100% of their time providing nursing services via phone or electronically to patients in a different location. This represents a 3.8 percentage point increase from 2015. See Table 37.
      Table 37Percent of Time Providing Telehealth—RN
      Weighted Sample Values
      2015 (n = 37,354.6)2017 (n = 39,441.6)
      nPercentnPercent
      Never19,119.151.2%18,095.045.9%
      1 to 25%11,710.731.4%12,490.631.7%
      26 to 50%2,560.56.9%2,851.27.2%
      51 to 75%1,785.34.8%2,201.65.6%
      76 to 100%2,179.15.8%3,803.29.6%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Never1,533,81151.2%1,467,92045.9%
      1 to 25%803,54931.4%1,013,26831.7%
      26 to 50%175,6916.9%231,2947.2%
      51 to 75%122,5024.8%178,6025.6%
      76 to 100%149,5195.8%308,5299.6%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Telehealth across state borders

      Of those providing nursing services remotely, 45.7% of responding RNs were providing phone or electronic services to patients or clients across state borders in 2017, compared to 39.4% in 2015. Over one-third of RN respondents (35.8%) provided such services to patients or clients across state borders up to 25% of the time. This represents a 4.1 percentage point increase from 2015. See Table 38.
      Table 38Percent of Time Providing Telehealth Across State Borders—RN
      Weighted Sample Values
      2015 (n = 18,456.1)2017 (n = 17,573.3)
      nPercentnPercent
      Never11,186.760.6%9,535.054.3%
      1 to 25%5,843.231.7%6,294.535.8%
      26 to 50%626.83.4%692.23.9%
      51 to 75%298.51.6%414.02.4%
      76 to 100%500.92.7%637.63.6%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Telehealth across national borders

      Only 11.1% of nurses providing remote services to patients or clients provide such services across national borders. Approximately 9% of nurses (9.1%) reported doing so up to 25% of their time. See Table 39.
      Table 39Percent of Time Providing Telehealth Across National Borders—RN
      Weighted Sample Values
      2015 (n = 18,096.1)2017 (n = 16,369.8)
      nPercentnPercent
      Never16,707.292.3%14,548.688.9%
      1 to 25%1,194.76.6%1,488.29.1%
      26 to 50%96.30.5%129.40.8%
      51 to 75%33.70.2%103.70.6%
      76 to 100%64.30.4%99.80.6%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Modes of communication used for telehealth

      Nurses providing services via phone or electronically to patients or clients were also asked to identify the modes of communication used; 94.6% of these nurses reported using a telephone. This is 2.5 percentage points fewer than in 2015. Nearly one-third (32.7%) reported using email, which is consistent with the 32.3% who indicated so in 2015. Over 20% reported using electronic messaging in 2017 compared to 18.6% in 2015.
      With the exception of telephones, a higher proportion of respondents used each of the modes of communication in 2017 than in 2015. See Table 40.
      Table 40Modes of Communication Used for Telehealth—RN
      Weighted Sample Values
      2015 (n = 15,864.1)2017 (n = 17,066.0)
      nPercentnPercent
      Electronic messaging2,954.018.6%3,599.621.1%
      VoIP528.73.3%817.34.8%
      Virtual ICU167.71.1%276.91.6%
      Telephone15,406.797.1%16,143.994.6%
      Email5,128.232.3%5,574.432.7%
      Video call463.72.9%619.83.6%
      Other1,070.96.8%926.45.4%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Respondents were asked to select all that apply. VoIP = voice over Internet protocol; ICU= intensive care unit.

      Discussion and Implications

      This study presents a national, randomized survey of 148,684 licensed RNs. Data collected from the 48,704 respondents (32.8%) provide the most recent and detailed information on characteristics of the RN workforce. These data not only illustrate current characteristics and trends of the nursing workforce but also provide valuable information with which to assess progress towards certain goals and priorities outlined by the Institute of Medicine’s (IOM; now the National Academy of Medicine) report on the future of nursing (
      • National Academy of Medicine
      The future of nursing: Leading change, advancing health.
      2010
      ), including RNs achieving higher levels of education and increased diversity of the nursing workforce.
      As of 2017, an estimated 3,951,001 individuals held an active RN license in the United States and its territories (up from 3,728,501 in 2015), representing an increase of 261,275 RN licensees when compared to 2015.
      To illustrate trends in workforce supply, the current study’s results were compared to national nursing workforce studies that based their findings on data collected years prior to the study publication date. For example, the 2013 National Nursing Workforce study was compared to HRSAs 2010 results, which were collected from RN workforce data collected in 2008. While the current study used a sample of all RN licensees, which included individuals who were not actively employed in nursing, the other studies may not have, such as the study conducted by
      • Buerhaus P.I.
      • Skinner L.E.
      • Auerbach D.I.
      • Staiger D.O.
      State of the registered nurse workforce as a new era of health emerges.
      Nursing Economics. 2017; 35: 229-237
      . When comparing the current study’s results to those of HRSA 2013, which contained data from the U.S. Census Bureau’s American Community Survey, it should be noted the data were from individuals who reported their current occupation as nursing and who currently had or were seeking a job. The HRSA 2017 data cited were for the U.S. working-age population age 16 or older who were currently employed or who were recently employed and were seeking employment (e.g., individuals who were recently laid off). Thus, the comparisons of statistics from various studies presented should be interpreted with the above considerations in mind.
      The average age of RNs is 51, which is largely consistent with previous study findings (2015 and 2013). The median age of RNs in this study was 53, with 50.9% of the respondents being 50+ years, which is notably higher than the 37% of the full-time equivalent (FTE) RN workforce between age 50 and 69 reported by
      • Buerhaus P.I.
      • Skinner L.E.
      • Auerbach D.I.
      • Staiger D.O.
      State of the registered nurse workforce as a new era of health emerges.
      Nursing Economics. 2017; 35: 229-237
      . In 2015, 12.4% of the RN respondents were age 65 or older compared to 14.6% in the current study, an increase of 2.2 percentage points, which indicates a slow but steady growth of RNs who may be heading for retirement.
      • Buerhaus P.I.
      • Skinner L.E.
      • Auerbach D.I.
      • Staiger D.O.
      State of the registered nurse workforce as a new era of health emerges.
      Nursing Economics. 2017; 35: 229-237
      predicted that as the baby boomer cohort of RNs continues to retire in large numbers, years of nursing experience and knowledge they have accumulated will be lost, having a tremendous impact on health care. An aging population, an aging workforce, and reported nursing shortages across the country have heightened discussions among employers about the utilization of internationally educated nurses to fill the gaps they are experiencing within their health care facilities. The current study found that approximately 5% of the RN workforce obtained their entry-level nursing education outside of the United States. This is consistent with results from 2015 (5.4%) and 2013 (5.0%).
      Evidence on the progress towards the IOM recommendation of increasing the proportion of nurses with a baccalaureate degree to 80% by the year 2020 has been steadily accumulating over the past 8 years. The trend toward a higher percentage of respondents pursuing a BSN degree as their initial nursing education continued in 2017, with 41.8% of the RNs reporting the BSN as the degree that qualified them for their first U.S. nursing license, which reflects a 2.8 percenage point increase when compared to 2015 (39.0%) and a 6.3 percentage point increase when compared to 2013 (35.5%). In 2017, 64.1% of the RNs obtained a baccalaureate or higher degree, which exceeds the 54% reported in 2016 by the Center to Champion Nursing in America Campaign for Action Dashboard (Campaign
      • Campaign Progress
      Welcome to the future of nursing: Campaign for Action dashboard.
      https://campaignforaction.org/wp-content/uploads/2017/07/Dashboard-Indicators_Dec17.pdf
      Date: 2017
      ). Enrollment in RN-to-BSN programs is increasing in response to calls from within and outside of the profession for a more highly educated nursing workforce. Many professional practice settings, including Magnet hospitals and academic health centers, now require or prefer the baccalaureate degree for specific nursing roles. From 2015 to 2016, enrollments increased by 1.0 percent, marking the 13th year of increases in RN-to-BSN programs (
      • American Association of Colleges of Nursing
      Degree completion programs for registered nurses: RN to masters degree and RN to baccalaureate programs.
      www.aacnnursing.org/News-Information/Fact-Sheets/Degree-Completion-Programs
      Date: 2017
      ).
      In terms of graduate education, the number of RNs with a master’s degree in nursing has increased from 13.8% in 2013 to 17.1% in 2017, an increase of 3.3 percentage points. Although small in terms of percentage, 1.1% of responding RNs reported having a DNP as their highest level of nursing education, which is double the percent of nurses who reported having a DNP in 2015. According to
      • American Association of Colleges of Nursing
      DNP fact sheet.
      www.aacnnursing.org/News-Information/Fact-Sheets/DNP-Fact-Sheet
      Date: 2017
      , the number of students enrolled in DNP programs went from 21,995 in 2015 to 25,289 in 2016, a 15.0% increase. There has been very little movement in terms of the number of RNs with a PhD in nursing. The number of responding RNs with a PhD in nursing went from 0.9% in 2015 to 0.6% in 2017.
      In 2015, the IOM (National Academy of Medicine) released a report in brief, “Assessing Progress on the Institute of Medicine Report on The Future of Nursing” (
      • National Academy of Medicine
      Assessing progress on the IOM Report The Future of Nursing.
      www.nationalacademies.org/hmd/Reports/2015/Assessing-Progress-on-the-IOM-Report-The-Future-of-Nursing.aspx
      Date: 2015
      ), a specific recommendation was to promote diversity in the profession to better represent the patient population it serves, including gender, race, and ethnic diversity. The percentage of male RNs (9.1%) in the workforce in 2017 increased by 2.5 percentage points when compared with findings from the 2013 study (6.6%). The 9.1% male RNs identified in the current study is less than the 12% male FTE RNs identified by
      • Buerhaus P.I.
      • Skinner L.E.
      • Auerbach D.I.
      • Staiger D.O.
      State of the registered nurse workforce as a new era of health emerges.
      Nursing Economics. 2017; 35: 229-237
      . Approximately 5.3% of the RNs indicated that they were of Hispanic or Latino origin compared to 17.8% of the U.S. population (U.S.
      • U.S. Census Bureau
      National population totals tables: 2010-2016.
      www.census.gov/data/tables/2016/demo/popest/nation-total.html
      Date: 2017
      ). In the current study 19.2% of the RN respondents were minorities, which includes other and two or more races: Asian (7.5%), Black/African American (6.2%), other (2.9%), and two or more races (1.7%). The percentage of nurses who identify as Asian in the current study exceeds the 5.7% represented in the U.S. population; the percentage of nurses who identify as Black/African American falls below the 13.3% in the U.S. population (U.S.
      • U.S. Census Bureau
      National population totals tables: 2010-2016.
      www.census.gov/data/tables/2016/demo/popest/nation-total.html
      Date: 2017
      ).
      Of all study respondents with a secondary position in nursing, 9.8% indicated they were nurse faculty compared to 9.9% in 2015. The national shortage of nurse faculty contributed to many qualified nursing school applicants in 2016 being turned down (
      • American Association of Colleges of Nursing
      Nursing faculty shortages.
      http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Faculty-Shortage
      Date: 2017
      ). While more full-time and primary nurse faculty are needed, RNs who work part time as nurse faculty in a secondary position are one avenue of increasing nurse faculty numbers.
      In the 2017 survey, response options related to primary and secondary practice setting were slightly modified. Hospice and dialysis center were added as new categories. Hospitals were the primary employment setting for 55.7% of RNs, 54.4% in 2015, but less than the 56.5% reported in 2013. Ambulatory care setting was the second most frequently selected setting reported by 9.4% of RNs, followed by nursing home/extended care (4.8%), and home health (4.3%). Nurses work setting is changing owing in part to the growing use and acceptance of technology (
      • American Well
      American Well® 2015 Telehealth Survey: 64% of Consumers Would See a Doctor Via Video.
      https://www.americanwell.com/press-release/american-well-2015-telehealth-survey-64-of-consumers-would-see-a-doctor-via-video/
      ; HIMSS
      • HIMSS Analytics
      2015 telemedicine study.
      https://www.himssanalytics.org/research/essentials-brief-telemedicine-study
      Date: 2015
      ).
      Telehealth is a growing trend in health care delivery and has the potential to affect the nursing workforce as well as nurse licensure issues. This was the second year that items related to telehealth practice by nurses were included in the survey. Respondents were asked to indicate the percentage of time they provided nursing services or communicated with a patient or client located somewhere different from where they were located, via phone or electronically. Results revealed that over half (54.1%) of responding RNs provided nurse services using telehealth technologies. In the current study, 45.7% provided these services across a state border compared to 39.4% in 2015, an increase of 6.3 percentage points, and 11.1% reported providing remote services to patients or clients across national borders, which is an increase of 3.4 percentage points when compared to 2015 (7.7%).
      These data raise important questions for employers and regulators. NCSBN is working with states to adopt the national Enhanced Nurse Licensure Compact (eNLC), a multistate licensure model that replaces the one-license, one-state model and would allow nurses to communicate and provide services remotely and over long distances (
      • National Council of State Boards of Nursing
      Enhanced Nurse Licensure Compact (eNLC) implementation.
      www.ncsbn.org/enhanced-nlc-implementation.htm
      Date: 2018
      ). The eNLC increases access to care while maintaining public protection at the state level. Under the eNLC, eligible nurses would possess a multistate license issued by their home state (state of residence) and would be able to provide care to patients in other compact states without the time and expense of obtaining additional licenses. As of May 2018, 30 states have adopted the eNLC.
      The median pre-tax annual earnings for RNs in the current study increased from $60,000 in 2015 to $63,000 in 2017, which is lower than the median salary of $70,000 for RNs reported by the Bureau of Labor Statistics Occupational Outlook Handbook (
      • U.S. Bureau of Labor Statistics
      Occupational outlook handbook.
      www.bls.gov/ooh/healthcare/registered-nurses.htm
      Date: 2018
      ). In the current study, responding RNs making between $80,000 and $100,000 increased by 1.6 percentage points and those making more than $100,000 increased by nearly 4 percentage points.

      Limitations

      Missing data exist for certain variables in certain categories. In an effort to present the data in the most accurate manner, the number of weighted valid responses to each question was reported for every table. Missing data were not imputed; hence, the presented statistics represent the weighted responses from participants who responded to each respective survey item. The data presented on male nurses, foreign-educated nurses, and APRNs represent smaller sample sizes. In general, caution should be taken in interpreting any statistics from a small group or cell size.

      Conclusion

      This national randomized survey provides a cross-sectional view of the current RN nursing workforce. The data generated contribute to a better understanding of the supply of nurses today and identify important trends in the national workforce. The workforce of today will change as older nurses retire and sufficient numbers of nurses step in to fill their shoes; the workforce of tomorrow will be slightly younger, highly educated, working in the community providing primary health care, and using technology and telehealth as a means to deliver health care. Advances in technology will continue to raise important questions for employers and regulators. This study also contributes information with which to assess progress towards the goals outlined in the Future of Nursing report (
      • National Academy of Medicine
      The future of nursing: Leading change, advancing health.
      2010
      ), including achieving higher levels of education, promoting diversity, and improving data collection concerning the national health workforce.

      Licensed Practical Nurse/Licensed Vocational Nurse Results

      Gender

      The current study indicated 92.3% of responding LPNs/LVNs were female and 7.7% of respondents were male. See Table 41.
      Table 41Gender Distribution of Nurses—LPN/LVN
      Weighted Sample Values
      2015 (n = 28,891.0)2017 (n = 34,616.8)
      nPercentnPercent
      Male2,169.77.5%2,670.97.7%
      Female26,721.392.5%31,945.992.3%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Male65,2467.5%61,0647.7%
      Female803,55992.5%730,38392.3%

      Race/Ethnicity

      One of the changes to the 2017 survey included the modification of the race/ethnicity question. Previously, race and ethnicity categories were listed in one question. The question was modified so that ethnicity and race are now two separate questions. Respondents were first asked whether they were of Hispanic or Latino origin and then asked to identify their race. Anyone who selected more than one race category was recoded into the two or more races category.
      Approximately 71% of responding LPNs/LVNs were White/Caucasian compared to 81% of responding RNs. Almost three times as many responding LPNs/LVNs were Black/African American (18.5%) compared to RNs (6.2%). See Table 42, Table 43.
      Table 42Race/Ethnicity-LPN/LVN
      Weighted Sample Values
      2015 (n = 28,656.3)2017 (n = 34,467.5)
      nPercentnPercent
      American Indian or Alaska Native267.60.9%219.80.6%
      Asian1,583.25.5%897.42.6%
      Black/ African American4,689.516.4%6,372.418.5%
      Native Hawaiian or other Pacific Islander144.40.5%62.40.2%
      White/Caucasian20,839.772.7%24,604.071.4%
      Other race429.21.5%1,568.54.6%
      Two or more races702.62.5%743.12.2%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      American Indian or Alaska Native8,0490.9%5,0240.6%
      Asian47,6105.5%20,5172.6%
      Black/ African American141,02116.4%145,69218.5%
      Native Hawaiian or other Pacific Islander4,3430.5%1,4270.2%
      White/Caucasian626,68972.7%562,52471.4%
      Other race12,9061.5%35,8604.6%
      Two or more races21,1292.5%16,9902.2%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.
      Table 43Ethnicity of Hispanic or Latino Origin–LPN/LVN
      Weighted Sample Values
      2015 (n = 30,620.8)2017 (n = 34,449.3)
      nPercentnPercent
      Hispanic or Latino origin1,964.66.4%2,558.67.4%
      Not of Hispanic or Latino origin28,656.393.6%31,890.692.6%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Hispanic or Latino origin59,0796.4%58,4987.4%
      Not of Hispanic or Latino origin861,74693.6%729,11992.6%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.
      The LPN/LVN workforce is also more ethnically diverse than the RN workforce, with 7.4% of responding LPNs/LVNs indicating that they were of Hispanic or Latino origin compared to 5.3% of RNs.

      Race/ethnicity by gender

      Results show racial groups other than White/Caucasian are gender diverse. Among White/Caucasian nurses, the percentage of men is 5.8%. This is in stark contrast to all other race and ethnic groups, ranging from 9.7% (American Indian or Alaska Native) to 19.2% (Asian). See Table 44.
      Table 44Race/Ethnicity by Gender—LPN/LVN
      Weighted Sample Values
      MaleFemalen
      American Indian or Alaska Native18.9176.7195.6
      9.7%90.3%
      Asian169.6714.8884.3
      19.2%80.8%
      Black/African American606.55,596.46,202.9
      9.8%90.2%
      Native Hawaiian or other Pacific Islander7.646.854.4
      14.0%86.0%
      White/Caucasian1,353.921,810.523,164.4
      5.8%94.2%
      Hispanic/Latino of any race373.22,173.22,546.4
      14.7%85.3%
      Other65.4593.3658.7
      9.9%90.1%
      Two or more races45.9597.0642.9
      7.1%92.9%
      Total2,641.031,708.634,349.6
      7.7%92.3%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the `Two or more races’ category.

      Age

      In 2017, the median age of LPN/LVN respondents was 54. This is 1 year older than the median age in 2015. More than 50% of respondents were age 50 or older, which is a four percentage point increase from 2015 (46.1%); 13.2% of respondents were age 65 or older in 2017 compared to 9.9% in 2015. See Table 45.
      Table 45Age Distribution—LPN/LVN
      Weighted Sample Values
      2015 (n = 27,172.4)2017 (n = 34,454.1)
      nPercentnPercent
      < 302,652.59.8%3,072.78.9%
      30-342,579.59.5%2,930.18.5%
      35-392,689.39.9%3,541.210.3%
      40-443,331.812.3%3,539.410.3%
      45-493,375.112.4%4,052.611.8%
      50-543,076.411.3%3,875.011.2%
      55-593,516.312.9%4,428.012.9%
      60-643,264.912.0%4,476.913.0%
      ≥ 652,686.69.9%4,538.313.2%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      < 3079,7649.8%70,2518.9%
      30-3477,5699.5%66,9918.5%
      35-3980,8739.9%80,96210.3%
      40-44100,19412.3%80,92110.3%
      45-49101,49512.4%92,65411.8%
      50-5492,51311.3%88,59511.2%
      55-59105,74212.9%101,23912.9%
      60-6498,18212.0%102,35613.0%
      ≥ 6580,7919.9%103,75913.2%

      Age by gender

      Among older age-groups (ages 55+), women comprise a much higher proportion than in younger age-groups (ages 30 to 54). See Table 46.
      Table 46Age Distribution by Gender—LPN/LVN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      Male303.2218.8263.6286.3349.9360.7291.3305.3220.92,600.0
      11.7%8.4%10.1%11.0%13.5%13.9%11.2%11.7%8.5%
      Female2,732.42,676.03,231.33,214.93,637.83,476.84,061.34,104.14,196.631,331.2
      8.7%8.5%10.3%10.3%11.6%11.1%13.0%13.1%13.4%
      Total3,035.52,894.83,495.03,501.23,987.73,837.64,352.64,409.44,417.533,931.2
      8.9%8.5%10.3%10.3%11.8%11.3%12.8%13.0%13.0%

      Age by race/ethnicity

      Hispanic LPNs/LVNs are more likely to be in age-groups under 40 as compared to other race and ethnic groups. See Table 47.
      Table 47Age Distribution by Race/Ethnicity—LPN/LVN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      American Indian or Alaska Native9.113.727.320.522.726.923.222.721.5187.4
      4.9%7.3%14.6%10.9%12.1%14.3%12.4%12.1%11.5%
      Asian104.9127.3120.1116.4112.489.177.281.853.1882.3
      11.9%14.4%13.6%13.2%12.7%10.1%8.7%9.3%6.0%
      Black/African American399.1508.0732.1815.9789.6737.1726.4636.1747.46,091.7
      6.6%8.3%12.0%13.4%13.0%12.1%11.9%10.4%12.3%
      Native Hawaiian or other Pacific Islander2.14.73.416.22.910.23.44.66.153.6
      3.9%8.8%6.3%30.2%5.4%19.0%6.3%8.6%11.4%
      White/Caucasian2,012.01,796.82,090.62,146.72,610.72,577.23,156.43,301.63,203.422,895.3
      8.8%7.8%9.1%9.4%11.4%11.3%13.8%14.4%14.0%
      Hispanic/Latino of any race374.2358.7364.3258.8282.6220.9231.4173.9243.62,508.3
      14.9%14.3%14.5%10.3%11.3%8.8%9.2%6.9%9.7%
      Other35.134.662.446.684.081.781.7117.5105.1648.6
      5.4%5.3%9.6%7.2%12.9%12.6%12.6%18.1%16.2%
      Two or more races79.857.693.466.082.975.773.663.939.9632.9
      12.6%9.1%14.8%10.4%13.1%12.0%11.6%10.1%6.3%
      Total3,016.42,901.43,493.63,487.13,987.73,818.54,373.34,402.04,420.033,900.1
      8.9%8.6%10.3%10.3%11.8%11.3%12.9%13.0%13.0%
      Note. In the 2013 and 2015 surveys, the Hispanic/Latino origin and race categories were combined into one question. For the race question, respondents were asked to select all that apply. The responses were subsequently recoded to ensure that the race categories were mutually exclusive. Respondents selecting multiple race categories were reclassified into the ‘Two or more races’ category.

      Education

      Type of nursing degree or credential for first U.S. nursing license

      In this survey, 83.2% of respondents indicated that a vocational/practical certificate in nursing qualified them for their first U.S. nursing license. An additional 12.0% reported that a diploma in nursing qualified them for their first U.S. nursing license, while 4.5% indicated that it was an associate degree in nursing. See Table 48.
      Table 48Type of Nursing Degree or Credential for First U.S. Nursing License—LPN/LVN
      Weighted Sample Values
      2015 (n = 30,231.1)2017 (n = 34,108.8)
      nPercentnPercent
      Vocational/practical certificate25,257.483.6%28,395.083.2%
      Diploma3,661.312.1%4,098.612.0%
      Associate degree1,168.83.9%1,521.34.5%
      Baccalaureate degree135.80.5%93.90.3%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Vocational/practical certificate759,53783.6%649,19783.2%
      Diploma110,10112.1%93,70712.0%
      Associate degree35,1463.9%34,7824.5%
      Baccalaureate degree4,0850.5%2,1460.3%
      Type of nursing degree or credential for first U.S nursing license by age. Those whose initial education to receive their license was an associate degree were more likely to be in the younger age-groups. This is opposite of the trend with RNs, where those whose initial education was an associate degree were more likely to be older. See Table 49.
      Table 49Type of Nursing Degree or Credential for First U.S. Nursing License by Age—LPN/LVN
      Weighted Sample Values
      Age cohort< 3030-3435-3940-4445-4950-5455-5960-64≥ 65n
      Vocational/practical certificate2,527.02,251.52,743.62,718.73,199.13,112.83,680.03,859.83,783.527,876.0
      9.1%8.1%9.8%9.8%11.5%11.2%13.2%13.8%13.6%
      Diploma336.7421.0485.0541.6510.2487.8463.3384.1375.94,005.6
      8.4%10.5%12.1%13.5%12.7%12.2%11.6%9.6%9.4%
      Associate degree142.7184.8215.1177.6217.1166.8140.6120.5128.31,493.7
      9.6%12.4%14.4%11.9%14.5%11.2%9.4%8.1%8.6%
      Baccalaureate degree6.15.19.411.916.711.122.57.33.493.5
      6.5%5.5%10.1%12.7%17.9%11.9%24.1%7.8%3.6%
      Total3,012.52,862.43,453.23,449.83,943.83,778.64,306.54,371.74,292.033,470.5
      9.0%8.6%10.3%10.3%11.8%11.3%12.9%13.1%12.8%

      Highest level of nursing education

      In terms of highest level of nursing education, 77.8% of respondents indicated that a vocational/practical certificate in nursing was their highest level of nursing education. This represents a slight increase of 1.8 percentage points from 2015 (76.0%). See Table 50.
      Table 50Highest Level of Nursing Education—LPN/LVN
      Weighted Sample Values
      2015 (n = 25,626.5)2017 (n = 34,208.6)
      nPercentnPercent
      Vocational/practical certificate19,481.376.0%26,615.377.8%
      Diploma3,882.515.2%4,900.814.3%
      Associate degree1,888.67.4%2,509.67.3%
      Baccalaureate degree308.51.2%182.80.5%
      Note. In the 2013 and 2015 surveys, a single question “What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.
      Highest level of nursing education by race. Across nearly all race/ethnicity groups the most common highest level of education is the vocational/practical certificate. Asian nurses are substantially more likely to have a baccalaureate degree as their highest education as compared to other groups (8.1% versus 0.5% overall). See Table 51.
      Table 51Highest Level of Nursing Education by Race—LPN/LVN
      Weighted Sample Values
      Vocational/Practical CertificateDiplomaAssociate DegreeBaccalaureate Degreen
      American Indian or Alaska Native136.724.727.30.7189.4
      72.2%13.0%14.4%0.4%
      Asian539.4146.3111.371.0871.6
      61.9%16.8%12.8%8.1%
      Black/African American4,388.11,146.6519.432.16,088.3
      72.1%18.8%8.5%0.5%
      Native Hawaiian or other Pacific Islander38.78.83.21.652.2
      74.0%16.8%6.1%3.1%
      White/Caucasian18,254.93,062.31,539.657.522,917.1
      79.7%13.4%6.7%0.3%
      Hispanic/Latino of any race2,044.2256.8178.09.12,488.1
      82.2%10.3%7.2%0.4%
      Other501.181.963.76.3654.0
      76.6%12.5%9.7%1.0%
      Two or more races458.9120.347.13.3629.7
      72.9%19.1%7.5%0.5%
      Total26,362.04,847.62,489.6181.533,890.4
      77.8%14.3%7.3%0.5%
      Note. In the 2013 and 2015 surveys, a single question ``What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. n 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.

      Highest level of non-nursing education

      Almost a quarter of responding LPNs/LVNs indicated they had a non-nursing degree. Of those respondents, 68.8% reported an associate level non-nursing degree, 25.0% reported a baccalaureate level non-nursing degree, and an additional 6.2% reported a graduate level non-nursing degree. See Table 52.
      Table 52Highest Level of Non-Nursing Education—LPN/LVN
      Weighted Sample Values
      2017 (n = 9,832.6)
      nPercent
      Associate degree6,762.068.8%
      Baccalaureate degree2,460.125.0%
      Master’s degree515.65.2%
      Doctoral degree95.01.0%
      Note. In the 2013 and 2015 surveys, a single question “What is your highest level of education?” was asked, with the set of possible responses including both nursing and non-nursing degrees. In 2017, two separate questions were asked, “Highest level of nursing education” and “Highest level of non-nursing education”.

      Licensure

      Number of years licensed

      LPN/LVN respondents to the 2017 survey were licensed for a median 19 years. Almost 40.7% of 2017 respondents were licensed for 10 years or less compared to 43.7% in 2015. An additional 19.8% were licensed between 11 and 20 years, which is consistent with the 20.1% who were licensed as long in 2015. See Table 53.
      Table 53Number of Years Licensed—LPN/LVN
      Weighted Sample Values
      2015 (n = 26,138.0)2017 (n = 33,652.6)
      nPercentnPercent
      0-10 years11,417.843.7%13,694.140.7%
      11-20 years5,258.920.1%6,674.019.8%
      21-30 years4,018.015.4%5,483.916.3%
      31-40 years3,552.013.6%4,531.913.5%
      > 41 years1,891.47.2%3,268.69.7%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      0-10 years343,35343.7%313,09040.7%
      11-20 years158,14520.1%152,58919.8%
      21-30 years120,82815.4%125,37916.3%
      31-40 years106,81513.6%103,61413.5%
      > 41 years56,8777.2%74,7309.7%

      Initially licensed in the United States

      In this survey, 97.5% of LPN/LVN respondents were initially licensed in the United States. This is consistent with results from 2015 (98.5%). See Table 54.
      Table 54Initially Licensed in the United States—LPN/LVN
      Weighted Sample Values
      2015 (n = 30,179.4)2017 (n = 34,598.2)
      nPercentnPercent
      No447.81.5%878.92.5%
      Yes29,731.698.5%33,719.397.5%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      No13,4661.5%20,0952.5%
      Yes894,08498.5%770,92997.5%
      Note. In the 2015 survey, respondents were asked “In what country were you initially licensed as an RN or LPN?”

      Employment

      Employment status

      Among responding LPNs/LVNs, 65.0% reported being actively employed in nursing full time, which is an increase over 2 years ago. The most notable decrease was among those who selected unemployed, seeking work as a nurse, which decreased from 5.1% in 2015 to 3.4% in 2017. See Table 55.
      Table 55Employment Status—LPN/LVN
      Weighted Sample Values
      2015 (n = 30,766.0)2017 (n = 34,570.2)
      nPercentnPercent
      Actively employed in nursing full time18,823.461.2%22,476.565.0%
      Actively employed in nursing part time3,714.012.1%4,151.912.0%
      Actively employed in nursing per diem2,179.47.1%2,227.56.4%
      Actively employed, non-nursing full time1,504.34.9%1,306.63.8%
      Actively employed, non-nursing part time868.52.8%756.72.2%
      Actively employed, non-nursing per diem386.71.3%193.60.6%
      Working in nursing as a volunteer366.11.2%408.91.2%
      Unemployed, seeking work as a nurse1,558.75.1%1,162.03.4%
      Unemployed, not seeking work as a nurse1,588.95.2%1,595.04.6%
      Retired2,927.19.5%2,991.28.7%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Actively employed in nursing full time566,05361.2%513,88465.0%
      Actively employed in nursing part time111,68612.1%94,92512.0%
      Actively employed in nursing per diem65,5407.1%50,9286.4%
      Actively employed, non-nursing full time45,2364.9%29,8743.8%
      Actively employed, non-nursing part time26,1162.8%17,3012.2%
      Actively employed, non-nursing per diem11,6291.3%4,4270.6%
      Working in nursing as a volunteer11,0081.2%9,3501.2%
      Unemployed, seeking work as a nurse46,8735.1%26,5663.4%
      Unemployed, not seeking work as a nurse47,7825.2%36,4674.6%
      Retired88,0249.5%68,3878.7%
      Note. Respondents were asked to select all that apply.

      Reasons for being unemployed

      Respondents were asked to select all the applicable reasons for being unemployed. Taking care of home and family was the most frequently selected reason for being unemployed; 41.4% of LPN/LVN respondents selected this reason in 2017, compared to 39.1% in 2015. The second and third most frequently selected reasons were other by 26.4% of respondents followed by disabled (21.1%). By comparison, the second most frequently selected reason in 2015 was difficulty in finding a nursing position (23.1%) followed by other (22.7%). See Table 56.
      Table 56Reasons for Being Unemployed—LPN/LVN
      Weighted Sample Values
      2015 (n = 2,644.5)2017 (n = 2,696.8)
      nPercentnPercent
      Taking care of home and family1,033.039.1%1,117.441.4%
      Disabled463.317.5%570.021.1%
      Inadequate salary77.93.0%111.54.1%
      School393.914.9%288.410.7%
      Difficulty in finding a nursing position610.423.1%419.615.6%
      Other600.122.7%713.026.4%
      Note. Respondents were asked to select all that apply.

      Number of positions currently held

      Respondents were asked to identify the number of positions in which they were currently employed as a nurse. In 2017, 82.4% of LPN/LVN respondents indicated holding just one position as a nurse compared to 84.5% in 2015. The percentage of nurses who reported working in two positions increased from 13.4% in 2015 to 14.9% in 2017. The percentage of respondents who indicated that they held three or more positions in nursing also increased slightly from 2.1% in 2015 to 2.7% in 2017. See Table 57.
      Table 57Number of Positions Currently Held—LPN/LVN
      Weighted Sample Values
      2015 (n = 23,317.3)2017 (n = 27,576.8)
      nPercentnPercent
      119,706.584.5%22,725.082.4%
      23,113.013.4%4,117.514.9%
      3 or more497.82.1%734.32.7%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      1592,61184.5%519,56382.4%
      293,61313.4%94,13914.9%
      3 or more14,9702.1%16,7882.7%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Number of hours worked during a typical week in all nursing positions

      In this survey, 59.4% of responding LPNs/LVNs reported working 32 to 40 hours in a typical week in all positions, representing a decrease of less than one percentage point. The second most frequently reported category was 41 to 50 hours (16.0%). This represents a slight increase from 2015 (15.2%). See Table 58.
      Table 58Number of Hours Worked During a Typical Week in All Nursing Positions—LPN/LVN
      Weighted Sample Values
      2015 (n = 22,450.6)2017 (n = 27,505.7)
      nPercentnPercent
      1-15913.14.1%1,132.64.1%
      16-231,088.94.9%1,298.44.7%
      24-311,866.48.3%2,031.17.4%
      32-4013,562.860.4%16,328.259.4%
      41-503,410.015.2%4,412.716.0%
      51-60928.34.1%1,391.15.1%
      61 or more681.13.0%911.53.3%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      1-1527,4594.1%25,8964.1%
      16-2332,7444.9%29,6864.7%
      24-3156,1268.3%46,4377.4%
      32-40407,85960.4%373,31459.4%
      41-50102,54615.2%100,88816.0%
      51-6027,9164.1%31,8055.1%
      61 or more20,4823.0%20,8413.3%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Primary nursing practice position setting

      In the 2017 survey, response options related to primary and secondary practice setting were slightly modified. Hospice and dialysis center were added as new categories. Of those LPNs/LVNs who responded to the question, 31.7% indicated that their primary nursing practice position was in a nursing home/extended care setting. This represents an increase of 1.6 percentage points from 2015. Home health was the second most frequently selected setting by 14% of LPNs/LVNs, followed by ambulatory care selected by 6.8%. The percentage of respondents who selected other increased from 14.9% in 2015 to 17.4% in 2017. See Table 59.
      Table 59Primary Nursing Practice Position Setting—LPN/LVN
      Weighted Sample Values
      2015 (n = 22,989.1)2017 (n = 26,459.8)
      nPercentnPercent
      Hospital2,478.910.8%2,540.39.6%
      Nursing home/extended care6,911.930.1%8,385.331.7%
      Assisted living facility1,369.56.0%1,484.25.6%
      Home health3,451.015.0%3,710.514.0%
      Hospice------426.61.6%
      Correctional facility670.22.9%738.62.8%
      School of nursing142.00.6%78.40.3%
      Public health399.81.7%498.31.9%
      Dialysis center------165.80.6%
      Community health922.64.0%888.13.4%
      School health service683.93.0%697.42.6%
      Occupational health174.90.8%166.60.6%
      Ambulatory care setting2,061.29.0%1,797.36.8%
      Insurance claims/benefits259.71.1%241.30.9%
      Policy/planning/regulatory/licensing agency32.30.1%24.40.1%
      Other3,431.214.9%4,616.717.4%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Hospital74,54410.8%58,0799.6%
      Nursing home/extended care207,85430.1%191,71531.7%
      Assisted living facility41,1836.0%33,9335.6%
      Home health103,77915.0%84,83414.0%
      Hospice------9,7531.6%
      Correctional facility20,1542.9%16,8872.8%
      School of nursing4,2700.6%1,7920.3%
      Public health12,0221.7%11,3941.9%
      Dialysis center------3,7900.6%
      Community health27,7454.0%20,3053.4%
      School health service20,5653.0%15,9452.6%
      Occupational health5,2600.8%3,8100.6%
      Ambulatory care setting61,9849.0%41,0916.8%
      Insurance claims/benefits7,8101.1%5,5170.9%
      Policy/planning/regulatory/licensing agency9730.1%5570.1%
      Other103,18214.9%105,55317.4%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Primary nursing position title

      In 2017, 73.1% of LPN/LVN respondents indicated that the title that most closely corresponds to their primary nursing position was that of staff nurse, an increase of 4.3 percentage points from 2015. The second most frequently selected position title was other–health-related. The proportion of respondents who selected other–health-related increased from 14.6% in 2015 to 16.0% in 2017. A higher proportion of LPNs/LVNs selected nurse manager in 2017 (6.2%) than in 2015 (5.8%). See Table 60.
      Table 60Primary Nursing Position Title—LPN/LVN
      Weighted Sample Values
      2015 (n = 23,567.8)2017 (n = 26,776.9)
      nPercentnPercent
      Consultant140.60.6%152.70.6%
      Nurse researcher65.00.3%51.20.2%
      Nurse executive137.60.6%70.90.3%
      Nurse manager1,365.45.8%1,661.56.2%
      Nurse faculty/educator967.94.1%257.51.0%
      Advanced practice registered nurse401.71.7%9.00.0%
      Staff nurse16,214.168.8%19,564.673.1%
      Case manager595.32.5%561.42.1%
      Other–health related3,444.214.6%4,275.516.0%
      Other–non-health related236.01.0%172.70.6%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Consultant4,2270.6%3,4900.6%
      Nurse researcher1,9550.3%1,1700.2%
      Nurse executive4,1380.6%1,6210.3%
      Nurse manager41,0605.8%37,9866.2%
      Nurse faculty/educator29,1074.1%5,8871.0%
      Advanced practice registered nurse12,0791.7%2060.0%
      Staff nurse487,58968.8%447,30873.1%
      Case manager17,9022.5%12,8352.1%
      Other–health related103,57214.6%97,75116.0%
      Other–non-health related7,0971.0%3,9490.6%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Primary nursing position speciality

      Response options related to primary and secondary practice specialty were modified from the 2015 instrument. Adult health and family health were separated into two categories; cardiology was added as a category; and other was separated into other–clinical and other–non-clinical. Primary care, genetics, informatics, neurology/neurosurgical, orthopedic, radiology, urology, and telehealth were all removed from the list of categories.
      Of LPN/LVN respondents, 30.5% selected geriatrics as the employment specialty that most closely corresponded to their primary nursing practice position. The second most frequently selected employment specialty was home health (8.8%) followed by adult health (7.8%). A smaller proportion of LPNs/LVNs selected other in 2017 (12.1%) compared to 2015 (15.5%). The 12.1% who comprised other in 2017 included the 10.8% of LPN/LVN respondents who indicated other–clinical specialties and 1.3% who indicated other–non-clinical specialties. See Table 61.
      Table 61Primary Nursing Position Specialty—LPN/LVN
      Weighted Sample Values
      2015 (n = 21,932.4)2017 (n = 25,214.9)
      nPercentnPercent
      Acute care/critical care458.52.1%670.02.7%
      Adult health960.64.4%1,968.07.8%
      Family health------1,712.46.8%
      Anesthesia18.00.1%17.60.1%
      Cardiology------250.41.0%
      Community262.61.2%216.80.9%
      Geriatric/gerontology6,064.127.7%7,685.830.5%
      Home health2,109.39.6%2,228.28.8%
      Maternal-child health/obstetrics120.50.6%225.10.9%
      Medical-surgical777.33.5%728.62.9%
      Nephrology133.70.6%201.00.8%
      Occupational health154.50.7%160.80.6%
      Oncology137.10.6%152.90.6%
      Palliative care/hospice348.21.6%354.71.4%
      Pediatrics1,326.06.1%1,880.27.5%
      Neonatal28.20.1%28.80.1%
      Perioperative93.10.4%76.40.3%
      Public health173.10.8%257.61.0%
      Psychiatric/mental health/substance abuse1,084.85.0%1,205.04.8%
      Rehabilitation847.73.9%1,081.54.3%
      School health612.92.8%646.22.6%
      Emergency/trauma157.20.7%127.50.5%
      Women’s health342.81.6%291.01.2%
      Other–clinical specialties------2,724.110.8%
      Other–non-clinical specialties------324.11.3%
      Other3,400.715.5%------
      Primary care1,695.57.7%------
      Genetics182.20.8%------
      Informatics41.40.2%------
      Neurology/neurosurgical90.60.4%------
      Orthopedic185.50.9%------
      Radiology24.20.1%------
      Urology102.10.5%------
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Acute care/critical care13,7872.1%15,3192.7%
      Adult health28,8884.4%44,9957.8%
      Family health------39,1516.8%
      Anesthesia5420.1%4010.1%
      Cardiology------5,7251.0%
      Community7,8961.2%4,9560.9%
      Geriatric/gerontology182,35927.7%175,72230.5%
      Home health63,4309.6%50,9448.8%
      Maternal-child health/obstetrics3,6230.6%5,1480.9%
      Medical-surgical23,3753.5%16,6592.9%
      Nephrology4,0220.6%4,5950.8%
      Occupational health4,6470.7%3,6770.6%
      Oncology4,1240.6%3,4970.6%
      Palliative care/hospice10,4711.6%8,1091.4%
      Pediatrics39,8756.1%42,9887.5%
      Neonatal8480.1%6590.1%
      Perioperative2,7980.4%1,7470.3%
      Public health5,2070.8%5,8891.0%
      Psychiatric/mental health/substance abuse32,6225.0%27,5504.8%
      Rehabilitation25,4933.9%24,7274.3%
      School health18,4322.8%14,7742.6%
      Emergency/trauma4,7290.7%2,9150.5%
      Women’s health10,3081.6%6,6531.2%
      Other–clinical specialties------62,28210.8%
      Other–non-clinical specialties------7,4111.3%
      Other102,26615.5%------
      Primary care50,9867.7%------
      Genetics5,4800.8%------
      Informatics1,2440.2%------
      Neurology/neurosurgical2,7230.4%------
      Orthopedic5,5770.9%------
      Radiology7270.1%------
      Urology3,0710.5%------
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing position setting

      Nursing home/extended care settings was the most frequently chosen setting by 32.5% of LPN/LVN respondents as their secondary nursing position This represents 5.6 percentage point increase from 2015. At the same time, the percentage of LPNs/LVNs who indicated their secondary nursing position was in a home health setting decreased by 5.1 percentage points from 31.9% in 2015 to 26.8% in 2017. The percentage that identified an assisted living facility to be their secondary nursing position setting saw little change between the two surveys. See Table 62.
      Table 62Secondary Nursing Position Setting—LPN/LVN
      Weighted Sample Values
      2015 (n = 3,018.7)2017 (n = 4,376.2)
      npercentnpercent
      Hospital180.46.0%261.26.0%
      Nursing home/extended care813.326.9%1,422.032.5%
      Assisted living facility232.57.7%332.37.6%
      Home health961.331.9%1,173.126.8%
      Hospice------115.72.6%
      Correctional facility108.73.6%136.63.1%
      School of nursing32.71.1%10.40.2%
      Public health30.31.0%55.81.3%
      Dialysis center------35.00.8%
      Community health69.12.3%85.22.0%
      School health service42.11.4%111.92.6%
      Occupational health16.90.6%31.10.7%
      Ambulatory care setting78.42.6%121.72.8%
      Insurance claims/benefits6.50.2%22.80.5%
      Policy/planning/regulatory/licensing agency15.90.5%16.60.4%
      Other430.514.3%444.810.2%
      Note: Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing position title

      Over three-quarters of LPN/LVN respondents reported their secondary nursing position title as staff nurse. This represents an increase of 5.8 percentage points between 2015 and 2017. The percentage of LPNs/LVNs who reported a secondary nursing position title of nurse manager increased by 1.4 percentage points from 2015 to 2017. The percentage of LPN/LVN respondents who were nurse faculty/educators in their secondary nursing position decreased from 4.4% in 2015 to 1.4% in 2017. See Table 63.
      Table 63Secondary Nursing Position Title—LPN/LVN
      Weighted Sample Values
      2015 (n = 2,980.3)2017 (n = 4,217.2)
      nPercentnPercent
      Consultant37.51.3%45.21.1%
      Nurse researcher7.00.2%1.30.0%
      Nurse executive10.40.4%10.00.2%
      Nurse manager59.92.0%141.43.4%
      Nurse faculty/educator132.04.4%58.41.4%
      Advanced practice registered nurse34.11.1%2.60.1%
      Staff nurse2,167.272.7%3,309.278.5%
      Case manager53.81.8%66.61.6%
      Other–health related440.314.8%528.912.5%
      Other–non-health related38.31.3%53.51.3%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Secondary nursing position specialty

      Over one-third of LPNs/LVNs (34.5%) reported their secondary nursing position specialty was geriatric/gerontology, an increase of 4.8 percentage points from 2015. Home health was the second most frequently selected specialty in both 2015 and 2017, though there was a decrease of 3.3 percentage points. See Table 64.
      Table 64Secondary Nursing Position Specialty—LPN/LVN
      Weighted Sample Values
      2015 (n = 2,809.3)2017 (n = 4,024.3)
      nPercentnPercent
      Acute care/critical care70.92.5%120.53.0%
      Adult health63.82.3%236.65.9%
      Family health------88.62.2%
      Anesthesia0.00.0%1.90.1%
      Cardiology------13.10.3%
      Community37.31.3%72.31.8%
      Geriatric/gerontology834.029.7%1,388.234.5%
      Home health568.120.2%679.516.9%
      Maternal-child health/obstetrics10.50.4%21.40.5%
      Medical-surgical48.21.7%73.91.8%
      Nephrology9.30.3%27.80.7%
      Occupational health17.20.6%27.30.7%
      Oncology1.60.1%9.00.2%
      Palliative care/hospice77.82.8%58.01.4%
      Pediatrics181.76.5%378.69.4%
      Neonatal8.40.3%1.70.0%
      Perioperative0.5<0.1%2.90.1%
      Public health21.60.8%57.61.4%
      Psychiatric/mental health/substance abuse111.84.0%159.54.0%
      Rehabilitation108.33.9%184.24.6%
      School health39.81.4%82.82.1%
      Emergency/trauma43.61.6%48.41.2%
      Women’s health10.50.4%17.10.4%
      Other–Clinical specialties------227.05.6%
      Other–Non-clinical specialties------48.31.2%
      Other420.115.0%------
      Primary care76.92.7%------
      Genetics29.91.1%------
      Informatics3.60.1%------
      Neurology/neurosurgical3.40.1%------
      Orthopedic6.70.2%------
      Radiology1.80.1%------
      Urology1.80.1%------
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Salary/Earnings

      2016 pre-tax annual earnings from primary nursing position

      The median pre-tax annual earnings for responding LPNs/LVNs increased from $38,000 in 2015 to $40,000 in 2017. Categorically, the percentage of respondents earning less than $40,000 annually decreased by 6.6 percentage points, while all other earnings categories increased. The percentage of respondents making between $40,000 and $60,000 increased by 3.6 percentage points; those making between $60,000 and $80,000 increased by 1.9 percentage points; and those making more than $80,000 increased by 0.9 percentage points. See Table 65.
      Table 65Annual Earnings—LPN/LVN
      Weighted Sample Values
      2015 (n = 19,436.4)2017 (n = 24,473.1)
      nPercentnPercent
      Less than $40,00010,138.352.2%11,190.345.7%
      $40,000 to $59,9997,088.336.5%9,819.440.1%
      $60,000 to $79,9991,418.57.3%2,243.99.2%
      $80,000 to $99,999174.60.9%361.11.5%
      $100,000 or more616.83.2%857.23.5%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Less than $40,000304,87752.2%255,84545.7%
      $40,000 to $59,999213,15736.5%224,50140.1%
      $60,000 to $79,99942,6577.3%51,3039.2%
      $80,000 to $99,9995,2500.9%8,2561.5%
      $100,000 or more18,5483.2%19,6263.5%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Salary includes overtime and bonuses, but does not include sign-on bonuses.

      Earnings by gender and specialty

      For all specialties, the median salary for males is higher than the median salary for females. LPNs/LVNs working in rehabilitation have the highest median salary overall, and LPNs/LVNs working in school health have the lowest median salary overall. See Table 66.
      Table 66Median Annual Earnings by Gender and Specialty—LPN/LVN
      MaleFemaleTotal
      Acute care/critical care$52,000$43,000$43,200
      76548624
      Adult health$50,000$42,000$42,000
      1381,4451,583
      Family health$40,000$36,000$36,000
      541,8411,895
      Anesthesia$57,500$41,500$44,000
      21315
      Cardiology$58,500$39,950$40,000
      12214226
      Community$45,000$44,000$44,000
      17214231
      Geriatric/gerontology$50,000$45,000$45,000
      4055,9296,334
      Home health$45,500$43,000$43,000
      1171,3801,497
      Maternal-child health/obstetrics$72,000$41,000$41,185
      1183184
      Medical-surgical$45,000$40,000$40,000
      42586628
      Nephrology$50,000$42,000$42,000
      10144154
      Occupational health$49,000$46,900$46,900
      12149161
      Oncology$54,000$43,750$45,000
      9127136
      Palliative care/hospice$46,000$45,000$45,000
      19253272
      Pediatrics$44,000$40,000$40,000
      451,1621,207
      Neonatal$46,000$46,000
      01212
      Perioperative$45,500$41,000$41,000
      26466
      Public health$42,000$40,000$40,000
      21193214
      Psychiatric/mental health/substance abuse$48,000$42,000$42,500
      1299741,103
      Rehabilitation$50,000$48,000$48,000
      85801886
      School health$42,500$28,000$28,000
      13451464
      Emergency/trauma$42,340$41,900$42,000
      1799116
      Women’s health$37,000$37,000
      0296296
      Total$48,000$42,000
      1,40119,683
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by highest education

      LPNs/LVNs with baccalaureate and master’s degrees have the highest median salaries. See Table 67
      Table 67Median Annual Earnings by Highest Education—LPN/LVN
      Median Salaryn
      Vocational/practical certificate$42,00016,750
      Diploma$41,6003,709
      Associate degree$40,0002,199
      Baccalaureate degree$51,619227
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by state

      Median earnings rose in most states. The highest median earnings were for LPNs/LVNs practicing in Alaska ($52,000). The lowest median earnings were for LPNs/LVNs practicing in South Dakota ($34,865), Alabama ($35,000), Mississippi ($35,000), and West Virginia ($35,000). See Table 68.
      Table 68Median Annual Earnings in Primary Nursing Position by State(s) Where Currently Practicing—LPN/LVN
      State20152017
      Alaska$50,000$52,000
      Alabama$33,000$35,000
      Arkansas$33,500$37,000
      Arizona$48,000$48,000
      California$45,000$48,000
      Colorado$42,000$45,000
      Connecticut$49,000$50,000
      District of Columbia$53,000$50,000
      Delaware$45,000$47,000
      Florida$37,000$40,000
      Georgia$36,000$39,800
      Hawaii$45,000$46,000
      Iowa$34,640$36,000
      Idaho$32,560$38,000
      Illinois$40,000$40,000
      Indiana$36,000$40,000
      Kansas$35,000$39,000
      Kentucky$35,000$40,000
      Louisiana$35,000$38,000
      Massachusetts$48,000$50,000
      Maryland$45,000$50,000
      Maine$36,000$40,000
      Michigan$35,000$40,000
      Minnesota$33,000$36,750
      Mississippi$35,000$35,000
      Montana$36,260$37,440
      North Carolina$38,000$41,000
      North Dakota$35,000$37,000
      Nebraska$33,000$38,000
      New Hampshire$42,000$45,500
      New Jersey$45,000$48,000
      New Mexico$45,000$45,000
      Nevada$48,000$49,000
      New York$40,000$45,000
      Ohio$34,000$36,000
      Oklahoma$35,000$37,000
      Oregon$42,240$47,000
      Pennsylvania$39,000$40,320
      Rhode Island$45,000$50,000
      South Carolina$37,124$40,000
      South Dakota$30,000$34,865
      Tennessee$34,000$36,000
      Texas$40,082$43,000
      Utah$36,000$41,000
      Virginia$36,000$40,000
      Vermont$37,128$42,000
      Washington$44,000$48,000
      Wisconsin$35,000$38,000
      West Virginia$32,000$35,000
      Wyoming$40,000$40,500
      American Samoa$30,000$30,000
      Guam$34,000$32,000
      Northern Mariana Islands$55,000$28,500
      Virgin Islands$35,000$39,000
      Note. Medians are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Earnings by years licensed and age

      Similarly to RNs, there are steady increases in median salary as the number of years licensed increases, and little to no trend when LPNs/LVNs increase in age. See Table 69
      Table 69Median Annual Earnings by Years Licensed and Age—LPN/LVN
      Licensed 0-1 YearLicensed 2-5 YearsLicensed 6-10 YearsLicensed 11+ YearsTotal
      < 30$31,000$35,000$38,200$39,500$35,000
      66794823761,858
      30-34$32,500$40,000$40,000$40,000$40,000
      2256685942951,782
      35-39$34,780$40,000$41,000$41,000$40,000
      1955665718372,169
      40-44$37,750$40,000$42,889$43,200$42,000
      1484315221,2132,314
      45-49$39,603$40,000$43,000$44,000$43,000
      963304601,8032,689
      50-54$34,000$40,000$43,000$45,000$45,000
      742483772,2402,939
      55-59$38,400$41,721$40,463$45,000$44,000
      331602963,1283,617
      60-64$33,500$42,000$43,464$45,000$45,000
      9691193,1523,349
      ≥ 65$27,000$39,500$40,000$45,000$45,000
      317381,4491,507
      Total$33,120$40,000$41,000$45,000
      1,4503,4373,21414,123
      Note. Sample sizes are unweighted. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Telehealth Utilization

      Percent of time providing telehealth

      Responding LPNs/LVNs indicated that 54.2% were providing nursing services remotely in 2017 compared to 46.1% in 2015. Almost a quarter (23.2%) of LPN/LVN respondents were spending up to 25% of their time providing services remotely. The largest increase occurred among those LPNs/LVNs who were providing nursing services remotely from 76 to 100% of the time, increasing from 7.2% in 2015 to 12.7% in 2017. See Table 70.
      Table 70Percent of Time Providing Telehealth—LPN/LVN
      Weighted Sample Values
      2015 (n = 23,619.9)2017 (n = 27,760.6)
      nPercentnPercent
      Never12,723.153.9%12,715.845.8%
      1 to 25%5,496.623.3%6,436.423.2%
      26 to 50%2,207.19.3%2,821.310.2%
      51 to 75%1,490.66.3%2,253.88.1%
      76 to100%1,702.47.2%3,533.312.7%
      Estimated Population Values
      20152017
      FreqPercentFreqPercent
      Never382,60653.9%290,72245.8%
      1 to 25%165,29423.3%147,15723.2%
      26 to 50%66,3739.3%64,50310.2%
      51 to 75%44,8266.3%51,5298.1%
      76 to 100%51,1957.2%80,78112.7%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Telehealth across state borders

      Of those providing nursing services remotely, 43.9%, provided such services across state borders, compared to 33.8% in 2015. About one-third of LPN respondents (33.1%) provided such services to patients or clients across state borders up to 25% of the time. This represents a 5.6 percentage point increase from 2015. See Table 71.
      Table 71Percent of Time Providing Telehealth Across State Borders—LPN/LVN
      Weighted Sample Values
      2015 (n = 11,421.5)2017 (n = 12,214.3)
      nPercentnPercent
      Never7,566.566.2%6,849.956.1%
      1 to 25%3,140.427.5%4,040.133.1%
      26 to 50%371.13.2%622.95.1%
      51 to 75%180.41.6%372.23.0%
      76 to 100%163.11.4%329.32.7%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Telehealth across national borders

      Only 11.8% of LPNs/LVNs providing remote services to patients or clients provide such services across national borders. In this survey, 7.3% of nurses reported doing so up to 25% of their time. See Table 72.
      Table 72Percent of Time Providing Telehealth Across National Borders—LPN/LVN
      Weighted Sample Values
      2015 (n = 11,089.2)2017 (n = 11,117.1)
      nPercentnPercent
      Never10,201.892.0%9,800.388.2%
      1 to 25%633.35.7%807.07.3%
      26 to 50%129.01.2%208.11.9%
      51 to 75%82.00.7%189.01.7%
      76 to 100%43.10.4%112.71.0%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing.

      Modes of communication used for telehealth

      LPNs/LVNs providing services via phone or electronically to patients or clients were also asked to identify the modes of communication used. In this survey, 93.2% of LPNs/LVNs reported using a telephone to communicate with patients or clients, a 2.5 percentage point decrease from 2015; 28.9% reported using email to communicate with patients or clients, which is a decrease from the 29.5% who indicated so in 2015; and 22.5% reported using electronic messaging for patient/client communication in 2017 compared to 21.9% in 2015. See Table 73.
      Table 73Modes of Communication Used for Telehealth—LPN/LVN
      Weighted Sample Values
      2015 (n = 8,881.7)2017(n = 11,164.0)
      nPercentnPercent
      Electronic messaging1,947.721.9%2,510.822.5%
      VoIP187.72.1%349.63.1%
      Virtual ICU84.91.0%125.21.1%
      Telephone8,498.595.7%10,405.093.2%
      Email2,622.229.5%3,226.228.9%
      Video call207.42.3%260.72.3%
      Other883.09.9%1,027.29.2%
      Note. Survey participants were asked to answer this question only if they were actively employed in nursing. Respondents were asked to select all that apply. VoIP = voice over Internet protocol; ICU = intensive care unit.

      Discussion and Implications

      Approximately 152,000 LPNs/LVNs were included in the sample; 40,272 responded (26.5%). These data provide the most recent and detailed information on characteristics of licensed LPNs/LVNs, such as age, diversity, education, employment setting, position title, employment specialty, and salary. Data and research on the nursing workforce are often focused more on RNs and less so on LPNs/LVNs; therefore, the present study was a critical addition to nursing workforce data.
      In terms of diversity, 29% of responding LPNs/LVNs identified themselves as a minority, with the largest reporting minority group being Black/African American, at 18.5%. Of the respondents, 71% were White/Caucasian. This study’s racial/ethnic diversity results are somewhat dissimilar to
      • Health Resources and Services Administration
      Nursing workforce projections by ethnicity and race: 2014-2030.
      https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf
      Date: 2017, December
      nursing projections report by racial/ethnic diversity of the U.S. LPN/LVN workforce for 2014, which found a 61% White (non-Hispanic) LPN/LVN workforce and a 24% Black LPN/LVN workforce.
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      reported a 61% White workforce, and the largest reporting minority group was Black/African American, at 24%. Concerning gender diversity, 7.7% of the LPN/LVN respondents were male, which is somewhat similar to two other recent analyses of gender in the LPN/LVN workforce at 9% (
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      ) and 7.6% (
      • Health Resources and Services Administration
      Nursing workforce projections by ethnicity and race: 2014-2030.
      https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf
      Date: 2017, December
      ).
      While 83% of respondents indicated a vocational/practical certificate was their entry qualification for their first U.S. nursing license, three-quarters (77.8%) of LPNs/LVNs did not receive higher degrees. This represents a slight increase of 1.8 percentage points from 2015 (76.0%). The vast majority (97.5%) were educated in the United States, which is consistent with results from the 2015 survey (98.5%). This is similar to
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      finding that 76% did not hold a college degree in preparation to be an LPN/LVN. Of respondents, 14.3% indicated they held a diploma in nursing and another 7.3% held an associate degree in nursing as their highest level of nursing education. Almost a quarter of responding LPNs/LVNs indicated they had a non-nursing degree. Of those respondents, 68.8% reported an associate level non-nursing degree, 25.0% reported a baccalaureate level non-nursing degree, and an additional 6.2% reported a graduate-level non-nursing degree.
      The most common care setting of LPN/LVN respondents was in nursing home/extended care (31.7%), followed by 14% in home health and 9.6% in hospitals. These percentages are similar to those found in the 2015 survey. Approximately 30.5% of LPNs/LVNs reported their primary practice specialty as geriatric/gerontology compared with 27.7% in the 2015 survey. These findings support a report by
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      that indicated long-term care employs more LPNs/LVNs than any other industry. In fact, they found the number of LPNs/LVNs working in long-term care increased from 258,670 in 2008 to 289,946 in 2013, an increase of 13%, while the number of LPNs/LVNs working in hospitals, outpatient care, and other sectors decreased by 20%. Over two-thirds (73.1%) of LPNs/LVNs’ primary title was staff nurse. The current survey also found that 54.2% of LPNs/LVNs provided patient care services utilizing telehealth technologies, representing an increase of 8 percentage points. Of those, 43.9% were providing electronic services across state borders, compared to 33.8% in 2015.

      Limitations

      Limitations of the current study include a response rate of 26.5%, which was lower than the response rate for the similar sample of RNs (32.8%). A nonresponse bias analysis was conducted and indicated a slight overrepresentation of three distinct variables: White/Caucasian, female, and age 50 and older in the responding sample. As described earlier, gender and age were used to make nonresponse weighting adjustments, along with weighting adjustments for differing nursing population sizes across states. An additional limitation was missing or incomplete data. While the large sample size partially compensated for this, certain item nonresponse bias could have impacted the results, such as salary (30.0% did not answer): Both upper and lower limits had been set on the salary figures; however, extreme values could still have skewed mean values upward; the medians were likely the more accurate statistic versus the mean for the measure of central tendency. Data used for comparison may have quite different samples; for example, the
      • Health Resources and Services Administration
      Nursing workforce projections by ethnicity and race: 2014-2030.
      https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf
      Date: 2017, December
      brief on gender and racial/ethnic diversity of U.S. health occupations used data on a U.S. working-age population age 16 or older who were currently employed or who were recently employed and were seeking employment (e.g., individuals who were recently laid off), and the
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      report relied on data from the American Community Survey and the Public Use Microdata Sample. Lastly, questions may be altered slightly from survey to survey, making comparisons potentially more challenging.

      Conclusion

      The current LPN/LVN workforce is expected to change in terms of the ratios of racial/ethnic minority groups and of men to women, though those changes are gradual. The LPN/LVN workforce is still largely composed of White/Caucasian women. Changes in the health care environment are especially relevant for LPNs/LVNs because where they are working is changing as more and more health care is delivered outside acute-care settings. Recent trends indicate strong demand for LPNs/LVNs in long-term care and community settings. The most recent HRSA projections on the supply and demand for LPNs/LVNs indicate there will be a shortage of 151,000 nurses by 2030, affecting all but 18 states (
      • Health Resources and Services Administration
      Nursing workforce projections by ethnicity and race: 2014-2030.
      https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf
      Date: 2017, December
      ). Of concern are the projections by
      • Coffman J.
      • Bates T.
      • Chan K.
      • Spetz J.
      Trends in the licensed practical nurse workforce from 2008 to 2013.
      The Gerontologist. 2015; 55: 776
      that indicate the LPN/LVN workforce in the United States is declining in size, from 675,918 in 2008 to 635,975 in 2013, a decrease of 6%. This decline is happening at a time when the supply and demand of LPNs/LVNs are likely to be affected by such factors as population growth, aging of the population, preferences for care delivery, and economic conditions.

      Appendices

      Appendix A Registered Nurse Nonresponse Analysis and Sample Weighting

      A formal nonresponse bias analysis was conducted following the close of the survey. Although response rates are a valuable indicator of survey quality, they are not a good measure of response bias. An analysis of basic demographic data (i.e., gender, age, race/ethnicity, number of years since graduation, number of years since first licensed) for all registered nurse (RN) licensees sampled from the Nursys® database was used to compare the survey respondents and nonrespondents to determine the representativeness of the survey participants. Variables in the data file came from both the Nursys database (i.e., the frame data) and responses to the survey (i.e., survey data). The variables used in the nonresponse analysis were from the frame and include state, date of birth, gender, and ethnicity. The dependent variable in the analysis was whether or not the sampled RN completed the questionnaire.

      Descriptive statistics

      Of the 153,920 RNs in the sample frame, 48,704 responded, for a response rate of 31.6% (Table A1). Table A2, Table A3 show the frequencies for the categorical variables of gender and race/ethnicity. Table A4 shows the descriptive statistics for age. The only demographic information used for the following analyses come from Nursys, and are not the demographic data received from the survey.
      Table A1Response Rate—RN
      (n = 153,920)Percent
      Nonresponse105,21668.4%
      Response48,70431.6%
      Table A2Gender of Sample—RN
      (n = 153,920)Percent
      Female95,56762.1%
      Male9,9856.5%
      Restricted/unknown40,24826.1%
      Missing8,1205.3%
      Table A3Race/Ethnicity of Sample—RN
      (n = 153,920)Percent
      White/Caucasian35,51823.1%
      Black/African American2,6971.8%
      Asian1,4991.0%
      Hispanic1,9571.3%
      Native American3560.2%
      Pacific Islander47<0.1%
      Other9050.6%
      Restricted/unknown40,24826.1%
      Missing70,69345.9%
      Table A4Age of Sample—RN
      nMeanStandard DeviationMinimumMaximum
      Age106,40246.813.616109
      This response rate corresponds to the American Association for Public Opinion Research Response Rate 1 (the minimum response rate), in which the numerator is the number of completed questionnaires and the denominator is the total sample size (

      American Association for Public Opinion Research. (n.d.). Response rates—An overview. Retrieved from www.aapor.org/Education-Resources/For-Researchers/Poll-Survey-FAQ/Response-Rates-An-Overview.aspx

      ).

      Bivariate Analysis

      Table A5, Table A6 show the bivariate relationships between the demographic variables from the sample frame and whether or not the respondent completed the survey. Table A5 shows there were far fewer men in the database (9,985 compared to 95,567 women) and they were less likely to complete the survey (25.2% compared to 34.1% women).
      Table A5Response Rate by Gender—RN
      Completed Survey
      nNoYes
      Female95,56765.9%34.1%
      Male9,98574.8%25.2%
      Total105,55266.8%33.2%
      Note. χ2(1, N = 105, 552) = 319.5, p < .001.
      Table A6Response Rate by Race/Ethnicity—RN
      Completed Survey
      Race/EthnicitynNoYes
      White/Caucasian35,51866.3%33.7%
      African American2,69777.7%22.3%
      Hispanic1,95775.1%24.9%
      Asian1,49973.4%26.6%
      Native American35677.5%22.5%
      Pacific Islander4785.1%14.9%
      Other90574.3%25.7%
      Total42,97967.9%32.1%
      Note. c2 (6, N = 42,979) = 266.0 p < .001.
      Table A7 displays the mean age of RNs of those who did and did not respond. On average, those who completed the survey were 5.4 years older than the nonrespondents. This relationship is statistically significant.
      Table A7Age by Response and Nonresponse—RN
      Completed SurveyAge
      Non70,748
      Mean44.9
      Standard deviation13
      Yesn35,654
      Mean50.4
      Standard deviation14.1
      Totaln106,402
      Mean46.8
      Standard deviation13.6
      Note. A t-test shows that the average age among those who did and did not respond is significantly different at the <.001 level.

      Weights

      In The 2015 National Nursing Workforce Survey, nonresponse adjustments were made for gender and age. For the 2017 survey, nonresponse adjustments were applied for gender and age in the jurisdictions for which data were obtained through the Nursys database. There was a high degree of missing race/ethnicity data in the sample frame (72.1% missing/unknown). Therefore, it was deemed impractical to use race/ethnicity for nonresponse adjustment even though there were differences in response rates by the category.
      In order to create the combined age and gender (Age × Gender) nonresponse weights, the survey response rates for the age variable were compared at the 5-year age-group level and neighboring cells with similar response rates were collapsed. Upon completion of this process, six age-groups were created (16 to 49, 50 to 54, 55 to 59, 60 to 64, 65 or older, missing). These six age-groups were combined with the gender variable response categories (male, female, missing) to produce 18 Age × Gender categories. The survey response rate for each Age × Gender category (# responding/# in sample frame) was calculated and used to create each category’s weight as follows:
      Age×Gender Category Weight=Overall Survey Response RateAge×Gender Category Survey Response Rate


      As an example of how this was calculated, there were 434 RNs in the sample frame whose gender was identified as male and whose age was missing. Out of these 434 RNs, 87 responded. The Age × Gender response rate for this category was determined to be 87/434 = .2005. The overall survey response rate in jurisdictions for which data was obtained through the Nursys database was 37,548/113,672 = .3303. So the Age × Gender weight for the age missing-gender male category was .3303/.2005 = 1.648.
      Respondents in jurisdictions for which data were not obtained through the Nursys database were not weighted for age and gender and therefore all assigned an Age × Gender weight of 1.000. When the Age × Gender weights for each respondent are totaled, the sum comes to 48,704, the same as the total number of respondents. Table A8 displays the weights for the 18 Age × Gender categories in jurisdictions for which data were obtained through the Nursys database.
      Table A8Age × Gender Response Rate—RN
      Gender
      Age-GroupInvalidFemaleMale
      16-491.3871.2251.610
      50-541.0530.9741.210
      55-590.8720.8221.033
      60-640.7910.7090.904
      65 or older0.6410.6050.720
      Age missing1.1201.3151.648
      In a similar manner, poststratification weights were constructed at the state level to adjust for differing sampling rates across states. These adjustments were made by comparing the number of responses to the number of licensees in that state. Analysis of the raw data, without accounting for the sample design, would lead to the overall results being too heavily influenced by states with fewer licensees.
      For example, there were 427,892 RNs in California, out of which 1,020 responded. The California re-sponse per license rate was 1,020/427,892 = .0024. The overall response per license rate was 48,704/4,639,548 = .0105. So the poststratification weight for California was .0105/.0024 = 4.375.
      Overall weights combined the Age × Gender and poststratification weights and were created by multiplying the Age × Gender and poststratification weights for each individual to create an initial set of weights, adding the initial weights together, and slightly adjusting the weights so that they sum up to 48,704.
      The overall weights adjust the distribution across states, age, and gender, but sum to the actual number of RNs in the subset of completed responses. They can be applied when analyzing relationships between variables without the effect of artificially altering the degrees of freedom and thereby affecting significance tests. The Age × Gender weights, poststratification weights, and overall weights are summarized in Table A9.
      Table A9Weight Summary Statistics—RN
      nMinimumMaximumSumMean
      Age by gender48,7040.6051.64848,7041.000
      Poststratification48,7040.0884.79248,7041.000
      Combined48,7040.0535.93248,7041.000
      Note. Combined weight was used in reporting results.

      Appendix B Licensed Practical Nurse/LicensedVocational Nurse Nonresponse Analysis and Sample Weighting

      As with the RNs, a formal nonresponse bias analysis was conducted of the LPN/LVN data following the close of the survey. Variables in the data file came from both the Nursys® database (i.e., the frame data) and responses to the survey (i.e., survey data). The variables used in the nonresponse analysis were from the frame and include state, date of birth, gender, and race/ethnicity. The dependent variable in the analysis was whether or not the sampled LPN/LVN completed the questionnaire.

      Preliminary analysis

      Of the 158,502 LPNs/LVNs in the sample frame, 40,272 responded, for a response rate of 25.4% (Table B1). Table B2, Table B3 show the frequencies for the categorical variables. Table B4 shows the descriptive statistics for age.
      Table B1Response Rate—LPN/LVN
      (n = 158,502)Percent
      No118,23074.6%
      Yes40,27225.4%
      Table B2Gender of Sample—LPN/LVN
      (n = 158,502)Percent
      Female92,88658.6%
      Male8,5505.4%
      Restricted/unknown46,21529.2%
      Missing10,8516.8%
      Table B3Race/Ethnicity of Sample—LPN/LVN
      (n = 158,502)Percent
      White/Caucasian33,23321.0%
      Black/African American6,1883.9%
      Asian7240.5%
      Hispanic2,8231.8%
      Native American5230.3%
      Pacific Islander71<0.1%
      Other8470.5%
      Restricted/unknown46,21529.2%
      Missing67,87842.8%
      Table B4Age of Sample—LPN/LVN
      nMeanStandard DeviationMinimumMaximum
      Age102,82547.313.21696

      Bivariate analysis

      Table B5, Table B6 show the bivariate relationships between the demographic variables from the sample frame and whether or not the respondent completed the survey. There were far fewer men in the database (8,550 compared to 92,886 women) and they were less likely to complete the survey (19.6% compared to 27.9% women).
      Table B5Response Rate by Gender—LPN/LVN
      Completed Survey
      nNoYes
      Female92,88672.1%27.9%
      Male8,55080.4%19.6%
      Total101,43672.8%27.2%
      Note. c2 (1, N = 101,436) = 275.6, p < .001.
      Table B6Response Rate by Race/Ethnicity—LPN/LVN
      Completed Survey
      Race/EthnicitynNoYes
      White/Caucasian33,23371.0%29.0%
      African American6,18879.8%20.2%
      Asian72475.8%24.2%
      Hispanic2,82378.1%21.9%
      Native American52375.5%24.5%
      Pacific Islander7181.7%18.3%
      Other84781.0%19.0%
      Total44,40973.0%27.0%
      Note. c2 (6, N = 44,409) = 287.1, p < .001.
      From Table B6, nurses who identified as White/Caucasian were most likely to respond, with a response rate of 29.0%. Those who responded other and Pacific Islander nurses were least likely to respond, with response rates of 19.0% and 18.3%.
      Table B7 displays the mean age of LPNs/LVNs by response or nonresponse. On average, those who completed the survey were 5.6 years older than the nonrespondents. This relationship is statistically significant.
      Table B7Age by Response and Nonresponse—LPN/LVN
      Completed Survey
      NoMean45.8
      Standard deviation12.8
      n74,736
      YesMean51.4
      Standard deviation13.5
      n28,089
      TotalMean47.3
      Standard deviation13.2
      n102,825
      Note. A t-test shows that this relationship is significant at the <.001 level.

      Weights

      In The 2015 National Workforce Survey of Registered Nurses report, nonresponse adjustments were made for gender and age. Due to the high degree of missing race/ethnicity data in the sample frame (72.0% missing/unknown), it was still deemed impractical to use that category for nonresponse adjustment.
      In order to create the combined age and gender (Age × Gender) nonresponse weights, the survey response rates for the age variable were compared at the 5-year age-group level and neighboring cells with similar response rates were collapsed. Upon completion of this process, six age-groups were created (16 to 49, 50 to 54, 55 to 59, 60 to 64, 65 or older, missing). These six age-groups were combined with the gender variable response categories (male, female, missing) to produce 18 Age × Gender categories. The survey response rate for each Age × Gender category (# responding/# in sample frame) was calculated and used to create each category’s weight as follows:
      Age×Gender Category Weight=Overall Survey Response RateAge×Gender Category Survey Response Rate


      An example of how this was calculated can be found in the RN nonresponse sample weighting section.
      Respondents in jurisdictions for which data was not obtained through the Nursys database were not weighted for age and gender and therefore all assigned an Age × Gender weight of 1.000. When the Age × Gender weights for each respondent are totaled, the sum comes to 40,272, the same as the total number of respondents. Table B8 displays the weights for the 18 Age × Gender categories in jurisdictions for which data was obtained through the Nursys database.
      Table B8Age × Gender Response Rate—LPN/LVN
      Gender
      Age-GroupMissing/InvalidFemaleMale
      18-491.5511.2891.796
      50-541.0040.9521.268
      55-590.9160.7881.051
      60-640.7540.6710.901
      65 or older0.6430.5950.733
      Age missing1.0971.1871.647
      In a similar manner, poststratification weights were constructed at the state level to adjust for differing sampling rates across states. However, these adjustments were made not by comparing the number of responses in a state’s sample frame count, but rather by comparing the number of responses to the number of licensees in that state. An example of how these weights were calculated can be found in the RN nonresponse sample weighting section.
      Overall weights that combined the Age×Gender and poststratification weights were created by multiplying the Age × Gender and poststratification weights for each individual to create an initial set of weights, adding the initial weights together, and slightly adjusting the weights so that they sum up to 40,272.
      The overall weights simply adjust the distribution across states, age, and gender, but sum to the actual number of LPNs/LVNs in the subset of completed responses. They can be applied when analyzing relationships between variables without the effect of artificially altering the degrees of freedom and thereby affecting significance tests. The Age × Gender weights, poststratification weights, and overall weights are summarized in Table B9.
      Table B9Weight Summary Statistics—LPN/LVN
      nMinimumMaximumSumMean
      Age by gender40,2720.5951.79640,2721.000
      Poststratification40,2720.1278.91640,2721.000
      Combined40,2720.0748.69640,2721.000
      Note. Combined weight was used in reporting results. Overall Survey Response Rate

      Appendix C List of Tables

      Tabled 1
      Table 1Number of Active RN LicensesS6
      Table 2Number of Active LPN/LVN LicensesS8
      Table 3Gender Distribution of Nurses—RNS11
      Table 4Race/Ethnicity—RNS11
      Table 5Ethnicity of Hispanic or Latino Origin—RNS12
      Table 6Race/Ethnicity by Gender—RNS12
      Table 7Age Distribution—RNS13
      Table 8Age Distribution by Gender—RNS14
      Table 9Age Distribution by Race/Ethnicity—RNS14
      Table 10Type of Nursing Degree or Credential for First U.S. Nursing License—RNS15
      Table 11Type of Nursing Degree or Credential for First U.S. Nursing License by Age—RNS16
      Table 12Highest Level of Nursing Education—RNS17
      Table 13Highest Level of Nursing Education by Gender—RNS17
      Table 14Highest Level of Nursing Education by Race—RNS18
      Table 15Highest Level of Nursing Education by Age—RNS19
      Table 16Highest Level of Non-Nursing Education—RNS19
      Table 17Type of License Currently Held—RNS20
      Table 18Number of Years Licensed—RNS21
      Table 19Initially Licensed in the United States—RNS22
      Table 20Credentialed to Practice as an APRNS22
      Table 21Employment Status—RNS23
      Table 22Reasons for Being Unemployed—RNS24
      Table 23Number of Positions Currently Held—RNS25
      Table 24Number of Hours Worked During a Typical Week in All Nursing Positions—RNS26
      Table 25Primary Nursing Practice Position Setting—RNS27
      Table 26Primary Nursing Position Title—RNS28
      Table 27Primary Nursing Position Specialty—RNS30
      Table 28Secondary Nursing Practice Position Setting—RNS32
      Table 29Secondary Nursing Position Title—RNS33
      Table 30Secondary Nursing Position Specialty—RNS34
      Table 31Annual Earnings—RNS36
      Table 32Median Annual Earnings by Gender and Specialty—RNS37
      Table 33Median Annual Earnings by Highest Education—RNS38
      Table 34Median Annual Earnings in Primary Nursing Position by State(s) Where Currently Practicing—RNS38
      Table 35Median Annual Earnings by Years Licensed and Age—RNS39
      Table 36Median Earnings by APRNsS40
      Table 37Percent of Time Providing Telehealth—RNS40
      Table 38Percent of Time Providing Telehealth Across State Borders—RNS41
      Table 39Percent of Time Providing Telehealth Across National Borders—RNS42
      Table 40Modes of Communication Used for Telehealth—RNS43
      Table 41Gender Distribution of Nurses—LPN/LVNS46
      Table 42Race/Ethnicity-LPN/LVNS46
      Table 43Ethnicity of Hispanic or Latino Origin–LPN/LVNS47
      Table 44Race/Ethnicity by Gender—LPN/LVNS48
      Table 45Age Distribution—LPN/LVNS48
      Table 46Age Distribution by Gender—LPN/LVNS49
      Table 47Age Distribution by Race/Ethnicity—LPN/LVNS50
      Table 48Type of Nursing Degree or Credential for First U.S. Nursing License—LPN/LVNS50
      Table 49Type of Nursing Degree or Credential for First U.S. Nursing License by Age—LPN/LVNS51
      Table 50Highest Level of Nursing Education—LPN/LVNS51
      Table 51Highest Level of Nursing Education by Race—LPN/LVNS52
      Table 52Highest Level of Non-Nursing Education—LPN/LVNS53
      Table 53Number of Years Licensed—LPN/LVNS53
      Table 54Initially Licensed in the United States—LPN/LVNS54
      Table 55Employment Status—LPN/LVNS55
      Table 56Reasons for Being Unemployed—LPN/LVNS56
      Table 57Number of Positions Currently Held—LPN/LVNS57
      Table 58Number of Hours Worked During a Typical Week in All Nursing Positions—LPN/LVNS58
      Table 59Primary Nursing Practice Position Setting—LPN/LVNS59
      Table 60Primary Nursing Position Title—LPN/LVNS60
      Table 61Primary Nursing Position Specialty—LPN/LVNS62
      Table 62Secondary Nursing Position Setting—LPN/LVNS65
      Table 63Secondary Nursing Position Title—LPN/LVNS66
      Table 64Secondary Nursing Position Specialty—LPN/LVNS67
      Table 65Annual Earnings—LPN/LVNS69
      Table 66Median Annual Earnings by Gender and Specialty—LPN/LVNS70
      Table 67Median Annual Earnings by Highest Education—LPN/LVNS71
      Table 68Median Annual Earnings in Primary Nursing Position by State(s) Where Currently Practicing—LPN/LVNS71
      Table 69Median Annual Earnings by Years Licensed and Age—LPN/LVNS72
      Table 70Percent of Time Providing Telehealth—LPN/LVNS72
      Table 71Percent of Time Providing Telehealth Across State Borders—LPN/LVNS73
      Table 72Percent of Time Providing Telehealth Across National Borders—LPN/LVNS74
      Table 73Modes of Communication Used for Telehealth—LPN/LVNS75
      Table A1Response Rate—RNS78
      Table A2Gender of Sample—RNS78
      Table A3Race/Ethnicity of Sample—RNS78
      Table A4Age of Sample—RNS78
      Table A5Response Rate by Gender—RNS78
      Table A6Response Rate by Race/Ethnicity—RNS79
      Table A7Age by Response and Nonresponse—RNS79
      Table A8Age × Gender Response Rate—RNS79
      Table A9Weight Summary Statistics—RNS80
      Table B1Response Rate—LPN/LVNS81
      Table B2Gender of Sample—LPN/LVNS81
      Table B3Race/Ethnicity of Sample—LPN/LVNS81
      Table B4Age of Sample—LPN/LVNS81
      Table B5Response Rate by Gender—LPN/LVNS81
      Table B6Response Rate by Race/Ethnicity—LPN/LVNS81
      Table B7Age by Response and Nonresponse—LPN/LVNS82
      Table B8Age × Gender Response Rate—LPN/LVNS82
      Table B9Weight Summary Statistics—LPN/LVNS82

      Appendix D 2017 National Workforce Study Questionnaire

      Unlabelled Image
      Unlabelled Image
      Unlabelled Image
      Unlabelled Image

      References

        • American Association of Colleges of Nursing
        DNP fact sheet.
        (Retrieved from)
        www.aacnnursing.org/News-Information/Fact-Sheets/DNP-Fact-Sheet
        Date: 2017
        View in Article
        • American Association of Colleges of Nursing
        Degree completion programs for registered nurses: RN to masters degree and RN to baccalaureate programs.
        (Retrieved from)
        www.aacnnursing.org/News-Information/Fact-Sheets/Degree-Completion-Programs
        Date: 2017
        View in Article
        • American Association of Colleges of Nursing
        Nursing faculty shortages.
        (Retrieved from)
        http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Faculty-Shortage
        Date: 2017
        View in Article

      4. American Association for Public Opinion Research. (n.d.). Response rates—An overview. Retrieved from www.aapor.org/Education-Resources/For-Researchers/Poll-Survey-FAQ/Response-Rates-An-Overview.aspx

        View in Article
        • American Well
        American Well® 2015 Telehealth Survey: 64% of Consumers Would See a Doctor Via Video.
        (Retrieved from)
        https://www.americanwell.com/press-release/american-well-2015-telehealth-survey-64-of-consumers-would-see-a-doctor-via-video/
        View in Article
        • Budden J.S.
        • Moulton P.
        • Harper K.J.
        • Brunell M.L.
        • Smiley R.
        The 2015 national nursing workforce survey.
        Journal of Nursing Regulation. 2016; 7: S1-S90
        View in Article
        • Buerhaus P.I.
        • Skinner L.E.
        • Auerbach D.I.
        • Staiger D.O.
        State of the registered nurse workforce as a new era of health emerges.
        Nursing Economics. 2017; 35: 229-237
        View in Article
        • Campaign Progress
        Welcome to the future of nursing: Campaign for Action dashboard.
        (Retrieved from)
        https://campaignforaction.org/wp-content/uploads/2017/07/Dashboard-Indicators_Dec17.pdf
        Date: 2017
        View in Article
        • Coffman J.
        • Bates T.
        • Chan K.
        • Spetz J.
        Trends in the licensed practical nurse workforce from 2008 to 2013.
        The Gerontologist. 2015; 55: 776
        View in Article
        • Health Resources and Services Administration
        Nursing workforce projections by ethnicity and race: 2014-2030.
        (Retrieved from)
        https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/hrsa-bhw-rn-lpn-factsheet-12-17.pdf
        Date: 2017, December
        View in Article
        • HIMSS Analytics
        2015 telemedicine study.
        https://www.himssanalytics.org/research/essentials-brief-telemedicine-study
        Date: 2015
        View in Article
        • Leiber N.
        Europe bets on robots to help care for seniors.
        (Retrieved from)
        www.bloomberg.com/news/articles/2016-03-17/europe-bets-on-robots-to-help-care-for-seniors
        Date: 2016
        • Masui A.
        Development of care robots growing in aging Japan. The Japanese Times.
        (Retrieved from)
        www.japantimes
        Date: 2016
        co.jp/news/2016/01/27/national/social-issues/development-care-robots-growing-aging-japan/#.W4KyOuhKhEY
        • National Academy of Medicine
        The future of nursing: Leading change, advancing health.
        2010
        View in Article
        • National Academy of Medicine
        Assessing progress on the IOM Report The Future of Nursing.
        (Retrieved from)
        www.nationalacademies.org/hmd/Reports/2015/Assessing-Progress-on-the-IOM-Report-The-Future-of-Nursing.aspx
        Date: 2015
        View in Article
        • National Council of State Boards of Nursing
        Enhanced Nurse Licensure Compact (eNLC) implementation.
        (Retrieved from)
        www.ncsbn.org/enhanced-nlc-implementation.htm
        Date: 2018
        View in Article
        • Susskind R.
        • Susskind D.
        The future of the professions: How technology will transform the work of human experts.
        Oxford University Press, Cary, NC2015
        • U.S. Bureau of Labor Statistics
        Occupational employment statistics, May 2016.
        (Retrieved from)
        www.bls.gov/oes/current/oes291141.htm
        Date: 2017
        • U.S. Bureau of Labor Statistics
        Occupational outlook handbook.
        (Retrieved from)
        www.bls.gov/ooh/healthcare/registered-nurses.htm
        Date: 2018
        View in Article
        • U.S. Census Bureau
        National population totals tables: 2010-2016.
        (Retrieved from)
        www.census.gov/data/tables/2016/demo/popest/nation-total.html
        Date: 2017
        View in Article
        • U.S. Census Bureau
        Quick facts.
        (Retrieved from)
        www.census.gov/quickfacts/fact/table/US/PST045217
        Date: 2017

      Article info

      Identification

      DOI: https://doi.org/10.1016/S2155-8256(18)30131-5

      Copyright

      © 2019 National Council of State Boards of Nursing. Published by Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      Linked Article

      • Conflict of Interest Compliance Article 1
        Journal of Nursing Regulation Vol. 12Issue 2
        • Preview
          As is standard in scholarly publishing, NCSBN’s Journal of Nursing Regulation (JNR) requires its authors to disclose any potential conflicts of interest (COI). Although COI information has always been collected by our staff in order to support editors’ review of the paper, it was not our standard practice to publish COI statements in each article. In this issue, JNR is retrospectively publishing the COI statements, which were collected with the below papers at submission, in order to make potential COI’s transparent to readers, as well as editors.
        • Full-Text
        • PDF

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX