Volume 1, Number 2 Fall 1998

We appreciate the letters and e-mails readers sent about the first issue. Nursing Counts will keep you informed and up to date with issues pertaining to the nursing workforce, particularly as it effects the elderly. This issue focuses on the nurses who work in home health care and ambulatory care. Data about nurses working in these settings are difficult to find. Home health agencies include those that are hospital and non-hospital-based, while ambulatory care includes physician-based practices, health maintenance organizations, nurse-run practices and dialysis units. Many of the ambulatory care settings employ only a few nurses. Where do we categorize the nurses who work in outpatient departments of hospitals? They are usually counted as hospital nurses. Confusing? You bet! If you missed the first issue of Nursing Counts, you can click here to view it now. You can also obtain a copy by contacting us at (212) 998-9018 or by e-mailing us at hartford.ign.@nyu.edu. We plan to make Nursing Counts a regular part of your life through the generous support of The John A Hartford Foundation Institute for Geriatric Nursing. Please feel free to copy this newsletter and pass it on; if you do, we ask that you copy the issue in its entirety. Enjoy! Christine Kovner, Editor Charlene Harrington, Associate Editor

Counting Nurses Healthcare Settings Research Briefs Winter 1999: Hospitals

Counting Nurses Counting nurses can be very confusing. Some sources report only those nurses working in the health sector, yet almost 16% of health professionals work in non-health settings (such as insurance companies). Some sources count individual nurses - an example is the New York State Education Department, which counts individuals who are registered nurses. But not all of these nurses are working. Some are in school; others have retired and still keep their licenses. Check the NYSED web page to see the number of nurses in NY State (http://www.nysed.gov/prof/98reg.htm) . Other sources count a sample of nurses and estimate the number of nurses from the sample. The Department of Health and Human Services, March 1996 National Sample Survey of Registered Nurses is an example of estimation the number of nurses from a sample. Another approach is counting fulltime equivalent nurses (FTE's). Using that method two individuals each of whom works part-time counts as ONE FTE. The U.S. Department of Labor uses still another method. They count paychecks. A nurse who works part-time at two places is counted twice. If home care agencies substitute part-time nurses for full-time nurses the Department of Labor would show an increase in the number of nurses, while the actual number of FTE nurses would stay the same. In this example, the Department of Labor would report twice as many nurses, while the elderly would not experience any increase in available nursing time. There is no "right" way to count nurses. This brief bit of information may help you understand why the numbers do not always add up. - Christine T. Kovner

The Employment of Registered Nurses: March 1996 According to the Division of Nursing Health Resources and Services Administration's (HRSA) latest findings from a March 1996 national survey of registered nurses, the majority of registered nurses (59%) worked in hospitals. Thirteen percent of nurses worked in a community of public health setting, 8.5% worked in a ambulatory care setting, 8.1% worked in a nursing home or extended care facility and 10.2% worked in anot6her employment setting. Of the 278,141 registered nurses who worked in community or public health, the majority either worked in non-hospital-based home health agencies (4.5% of nurses overall). Of the 178,930 registered nurses who worked in ambulatory care, the majority of these nurses worked in physician-based practices (4.1% of nurses overall). The educational background for registered nurses varied across employment settings. The majority of registered nurses had either an associate (35%) or a baccalaur5eate (32%) degree. Nurses in nursing homes and ambulatory care settings, community or public health and other settings had the highest percentages of registered nurses working with either a master's or doctoral degree. The earnings figure for registered nurses showed a total average annual income of $42,071 in 1996. The average earnings for nurses in ambulatory care, community or public health, and other nursing settings was three percent below thew national average. Registered nurses who worked in a nursing home or extended care facility received 11% less than their counterparts in other employment settings. - Charlene Harrington Source: Moses E. (March 1997) The Registered Nurse Population: Findings from the National Sample Survey of Registered Nurses. Washington, D.C.: U.S. Department of Health and Human Services, Health Resources and Services Administration