Too many nursing grads? A look at first-time test takers

We spent a good chunk of last week examining the question: Are colleges producing too many registered nurses?

We heard from lots of people who say no, that the shortage of RNs is real and that the idea schools are producing too many is wrong or that any imbalance is simply a short-term blip caused by the recession.

Our audience has been great about passing on data to us. Much obliged. We'll have at least two posts on the issue this week.

Today, we look at Minnesota and national data suggested by a reader: The number and pass rates of students who take the NCLEX exam for the time to become registered nurses.

This is the gateway national exam that "measures the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse." So as a measure of annual new supply of nurses, it's not bad. (As we'll also see, it's not conclusive!)

Let's look first at Minnesota data (.pdf page 20). The National Council of State Boards of Nursing reports that 2,939 students in Minnesota took the NCLEX RN test for the first time between October 2008 and September 2009. A total of 2,501 passed.

That likely underestimates the number of new nurses supplied annually, however. The national nursing group doesn't provide state-by-state data on repeat takers -- students who failed the exam once and tried again. Nationally, repeaters made up about 11 percent of the total pool of successful U.S. test takers.

So if we tack on 11 percent on to 2,501 we get about 2,776 students who passed the NCLEX in Minnesota in the most recent 12 month period available.

Here are the two estimates we have for the demand for RNs in Minnesota:

State officials project a need for about 2,400 new nurses a year through 2019.

EMSI projects 2,629 Minnesota RN openings per year though 2015.

The EMSI data suggests the supply of new Minnesota nurses matches up pretty well with projected demand, though the official state projections suggest an annual oversupply of about 17 percent.

If you step back, though, and look at the national and international supply of nurses, there's still reason to be worried.

The national nursing council data (.pdf page 19) show a total of 132,940 U.S. students passing the NCLEX exam for the first time in fiscal 2009. That's significantly higher than the 105,020 annual national need EMSI projects.

Now add in the number internationally educated students who took the NCLEX exam for the first time or repeated and you get a total of 148,266 nurses who passed the exam and are able to enter the health system work force as RNs.

Nearly all those international students come from countries where the council expects them to be licenses and in U.S. states and territories.

In fiscal 2006, that total number of domestic and international students passing came in at 128,154.

That's a big jump in just a few years.

The Bureau of Labor Statistics still views the overall job outlook for RNs as excellent and notes that "hundreds of thousands of job openings will result from the need to replace experienced nurses who leave the occupation."

The American Association of Colleges of Nursing says, "The United States is in the midst of a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care."

The national data, though, show the supply of students passing their gateway RN exam each year is significantly higher than the annual needs BLS and others are projecting.

So how do we reconcile the data? Drop us a line if you can do it.

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