Are We Producing Too Many Nurses?

Point and Counterpoint ...

A recent posting on the Minnesota Public Radio blog suggested that Minnesota (and other states) are producing more nursing graduates than necessary. The analysis uses data from Economic Modeling Specialists, Inc. (EMSI). A written response from the National Forum of State Nursing Workforce Centers can be downloaded from Forum Response to EMSI

Center staff are not in a position to comment on Minnesota, but the data in the blog also indicated that Colorado’s annual need for new nurses (replacement for retiring nurses plus expansion for population growth) is only 1,830 and Colorado schools of nursing graduated 2,660 nurses per year, prompting the “overproduction?” question.

The flaw in the blog commentary is that national workforce projections such as this (covering all types of occupations for all regions) rely heavily on assumptions and equations to make projections, not specific data. A more detailed and fact-based analysis gives a very different result for Colorado.

1. There are currently 21,000 licensed registered nurses in Colorado over the age of 55 (indicating an annual retirement rate of 2,100 nurses) and the state is projected to grow at 100,000 residents per year for the next decade (generating a need for 800 new nurses per year just to stay even with our current population-to-nurse ratio). Even using the conservative assumption that no nurse will retire before age 65 (a sharp break with historical patterns), these facts would indicate an annual need for at least 2,900 nurses, creating a shortfall of at least 300 nurses per year from our schools of nursing.

2. This shortfall will be further increased by the 400-600 nurses required to support the 150,000 additional Colorado residents accessing the health care system due to state health reform (HB 09-1293) and another 200-400 nurses required to support the additional 50,000 residents that will have access to health care due to national health reform. (See the Colorado Health Institute's issue brief on the growth in covered Coloradans at CHI Health Insurance Coverage Analysis).

3. Finally, the state’s 65+ population will nearly double from 550,000 to 950,000 over the coming decade. According to research done by both the National Institute of Medicine and the Association of Medical Colleges, individuals 65 and over use health services at a rate that is 200-300 percent greater than younger populations. This profound demographic shift in Colorado's population will further increase the need for health services.

These three facts yield a very different answer than that found on the Minnesota blog. Assuming no increase in nursing school graduates over the coming decade, even a conservative analysis indicates that Colorado will be under-producing nursing graduates by at least 500 nurses per year, given the change in demographics, the need to replace retiring nurses, the increased number of individuals that will be able to access health care due to reforms, and the growth in the state's overall population.

The original Minnesota Public Radio posting can be found at