Nursing in Wyoming: Part Three

Nursing in Wyoming, Part Three: Net Flow of Employment

by: Tony Glover, Senior Research Analyst

"While the net flow still shows more RNs entering Wyoming than leaving, it appears that within the next few years these trends will converge with the number of exits equaling the number of entries."

In Part Three of our “Nursing in Wyoming” series,¹ we explore two issues related to the flow of Registered Nurses (RNs) inside and outside of Wyoming’s labor market. First, we demonstrate the flow of labor by focusing on RNs working in Wyoming hospitals in 1999. We attempt to answer the questions, Where did they come from? and Where did they go? Section I uses data from our Interstate Wage Records² database. Section II returns our focus to all RNs working in Wyoming over the past decade. It demonstrates that due to a decrease of new RNs entering and an increase in those leaving our labor market, Wyoming could soon face a statewide nursing shortage.

Section I

Figure 1³ was created by first restricting our analysis to the 2,152 RNs who worked in Wyoming hospitals (SIC 806)⁴ in 1999. We then determined their state and industry origin in 1998 and, likewise, their labor market destination in 2000. In 1999, 375 RNs began working in Wyoming hospitals. Of these, 74 (19.7%) had an origin in one of the seven states⁵ with which Wyoming has a data sharing agreement. In this analysis, the seven states are referred to as Memorandum of Understanding (MOU) states. Those entering Wyoming from MOU states increased their average quarterly wage from $7,729 in 1998 to $8,476 in 1999. Conversely, from 1999 to 2000, we see that 52 RNs left employment in Wyoming hospitals for employment in one of our MOU states and increased their average quarterly wage from $8,686 in 1999 to $9,815 in 2000. The majority of RNs entering employment in Wyoming hospitals from another state in 1999 were classified as “unknown origin.” Similarly, a majority of those leaving the state were not found in MOU states and are identified as “unknown destination.” These workers remain an enigma that may be cleared up with cooperation of additional states (i.e., Montana and California). However, we do know that those who leave tend to have more nursing experience.⁶

The largest group (52.3%) of RNs entering the hospital industry in 1999 worked in another Wyoming industry in 1998. This group is dominated by RNs with three or more years of experience who have transitioned from other health care industries, particularly nursing care facilities and offices & clinics.⁷ Furthermore, a sizeable portion (39.9%) of those leaving hospital employment in 2000 had a destination of another industry within Wyoming in 2000.

Section II

In this section we expand our analysis to all licensed RNs working in all Wyoming industries from 1993 to 2000. We also shift our focus to those either entering Wyoming’s labor market as an RN for the first time or permanently exiting Wyoming employment. A first time entry is comprised of two types of individuals. The first group are those who have worked in Wyoming in the past but appear for the first time in Wage Records as RNs after gaining a nursing license. Second are individuals who have never before appeared in Wage Records and enter Wyoming’s labor market as an RN. A permanent exit is an RN who has worked in Wyoming as an RN, but whose employment never again appears in Wage Records.

Table 1 and Figure 2 show the first time entries, permanent exits, and the net flow of RNs who entered and left employment in Wyoming during the last decade. Specifically, Table 1 shows licensed RNs who appeared in Wage records for the first time in the given year (i.e., either relocated to Wyoming or became a licensed RN), licensed RNs who appear to have permanently exited Wyoming’s labor force, and the net flow (defined as initial entries minus permanent exits).

Table 1 indicates that the number of entries of RNs in the state from 1993 to 2000 has gradually declined, while the number of RNs leaving the state has steadily increased. While the net flow still shows more RNs entering than leaving, it appears that within the next few years these trends will converge with the number of exits equaling the number of entries. As discussed in Part One of this series,⁸ from 1998 to 2008 the number of RNs is expected to increase approximately 13 percent, requiring an average of 48 new RN positions per year. The national RN shortage will continue to impact Wyoming, due to decreasing supply and an increase in projected demand.

Conclusions

The findings suggest that Wyoming’s nursing shortage is likely to worsen due to multiple factors. Declining nursing program enrollments nationwide and, specifically, the decline in the number of graduates with RN degrees from Wyoming-based institutions mean that fewer new RNs will enter Wyoming’s workforce. Meanwhile, the increased demand for RNs throughout the country and vacancies due to retirements will make it more difficult to retain RNs in Wyoming. These trends are further supported by Section II of this article, which shows a decline in the number of RNs entering Wyoming and an increase in the number leaving the state over the last decade. If current trends continue, more Wyoming RNs will leave than enter Wyoming employment.

While this series only serves as a beginning, our intention is to demonstrate the power of using administrative databases to explore a current labor market issue. In sum, the findings support many of the conclusions of a General Accounting Office (GAO) report⁹ and extend the analysis using several methods developed by Research & Planning.

¹Tony Glover, “Nursing in Wyoming, Part One: Supply and Retention,” Wyoming Labor Force Trends, September 2002, pp. 9-15 and “Nursing in Wyoming, Part Two: Turnover,” Trends, October 2002, pp. 1-7.

²Wage Records is an administrative database. Each employer in the state that has employees covered under Unemployment Insurance, by law, must submit quarterly tax reports to the state showing each employee’s Social Security Number and wages earned. Wage Records does not include employees of federal hospitals.

³Figure 1 of this article summarizes data from a much more detailed table in “Nursing: Supply Shortage or Retention Issue?” available on our website at <http://doe.state.wy.us/LMI/staff/RNsWy.pdf>. The detailed table includes data on prior industry of employment as well as the experience level of the Registered Nurses.

⁴Standard Industrial Classification (SIC) 806 includes medical and surgical hospitals, psychiatric hospitals, and other specialty hospitals providing extensive medical treatment and continuous nursing services.

⁵The other states used in this analysis are Colorado, Idaho, Nebraska, New Mexico, South Dakota, Texas, and Utah.

⁶Experience is documented in the article “Nursing: Supply Shortage or Retention Issue?” at <http://doe.state.wy.us/LMI/staff/RNsWy.pdf>.

⁷Standard Industrial Classification (SIC) codes 801 through 805. These include offices and clinics of doctors of medicine and osteopathy; offices and clinics of dentists, chiropractors, optometrists, podiatrists, and other health practitioners; and nursing and personal care facilities.

⁸Tony Glover, “Nursing in Wyoming, Part One: Supply and Retention,” Wyoming Labor Force Trends, September 2002, pp. 9-15.

⁹U.S. General Accounting Office, “Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors,” GAO Report GAO-01-944, July 10, 2001, <http://www.gao.gov> (September 10, 2002).

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