The Nursing Workforce - 2010

3. A dynamic model of nurses – ‘supply model’

The shift-share analysis included a number of factors that clearly drive demand. In this section we build a model that focuses on the supply side.

We begin with a simple idea: the number of nurses this year depends on the number last year, the number of new graduates entering nursing, and the number of immigrant nurses entering nursing, the number of already qualified nurses returning to nursing less the number of nurses exiting from nursing.

We further enrich the model by tracking these flows by single year of age for registered nurses (the data for enrolled nurses are not sufficiently robust). This complexity allows us to determine the effect of the ageing of the nursing workforce.

Unfortunately, we do not have data on the number of nurses returning to nursing and the number leaving. We overcome this data limitation by estimating the net exit rate, using the data on new graduates, immigrants and overall nursing numbers. The algebra for doing this is given in Appendix 2.

The following figures present the ingredients of the model Registered nurses

Registered nurses

Figure 3.1 The number of registered nurses by age, 1993-1999

Source: Australia Institute of Health and Welfare (see Appendix 4)

Figure 3.2 New nurse graduates by age, 1995 – 2000

Source: Department of Education, Science and Training, Higher Education Statistics collection (see Appendix 4)

Figure 3.3 Overseas nurses by age with permanent migration to Australia, 1993-1999

Source: Australia Institute of Health and Welfare (see Appendix 4)

From the three distributions above we can derive the net exit rate for 1995 and 1996 (Figure 3.4)

Figure 3.4 The calculated net nurse exit rates by age, 1995 and 1996

We see from Figure 3.4 that the patterns of 1995 and 1996 exit rates are similar. To make these results more useful for our projections we smooth the result as well as imposing some boundary conditions (for example, we assume everyone retires at 70 years).

Figure 3.5 The smoothed and extrapolated net exit rate by age, registered nurses

From this figure it can be seen that the net exit rate is quite high at young ages (as young nurses enter the occupation), with the rate declining to around zero for the 35 year old age group. The exit rate then begins to pick up at age 45 and increases substantially in the over 55 year old group.

Enrolled nurses

The historical age distributions of enrolled nurses are shown in Figure 3.6.

Figure 3.6 The number of enrolled nurses by age, 1993-1999

Source: Australian Institute of Health and Welfare (see Appendix 4)

Completions

Unfortunately, data on completions of awards that enable a person to practise as an enrolled nurse do not appear to be reliable. However, we can get some idea from data on enrolments and commencements as shown in Table 3.1

Table 3.1 Enrolments and commencements for vocational qualifications that lead to enrolled nurse status

Source: McKenna, L, Sadler, R, Long, M and Burke, G (2001) (see reference)

While we do not know the completion rate for modelling purposes we assume that 70-75 per cent of commencements complete⁸. If we assume further that the ratio of enrolments to commencements is 1.23 (based on Table 3.1) we can derive a net aggregate exit rate as shown in Figure 3.7. It is clear that there is a fair bit of variability in the data. For projection purposes we average the data over the six years to get a mean exit rate of 0.074 (if we assume 75 per cent complete, and 95 per cent of these graduates enter the nursing workforce – Case I) or 0.065 (if we assume 70 per cent of commencements complete and 85 per cent of these graduates enter the nurse workforce – Case II).

Figure 3.7 Derived net exit rate for enrolled nurses, 1993-1998 (Case I results)

Foot Notes:

8.Martin et al. (2001) found that about 70% of university commencements completed an award, with most attrition in the first year (see reference)

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