More than 4 million strong, nurses are the largest profession in the U.S. health care sector. Yet the nation faces a critical nursing shortage stemming from a wave of nurses reaching retirement age and an aging population that relies heavily on nursing care. Georgia is one of several states where demand for nurses is expected to outpace supply.
Emory's nursing school took on the problem last year by launching the Georgia Nursing Workforce Initiative, funded with a $200,000 grant from the Robert W. Woodruff Foundation. The initiative is housed within the school's Center for Data Science, which helps nursing faculty and students tap into vast amounts of health, disease, and patient care data at Emory.
"Our first goal is to determine what the supply of nurses looks like in Georgia," says associate professor Jeannie Cimiotti, an expert in nurse workforce issues and quality of care. "We want to know nurses' level of educational preparation, whether they are registered nurses (RNs) or advanced practice registered nurses (APRNs), where they live, and where they practice."
The initiative stemmed in part from Dean Linda McCauley's role in the Georgia Nursing Leadership Coalition (GNLC) and its 2015 report on the Registered Nursing Workforce in Georgia. That report analyzed data from Georgia Board of Nursing (GBON) workforce surveys, part of the online re-licensure process since 2011. While participation in the survey is now 86.7%, the data are not exhaustive.
"We are in the process of locating and gathering data from other sources in order to put together a more complete picture of nursing in Georgia," says assistant research professor Yin Li.
She and Cimiotti are scrutinizing data from the American Community Survey of the U.S. Census Bureau and the U.S. Bureau of Labor Statistics to augment the information obtained from the GBON survey.
According to the 2017 Health Resources and Services Administration report on Supply and Demand Projections of the Nursing Workforce: 2014-2030, national nursing demand will increase from 2,806,100 RNs in 2014 to 3,601,800 RNs in 2030. Many states are projected to have an undersupply of nurses, while a few others will have an oversupply. The report projects Georgia will have a shortage of 2,200 RNs and 10,000 APRNs by 2030.
"We know that Georgia is going to have a greater need in some geographic areas and clinical specialties than others," says Cimiotti. "Many new nurses are attracted to the fast pace and high acuity of university hospitals and less inclined to work at small community hospitals and in long-term care."
According to the GNLC report, fewer RNs in Georgia work in gerontology and assisted living/nursing homes/extended care facilities than the national average. Cimiotti and Li suspect that the rural/urban question will be important for the state. If their findings support greater shortages in rural areas, the data will help state health leaders look for solutions. For instance: "They might adjust salaries to make rural areas more attractive," notes Cimiotti.
The first product of Cimiotti and Li's work will be a 10-year longitudinal snapshot analysis of nursing in Georgia. Slated for completion this spring, the report will describe the demographic and employment characteristics of nurses, including where they work and at what salaries.
While various organizations have focused on the nursing shortage in general, few have looked at specifics such as the need for more nurse practitioners in rural areas, the untapped resource of clinical nurse specialists, and the shortage of nursing faculty. In time, the researchers' work at Emory may lead to establishing a major nursing workforce data center.
McCauley sees the Georgia data being used to address key health issues in Georgia (i.e., maternal mortality, infections, blood pressure control, healthy behaviors, and rehospitalizations) and workforce needs in the face of major health crises such as flu or pandemics. Understanding the nursing workforce, she says, is also crucial to helping transform models of care, one of the strategic goals of the Woodruff Health Sciences Center.--Pam Auchmutey | 
