Highlights

• Number of licensed registered nurses (RNs) in the United States grew by almost 8 percent between 2000 and 2004 to a new high of 2.9 million
• Average age of RNs climbed to 46.8 years, the highest average age since the first comparable report was published in 1980.
  • Just over 41 percent of RNs were 50 years of age or older (33 percent in 2000 and 25 percent in 1980).
  • Only 8 percent of RNs were under the age of 30, compared with 25 percent in 1980.
• Average annual earnings for RNs were $57,785.
• Real earnings (comparable dollars over time) have grown almost 14 percent since 2000, the first significant increase in more than a decade.
• Employment in nursing rose to more than 83 percent of RNs with active licenses, the highest since 1980.
• RNs with master's or doctorate degrees rose to 376,901, an increase of 37 percent from 2000.

I. The 2004 National Sample Survey of Registered Nurses (NSSRN)

The eighth sample survey, the 2004 NSSRN, collected data on the actively licensed registered nurse population as of March 2004. The HRSA Bureau of Health Professions was responsible for the administration of this study. The Gallup Organization, under a contract with the HRSA, carried out the sample selection, data collection, and processing of this study. This report summarizes results of the study.

As in previous NSSRN studies, the eighth sample survey instrument maintains the specific data requirements of section 951 of P.L. 94-63 and provides the necessary base data for developing projections of the supply, distribution, and educational requirements for registered nurses. It also contains some new areas of inquiry designed to provide information on issues of current importance. However, as in prior studies, the survey instrument was designed to ensure that the data collected from study to study provides sufficient continuity so that an evaluation can be made of trends in nursing.

As in prior years, samples were drawn for each State's list of active licensees, because no single unduplicated list of licensed registered nurses exists in this country. Approximately 15 percent of RNs are estimated to have more than one RN license. Disproportionate sampling from State to State was used to provide statistically improved estimates of the number of individual RNs in each State, while maintaining the overall sample size within reasonable bounds. Larger proportions of licensees were sampled in the States with fewer registrants than in States with more registrants. A weighting procedure was used to account for duplication of licenses from State to State so that estimates could be developed of the number of individuals who hold active licenses to practice as RNs, regardless of the number of State licenses they hold. Based on March 2004 data, over 3,252,548 licenses to practice as registered nurses in the United States were held by an estimated 2,915,309 nurses. [ 1 ]

The initial sample selection for this survey consisted of 56,917 licenses, of which 4,250 were identified as duplicates for nurses licensed in other States. After taking account of duplications and frame errors, a total of 50,691 RNs were estimated to be eligible to participate in NSSRN, with a total of 35,724 individual RNs responding to the survey request, for a final response rate of 70.47 percent. This report primarily presents data and analysis of those RNs who were licensed in nursing as of March 2004, including those employed in nursing or if not employed in nursing, resided in the United States—35,635 of the 35,724 respondents. Applying weights to these responses [ 2 ] , there are an estimated 2,909,357 employed or living in the United States, an increase of 7.9 percent or 212,817 above the 2,696,540 licensed RNs estimated in 2000.

To ensure an adequate response to the survey, four mailings were sent out, and these were followed by telephone interviews with those who did not respond to the mailing. Unlike previous iterations of the NSSRN, the packages for the third mailing were shipped via USPS Priority Mail and a Web version of the survey was provided to respondents in an attempt to improve responsiveness. In addition to the efforts to reduce the nonresponse to the survey, careful screening of responses received was undertaken to minimize ambiguous responses and nonresponse to individual questions. Responses were accepted through November 2004.

Questions on the survey instrument were prioritized as to their importance to the overall registered nurse database, and the degree to which a question might be sensitive in nature. If high priority items were skipped or answered improperly, respondents were called to clarify the response made or to obtain the missing information. When a call was made concerning a high priority question, the respondent also was queried about other ambiguous or missing items regardless of their priority order.

All respondents to the survey were classified according to whether they were employed in nursing as of March 2004, and also according to State of residence and/or employment. In addition to the identification and follow-up of missing data, open-ended responses written in the “other-specify” categories within the questions were reviewed and reclassified to already stated categories, if possible. The remaining responses were reviewed to determine whether there was a sufficient number of a particular response to warrant a new category.

Organization of the Report

The substantial database resulting from the 2004 study may be used for many different types of analyses concerning a variety of subjects. This report presents an overview of the personal, professional, and employment characteristics of the 2.9 million registered nurses residing in the United States as of March 2004.

Chapter II and Chapter III contain a summary of the findings from the study and comparisons to the findings of prior studies in this series.

Appendix A contains a series of tables summarizing the data.

Appendix B contains a review of the survey methodology and the statistical techniques used in sample selection, response weighting, and identification of sampling errors are found in.

Appendix C (pdf) is the survey instrument.