Survey Report

PREFACE
The Health Resources and Services Administration (HRSA) is the key Federal agency responsible for nursing
workforce analysis and development in the United States. The Bureau of Health Professions (BHPr) within
HRSA provides national leadership to assure an adequate supply and distribution of qualified nursing personnel
to meet the health needs of the Nation. This responsibility includes examination of the supply, composition, and
distribution of nurses on the national and State levels in order to assure an adequate supply of qualified nursing
personnel against requirements. For several decades, the Division of Nursing (DN) had primary responsibility
for the assessment and examination of the Nation’s nursing workforce. Since 2001, the analytical aspects of
these efforts on the nursing workforce have resided in BHPr’s Evaluation and Analysis Branch (EAB). These
activities of the EAB have included leadership and direction in the administration of the 2004 National Sample
Survey of Registered Nurses (NSSRN), the reporting of findings from the Survey, and analytic support in shortterm and long-term assessments of both the supply of nurses in the workforce and the requirements for nurses in
the workforce. In pursuing these analytical efforts on the nursing workforce, BHPr has worked with other
agencies within the Federal Government, as well as with various State agencies and private nursing
organizations, in the development of methods for the study and acquisition of data on the RN population.
The NSSRN is the Nation’s most extensive and comprehensive source of statistics on all individuals with active
registered nurse licenses to practice nursing in the United States whether or not they are employed in nursing. It
provides information on the number of registered nurses, their educational background and practice specialty
areas, their employment settings, position levels, job satisfaction and salaries. It also provides information on
their geographic distribution and personal characteristics including gender, racial/ethnic background, age, and
family status.
The development of a design for collecting data through national sample surveys of registered nurses originated
in July 1975 in a contract with Westat, Inc. Subsequently, reports for seven studies, conducted in September
1977, November 1980 and 1984, and March 1988, 1992, 1996, and 2000 have been published and made
available to people and organizations involved in health care planning and evaluation as well as to the public.
This publication is the report of the eighth study, conducted in March 2004.
The 2004 NSSRN benefited from a wide range of professional nurse associations and organizations with large
or diverse memberships of individual RNs that endorsed the study and encouraged their members to participate
in it. The organizations included the American Academy of Nurse Practitioners, American Association of
Critical-Care Nurses, American Association of Nurse Anesthetists, American Nurses Association, American
College of Nurse-Midwives, Asian American Pacific Islander Nursing Association, Association of Perioperative
Registered Nurses, Association of Women’s Health Obstetric and Neonatal Nurses, Emergency Nurses
Association, National Alaska Native/American Indian Nurses Association, National Association of Hispanic
Nurses, National Black Nurses Association, and the National Council of State Boards of Nursing.
The 2004 NSSRN survey application, including survey administration, data collection, and reporting, was
carried out by The Gallup Organization through a contract with the U.S. Department of Health and Human
Services (USDHHS), HRSA, and administered by the EAB. Under a subcontract with The Gallup Organization,
Insight Policy Research, Inc. led the data analysis, sample design, and the development and writing of the final
report. Funding for the 2004 NSSRN was provided by the Division of Nursing. EAB staff were responsible for
overseeing the study (Dr. Christine Hager, Steve Tise, Louis A. Kuta, William Spencer, and Marshall Fritz). In
addition, other HRSA staff including, Dr. Denise Geolot, Donna English, Dr. Annette Debisette, Dr. Joan Weiss,
and other members of their staff in the Division of Nursing provided guidance on nursing education and practice
during the review of the questionnaire drafts, the interpretation of the raw response data, and the preparation of

i

the Findings Report. Members of the Interagency Collaborative on Nursing Statistics (ICONS) also reviewed
the questionnaire draft and offered suggestions prior to finalization. The report was authored by Darby Miller
Steiger of the Gallup Organization and Sara Bausch, Bryan Johnson, and Dr. Anne Peterson of Insight Policy
Research. Zac Arens of the Gallup Organization programmed and summarized the data into tables. HRSA’s
BHPr is pleased to make this important information on the Nation’s RNs population available to the public
through this report.

ii

TABLE OF CONTENTS
Chapter
I. INTRODUCTION .................................................................................................................................... 1
EARLY REGISTERED NURSE WORKFORCE STUDIES .................................................................... 1
DEVELOPMENT OF NSSRN METHODOLOGY................................................................................... 2
THE 2004 NATIONAL SAMPLE SURVEY OF REGISTERED NURSES (NSSRN) ............................ 2
ORGANIZATION OF THE REPORT....................................................................................................... 4
REFERENCES ........................................................................................................................................... 5
II. THE REGISTERED NURSE POPULATION 1980 – 2004 ............................................................... 7
REGISTERED NURSES IN THE U.S....................................................................................................... 7
EDUCATIONAL PREPARATION ........................................................................................................... 9
AGE .......................................................................................................................................................... 12
GENDER .................................................................................................................................................. 13
RACIAL/ETHNIC BACKGROUND....................................................................................................... 14
FAMILY STATUS ................................................................................................................................... 17
EMPLOYMENT SETTINGS................................................................................................................... 17
LONG-TERM TRENDS IN AVERAGE SALARIES/EARNINGS........................................................ 20

III. THE REGISTERED NURSE POPULATION 2004 ....................................................................... 23
AGE .......................................................................................................................................................... 23
GENDER .................................................................................................................................................. 25
RACIAL/ETHNIC BACKGROUND....................................................................................................... 26
EDUCATION AND EMPLOYMENT PRIOR TO INITIAL NURSING EDUCATION ....................... 28
NURSING EDUCATIONAL PREPARATION....................................................................................... 29
ADVANCED PRACTICE NURSES ....................................................................................................... 32
Nurse Practitioners ............................................................................................................................... 33
Clinical Nurse Specialists..................................................................................................................... 34
Nurse Practitioners and Clinical Nurse Specialists .............................................................................. 35
Nurse Anesthetists ................................................................................................................................ 35
Nurse Midwives ................................................................................................................................... 36
Nurse Practitioners and Nurse Midwives ............................................................................................. 36
Non-White, Hispanic, or Latino Advanced Practice Nurses ................................................................ 37
REGISTERED NURSES IN THE WORKFORCE.................................................................................. 37
Characteristics within Employment Setting ......................................................................................... 39
Registered Nurses in Nursing Faculty Positions .................................................................................. 42
Base of Employment ............................................................................................................................ 43
Position Levels ..................................................................................................................................... 44
Functions During Usual Workweek ..................................................................................................... 48
Recent Indices of Annual Salaries/Earnings Trends ............................................................................ 49
Job Satisfaction..................................................................................................................................... 52
REGISTERED NURSES NOT EMPLOYED IN NURSING.................................................................. 55
Nurses Seeking Nursing Employment.................................................................................................. 56

iii

Nurses Employed in Non-Nursing Occupations .................................................................................. 56
Registered Nurses Not Employed in Nursing And Not Seeking Nursing Employment ...................... 57
GEOGRAPHIC AND EMPLOYMENT MOBILITY.............................................................................. 57
Location of Initial Nursing Education.................................................................................................. 57
Registered Nurses Educated outside the U.S........................................................................................ 58
Residence in March 2004 and 2003 ..................................................................................................... 59
Employment Status in 2004 and 2003.................................................................................................. 59
Employment Setting Changes .............................................................................................................. 59
GEOGRAPHIC DISTRIBUTION OF THE REGISTERED NURSE POPULATION ........................... 60
Distribution by State............................................................................................................................. 60
Metropolitan Areas............................................................................................................................... 61
Educational Background ...................................................................................................................... 61
Racial/Ethnic Background.................................................................................................................... 62
Age Distribution ................................................................................................................................... 62
Employment Settings ........................................................................................................................... 63
Changes in Employers and/or Positions ............................................................................................... 63
Average Earnings within Geographic Area for Staff Nurses ............................................................... 64
Compact States ..................................................................................................................................... 64
Appendix
A. Tables
B.

Survey Methodology

C.

Questionnaire

List of Charts
Chart 1.

Registered nurse population, by nursing employment status, 1980-2004 .................................... 9

Chart 2.

Distribution of registered nurses according to initial nursing education, 1980-2004 ................. 10

Chart 3.

Distribution of the registered nurse population by highest nursing or nursingrelated educational preparation, 1980-2004................................................................................ 12

Chart 4.

Age distribution of registered nurse population 1980-2004 ....................................................... 13

Chart 5.

Trend in the number of racial/ethnic white, non-Hispanic and non-white RNs,
1980-2004 ................................................................................................................................... 15

Chart 6.

Distribution of registered nurses by racial/ethnic background, March 2004 .............................. 16

Chart 7.

Distribution of registered nurses by employment settings, in thousands, 1980-2004................. 19

Chart 8.

Percent change in the number of registered nurses employed in selected settings,
1980 to 2004 ............................................................................................................................... 20

Chart 9.

Actual and "real" income for registered nurses, 1980 to 2004 ................................................... 22

Chart 10.

Average age of graduation from initial nursing education programs, March 2004 .................... 24

iv

Chart 11.

Percent distribution of registered nurses by initial nursing and highest nursing or
nursing-related educational preparation, March 2004 ................................................................ 25

Chart 12.

Percent distribution of registered nurses in each reported racial/ethnic group by
highest nursing or nursing-related educational preparation, March 2004................................... 28

Chart 13.

Registered nurses whose highest nursing or nursing-related education was a
master's or doctoral degree, by type of initial nursing education, March 2004 .......................... 31

Chart 14.

Registered nurses prepared for advanced practice, March 2004................................................. 33

Chart 15.

Distribution of registered nurses employed in hospitals by dominant function,
March 2004 ................................................................................................................................. 38

Chart 16.

Selected hospital work units for registered nurses providing some direct patient
care, 2000 and 2004 .................................................................................................................... 39

Chart 17.

Average age of employed registered nurses for selected employment settings,
March 2000 and 2004 ................................................................................................................. 41

Chart 18.

Distribution of employed registered nurses by highest nursing or nursing-related
educational preparation for selected employment settings, March 2004.................................... 43

Chart 19a.

Distribution of registered nurses by selected position titles, 1988-2004 .................................... 45

Chart 19b.

Distribution of registered nurses by selected position titles, 1988-2004 .................................... 46

Chart 20a.

Distribution of registered nurses with selected position titles by highest nursing or
nursing-related educational preparation, March 2004 ................................................................ 47

Chart 20b.

Distribution of registered nurses with selected position titles by highest nursing or
nursing-related educational preparation, March 2004 ................................................................ 48

Chart 21.

Average percent of time in work week spent by registered nurses in each function,
March 2004 ................................................................................................................................. 49

Chart 22.

Percent of registered nurses who reported being moderately or extremely satisfied
with their jobs by employment setting, March 2004 .................................................................. 53

Chart 23.

Percent of staff nurses and non-staff nurses satisfied in their jobs by employment
setting, March 2004 .................................................................................................................... 54

Chart 24.

Percent of staff nurses and non-staff nurses satisfied in their jobs by highest
nursing or nursing-related educational preparation, March 2004 ............................................... 55

Chart 25.

Changes in registered nurses employment status, 2003 to 2004................................................. 60

Chart 26.

Average age of registered nurses by region ................................................................................ 63

v

List of Tables
Table 1.

Registered nurse population, by employment status, gender, racial/ethnic
background, and age group, March 2004..................................................................................A-1

Table 2.

Year of graduation from initial nursing education and the average age at graduation
for the registered nurse population, by type of initial nurse education, March 2004 ...............A-2

Table 3.

Health occupation prior to initial nursing education, by type of initial nursing
education, March 2004 .............................................................................................................A-3

Table 4.

Registered nurses who were ever licensed as practical/vocational nurse, by type of
initial nursing education, March 2004 ......................................................................................A-4

Table 5.

Characteristics of registered nurses with post-high school academic degree before
entering initial nursing education, by type of initial nursing education,
March
2004 ..........................................................................................................................................A-5

Table 6.

Marital status and presence of children, by employment status in principal nursing
position, March 2004 ................................................................................................................A-6

Table 7.

Marital status and caring for other adults at home or others elsewhere, by
employment status in principal nursing position, March 2004 .................................................A-7

Table 8.

Financial resources used for tuition and fees for initial nursing education, by type
of initial nursing degree, March 2004.......................................................................................A-8

Table 9.

Distribution of registered nurses according to total household income, by marital
and employment status, March 2004 ........................................................................................A-9

Table 10.

Registered nurse population, by initial nursing and highest nursing or nursingrelated education, March 2004................................................................................................A-10

Table 11.

Primary focus of post-RN master's and doctoral degree, March 2004 ...................................A-11

Table 12.

Current enrollment of registered nurses in nursing or nursing-related academic
degree educational programs, by employment status and student status,
March
2004 ........................................................................................................................................A-12

Table 13.

Distribution of advanced practice nurses by employment status, and by national
certification and state nursing board recognition, March 2004 ..............................................A-13

Table 14.

Distribution of registered nurses with specialties in advanced practice nursing
preparation and credentials, March 2004................................................................................A-14

Table 15.

Distribution of registered nurses with national certifications in advanced practice
nursing, March 2004 ...............................................................................................................A-15

Table 16.

Employment setting of primary positions of registered nurses employed in nursing,
March 2004 ........................................................................................................................A-16/17

vi

Table 17.

Type of patient treated in organization or unit for principal position in nursing, by
employment status, March 2004 .............................................................................................A-18

Table 18.

Type of hospital work unit where hospital-employed registered nurses spent more
than half their direct patient care time, by employment status in principal nursing
position, March 2004 ..............................................................................................................A-19

Table 19.

Registered nurses employed in each employment setting, by employment status
and average annual hours worked, March 2004 .....................................................................A-20

Table 20.

Average hours worked per week and overtime hours per week of employed
registered nurses in their principal nursing position, by employment setting, March
2004 ........................................................................................................................................A-21

Table 21.

Average overtime and mandatory overtime hours for full time nurses by
employment setting and position title, March 2004................................................................A-22

Table 22.

Employed registered nurses, by employment setting and age group, March 2004.................A-23

Table 23

Employment setting, by highest nursing or nursing-related educational preparation
of registered nurses employed in nursing, March 2004 ..........................................................A-24

Table 24.

Employment setting of registered nurses in principal nursing position, by work
basis, March 2004 ...................................................................................................................A-25

Table 25.

Position titles in primary nursing jobs for registered nurses employed in nursing,
March 2004 .............................................................................................................................A-26

Table 26.

Employment setting and type of principal nursing position of employed registered
nurses, March 2004.................................................................................................................A-27

Table 27.

Type of principal nursing position and highest nursing or nursing-related
educational preparation of registered nurses employed in nursing, March 2004....................A-28

Table 28.

Percentage of time spent in each functional area in principal nursing position
during usual work week for employed registered nurses, March 2004 ..................................A-29

Table 29.

Average percent of time in work week in principal nursing position spent by
employed registered nurses in each function, by highest nursing or nursing-related
educational preparation, March 2004 .....................................................................................A-30

Table 30.

Average annual earnings in principal nursing position for registered nurses
employed full time, by employment setting and position title, March 2004 ..........................A-31

Table 31.

Average annual earnings in principal nursing position of nurses employed full-time, by
type of position and highest nursing or nursing-related educational preparation,
March 2004 .............................................................................................................................A-32

Table 32.

Distribution of employed registered nurses with one and more than one nursing
position, by employment status and average total earnings, March 2004 ..............................A-33

vii

Table 33.

Job satisfaction of registered nurses employed in nursing, by position title in
principal nursing position, March 2004 ..................................................................................A-34

Table 34.

Job satisfaction of registered nurses employed in nursing, by highest nursing or
nursing-related educational preparation, March 2004 ...........................................................A-35

Table 35.

Distribution of registered nurses not employed in nursing, by length of time since
last worked as a nurse and whether or not nurse was seeking nursing position or
had other occupation, March 2004..........................................................................................A-36

Table 36.

Age distribution of registered nurses not employed in nursing, by length of time
not working in nursing, March 2004.......................................................................................A-37

Table 37.

Registered nurses not employed in nursing actively seeking employment in
nursing, by type of employment sought and number of weeks looking,
March 2004 .............................................................................................................................A-38

Table 38.

Type of employment of registered nurses in non-nursing occupations,
March 2004 .............................................................................................................................A-39

Table 39.

Detailed type of employment of registered nurses in non-nursing occupations,
March 2004 ...............................................................................................................................A-40

Table 40.

Reasons for registered nurses to have occupation other than nursing, March 2004 ...............A-41

Table 41

Marital status and presence of children at home of nurses who were not employed
at all and not seeking nursing employment, by age group, March 2004 ................................A-42

Table 42.

Marital status and presence of others provided care by nurses who were not
employed at all and not seeking nursing employment, by age group,
March
2004 ........................................................................................................................................A-43

Table 43.

Comparison between state of location of registered nurses as of March 2004 and
state of graduation, by type of initial nursing education and number of years since
graduation, March 2004 .........................................................................................................A-44

Table 44.

Top countries where nurses received initial nursing education, by employment
status, March 2004..................................................................................................................A-45

Table 45.

Top states employing foreign-educated nurses, March 2004 .................................................A-46

Table 46.

Employment setting of foreign-educated nurses, by position of employment,
March 2004 ...............................................................................................................................A-47

Table 47.

Comparison between resident states in 2003 and 2004 for the registered nurse
population, by age group, March 2004 ...................................................................................A-48

Table 48.

Comparison of employment status of registered nurse population in 2003 and
2004, March 2004 ...................................................................................................................A-49

Table 49

Percent distribution of registered nurses in each employment setting in 2004, by
employment setting in 2003, March 2004 ..............................................................................A-50

viii

Table 50.

Percent distribution of the registered nurse population in each geographic area who
changed employer or position between March 2004 and 2003, by principal reason
for change ...............................................................................................................................A-51

Table 51.

Registered nurse population in each state and geographic area by activity status,
March 2004 ..........................................................................................................................A-52/53

Table 52.

Supply of registered nurses in each state and geographic area according to whether
employed in nursing on a full-time or part-time basis, March 2004..................................A-54/55

Table 53.

Registered nurse population, by activity status and geographic location,
March 2004 .............................................................................................................................A-56

Table 54.

Registered nurses employed in nursing in each state and geographic area, by
highest nursing or nursing-related educational preparation, March 2004..........................A-57/58

Table 55.

Racial/ethnic background distribution (percents) of registered nurses, by
geographic area, March 2004..................................................................................................A-59

Table 56

Age distribution (percents) and average age of registered nurses, by geographic
area, March 2004 ....................................................................................................................A-60

Table 57.

Employment setting of principal nursing position for registered nurses in each
geographic area, March 2004..................................................................................................A-61

Table 58.

Average annual earnings from principal nursing position of registered nurses in
full-time staff nurse positions in each geographical area, March 2004 ..................................A-62

ix

Chapter I

INTRODUCTION
The Health Resources and Services Administration (HRSA) is the key Federal agency responsible for
nursing workforce analysis and development in the United States. The Bureau of Health Professions
(BHPr) within HRSA provides national leadership to assure an adequate supply and distribution of
qualified nursing personnel to meet the health needs of the Nation. This responsibility includes
examination of the supply, composition, and distribution of nurses on the National and State levels in
order to assure an adequate supply of qualified nursing personnel against requirements. For several
decades, the Division of Nursing (DN) had primary responsibility for the assessment and examination of
the Nation’s nursing workforce. Since 2001, the analytical aspects of these efforts on the nursing
workforce have resided in BHPr’s Evaluation and Analysis Branch (EAB). These activities of the EAB
have included leadership and direction in the administration of the 2004 National Sample Survey of
Registered Nurses (NSSRN), the reporting of findings from the Survey, and analytic support in short-term
and long-term assessments of both the supply of nurses in the workforce and the requirements for nurses
in the workforce. In pursuing these analytical efforts on the nursing workforce, BHPr has worked with
other agencies within the Federal Government, as well as with various State agencies and private nursing
organizations, in the development of methods for the study and acquisition of data on the RN population.

EARLY REGISTERED NURSE WORKFORCE STUDIES
National studies to determine the number and characteristics of the Nation’s registered nurses were
initiated in 1949 when the American Nurses Association (ANA) conducted the first Inventory of
Registered Nurses1. Data were collected through postcard questionnaires mailed by the licensing entity in
the States and territories that require renewal of registration to each registrant on record at the time of the
study. In Maryland and Ohio, where renewal and registration was not required, questionnaires were
distributed through State nurses’ associations and employing agencies. About 62 percent of all
questionnaires sent to nurses by the States were returned. The number of nurses who had licenses to
practice in 1949 was estimated by eliminating duplication resulting from nurses having licenses in more
than one State, and accounting for those nurses who did not respond to the survey.2
The ANA conducted a similar study in 1951, but decided to mail the questionnaires with the license
renewal notices to RNs in each State. About 71 percent of the questionnaires were returned. This change
in data collection methodology improved the response rate but lengthened the data collection period
because of variation in renewal dates from State to State. The number of nurses who had licenses to
practice in 1951 was estimated using the same procedures used in the 1949 inventory: elimination of
duplication due to RN licensure in more than one State, and accounting for nonrespondents to the
inventory.
In the mid-1950s, the ANA promoted the inclusion of a uniform set of questions about RNs’
characteristics on each State’s licensing application form rather than using a postcard or a separate
questionnaire. An Inventory of Registered Nurses was initiated in 1956 using this data collection process.
The length of time it took to include the questions in the licensing process and the limited funds available

1

for compiling and analyzing the data resulted in an extended time frame for both the data collection and
analysis. The actual data summary for the 1956-1958 inventory was published in 19633.
The ANA conducted four subsequent inventories of registered nurses4,5,6,7. HRSA was instrumental in
providing Federal financial support to the ANA to defray the costs of obtaining and processing the data
for these studies. This support ensured a more centralized approach to data collection and processing as
well as greater use of automated procedures to summarize the data.

DEVELOPMENT OF NSSRN METHODOLOGY
Originally, the nursing inventories were based on data collection at the State level using the licensing
mechanism as an opportune time for asking registered nurses to complete the questionnaires. This data
collection process, although logical and potentially comprehensive, encompassed some serious
limitations. The size of the questionnaire had to be limited and follow-up on forms not returned, missing
data, or ambiguous data were not part of the data collection process. Moreover, the wide variation in
renewal dates from State to State led to a lengthy data collection period. It took as long as 3 years to
present a national picture through analysis of data from all States.
The need for more comprehensive data on the nursing workforce, concerns about the limitations of the
nursing inventories, and the enactment of Public Law (P.L.) 94-63 were the impetus for the development
of the present methodology for collecting data on the nursing workforce. Section 951 of P.L. 94-63 called
for the collection of information on a continuous basis regarding the current and future supply,
distribution, and educational requirements for nurses, nationally and within each State. The data
acquisition requirements listed in the law were very specific. For example, the law required data on the
number of nurses with advanced education or graduate degrees by specialty, and data on average rates of
compensation by type of employment and location of practice.8
In the mid 1970s, the Department of Health, Education and Welfare (DHEW) contracted with Westat
Inc., a survey research firm with expertise in complex survey design, to develop a comprehensive survey
plan. Westat worked with the ANA and the DN to develop a survey plan to implement the data element
requirements in section 951 of P.L. 94-63: 1) to provide baseline data for the development of estimates
and projections regarding the registered nurse population both nationally and for each State; and 2) to
provide data on nurse characteristics needed for program planning, administration, monitoring, and
evaluation by Congress, State legislators, and Federal and State agencies and associations.9 A complex
sample survey was developed using licensure listings from each of the 50 States and the District of
Columbia. A single questionnaire was designed and data collection and data follow-up processes were
established. The data collection was to be done by mail with telephone follow-up for nonrespondents.
The first study using this survey methodology was conducted in September 1977, under contract to the
ANA with a subcontract to Westat. During the conduct of that study, the design and data processing
procedures were refined10. Subsequent studies using the same design were carried out in 1980, 1984,
1988, 1992, 1996 and 200011, 12,13,14,15,16 .
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. NCHWA 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.

2

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.
1

National estimate of the total number of RNs (RN population) is between 2,897,467 and 2,921,467 RNs at the 95
percent confidence level, a margin of error of +/- 0.7 percent. For the purposes of this document, the weighted
estimates are stated without reporting the sampling errors associated with each characteristic.

2

For specific information regarding the sampling estimation and weighting methodologies, see 2004 National
Sample Survey of Registered Nurses: Technical Report.

3

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. A summary of the findings from the study and comparisons to the findings of prior studies in this
series are presented in Chapters II and III. Appendix A contains a series of tables summarizing the data.
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 B. The survey instrument is
included in Appendix C.

4

REFERENCES
1. Inventory of Professional Registered Nurses 1949, American Nurses Association, Inc., New York.
2. Inventory of Professional Registered Nurses 1951, American Nurses Association, Inc. New York.
3. “Nurses ….Numbers and Characteristics”, American Journal of Nursing, Vol. 63, Jan 1963.
4. Marshall, Eleanor D. and Moses, Evelyn B. The Nation’s Nurses, the 1962 Inventory of Professional
Registered Nurses, American Nurses Association, New York, 1965.
5.

Marshall, Eleanor D. and Moses, Evelyn B. RNs 1966….An Inventory of Registered Nurses.
American Nurses Association, New York, 1965.

6. Roth, Aleda V. and Walden, Alice R. The Nation’s Nurses, 1972 Inventory of Registered Nurses.
American Nurses Association, Kansas City, 1981.
7. Schulte, Duane C. Inventory of Registered Nurses 1977-1978. American Nurses Association, Kansas
City 1981.
8. First Report to Congress, February 1, 1977, Nursing Training Act of 1975. Health Resources and
Services Administration, Public Health Service, USDHEW, DHEW publication No. HRA 78-38,
1977. (Available through NTIS, Access Number HRP-0900501.)
9. Sample Survey for the National Survey of Registered Nurses, Technical Report (Volume I), and
Appendices (Volume II). Westat Inc. and the American Nurses Association, 1976 (unpublished).
10. Roth, Aleda, Graham, Deborah, and Schmittling, Gordon. 1977 National Sample Survey of
Registered Nurses and Factors Affecting their Supply. American Nurses Association, Kansas City,
1978. (Available through NTIS, Access Number HRP-0900603.)
11. The Registered Nurse Population, An Overview from the National Sample Survey of Registered
Nurses, November 1980. Office of Data Analysis and Management, Bureau of Health Professions,
Health Resources and Services Administration, PHS, USDHHS, 1982. (Available through NTIS,
Access Number HRP-0904551.)
12. Moses, Evelyn B., 1984. The Registered Nurse Population, Findings from the National Sample
Survey of Registered Nurses, November 1984. Division of Nursing, Bureau of Health Professions,
Health Resources and Services Administration, PHS, USDHHS, 1986. (Available from NTIS,
Access Number HRP-0904551.)
13. Moses, Evelyn B. 1988. The Registered Nurse Population, Findings from the National Sample Survey
of Registered Nurses, March 1988. Division of Nursing, Bureau of Health Professions, Health
Resources and Services Administration, PHS, USDHHS, 1990. (Available from NTIS, Access
Number PB91-145391.)
14. Moses, Evelyn B. 1992. The Registered Nurse Population, Findings from the National Sample Survey
of Registered Nurses, March 1992. Division of Nursing, Bureau of Health Professions, Health
Resources and Services Administration, PHS, USDHHS, 1994. (Available from NTIS, Access
Number PB97- 108187.)

5

15. Moses, Evelyn B. 1996. The Registered Nurse Population, Findings from the National Sample Survey
of Registered Nurses, March 1996. Division of Nursing, Bureau of Health Professions, Health
Resources and Services Administration, PHS, USDHHS, 1997.
16. Spratley, Ernell, Johnson, Ayah, Sochalski, Julie, Fritz, Marshall, and Spencer, William. 2000. The
Registered Nurse Population, Findings from the National Sample Survey of Registered Nurses,
March 2000. Division of Nursing, Bureau of Health Professions, Health Resources and Services
Administration, PHS, USDHHS, 2001.

6

CHAPTER II

THE REGISTERED NURSE
POPULATION 1980 – 2004
REGISTERED NURSES IN THE U.S.
The 2004 National Sample Survey of Registered Nurses (NSSRN) provides information about the current
population of registered nurses (RNs 3 ) with an active license to practice in one or more of the 50 States
and the District of Columbia. The data in this report focus on the 2,909,357 RNs located in the United
States. RNs are considered to be located in the United States if they were employed in nursing in
one of the 50 States and the District of Columbia or, if not employed in nursing, were residents of
the United States. Those RNs with licenses from the United States Territories are not included in
this population of RNs from the United States. This study has been conducted every 4 years since
1980 and examines trends over time in the Nation’s largest health profession.
The estimated RN population increased by 1,246,975 between November 1980 and March 2004. In
2004, 2,909,357 4 persons were estimated to have licenses to practice as RNs in this country, an increase
of 75.0 percent since 1980. From 1992 to 1996, there was a 14.2 percent increase in the RN population.
After a record slow down in growth of the RN population between 1996 and 2000 (5.4 percent), the RN
population bounced back to a more robust increase of 7.9 percent between 2000 and 2004. The years
between 1996 and 2000 had marked the lowest growth in the RN population over the span of the NSSRN
study, increasing only 1.3 percent each year compared with average annual increases of 2-3 percent in
earlier years (See Chart 1). For the past 4 years, the RN population grew just under 2.0 percent per year.
In the last 24 years, the number of RNs employed in nursing increased 90.2 percent (from 1,272,851 in
1980 to 2,421,351 in 2004, with an estimated increase of 219,538 RNs just from 2000 to 2004). In 2004,
83.2 percent of those with active licenses were employed in nursing, an increase of 1.6 percent from the
2000 estimate of 81.7 percent. The 2004 employment percentage marks the highest employment rate
3

The term “nurse” encompasses professionals concerned with health care at a number of skill levels, such as
registered nurse, advanced practice nurse, and licensed practical nurse/vocational nurse. The NSSRN population,
however, consists of all registered nurses who are currently eligible to practice as an RN in the United States. This
includes RNs who have received a specialty license or have been certified by a State agency as an advanced practice
nurse (APN) such as nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or clinical
nursing specialist, but excludes licensed practical nurses (LPNs)/licensed vocational nurses (LVNs).
4

National estimate of the total number of RNs (RN population) is between 2,897,467 and 2,921,467 RNs at the 95
percent confidence level, a margin of error of +/- 0.7 percent. For the purposes of this document, the weighted
estimates are stated without reporting the sampling errors associated with each characteristic. Refer to Appendix B
for the standard errors for other variables as well as a general methodology for estimating standard errors overall.

7

since the start of the study in 1980, eclipsing the previous peak of 82.7 percent in both 1996 and 1992.
From 2000 to 2004, however, the number of RNs employed in nursing grew by an average annual rate of
increase of about 2.4 percent. In contrast, from 1996 to 2000 there was only a 1.0 percent average annual
rate of increase in employed RNs. Larger annual average rates of increases in RN employment rates (3.3
percent), occurred from 1988 to 1996. From 1984 to 1988, the average annual rate of increase in RN
employment rates was 2.3 percent. From 1980 to 1984, the average annual rate of increase in RN
employment rates was the highest, at 3.9 percent.
The total number of RNs employed full-time in nursing nearly doubled from 854,813 to 1,696,807
between 1980 and 2004. From 2000 to 2004, the percentage of RNs employed full-time in nursing
increased by 7.6 percent (or 120,132 RNs), from 1,576,675 to 1,696,807. This increase represents a
significant improvement over the 1996 to 2000 increase of 4.4 percent, the lowest increase over the
duration of the study. However, the 2000 to 2004 increase still falls in lower than the average 4-year rate
of increase seen from 1980 through 1996 (15.3 percent). From 2000 to 2004 there was a 15.2 percent
increase in the number of nurses employed part-time (an estimated increase of 95,144 part-time nurses,
leading to an overall increase from 28.4 to 29.7 percent in the percentage of employed RNs who work
part-time in their principal employment in nursing).
Over the last seven surveys, the numbers, percents, or rates of change of licensed RNs who were not
employed in nursing vacillated somewhat across each 4-year period. The number of RNs not employed
in nursing, however, changed little from 1980 to 1992 while the total number of RNs grew substantially
over this period. Between 1992 and 2004, the number of RNs not employed in nursing increased about
26.2 percent, from 386,791 to 488,006. In 2004, 16.8 percent of all RNs were not employed in nursing,
with the number of RNs not employed in nursing decreasing by 1.4 percent from 2000 to 2004. From a
high of 23.4 percent in 1980, this 2004 rate of being not employed in nursing marks the lowest percentage
of licensed RNs not employed in nursing since the inception of the study.
The 2004 finding breaks a pattern over the last two surveys. While the rates of increase from 1980 to
1988 of those not employed in nursing were low (totaling 4.5 percent), and there was a decrease of 4.7
percent from 1988 to 1992, the rates of increase were much higher from 1992 to 2000. From 1992 to
1996 the number of RNs not employed in nursing increased by 14.5 percent, and from 1996 to 2000 the
number increased 11.7 percent. All of the survey statistics on nurses who are not in the workforce must
be tempered against the unknown numbers who have not renewed their RN licenses for whatever reason
and are not being surveyed under the NSSRN sample survey design. For example, some retired nurses
maintain their licenses while others may have chosen not to renew their licenses.

8

Chart 1.

Registered nurse population,
by nursing employment status, 1980-2004*

In Thousands
3000
2909
2697

2500
2559

2421
2240

2000

2116

2033
1888
1500

1662

1853
1697

1627
1510

1486
1000

1273

1577

1276

855
405

500

2202

984
501

1100
577

526

605

720

625

389

402

406

387

443

495

488

1980

1984

1988

1992

1996

2000

2004

0
*The totals of full-time and part-time employment may not add to the estimate of all RNs employed in
nursing due to incomplete information provided by respondents on employment status.

All RNs

Employed RNS

Not employed

Employed Part time

Employed Full time

EDUCATIONAL PREPARATION
One of the most substantial changes in the RN population over the past nearly quarter century has been in
the type of program RNs enter to obtain their initial nursing education. Between 1980 and 2004, the
percentage of nurses who received their initial nursing education in diploma programs decreased from
63.2 percent to 25.2 percent of the RN population (a net decrease of 317,284 nurses). During the same
period, the percentage receiving their initial nursing education in associate degree programs increased
from 18.6 percent to 42.2 percent of the RN population (a net increase of 918,640 nurses); and the
percentage receiving initial nursing education in baccalaureate programs or higher degree programs
increased from 17.4 percent to 31.0 percent of the RN population (a net increase of 613,039 nurses; see
Chart 2).

9

Chart 2.

Distribution of registered nurses according to
initial nursing education, 1980-2004*

Thousands

1400
1,227

1200
1000

1,051 1,021
990

1,088
951

965

911

903
802

799
733

800

729

681

576

600

558

467

454
388

400

309

290

200
0
Diploma

Associate Degree

Baccalaureate Degree and Higher

*The counts for all initial degrees may not add to the total RN estimates for each survey due to incomplete
information provided by respondents and the effect of rounding. Only those who provided educational preparation
information are included in the calculations used for this chart.

1980

1984

1988

1992

1996

2000

2004

Between 2000 and 2004, there were similar increases between the percentage of RNs who received their
initial nursing education in baccalaureate-and-higher programs (12.6 percent, from 801,811 RNs in 2000
to 902,625 RNs in 2004) and those who received their initial nursing education in associate degree
programs (12.8 percent, from 1,087,602 RNs in 2000 to 1,227,256 RNs in 2004). From 1980 through
1996, the percentage of nurses who received their initial nursing education in associate degree programs
increased at a faster rate than those who received their initial education in baccalaureate-and-higher
programs. Between 1996 and 2000, however, there had been a reversal of the trend, when the percentage
of nurses educated in baccalaureate-and-higher degree programs increased at a rate faster than those who
received their initial nursing education in associate degree programs (increases of 17.3 percent and 12.7
percent respectively). Meanwhile, the percentage of nurses who received their initial nursing education
in diploma programs declined steadily during the period from 1980 to 2004 from 63.2 percent to 25.2
percent (an estimated change from 1,050,661 RNs to 733,377 RNs). There was an 8.3 percent decline in
RNs receiving their initial nursing education in diploma programs from 2000 to 2004 (from 799,354 RNs
in 2000 to 733,377 RNs in 2004), the second largest decline in diploma-educated RNs since the inception
of the NSSRN. It follows a decline of 12.2 percent between 1996 and 2000, the largest decline since the
inception of the NSSRN. The number of new RNs prepared in diploma programs from 2000 to 2004 has
continued its decline in recent years, now at an average rate of decline of about 2.0 percent per year.

10

The distribution of RNs according to their highest nursing or nursing-related educational preparation,
including any post-RN degree received, also changed substantially over the past 24 years. 5 In 1980, the
diploma was the highest nursing or nursing-related educational level of the majority of nurses (54.3
percent of all RNs). Since 1996, nurses with associate and baccalaureate degrees as their highest level of
nursing or nursing-related education have had the largest presence among the RN population while the
percent of nurses who hold only diploma degrees has continued to drop. While associate degrees have
remained the largest entry program into nursing for many years, RNs with baccalaureate, master’s, and
doctorate degrees have increased their presence among the nurse population in recent years. As a result,
even though associate degree programs have graduated large numbers of nurses in recent decades from
their initial educational programs, the percent of the nurses having associate degrees as their highest level
of nursing or nursing-related education decreased slightly since 2000.
In 2004, 33.7 percent of nurses (981,238 RNs) reported the associate degree as their highest level of
nursing or nursing-related education, 34.2 (994,276) percent reported the baccalaureate degree as their
highest level and 13.0 percent (376,901) reported a master’s or doctoral degree as their highest level (see
Chart 3). Only 17.5 percent of RNs (510,209) reported that the diploma degree was their highest nursing
or nursing-related education. From 2000 to 2004, the percentage of RNs with associate degrees as their
highest nursing or nursing-related education level decreased slightly, from 34.3 percent to 33.7 percent
(although the number of RNs increased from 925,516 in 2000 to 981,238 in 2004). The numbers of
nurses whose highest education was the associate degree has increased by 232 percent since 1980 from
295,318. From 2000 to 2004, the percentage of RNs whose highest nursing or nursing-related
educational preparation was a baccalaureate degree increased from 32.7 percent to 34.2 percent (the
number increased from 880,997 in 2000 to 994,276 in 2004). Overall, this is a 170 percent increase in
baccalaureate education for RNs since 367,816 RNs in 1980. Many RNs initially educated in associate
degree programs eventually receive their baccalaureate degree. In 2004, nearly 21 percent (20.9 percent)
of RNs initially educated in associate degree programs received baccalaureate degrees and higher. This
estimate represents an increase from 2000, when 15.5 percent of RNs initially educated in associate
degree programs received baccalaureate degrees or higher. In 1996, 16.4 percent of RNs initially
prepared in associate degree programs received baccalaureate degrees or higher, an increase from 11.8
percent of RNs initially prepared in associate degree programs in 1988 and 10.3 percent in 1984. In
1980, only 8.8 percent of RNs initially prepared in associate degree programs eventually received a
higher degree.
The highest increase from 2000 to 2004 was for the number of RNs receiving nursing or nursing-related
master’s or doctorate degrees (an estimated increase of 101,833 or 37.0 percent) compared to a decrease
of 91,495 nurses or 15.2 percent in the number of RNs whose highest nursing or nursing-related degree
was a diploma. Over the entire period from 1980 to 2004, there was a 43.5 percent decrease (an estimated
change from 903,131 to 510,209) in the number whose highest level of nursing or nursing-related
5

In the terminology used here to identify highest educational preparation, the following convention has been
used in current and past NSSRN survey analyses. In addition to degrees strictly in nursing, additional formal
academic education reported by the nurse that would enhance the nursing career is considered to be ‘nursing-related’
education. The term ‘highest nursing or nursing-related’ education is used here to denote the highest degree level,
overall, among these academic degrees that are in nursing or which enhance a nursing career. For example, a nurse
reporting a baccalaureate degree in nursing and a nursing-related master’s degree in social work would be
considered to have the highest nursing or nursing-related education at the master’s level.

11

education was a diploma, while the number whose highest level of nursing or nursing-related education
was a master’s or doctorate increased by 339 percent (from 85,860 to 377,046). Similarly, from 1980 to
2004 the estimated number of RNs whose highest nursing or nursing-related educational preparation was
a baccalaureate increased by 170 percent (from 367,816 to 994,276) and the estimated number whose
highest nursing or nursing-related preparation was an associate’s degree increased by 232 percent (from
295,318 to 981,238).

Chart 3. Distribution of the registered nurse population by highest
nursing or nursing-related educational preparation, 1980-2004*
Thousands
3,500

3,000
2,500

275

248

377

179
2,000
111

130

800

881

994

671

557

1,500

86
368

481

1,000

295

430

512

632

812

926

981

500

903

855

821

755

697

602

510

1992

1996

2000

2004

0

1980

1984

1988
Year

*The totals in each bar may not equal the estimated numbers of RNs in each survey year due to incomplete
information provided by respondents and the effect of rounding. Only those provided initial RN educational
preparation information are included in the calculations used for this chart.

Diploma

Associate Degree

Baccalaureate Degree

Masters and Doctorate Degree

The number of RNs whose highest level of nursing or nursing-related educational preparation was either a
master’s or a doctorate degree has more than quadrupled since the inception of the NSSRN.
In
November 1980, RNs with nursing or nursing-related master’s or doctorate degrees were estimated at
85,860, while in 2004, they numbered 376,901, an increase of 339 percent. Therefore, the proportion of
RNs with master’s or doctorate degrees has more than doubled from 5.2 percent of the RN population in
1980 to 13.0 percent of the RN population in 2004. The number of master’s and doctorally-prepared
nurses has also grown dramatically since 2000, increasing by 101,833 RNs from 275,068, when it was
10.2 percent of the RN population. This change represents an unprecedented 37 percent increase in
master’s and doctorally prepared nurses over the past 4 years.
AGE
The average age of the RN population continued to climb, increasing to 46.8 years of age in 2004,
compared to 45.2 years in 2000, and 44.3 years in 1996.

12

In 1980, the majority (52.9 percent) of the RN population was under the age of 40, while in 2004 just
above one quarter (26.3 percent) were under the age of 40 (See Chart 4). The major drop was among
those under the age of 35. In 1980, 40.5 percent of RNs were under the age of 35 compared to just 16.4
percent in 2004. Similarly, in 1980, 25.1 percent of RNs (418,331) were under the age of 30, compared
to only 8.0 percent of RNs (233,437) in 2004. The 2004 figure reflects a 4.0 percent decrease from the
243,239 younger RNs estimated under the age of 30 in 2000 (9.0 percent of all RNs). Meanwhile, the
percent of nurses over 54 years of age increased to 25.2 percent in 2004, compared to 20.3 percent in
2000 and 16.9 percent in 1980.

Chart 4. Age distribution of registered nurse population 19802004*
600,000

500,000
1980
1984
1988

400,000

1992
1996
2000
300,000

2004

200,000

100,000

0
<25

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

>65

Years of Age
*The total numbers of nurses in each survey, across age ages, may not equal the estimated
total of all RNs due to incomplete information provided by respondents. Only those who
provided age information are included in the calculations used for this chart

GENDER
Men still comprise a very small percentage (5.8 percent) of the total RN population although their
numbers have continued to grow. Of the estimated 2,909,357 RNs in the US, 168,181 are men. This
represents a 14.5 percent increase over the 2000 NSSRN estimate, when 146,902 RNs were male. This
also represents a 273.2 percent increase over 1980, when the number of men in the RN population was
estimated at 45,060.

13

RACIAL/ETHNIC BACKGROUND
Comparisons of the racial/ethnic composition of the RN population in 2004 with previous years should be
interpreted with caution. In accordance with Office of Management and Budget (OMB) guidelines issued
in 1999, the question regarding racial and ethnic background changed in 2000. Unlike earlier NSSRN
surveys, which included a single question and asked the respondent to choose only one racial/ethnic
background, the 2000 and 2004 surveys collected this information in two questions. Respondents were
asked to indicate whether their ethnic background was either Hispanic or Latino or not; they were also
asked to identify all races that described them. The survey information was aggregated into categories
similar to those reported in previous years, with one additional category that delineates Hispanic and nonHispanic RNs who reported two or more races. In 2004, the number of nurses in the two or more races,
non-Hispanic category, was estimated to be 41,244 or 1.4 percent of the RN population. In 2004, 7.5
percent of RNs (217,651) did not specify their combined racial/ethnic background, while in 2000 only 1.1
percent of RNs did not specify their combined racial/ethnic background. 6
The number of nurses identifying their combined racial/ethnic background as one or more non-white
groups, Hispanic, or Latino numbered 311,177 (10.7 percent) in 2004. This change is a decrease of
22,190 RNs from 2000, but nearly triple the number of non-white, Hispanic, or Latino nurses in 1980
(See Chart 5). In 2000, 12.4 percent of all RNs (333,368) came from one or more of the identified racial
and ethnic non-white, Hispanic, or Latino groups. It must be noted that this apparent decline may be a
result of an increase in the proportion of RNs who did not completely specify their combined racial or
ethnic background. 7 .
In the past, non-White, Hispanic, or Latino RNs have grown at a greater rate than white, non-Hispanic
RNs for all of the years from 1980-2000, except the period from 1984-1988. These growth rates were
particularly pronounced between 1996 and 2000, when the number of non-white, Hispanic, or Latino RNs
increased about 35.3 percent while the number of white, non-Hispanic RNs increased by 1.7 percent.
Most of the increase in the RN population between 1996 and 2000 was a result of the growth in the nonwhite or Hispanic or Latino nurse population (which increased by 87,003 RNs). However, because the
population of white, non-Hispanic nurses is almost 7 times larger than the population of non-white,
Hispanic, or Latino nurses, even small percentage changes in the non-white, Hispanic, or Latino nurse

6

Of the 217,651 RNs with missing values for race or ethnicity, 27.0 percent (58,859 RNs) did not specify either race
or ethnicity, 13.9 percent (30,147) specified ethnicity but not race, and 52.1 percent (128,645) specified race but not
ethnicity. Fifty-one percent of those who specified ethnicity but not race (15,231) indicated they are Hispanic or
Latino. Of the estimated 128,645 who specified race but not ethnicity, 78.2 percent are White and 21.8 percent
(28,067) are racial minorities. Of these registered nurses who specified race but not ethnicity, 56.3 percent are
Black or African-American, 4.6 percent are American Indian or Alaska Native, 29.3 percent are Asian or Other
Pacific Islander, and the remaining registered nurses checked two or more races. Therefore, a total of 354,475 (12.2
percent of the RN population) can be considered minority by race and/or ethnicity. However, for the purposes of
clarity and consistency in this narrative report on minority comparison with White non-Hispanic RNs, only RNs
with both race and ethnicity provided are generally being compared in the text, charts, and tables.
7

This change reflects, in part, a change in the data retrieval practices for missing variables. In previous NSSRN
administrations, missing data were retrieved via a process of re-contacting the respondent by telephone. The 2004
survey limited this practice to certain critical missing variables, not including race.

14

population involve a much larger volume of nurses, and masks the growing presence of non-White,
Hispanic, or Latino RNs in the population.

Chart 5:

Trend in the number of racial/ethnic White,
non-Hispanic and non-White, or Hispanic
registered nurses, 1980-2004*

10,000,000

1,521,752

1,705,393

1,864,157

2,018,456

2,294,092

2,333,896

2,380,529

333,368

311,177

2000

2004

1,000,000

206,834
155,390

154,859

1984

1988

246,365

119,512
100,000

Logarithmic scale

1980

1992

1996

*The total numbers of RNs across all race/ethnicity combinations may not equal the total numbers
of RNs estimated from each survey due to incomplete information provided by respondents and
the effect of rounding. Only those who provided both race and ethnicity information are included in
the calculations used for this chart.

White, non-Hispanic

Non-white or Hispanic

The racial and ethnic groups comprising the non-white or Hispanic or Latino RN population differ in the
rates at which their numbers have increased over the past 24 years. The number of nurses from nonHispanic Asian or Other Pacific Islander backgrounds showed the highest relative increase at 167.8
percent from 33,600 RNs in 1980 to 89,977 RNs in 2004. The number of Hispanic or Latino RNs
increased by 203.8 percent, from 20,816 in 1980 to 63,240 in 2004 (including 15,231 who failed to
specify any race in 2004). The number of RNs reporting American Indian or Alaska Native non-Hispanic
backgrounds increased by 122.5 percent from 4,249 in 1980 to 9,453 in 2004. The increase for Black or
African American non-Hispanic RNs over the same period is an estimated 101.3 percent (from 60,845 in
1980 to 122,495 in 2004). Note that despite the impressive growth rates, the actual numbers of nonwhite, Hispanic, or Latino nurses remain relatively small.
The representation of identified non-White, Hispanic, or Latino nurses among the total nurse population
increased from 7.2 percent in 1980 to at least 12.2 percent in 2004, after accounting for those who gave
responses in 2004 where either the provided race or ethnicity indicated a minority. Despite these
increases, the diversity of the RN population remains far less than that of the general United States

15

population, where 32.6 percent of the United States population identified themselves as non-White,
Hispanic, or Latino in 2004 8 (see Chart 6).

Chart 6:

Distribution of registered nurses by
racial/ethnic background, March 2004
81.8

White, non-Hispanic

67.4
1.7

Hispanic or Latino, race
specified

14.1

Black or African American,
non-Hispanic

4.2

Asian or Native Hawaiian or
Pacific Isl., non-Hispanic

3.1
4.2

12.2

Two or more races, nonHispanic

1.4
1.3

American Indian or Alaska
Native, non-Hispanic

0.3
0.8
7.5

Unknown race and/or
ethnicity

0
0

10

20

30

40

Percent

50

United States Population

60

70

80

90

100

RN Population

Hispanic or Latino RNs still remain the most underrepresented group of nurses when compared with the
representation in the United States population. After adjusting for those Hispanic or Latino RNs who
provided no response to the question on race, only 2.2 percent of the RN population are Hispanic or
Latino nurses, although Hispanics or Latinos comprise 14.1 percent of the general population. Note
however, that of the 7.5 percent of respondents who did not specify one or both of race and ethnicity, 6.4
percent of respondents were of unknown ethnicity in 2004.

8

See U.S. Census Bureau Statistical Abstract of the United States, 2006, Resident Population by Sex, Race, and
Hispanic Origin Status: 2000 to 2004, Table 13, January 4, 2006, at
http://www.census.gov/prod/2005pubs/06statab/pop.pdf. Census reports that, of the 293,655,000 in the U.S.
population for 2004, 197,841,000 are of White race, only, and non-Hispanic. Thus, while 67.4 percent of the U.S.
population are white, non-Hispanic, 32.6 percent are non-White or Hispanic.

16

FAMILY STATUS
In 2004, 70.5 percent of all RNs were married; 18.1 percent were widowed, divorced or separated; and
9.2 percent were never married. Roughly 42.5 percent of all RNs had children under the age of 18 living
in the household, including 14.8 percent who had children less than 6 years of age living in the household.
Over half of all RNs, 54.5 percent, had no children under the age of 18 living in the household. The
remaining 3.1 percent did not report any information on the presence of children in the household (see
Appendix A, Table 6).
Nearly 16 percent (15.9) of all RNs were caring for other adults in their home, and 15.5 percent were
caring for other adults living elsewhere (see Appendix A, Table 7). The majority (52.1 percent) of RNs
have children and/or other adults at home. Of these RNs and allowing for multiple responses, 28.3 percent
have children under age 6 at home, 65.2 percent have children of ages 6 to 18 at home, and 30.6 percent
have other adults at home. An additional 14.8 percent of these nurses caring for others at home also have
other dependents who do not live at home.
EMPLOYMENT SETTINGS
Substantial changes in the health care delivery system over the past two decades have had major effects
on the settings in which nurses are employed. Five major employment settings were identified for RNs:
hospitals, nursing homes and extended care facilities, community and public health settings, nursing and
other health education, and ambulatory care settings. Community and public health settings include: State
and local health departments, visiting nursing services and other health agencies, community health
centers, student health services, occupational services and school health. These settings continue to be the
major employment settings for nurses, although there have been substantial shifts in the mix since 1980
(see Chart 7). Every NSSRN survey since 1980 has revised the questionnaire and expanded the choices
available to nurse respondents for identifying the types of facilities, institutions and service delivery
systems in which they were employed. Despite these data collection changes, major employment sectors
are sufficiently distinct to allow adjustments in the data in order to analyze trends in the employment
settings of nurses over the past 24 years.
Results from the 2004 survey indicate a slight trend away from the hospital as the setting for the principal
nursing position, although changes in the structure of hospitals (e.g., more specialty outpatient clinics)
may explain some of the change. Hospitals remain the major employer of nurses, although the number of
nurses employed in other sectors has increased (see Chart 7). Although the estimated number of RNs
whose principal position was in hospitals was greater than in 2000, the percentage of RNs working in
hospitals decreased from 2000 to 2004. In March 2004, out of an estimated 2,421,351 RNs employed in
nursing, 56.2 percent (1,360,847) worked in hospital settings compared to 59.1 percent (1,300,323) in
March 2000. The number of RNs employed in hospitals increased by over one-half million (525,200)
between 1980 and 2004. However, the proportion of the nurse workforce employed in hospitals, after a
peak of 68.1 percent in 1984, has declined steadily to its current low of 56.2 percent of employed RNs.
This percentage decline reflects the growth in nurse employment opportunities in other sectors.
In 1980, 65.6 percent of employed RNs worked in hospitals. From 1980 through 1992, the percentage of
nurses employed in hospitals remained relatively stable, ranging only 2.5 percentage points over a 12-year
period (65.6 in 1980, 68.1 in 1984, 67.9 in 1988, and 66.5 in 1992). However, since 1992, there has been
a significant drop in the percentage of hospital based RNs, declining to 56.2 percent in 2004. The 2.9
percent drop from 2000 to 2004 is the second largest, second only to the 6.4 percent drop from 1992 to
1996.

17

In contrast, the percent of RNs reporting their principal nursing position in other types of settings,
particularly ambulatory care, increased from 2000 to 2004. In 2004, 11.5 percent of RNs were estimated
to be employed in ambulatory care settings, including physician-based practices, nurse-based practices,
and health maintenance organizations, compared to 9.5 percent in 2000.
Community and public health settings remained the next largest type of predominant employment for
RNs; but the percent of RNs employed in these settings also decreased, from an estimated 18.3 percent of
RNs reporting public or community health settings in 2000 to 14.9 percent in March 2004. (For the
purpose of these comparisons, both school health services and occupational health settings have been
added to traditional community/public health settings.) The percent of RNs reporting nursing homes and
extended care facilities as their principal setting remained relatively constant between 2000 (6.9 percent)
and 2004 (6.3 percent).
The remaining RNs employed in nursing reported working in such settings as nursing education, Federal
administrative agencies, State boards of nursing or other health associations, health planning agencies,
prisons/jails, insurance companies, and other miscellaneous settings such as pharmaceutical and durable
medical equipment companies (Chart 7). It appears likely that the number and percent of nurses employed
in these “other” settings may continue to increase given changes in health care delivery.
Public and community health, ambulatory care, and other non-institutional settings have historically had
the largest increases in RN employment. Between 1980 and 2004, RNs employed in ambulatory care
settings increased by 168.7 percent (from 103,362 to 277,774) while those employed in public health and
community health settings increased by 128.8 percent (from 157,504 to 360,380; see Chart 8).
The number of nurses employed in nursing education has changed little since 1980. This, coupled with
an increase in the total number of nurses, has led to a decline in the overall percent of RNs employed as
nurse educators. In 1980, 47,507 RNs (3.7 percent of all RNs employed in nursing) were in nursing
education settings of RN, LPN/LVN, or nursing aide programs. In 2004, the number of RNs employed in
these same nursing education settings had increased to 57,897 (or 2.4 percent of all RNs employed in
nursing). The number of nurses employed in nursing homes has increased by 51,963 (or 51.3 percent)
since 1980, although the numbers and the percentage of nurses employed in nursing homes and other
extended care facilities remained essentially the same between 2000 (152,894) and 2004 (153,172), an
increase of 278 RNs. In percentage terms, the share among all RNs dropped from 5.7 percent compared
to 5.3 percent, with a drop in its share among employment settings from 6.9 percent to 6.3 percent).

18

Chart 7.

Distribution of registered nurses
by employment settings,
in thousands, 1980-2004****

Hospital
836

Public/Community Health*

Ambulatory Care

Nursing Homes/Extended
Care

Nursing Education***

Other**

181
167
158

250

209
179
144
159
129
103
153
153
171
129
108
115
101
63
47
49
37
30
40
48
156
81
83
56
43
21
22

1,105
1,012

1,361
1,300
1,271
1,233

360
402
363

278

0
200
400
600
800
1000
1200
1400
1600
Number of Nurses
* Public/Community Health includes school and occupational health
**Other includes positions in insurance claims/benefits, policy/planning/regulatory/licensing, correctional facilities, private
duty, and home based self employment.
***For 2004, this Nursing Education category collectively includes not only RN, LPN/LVN, but also allied health, medical
school, and consumer education settings. 55,910 are in RN and LPN/LVN education settings in 2004, regardless of
position. The difference accounts for some of the increase from earlier surveys in the Nursing Education category.
****The total numbers of RNs across all settings of employment may not equal the total estimated numbers of nurses
due to incomplete information provided by respondents on settings and the effect of rounding. Only those who provided
setting information are included in the calculations used for this chart.

1980

1984

1988

19

1992

1996

2000

2004

Chart 8.

Percent change in the number of registered nurses
employed in selected settings, 1980 to 2004***
62.8

Hospital

128.8

Public/Community Health*

169.5

Ambulatory Care

51.3

Nursing Homes/Extended
Care

21.9

Nursing Education**

0

20

40

60

80

100

120

140

160

180

200

Percentage Change
*Includes School and Occupational Health
**Nursing Education includes teachers in LPN/LVN, Diploma, Associate Degree, and Bachelors and higher degree programs
***Only those who provided employment setting information are included in the calculations used for this chart.

LONG-TERM TRENDS IN AVERAGE SALARIES/EARNINGS
Changes in overall average earnings 9 for RNs between November 1980 and March 2004 are shown using
two separate measures. The first measure is the “actual” average earnings reported by RNs employed
full-time, and the second measure uses the consumer price index (CPI) for urban consumers to adjust for
the changes in the purchasing power of the dollar against the actual earnings of full-time employment for
obtaining “real” average earnings 10 . In examining the extent to which average RN earnings have
9

For the purposes of this discussion, the term “earnings” is used to collectively represent salaries and/or earnings
self-reported by survey respondents.

10

Adjustments based on the CPI were made using the geometric-average quartic root. Average yearly increase over
4 years was calculated as (1 + (percent change in earnings during time period)0.25 - 1. The geometric median-based
annual average CPI increase can be found as: (1 + (percent of CPI increase over time period))0.25 - 1. The net
geometric median-based real percent increase each year can be found as: (1+ (percent of salary increase))0.25 - (1 +
(percent of CPI increase over time period)).0.25.

20

increased over the years, and the related economic demand for RNs, it is important to consider how
earnings have increased during times of relatively high inflation as well as during times of relative
stability in the cost of living. It is important to note, though, that inflation is only one of the factors
influencing the size of increases in RN earnings over time.
The average actual annual earnings of RNs employed full-time in March 2004 was $57,785, reflecting a
23.5 percent actual earnings increase since March 2000 (See Chart 9). However, it should be noted that
there was a change in the context of the question from 2000 to 2004. In 2000, the question asked for
income in the year 2000, requiring the RN to estimate income or report for the previous year. In 2004,
the question did not ask for income in a specific year, only for annual income. In spite of this wording
change, this increase in income is substantially higher than the 11.2 percent actual earnings increase
between 1996 and 2000 and the 11.5 percent actual earnings increase between 1992 and 1996. The
highest increases in actual annual earnings (35.1 percent) were experienced during the period from 1980
to 1984, with the second highest increase of 33.0 percent increase in average earnings coming between
1988 and 1992. These were times of relatively high increases in the cost of living, as well as periods
when nurses were being actively sought for employment. For example, there were substantial increases
in the supply of RNs in the workforce from 1977 to 1984 and a perceived nursing shortage from 1988 to
1992.
The real increase in earnings is determined by adjusting the actual earnings by changes in the CPI.
Obtaining the trends over time in ‘real’ increases in RN earnings is possible after accounting for the
changes in purchasing power of the dollar from the reported earnings found in each respective NSSRN.
In the comparisons over time, 1980 is the starting point of the time frame for analysis of real versus actual
earnings. Thus, it is modeled here that, in 1980, real and actual earnings are assumed to be equal (i.e., the
1980 relative Consumer Product Index (CPI) = 100).
From 2000 to 2004, the CPI increase was 9.5 percent. As such, the actual adjusted increase, or real
earnings increase, for this period was 14.0 percent (23.5 percent actual increase, less the 9.5 percent CPI).
The 14.0 percent increase in real earnings for 2000 to 2004 is the largest since the inception of the
NSSRN. Comparatively, the 1996 to 2000 actual earnings increase of 11.2 percent and the 1992 to 1996
actual earnings increase of 11.5 percent can be almost completely attributed to the corresponding 10
percent change in the CPI over each of those 4-year periods. Between 1988 and 1992, RNs experienced a
real earnings increase of 11.2 percent and a similar real earnings increase between 1980 and 1984 of 9.7
percent. As in the past, these increased earnings have occurred during periods when the supply of
employed nurses increased substantially. This pattern signals the existence of significant economic
demand for RNs over this period. Note that any changes in earnings since March 2004 are not reflected.

21

Chart 9. Actual and "real" earnings for registered nurses, 1980 to 2004*
Salary
$70,000

$60,000
$57,785
$50,000
$46,782
$40,000

$42,071
$37,738

$30,000
$28,383
$23,505

$20,000
$17,398

$19,079

$26,654
$23,166

$23,103

$23,369

1992

1996

2000

$20,839

$10,000

$0

1980

1984

1988

* Only those who provided earnings information are included in the calculations used
for this chart.
Actual Annual Average Salary

22

Real Annual Average Salary

2004

CHAPTER III

THE REGISTERED NURSE
POPULATION 2004
As of March 2004, an estimated 2,915,309 individuals had current licenses to practice as registered nurses
(RNs) in the United States. Approximately 2,909,357 of these RNs lived and worked in the United
States. This estimate represents an increase of 7.9 percent, or 212,817 above the 2,696,540 estimated
number of RNs living and working in the United States in the year 2000. Though this change is greater
than the 5.4 percent increase seen across the last survey years (1996 to 2000) it is one of the lowest
increases since the inception of the NSSRN. By comparison, the highest increase in the RN population
was experienced between 1992 and 1996 when the total number of RNs increased by an estimated 14.2
percent or 319,058 (from 2,239,816 to 2,558,874). The number of RNs working outside the United States
declined from 18,131 RNs in 2000 to 5,952 RNs in 2004.
The data in this report focus on the 2,909,357 RNs located in the United States. RNs are considered
to be located in the United States if they were employed in nursing in one of the 50 States and the District
of Columbia or, if not employed in nursing, were residents of the United States. Of the 2,909,357 RNs
located in this country, 83.2 percent or 2,421,351 were employed in nursing (see Appendix A, Table 1).
This estimate of the number employed in nursing is an increase of 219,538 RNs (10.0 percent) over the
estimated 2,201,813 RNs employed in nursing in 2000.
AGE
The aging of the RN workforce in the United States has continued. As of 2004, the average age of the
total RN population (including those who are retired and not employed in nursing) was estimated to be
46.8 years. This is the highest average age since the inception of the survey, more than 1 year older than
the average age estimated in 2000 (45.2 years) and more than 2 years older than the average age estimate
in 1996 (44.3 years).
The aging RN workforce reflects fewer young nurses entering the RN population, large cohorts of the RN
population moving into their 50s and 60s, and older graduates from initial nursing education programs
entering the RN population. In 2004, only 8.0 percent of the RN population was under the age of 30, a
decrease from 9.0 percent in 2000 and 25.1 percent in 1980. At the same time, in 2004, 41.1 percent of
RNs were 50 years of age or older, a dramatic increase from 33.0 percent in 2000 and 25.1 percent in
1980 (see Appendix A, Table 1). The increase in the number of older nurses who returned to the
workforce in response to the higher salaries and reported shortages may have contributed to the trend.
The average age at graduation for recent RN graduates appears to be slightly lower than in 2000. The
average age at graduation for RNs during the 5 years prior to the survey was 29.6 years for the 2004
survey compared to 30.9 years in the 2000 survey; however, RNs who graduated between 1995 and 1999

23

in the 2004 survey were 31.0 years of age at graduation. In 2004, the average age of nurses who graduated
from initial nursing education in 1984 or earlier was 23.8 years (see Appendix A, Table 2 for statistics on
age at graduation); this is similar to the 23.9 years average age at graduation in 2000.
When the distribution of age at graduation is observed by age groups, the indication that graduates from
initial education programs in more recent years are younger becomes clearer. In the 2004 survey, 39.4
percent of those graduating between 2000 and 2004 were under 25 compared to 30.9 percent of RNs
under age 25 who completed their initial education between 1990 and 1999. Complementing this increase
in younger graduates, 29.7 percent of nurses who completed their initial education between 1990 and
1999 were in the 35 to 49 age interval, while only 21.0 percent of RNs completing their initial education
programs between 2000 and 2004 were in the 35 to 49 year age interval.
The average age of RNs at graduation from initial nursing education also varied by type of program.
Graduates of diploma and associate degree programs in 2000 or later were the same age (31.8 years) and
were older than graduates of bachelor’s degree or higher programs (26.3 years) during this time period. In
other graduation years, graduates of associate degree programs were older than all other graduates.
Across survey years, the age of diploma graduates has steadily been increasing across graduation cohorts.
Baccalaureate degree recipients graduating after 1989 were the youngest (see Chart 10). However, the
average age at graduation is lower since 2000 among recent graduates of associate degree and bachelor’s
degree programs (declining by 1.5 years and 1.2 years respectively, compared to those who graduated
during the 1990s (see Appendix A, Table 2).

Chart 10.

Average age at graduation from initial nursing
education programs, March 2004*

Age
40
35
31.0 31.0
28.4

30

29.6

28.9

31.0

30.2

31.8
27.2 27.5

26.7

25.5
25

33.2 33.3

31.8

25.5

23.8

26.3

23.4

22.0

20
15
10
5
0
All Graduates

Diploma Graduates

Associate Degree
Graduates

Baccalaureate or Higher
Graduates

*Only those who provided age information are included in the calculations used for this chart.

1984 or earlier

1985-1989

1990-1994

24

1995-1999

2000 or later

GENDER
Men still comprise a very small percentage of the total number of RNs living and working in the United
States, although their numbers have continued to grow. In 2000, 146,902 or 5.4 percent of RNs were
men. In 2004, 5.8 percent (168,181 RNs) were male (see Appendix A, Table 1).
Male RNs are more likely to be younger than female RNs, with 30.1 percent of male RNs under the age
of 40 compared to 26.1 percent of female RNs, and 65.7 percent of male RNs under the age of 50
compared to 57.4 percent of female RNs. The average age for male RNs was 44.6 compared to female
RNs at 47.0 years of age. Male RNs are more likely to be employed in nursing (88.4 percent) compared
to female RNs (82.9 percent).
Male and female RNs also differ with respect to the type of program in which they received their initial
nursing education. Male and female RNs differ in the proportions graduating with either a diploma or an
associate degree, with males more often receiving an associate’s degree than a diploma. Approximately
13.5 percent of male RNs graduated from diploma programs, compared with 25.9 percent of female RNs;
and 52.0 percent of male RNs graduated from associate degree programs, compared with 41.6 percent of
female RNs.

Chart 11.

100
90
80
70
60
50
40
30
20
10
0

Percent distribution of registered nurses by
initial nursing and highest nursing or nursingrelated educational programs, March 2004*

52.0
42.6

41.6
31.0

25.9

13.5

13.7

9.2
0.87

33.2 34.3

31.6

30.5

18.0

12.9

<1

Male

Female

Male

Initial Education

Female
Highest Education

*The statistics used in this bar chart will not add to 100 percent in each cluster due to those few
who did not respond to the question on gender or education and the effect of rounding. Only
those who provided gender and initial educational preparation information are included in the
calculations used in this chart.

Diploma

Associate Degree

Baccalaureate

Masters and Doctorate

When the highest nursing or nursing-related educational preparation is considered, a similar pattern
emerges with respect to education below the baccalaureate degree. Females were nearly twice as likely as
compared to males to list a diploma as their highest nursing or nursing-related educational preparation
(18.0 percent compared to 9.2 percent). Conversely, 42.6 percent of males listed an associate degree as
the highest-related educational preparation, compared to 33.2 percent of female RNs. However, more

25

female RNs had baccalaureate degrees (34.3 percent) than male RNs (31.6 percent). The percent of male
and female RNs completing master’s or doctoral programs as their highest nursing or nursing-related
education were similar, 13.7 percent and 12.9 percent, respectively (see Chart 11).
RACIAL/ETHNIC BACKGROUND
As explained in Chapter II, due to a change in definitions, caution should be used when comparing the
racial/ethnic composition of the RN population to surveys prior to 2000. In accordance with the Office of
Management and Budget (OMB), the question regarding racial and ethnic background in the March 2000
survey was changed from the previous surveys. In 2004, as in 2000, nurses were asked to identify their
ethnic background and then asked to identify all races that could best describe them. The information was
aggregated to categories similar to those reported in previous years, with one additional grouping of two
or more races, non-Hispanic. The 2004 and 2000 estimates for these RNs were relatively unchanged (1.4
percent and 1.2 percent, respectively). In surveys prior to 2000, nurses had to choose from one of the
racial/ethnic categories presented and could not designate multiple races.
In 2004, 10.7 percent (311,177) of all RNs identified themselves as a racial or ethnic minority in their
responses to both the questions on race and ethnicity. However, 354,475 RNs (an additional 43,298, or
about 1.5 percent of all RNs) identified themselves in 2004 as a racial or ethnic minority (see Footnote 6),
even if their responses were incomplete through missing race or ethnicity information. In 2000, 12.4
percent of the RN population (333,368) was estimated to be members of minority groups. This apparent
percentage decline, even after the adjustment for minority respondents who did not provide complete
race/ethnicity information, is slight and should be seen in light of the apparent absolute increase in
minority RNs. In 2004, 7.5 percent of RNs were of unspecified racial or ethnic background; in 2000, only
1.1 percent of RNs were of unspecified racial or ethnic background. Of the 217,651 RNs in 2004 with
missing values for race or ethnicity, 27.0 percent (58,859 RNs) did not specify either race or ethnicity,
13.9 percent (30,147 RNs) specified ethnicity but not race, and 52.1 percent (128,645 RNs) specified race
but not ethnicity. This increase in missing information, and the concurrent decrease in minority RNs who
specified both race and ethnic demographic information, may in part reflect a change in the data retrieval
practices for missing variables. 11
Of the RN population who specified both race and ethnicity background, 4.2 percent (122,495) were
Black or African American (non-Hispanic); 3.1 percent (89,976) were Asian, Native Hawaiian, or Other
Pacific Islander (non-Hispanic); 1.7 percent (48,009) were Hispanic or Latino, with any race specified;
and 0.3 percent (9,453) were American Indian or Alaska Native (non-Hispanic). An estimated 1.4
percent (41,244) reported that they were two or more races and non-Hispanic (see Appendix A, Table 1).
These minority distributions in the RN population contrast with the minority distribution of the general
United States population. In the United States population for 2004, 12.2 percent were Black or African
American (non-Hispanic), 4.1 percent were Asian, Native Hawaiian, or Other Pacific Islander (non-

11

In previous survey years, missing data was retrieved via an additional process of re-contacting the respondent for
critical information. The 2004 survey limited the practice of follow-up contact to certain critical variables, not
including race. Thus, the results should be interpreted with caution.

26

Hispanic), 13.7 percent were Hispanic or Latino with any race specified, 0.7 percent were American
Indian or Alaska Native (non-Hispanic), and 1.3 percent were of two or more races (non-Hispanic). 12
Similar to the 2000 survey, minority RNs were on average younger than white, non-Hispanic RNs (45.5
years of age on average versus 47.1 for White, non-Hispanic RNs). Asian, Native Hawaiian, or Other
Pacific Islander RNs were the youngest, at 43.9 years of age, followed by Hispanic or Latino RNs at 44.1
years of age on average. Black or African American, non-Hispanic RNs were on average the oldest, at
47.2 years of age.
RNs from minority backgrounds were more likely than non-minority nurses to be employed in nursing
and to work full-time. Nearly 88 percent of non-Hispanic minority nurses and 88.0 percent of Hispanic or
Latino nurses were employed in nursing, compared with 82.6 percent of White, non-Hispanic nurses.
Minority nurses employed in nursing were also more likely than non-minority nurses to be employed fulltime. The percentage of employed RNs working full-time ranged from 75.2 percent for Hispanic or
Latino RNs to 81.2 percent for non-Hispanic minority RNs. In comparison, 68.5 percent of employed
non-Hispanic White RNs worked full-time.
Most RNs in each racial/ethnic group received their initial nursing education in associate degree
programs, with the exception of RNs from Asian, Native Hawaiian, or Other Pacific Islander, nonHispanic (19.0 percent) backgrounds. RNs from American Indian or Alaska Native, non-Hispanic
backgrounds were the most likely to receive their initial nursing education in associate degree programs
(60.8 percent) followed by multi-racial RNs (55.1 percent), Hispanic or Latino RNs (54.5 percent), Black
or African American non-Hispanic RNs (48.7 percent) and white non-Hispanic RNs (42.4 percent).
White, non-Hispanic nurses were more likely than other nurses to have received their initial nursing
education in diploma programs. Twenty-seven percent (26.9 percent) of white, non-Hispanic nurses were
prepared for RN licensure in diploma programs compared with 14.7 percent of Hispanic or Latino RNs
and 17.8 percent of nurses who were non-White non-Hispanic. The majority (64.0 percent) of RNs from
Asian, Native Hawaiian, or Other Pacific Islander, non-Hispanic backgrounds received their initial
nursing education in baccalaureate programs. It should be recognized, however, that most Philippinetrained nurses had baccalaureate education as their initial nursing preparation.
Chart 12 illustrates how racial/ethnic groups compare in terms of highest nursing or nursing-related
educational preparation. White (non-Hispanic) RNs were most likely to have a diploma as the highest
educational preparation (18.9 percent). Asian, Native Hawaiian, or Other Pacific Islanders (nonHispanic), as well as Black or African American (non-Hispanic) RNs were more likely than either
Hispanic, Latino, or White (non-Hispanic) RNs to attain at least baccalaureate preparation. Black or
African American, non-Hispanic (14.2 percent) and White, non-Hispanic nurses (13.2 percent) were the
racial/ethnic groups with the highest percentages of master’s and doctoral degrees.

12

This information was reported in Table 3: Annual Estimates of the Populations by Sex, Race and Hispanic or
Latino Origin for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-03). Population Division, U.S.
Census Bureau. Release Date: June 9, 2005.

27

Chart 12.

Percent distribution of registered nurses in each reported
racial/ethnic group by highest nursing or nursing-related
educational preparation, March 2004*

100
90

13.2

10.3

33.3

36.1

80
70

9.9

9.8

14.2

26.6

10.5

30.2
37.8

60

62.7

50
40

49.4

34.2

46.7

42.2

30

35.8

20
10

15.8
18.9

13.2

10.1

11.4

11.2

12.4

0

White (nonHispanic)

Hispanic or
Latino, race
specified

American
Asian/Native
Black or
Indian or
Hawaiian/
African
Alaska Native Other Pacific American (non(non-Hispanic) Islander (nonHispanic)
Hispanic)

Multi-Racial

*The totals of the percents in each bar may not equal 100 percent due to the effect of rounding. Only
those who provided both race and ethnicity information (such as Hispanic/Latino, race specified), as
well as initial educational preparation information, are included in the calculations used for this chart.

Diploma

Associate Degree

Baccalaureate Degree

Master's/Doctoral Degree

EDUCATION AND EMPLOYMENT PRIOR TO INITIAL NURSING EDUCATION
Individuals come to nursing through various career paths, and a significant number choose nursing after
employment in other health-related fields or after receiving other post high school academic degrees. In
2004, about 1,512,259 (52.0 percent) of all RNs had worked in other health-related occupations prior to
attending their initial nursing education (see Appendix A, Table 3). This estimate is an increase from
2000, when 37.3 percent of RNs followed the same path, although a change in question wording can
account for this marked increase. In 2000 the questionnaire asked for the respondent’s employment status
immediately prior to beginning initial nursing education, while the 2004 questionnaire asked for
employment status at any time prior to beginning initial nursing education. In 2004, the majority of these
nurses who had previously worked did so as nurse aides (974,764 RNs or 64.5 percent), Licensed
Practical Nurses/Licensed Vocational Nurses (LPN/LVNs; 364,527 RNs or 24.1 percent) or as clerks in
health care settings (208,337 RNs or 13.8 percent). The majority of RNs who were employed before
entering an initial nursing education program tended to enroll in associate degree programs (797,925 RNs
or 52.8 percent) to prepare for RN licensure. In addition, 29.9 percent of RNs (451,499 RNs) who were
employed in a health occupation prior to their initial nursing education received their education in
baccalaureate-or-higher degree programs.
While 484,809 RNs were estimated as ever being licensed as an LPN/LVN, 120,282 were NOT employed
as LPN/LVNs prior to starting their initial RN preparation program. Some of these 120,282 may have

28

obtained RN licenses during the period of initial RN education for related employment purposes. In total,
there were 364,527 RNs who were employed as LPNs/LVNs prior to beginning their initial nursing
education. The majority of all RNs who were once employed as LPN/LVNs (80.2 percent or 292,365
RNs) reported an associate’s degree as their initial RN education, 11.5 percent had a baccalaureate-orhigher degree (41,927 RNs; see Appendix A, Table 3). In contrast, only 47.1 percent of RNs employed as
nurse aides prior to initial nursing education received an associate degree as their initial nursing
education, while 33.4 percent obtained baccalaureate-or-higher degrees.
In 2004, about 16.2 percent of the RN population, or 471,603 RNs, had post-high-school academic
degrees prior to entering an initial nursing education program (see Appendix A, Table 5). This is an
increase from the 2000 estimate, when 13.3 percent of the RN population had post-high-school academic
degrees prior to their initial nursing education. Over half of the 2004 RNs who had a post-high-school
academic degree prior to initial nursing education had associate degrees (52.6 percent or 247,962 RNs),
and half had bachelors degrees 13 (50.2 percent or 236,871 RNs; see Appendix A, Table 5). RNs with
post-high-school academic degrees prior to their initial nursing education were less likely to report an
associate degree as their initial nursing education than RNs who had been employed as LVN/LPNs. Just
over 80 percent (80.2 percent) of those previously employed as LVN/LPNs reported an associate degree
as initial nursing education, compared to 52.6 percent of RNs with prior academic degrees. This is
virtually unchanged since 2000, when 82.1 percent of those previously employed as LVN/LPNs reported
an associate degree and 53.0 percent of RNs with prior academic degrees reported an associate degree as
their initial nursing education.
NURSING EDUCATIONAL PREPARATION
The initial educational preparation for the largest proportion of RNs is the associate degree. Forty-two
percent, or 1,227,256 of the 2,909,357 RNs received their initial nursing education in an associate degree
program (see Appendix A, Table 2). Similarly, in terms of the highest level of preparation for nursing,
the trend from 1980 to 2004 indicates that an increasing number of RNs receive baccalaureate and
master’s degrees, even if their initial preparation for nursing was an associates degree or a diploma (see
Chart 13; see Appendix A, Table 10).
Of those RNs completing their initial nursing education in the period between 2000 and early 2004, 56.9
percent graduated from an associate degree program and 39.9 percent (including 1.0 percent from masters
and doctoral initial programs) graduated from a baccalaureate-or-higher initial RN program; only 2.8
percent graduated from diploma programs (see Appendix A, Table 2).
RNs relied on different sources of funding to finance their initial nursing education. The three primary
sources were personal resources, family resources, and federally assisted loans. An estimated 53.0
percent of students used some personal resources, such as earnings and savings; while 48.2 percent used
family assistance to help pay for tuition and fees. Over 22 percent (22.1 percent) used federally-assisted
loans as a resource. Federal sources of support in the form of traineeships, scholarships or grants were a
resource for 13.2 percent of RNs, and employer tuition and reimbursement plans were a resource for
about 8.2 percent of RNs attending school. 14 Reliance on Federal resources increased with the educational
level. About 60.7 percent of master’s and doctoral degree students relied on some type of Federal support
13

The numbers in this calculation overlap because respondents were able to name more than one degree.

14

The percentage of nurses using each source of funding adds to more than 100 percent because more than one
source could be named.

29

compared to about 49.0 percent of baccalaureate students, 37.1 percent of associates degree students and
16.9 percent of diploma students (see Appendix A, Table 9).
The 2004 survey indicates that the RN population is increasingly prepared with a baccalaureate, a
master’s, or doctoral degree. The highest level of nursing or nursing-related preparation for an estimated
17.5 percent of RNs (510,209) is a diploma; for an estimated 33.7 percent (981,238) the highest
preparation is an associate degree; for 34.2 percent (994,276) it is a baccalaureate degree; and for 13.0
percent (376,901) a master’s or doctoral degree is their highest nursing or nursing-related education (see
Appendix A, Table 10).
In addition to degrees in nursing, it should be noted that some nurses have advanced degrees that are not
in nursing but related to their career in nursing (see Appendix A, Tables 10 and 11). Of the estimated
376,901 RNs with master’s or doctoral degrees in nursing or nursing-related areas, 267,963 (71.1 percent)
held nursing degrees as their highest nursing or nursing-related degree. At the master’s level of highest
nursing or nursing-related education attained, 256,415 (73.1 percent) held nursing master’s degrees. At
the doctoral level of highest nursing or nursing-related education attained, 11,548 (44.2 percent) held
nursing doctoral degrees. Nurses reported attaining an additional 105,922 master’s degrees and 29,755
doctoral degrees in fields that are not related to a career in nursing. .
The highest increase from 2000 to 2004 was for the number of RNs receiving a nursing or nursing-related
master’s or doctorate degree (an estimated increase of 101,833 RNs or 37 percent) compared to a
decrease of 91,495 nurses or 15.2 percent in the number of RNs whose highest nursing or nursing-related
degree was a diploma. Also noteworthy is the 12.9 percent increase in nursing or nursing-related
baccalaureates, from 880,997 to 994,276. As illustrated by Chart 13, by 2004 the majority (52.1 percent)
of RNs who earned a master’s or doctoral degree as their highest nursing or nursing-related educational
preparation received a baccalaureate degree as their initial nursing education.
Over the entire period from 1980 to 2004, there was a 43.5 percent decrease (an estimated change from
903,131 RNs to 510,209) in the number whose highest level of nursing or nursing-related education was a
diploma, while the number whose highest level of nursing or nursing-related education was a master’s or
doctorate increased by 339 percent (from 85,860 to 376,901). Similarly, the estimated number of RNs
whose highest nursing or nursing-related preparation was a baccalaureate increased by 170 percent
(367,816 to 994,276) and the estimated number whose highest nursing or nursing-related preparation was
an associate’s degree increased by 232 percent, from 295,318 to 981,238 RNs.

30

Chart 13. Registered nurses whose highest nursing or nursingrelated education was a master's or doctoral degree,
by type of initial nursing education, March 2004*
4.1%
Master's/
Doctoral Degree

22.7%
Diploma

52.1%
Baccalaureate
Degree

20.6%
Associate Degree
*The totals of the initial educational preparation distribution percents for those RNs with
advanced education may not equal 100 percent due to the effect of rounding. Only
those who provided initial education preparation information are included in the
calculations used for this chart.

Of the 1,227,256 RNs initially prepared in associate degree programs, 20.7 percent or an estimated
253,453 of the nurses (i.e., 8.7 percent of all RNs) obtained additional nursing or nursing-related degrees.
Of the 733,377 RNs initially prepared in diploma programs, 30.2 percent or an estimated 221,608 (i.e.,
7.6 percent of all RNs) obtained post-RN nursing or nursing-related degrees. In addition, of the 887,114
RNs initially prepared in baccalaureate programs, 22.1 percent or an estimated 196,494 (i.e., 6.8 percent
of all RNs) subsequently received master’s or doctorate nursing or nursing-related degrees.
In terms of overall education, including nursing degrees, nursing-related degrees, and degrees that were
unrelated to nursing, an estimated 391,472 RNs received master’s degrees and 40,038 RNs received
doctoral degrees after becoming RNs (see Appendix A, Table 11). Nearly 44 percent (43.8 percent) of
RNs with post-RN master’s degrees that may or may not be related to nursing chose clinical practice as
their field of study. Nearly 15 percent (14.5 percent) focused on supervision/administration while 13.4
percent studied education. Post-RN doctoral degrees were frequently focused on either education (21.3
percent), research (17.7 percent), or law (11.3 percent). In contrast, clinical practice was the focus of just
5.8 percent of post-RN doctoral degrees (see Appendix A, Table 11).
In 2004, 7.6 percent, or 220,412 RNs, were enrolled in formal education programs leading to an academic
degree or a certificate. Most of these award programs were in nursing or would enhance a career in
nursing (172,150; see Appendix A, Table 12). The RNs pursuing these academic degree programs useful
to a career in nursing were mostly part-time students employed full time in nursing (54.0 percent;) Of the

31

estimated 166,768 RNs pursing academic degrees in nursing or related to nursing, an estimated 49.1
percent (81,402 RNs) were currently pursuing baccalaureate degrees, 45.7 percent (75,879 RNs) were
pursuing master’s degrees, and 5.2 percent (8,617 RNs) were pursuing doctoral degrees. The majority of
these formal nursing or nursing-related academic degree programs (138,618) were actually in nursing,
while a smaller number (30,151) were in nursing-related academic programs that would enhance a career
in nursing. Of the 111,282 RNs initially prepared in associate degree programs that were enrolled in
nursing or nursing-related educational programs, 71,373 RNs (64.1 percent) were pursuing baccalaureate
degrees. A smaller number are pursuing certificates in nursing or related to nursing (20,048). An
additional 23,689 RNs were pursuing formal academic education in other fields not related to enhancing a
career in nursing
ADVANCED PRACTICE NURSES
Increased interest in expanding the access and availability of health care services has led to particular
emphasis on advanced practice registered nurses (APNs). The APN is an umbrella term used to describe
RNs who have met advanced educational and clinical practice requirements beyond the initial nursing
education required of all RNs. Many States require APNs to be recognized either by a State agency or
certified by a national organization such as the American Nurses Credentialing Center (ANCC) or the
relevant specialty nurses association. APNs include clinical nurse specialists, nurse anesthetists, nurse
midwives and nurse practitioners. For this study, APNs were defined as such if they reported that they
were prepared as an APN in a specific specialty field. 15
In total, an estimated 240,460 RNs, or 8.3 percent of the RN population, were prepared for advanced
practice. This estimate represents a 22.5 percent increase from the 196,279 APNs, or 7.3 percent of RNs
estimated in 2000. Almost three in four (74.8 percent or 179,932 APNs) of the 240,460 RNs reported a
master’s degree for APN educational preparation; an additional 18,631 APNs reported at least one postmaster’s certificate for their APN educational preparation. Over 70 percent of APNs (70.1 percent or
168,546 APNs) were nationally certified and 61.8 percent (148,647 APNs) were State recognized to
practice in the respective State in at least one APN specialty 16 (see Appendix A, Table 13). Others
prepared as APNs may have been not actively practicing in 2004 to have required current APN
credentials.
As shown in Chart 14, the majority of those who completed APN programs were prepared as nurse
practitioners (NPs; 141,209 RNs) followed by clinical nurse specialists (CNSs; 72,521 RNs). A
significant portion of RNs were at least dually prepared as both NP and CNS (14,689 RNs). These two
groups together, including those with dual or multiple preparations as a nurse practitioner, clinical nurse
specialist, nurse midwife, and/or or nurse anesthetist, comprised over 199,000 nurses (or 82.8 percent) of
all APNs.

15

The NSSRN does not sample APNs, per se. Rather, the NSSRN samples RNs who may also claim APN
preparation. Constraints to this sampling design limited the pool and representativeness of APNs who were
sampled. The resulting sampling weights for APNs from the NSSRN do not scientifically represent the numbers of
APNs actually prepared in these four specialties. Furthermore, the numbers of prepared APNs include many who
are not currently practicing in their specialty but who were once prepared as and completed an APN program earlier
in their careers.
16

Percents do not add up to 100 because respondents could be certified in multiple specialties by multiple
organizations.

32

An estimated 32,523 of those who completed APN programs were prepared as nurse anesthetists, and an
estimated 13,684 APNs were prepared as nurse midwives, with 21.1 percent (2,892 APNs) of nurse
midwives being prepared as both NPs and nurse midwives (see Appendix A, Table 13).

Chart 14.

Registered nurses prepared for advanced practice,
March 2004
Total: 240,460 RNs (8.3 percent of registered nurses)*
Nurse
Practitioners/Clinical
Nurse Specialists
Only
Nurse Midwives/
6.0%
Nurse Practitioners

Nurse
Practitioners Only
51.1%

1.2%
Other
Combinations
0.8%

Nurse
Anesthetists Only
12.9%

Nurse Midwives Only
4.3%
Clinical Nurse
Specialists Only
23.7%
*The totals of the APN preparation distribution percents may not equal 100 percent due to the effect of rounding. This chart
covers those who claimed advanced preparation as APNs in at least one specialty.

The most common specialty among those who completed APN programs was family practice (25.0
percent), followed by adult health/medical/surgical (14.3 percent), anesthesia (13.1 percent),
psychiatric/mental health (8.2 percent), pediatrics (8.1 percent), and acute/critical care (6.6 percent).
Among APNs with national certification, family practice was the most common specialty APNs were
certified in (20.1 percent), followed by anesthesia (12.7) and adult medicine (7.1 percent) (see Appendix
A, Table 14).
Nurse Practitioners
The nurse practitioner (NP) group included all RNs prepared beyond initial nursing education in a formal
nurse practitioner program of at least three months. Generally, a minimum of a master’s degree in
nursing is currently required for academic achievement in advance of national certification as a new NP.
In 2004, 141,209 RNs, were prepared to practice as NPs, which included 14,689 NPs with both NP and
CNS training. This estimate reflects a 37.3 percent increase (38,380) from the 2000 to the 2004 survey.
In 2000, there were an estimated 102,829 NPs, which included 14,643 who were also prepared as CNSs.
As reported by the NPs, 77.6 percent (109,582) of APNs with formal preparation as NPs also had national

33

NP certification. The number with State Board of Nursing recognition was 72.3 percent or 102,142 (see
Appendix A, Table 13).
Since the early 1990s, master’s degrees have become almost always mandatory for new NPs. The data
show that the education of NPs takes place primarily in master’s degree programs, with 65.5 percent
(92,449) of NPs reporting having completed a master’s degree program as part of their formal APN
related education. This is an increase in master’s degree NP preparation from 2000 (when 62 percent did
the same) and 1996 (when 46 percent of NPs had completed a master’s degree). In addition to master’s
NP training, there were others who reported having pursued post-master’s certificates as their NP
preparation (14,821 or 10.5 percent).
Almost 88 percent (87.7 percent), or 123,857 of the 141,209 NPs were employed in nursing, although
only 57.7 percent (81,433) of the NPs (i.e., 65.7 percent of the NPs employed in nursing) were employed
with the title of nurse practitioner (see Appendix A, Table 13). The second and third most-common job
titles were staff nurse (14,358 or 11.6 percent of those NPs employed in nursing) and professor/instructor
(7,715 or 6.2 percent of those NPs employed in nursing), respectively.
Clinical Nurse Specialists
Clinical nurse specialists (CNSs) included those RNs who had formal preparation related to the clinical
nurse specialty. Generally, a minimum of a clinical master’s degree in nursing has been required as
academic achievement in advance of practicing as a CNS.
There were an estimated 72,521 RNs (2.5 percent of all RNs) prepared to practice as CNSs in 2004,
including the 14,689 RNs who were prepared as both NPs and CNSs (see below). Between 2000 and
2004, the number of CNSs increased by 5.1 percent (an additional 3,504 CNSs). In 2000, the number of
RNs trained as CNSs was 69,017, including 14,643 who were trained as both a NP and a CNS. In 2004,
of all CNSs a total of 32,385 had national certification, a 2.1 percent increase over the 2000 level of
31,713 RNs. An estimated 27,379 CNSs had State certification in 2004, a 31.2 percent increase over the
2000 estimate of 20,863 (see Appendix A, Table 13).
The highest education of the vast majority of CNSs takes place primarily in master’s degree programs,
with 93.3 percent (67,666 CNSs) reported having completed a master’s degree program for their CNS
educational preparation. An additional 3.8 percent of CNSs (2,731 CNSs) reported having post-master’s
certificates and 0.3 percent (194 CNSs) reported having doctoral degrees as their CNS educational
preparation.
Of all those prepared as CNSs, 85.1 percent (or 61,735 CNSs) were employed in nursing but only 16.5
percent of the prepared CNSs (11,988 and 19.4 percent of those CNSs employed in nursing) used clinical
nurse specialist as their position title. Nevertheless, there were numerous respondents who reported
having a position title of CNS but who neither appeared from the respondent data to have completed an
APN educational program nor otherwise reported completing at least a master’s degree in nursing. 17
Among a wide variety of other position titles that prepared CNSs hold were instructor/faculty member
17

In the July 1999 publication from the National Advisory Council on Nurse Education and Practice (NACNEP) to
the Secretary of HHS, “Federal Support For The Preparation Of The Clinical Nurse Specialist Workforce Through
Title VIII”, NACNEP noted the passing of Federal legislation in 1997 which required that practicing CNSs hold a
master’s degree in a clinical area of nursing. NACNEP notes, however, that “a substantial proportion of those who
have position title as a “clinical nurse specialist” do not have graduate degrees.”

34

(16.2 percent of those employed in nursing or 10,022) and nurse practitioner (15.9 percent of those
employed in nursing or 9,802).
Nurse Practitioners and Clinical Nurse Specialists
In 2004, there were 14,689 APNs with preparation as both a NP and a CNS, representing only a slight
increase from the 2000 estimate of 14,643. The majority reported to have received APN educational
preparation in at least one master’s degree program (93.4 percent or 13,716 APNs); this is consistent with
the master’s educational preparation requirement for CNS’s. Others, including some of these 13,716
APNs, reportedly received APN educational preparation through one or more post-master’s certificate
programs (33.9 percent or 4,973 APNs), or Doctoral degrees (2.6 percent or 377 APNs) Nearly all were
employed in nursing (93.4 percent or 13,717 APNs). Most of these nurses prepared as both NP and CNS
who were employed in nursing had nurse practitioner as their position title (8,990 APNs or 61.2 percent
of those prepared as both NP and CNS and 65.5 percent of those employed in nursing), followed by
instructor/faculty member, (1,310 APNs or 9.6 percent of those employed in nursing) and staff nurse
(1,072 APNs or 7.8 percent of those employed in nursing). Only 5.7 percent of those employed in nursing
(776 APNs) reported clinical nurse specialist as their position title.
Nurse Anesthetists
Nurse anesthetists (NAs) are the third largest group of advanced practice nurses. Included in the nurse
anesthetists category were all RNs with formal preparation beyond initial nursing education in which the
specialty of anesthesia was studied. Generally, a minimum of a master’s degree is currently required for
academic achievement in advance of national certification as a new NA. This national certification is a
prerequisite to practicing as a NA.
In 2004, 32,523 RNs (1.1 percent of all RNs) were prepared as NAs. In 2000, there were 29,844 NAs,
representing a 9.0 percent increase from 2000 to 2004. Virtually all (30,446 or 93.6 percent) NAs had
national certification and 24,168, or 74.3 percent, had State recognition in 2004 (see Appendix A, Table
13).
The majority (18,870 or 58.0 percent) of all NAs reported receiving their educational preparation in postRN certificate/award programs. Just over one-third (12,083 or 37.2 percent) of all nurse anesthetists
reported receiving their educational preparation in master’s degree programs. An estimated 287 NAs (or
0.9 percent) reported educational preparation through post-master’s certificate programs. At least a
master’s degree is currently required to become a new NA. Almost all NAs, 89.6 percent (29,150 NAs),
were employed in nursing, with 26,116 NAs (80.3 percent of all prepared NAs) in positions where the job
title was nurse anesthetist. Other job titles included staff nurse (1,142 or 3.9 percent of those employed
in nursing) and instructor/faculty member (331 NAs or 1.1 percent of those employed in nursing). NAs
who also had formal preparation as a CNS or NP were more likely to be employed with the title nurse
anesthetist than either the titles of clinical nurse specialist or nurse practitioner. Many of the rest of those
who completed NA programs may be employed in other positions that do not require certification in their
specialty.

35

Nurse Midwives
Among the APNs, there are fewer nurse midwives (NMs) prepared or employed in this specialty than in
the other three groups. 18 To assure that NMs were appropriately classified, several screening steps were
taken via responses to the survey questionnaire. The formal education beyond initial nursing education
had to be at least 9-months in length. A second screen was needed for the relatively large proportion of
RNs in the sample who indicated they had formal preparation as NMs and were initially foreign educated.
Such nurses usually need additional education to qualify for certification in this country. Generally, a
minimum of a master’s degree in nursing is currently required for academic achievement in advance of
national certification as a new NM. This national certification is a prerequisite to practicing as a NM.
After these screening steps were taken, the several hundred RNs who reported NM preparation was
ultimately reduced to a corps of 175 who were considered prepared as APNs.
In 2004, there were 13,684 nurses formally prepared as NMs (0.5 percent of all RNs), including 2,892
who had preparation as both NPs and NMs. This estimate, though based on a relatively small sample,
represents a 48.2 percent increase in formal NM preparation from 2000, when 9,232 RNs were trained as
NMs. Virtually all (93.7 percent or 12,820 ) of RNs trained as NMs had national certification as NMs and
three-quarters (75.2 percent or 10,296) had State Board of Nursing recognition.
The majority of NMs (7,733 or 56.5 percent) reported receiving a master’s degree for their educational
preparation, while 792 NMs (or 5.8 percent) reported receiving a post-master’s certificate and 5,053 NMs
(36.9 percent) reported receiving a post-RN certificate. Almost all NMs (89.3 percent or 12,217 NMs)
were employed in nursing; with 7,037 NMs (or 57.6 percent of those employed in nursing and 51.4
percent of all NMs) employed with the position title of nurse midwife. Other common job titles included
staff nurse (1,636 or 13.4 percent of those employed in nursing) and nurse practitioner (1,131 or 9.3
percent of NMs employed in nursing). Over 10 percent (10.7 percent) were not employed in nursing.
NMs who also had formal preparation as a clinical nurse specialist or nurse practitioner were more likely
to be employed in the job title of nurse midwife than either the titles of clinical nurse specialist or nurse
practitioner. Many of the rest of those who completed NM programs may be employed in other positions
that do not require certification in their specialty or may be retired from practice as an NM.
.
Nurse Practitioners and Nurse Midwives
In 2004, there were 2,892 RNs (less than 1 percent of all RNs) who were prepared as both nurse
practitioners and nurse midwives. Comparable information is not available from the 2000 NSSRN as
there were not enough observations to make reliable estimates. The largest group reported receiving their
APN educational preparation in at least one master’s degree programs (45.2 percent or 1,307 NM/NPs),
with additional nurses reporting APN educational preparation in at least one post-RN certificate program
(33.2 percent or 960 NM/NPs) or post-master’s certificate program (536 NM/NPs or 18.5 percent). Most
were employed in nursing (80.4 percent or 2,326 NM/NPs) but only 29.9 percent of the prepared NM/NPs
and 37.2 percent of those employed in nursing used nurse midwife as their position title (865 NM/NPs).
Other common titles were nurse practitioner (29.4 percent of those employed in nursing or 684 NM/NPs)
followed by staff nurse (9.0 percent of those employed in nursing or 209 NM/NPs).

18

In the survey, only 98 RNs responded that they were currently employed with an NM position title.

36

Non-White, Hispanic, or Latino Advanced Practice Nurses
Only 8.0 percent (19,325 RNs) of APNs were from racial/ethnic minority backgrounds (that is, non-White
non-Hispanic, Hispanic, or Latino APNs of any race). Non-White, Hispanic, or Latino nurses were most
likely to be found among NPs (8.9 percent or 12,529 NPs). In addition, non-White non-Hispanic,
Hispanic, or Latino APNs of any race comprised 7.8 percent (2,538 NAs) of all NAs, 7.6 percent of NMs
(1,040 NMs), and 6.3 percent of CNSs (4,547 CNSs).

REGISTERED NURSES IN THE WORKFORCE
In 2004, 83.2 percent of the RN population, or an estimated 2,421,351 RNs, were employed in nursing.
This estimate represents a 10.0 percent increase since 2000 (when 2,201,813 or 81.7 percent of RNs were
employed in nursing). Although RNs can be found in all sectors of the health care system, the
predominant employment setting remains the hospital, employing 1,360,847 or 56.2 percent of all RNs.
The next largest group was ambulatory care settings, with 11.5 percent or 277,774 RNs. Ambulatory care
settings include physician-based practices, nurse based practices, and health maintenance organizations.
The next largest group was composed of an estimated 259,911 (10.7 percent) who worked in
public/community health settings, including State or local health departments, community based homehealth agencies, various types of community health centers, student health services, and occupational
health services. The fourth largest employer of RNs in 2004 was nursing homes/extended care facilities,
which employed a total of 153,172 (6.3 percent) of all RNs employed in nursing. The remainder of
employed nurses worked in diverse settings such as nursing education (2.6 percent), school health
agencies (3.2 percent), and insurance claims/benefits (1.8 percent; see Appendix A, Table 16). Over 4
percent (4.3 percent) worked in settings categorized as “other”, composed of RNs working in correctional
facilities, clinical research, home-based self-employment, private-duty nursing, call-center/telephone
triage, and pharmaceuticals/medical-devices settings.
The percent of RNs employed in hospitals decreased slightly between 2000 and 2004, declining from 59.1
percent to 56.2 percent. However, the actual number of RNs employed in hospitals increased by 4.7
percent, from 1,300,323 RNs in 2000 to 1,360,847 in 2004. This is a somewhat greater rate than the 2
percent increase from 1996 to 2000. Ambulatory care showed the greatest gain in RN employment from
2000 to 2004, with a 32.7 percent increase in RNs reporting employment in ambulatory care settings
(from 209,324 to 277,774 RNs). Some respondents may have had difficulty in distinguishing between
ambulatory in a hospital setting versus ambulatory care outside a hospital setting such as: a clinic within a
hospital, an ambulatory surgical center in a hospital or run by a hospital off-site, an ambulatory center
nearby a hospital, a doctor’s private office within a hospital, and a doctor’s office nearby a hospital.
Over one quarter (25.1 percent) of all employed RNs (608,940), could not specify one type of patient with
whom they worked, as they worked with multiple patient types. The majority of employed RNs who
could specify a patient type that they, or their unit, cared for reported providing general adult care
(513,834 or 21.2 percent), followed by pediatric care (176,698 or 7.3 percent) and cardiovascular care
(171,219 or 7.1 percent; see Appendix A, Table 17). Comparisons cannot be made with the 2000 NSSRN
due to a change in the scope of the question to include all employed nurses, instead of nurses only
employed in hospital inpatient or outpatient units. Of all employed RNs, 1,584,615 RNs (or 65.4 percent)
reported spending more than 50 percent of their time in direct patient care, although 81.9 percent of
employed RNs (1,984,224 RNs) spent at least some time (1 percent or more) in direct patient care.
RNs employed in hospitals were asked to report the function in which they spent 50 percent or more of
their time. Over 19 percent (19.3 percent) either could not or did not report a dominant function or
reported “other” as the dominant function. Over two-thirds of RNs employed in hospitals (70.6 percent)

37

reported spending more than 50 percent of their time in direct patient care, as illustrated by Chart 15. Just
over 5 percent (5.3 percent or 71,696 RNs) of hospital employed RNs reported spending more than 50
percent of their time in supervisory capacities and 2.5 percent (33,446 RNs) reported spending more than
50 percent of their time in administration. However, 89.0 percent of all hospital employed RNs
(1,211,632 RNs) reported spending at least some time (1 percent or more) in direct patient care.

Chart 15. Distribution of registered nurses employed in hospitals
by dominant function, March 2004*
1.1%
2.5%

Administration
Consultation
Direct Patient Care

19.3%

Research
Supervision
70.6%

Teaching

<1%

Other
5.3%
<1%
*The totals for the distribution percents for the predominant functions of hospital nurses may
not equal 100 percent due the effects of rounding.

As shown in Chart 16, inpatient bed units are where the majority of hospital employed nurses spend more
than half their direct patient care time. Among nurses who provided direct patient care services and
reported the type of work unit where they spent more than half their patient care time, 53.7 percent
reported working in inpatient bed units, similar to 2000 when 53.7 percent of RNs reported working in
these units. In 2004, 382,331 RNs reported working in general/specialty inpatient bed units; in 2000,
369,832 RNs reported working in these units, an increase of 3.4 percent. Hospital-employed RNs
working in outpatient departments experienced the greatest increase at 76.7 percent, from 69,707 in 2000
to 123,166 in 2004. Hospital-employed RNs working in critical care or step down units increased 18.6
percent, from 272,074 RNs in 2000 to 322,740 RNs in 2004 (see Appendix A, Table 18). Comparisons
between the results of the 2000 and 2004 NSSRN surveys with respect to this issue must be interpreted
with caution as there was a high number of hospital-based RNs who did not specify a work unit in 2000
(8 percent) relative to 1.3 percent of RNs reporting the same in 2004. In addition to those unknowns
without any response by the nurse, other responses did not provide an individual unit for the nominal list
of specific units of Table 18. However, in 2000, an additional 4.0 percent reported no specific area or
some other specific area, in 2004, 4.5 percent of these hospital nurses providing direct patient care
reported working in multiple units, no specific area, or other specific area.

38

Chart 16. Selected hospital work units for registered nurses
providing some direct patient care, 2000 and 2004*

Percent
100
90
80
70
60

53.7 53.7

50
40
30
20
8.7

10

7.9

9.1

8.2

7.1

13.3 12.1
5.8

0
Inpatient

Emergency
Department

Labor and
Delivery

Outpatient

Surgical

*The totals for the distribution percents of hospital employment settings where the nurse spends more than half
of the patient care time may not equal 100 percent due to incomplete information provided by respondents and
th ff t f
di

2004

2000

Characteristics within Employment Setting
An estimated 29.7 percent or 720,283 of the 2,421,351 RNs employed in nursing were employed in
nursing part-time. In general, family status made a difference in whether nurses were employed full-time
or part-time. Employed married nurses with children, particularly those with children under the age of
six, were more likely than other employed nurses to be employed on a part-time basis. Overall, nearly 30
percent (29.8 percent) of the 2,421,351 employed RNs were working on a part-time basis. However,
slightly over 45 percent (45.4 percent) of employed married nurses with children younger than 6 worked
part-time. Married nurses with children under 6 years of age represented 13.8 percent of all employed
nurses (see Appendix A, Table 6). In addition, these married nurses with children under 6 years of age
were 10.7 percent of all RNs employed full-time in nursing as well as 7.5 percent of all employed RNs.
The employment status (i.e., full-time or part-time employment) of nurses varied according to the
employment setting. The highest percentage of part-time employees was found among RNs working in
school health (37.6 percent of all RNs employed in school health) and ambulatory care settings (34.4
percent of all RNs employed in ambulatory care). The lowest percentage of part-time workers was found
among nurses working in the insurance/claims/benefits field (12.5 percent of all RNs employed in this
setting) and policy/planning/licensing/regulatory agencies (14.8 percent or all RNs employed in this
setting; see Appendix A, Table 19).
In 2004, after excluding the hours of work information of those nurses with any on-call hours, the average
scheduled work hours per year for full-time nursing positions, including paid vacations, holidays, and sick

39

leave was 2,160 hours; for part-time nursing positions it was 873 hours (see Appendix A, Table 19). Fulltime nurses worked an average of 7.5 hours of overtime per week, while part-time nurses worked an
average of 5.6 hours of overtime (see Appendix A, Table 20). Due to a difference in data collection
practices, overtime hours cannot be accurately compared with the data collected in 2000 19 .
Nurses in all employment settings tended to work more hours than they were scheduled. However, the
greatest amount of overtime for full-time nurses were in nursing education (8.5 hours per week). The
least amount of weekly overtime hours for full-time nurses was found in the occupational health (5.7
hours) and ambulatory care settings (5.3 hours). For part-time nurses, there were not enough data points
for a reliable analysis (see Appendix A, Table 20). For full-time employed RNs with overtime, 32.5
percent, or 2.4 of their average weekly 7.5 overtime hours, were mandatory. Staff nurses worked fewer
hours of overtime and a slightly smaller proportion of this overtime was mandatory than for all other
RNs. This finding may be partly due to the differences between hourly and salaried nurses, the latter of
whom may be required to work, or believed they are required to work, additional hours per week as part
of their job duties and base salary. For full-time staff nurses, 31.7 percent of their average weekly 7.5
hours of overtime were mandatory; for all other RNs, 35.5 percent of their 7.5 average weekly hours of
overtime were mandatory (see Appendix A, Table 21). This finding held true for staff nurses in
hospitals, where the average amount of weekly overtime for staff nurses was 7.5 hours compared to 7.9
hours for non-staff nurses. Additionally, for a greater percent of non-staff nurses employed in hospitals,
compared with staff nurses employed in hospitals, overtime was mandatory (39.4 percent for non-staff
nurses versus 29.4 percent for staff nurses).
As indicated in earlier surveys, younger nurses were more likely than older nurses to be employed in
hospitals. In 2004, the average age of the hospital nurse was 43.4, 2 years less than the average age of
45.4 for all employed RNs. Nurses in occupational health had the highest average age at 50.8 years (see
Chart 17). Across all settings, staff nurses were on average younger than non-staff nurses, 43.6 years of
age on average versus 48.0 years of age. This finding held true of nurses employed in hospitals, where
staff nurses were 42.1 years of age on average versus 47.2 years of age for non-staff nurses.

19

In 2000, the questionnaire asked two questions, “16a. Approximately how many hours are you usually scheduled
to work during a normal workweek (as defined by the organization) at your principal nursing position? 16b. How
many hours did you actually work during the week beginning on March 20, 2000? (Include overtime but exclude
holidays, sick leave, vacation, and time not worked.)” Overtime hours were derived by subtracting hours scheduled
from hours worked. In 2004, the questionnaire asked to specify in this question “Please provide information on
the number of hours you worked in your last full workweek at your principal nursing position in nursing a) Number
of hours worked in your last full workweek (including paid hours of on call duty and overtime); b) Number of hours
reported in Item33a that were paid on-call; c) Number of hours reported that were paid as overtime; and d) Number
of overtime hours reported that were mandatory/unscheduled.

40

Chart 17.

Average age of employed registered nurses
for selected employment settings,
March 2000 and March 2004*
Average Age
45.8

Occupational Health

50.8

Plan/Licensing Agencies

47.5
49.6

Nursing Home/Extended Care

45.3
49.0

School Health Service

46.8
49.0

Nursing Education

49.4
48.9

Insurance/Claims Benefits

45.8
48.5

Public Health/Community Health

45.2
48.4
49.7
47.8

Ambulatory Care (Nurse Owned/Operated)

44.3
45.9

Ambulatory Care (Except Nurse Owned and Operated)

41.8
43.4

Hospital

45.7
48.9

Other

0

10

20

30

40

50

60

Average Years of Age
*Only those who provided employment setting and age information are included in the calculations used for this chart.

2004 Average

41

2000 Average

Over three-fourths (77.6 percent) of employed RNs under the age of 30 worked in hospitals. In contrast,
less than half (46.2 percent) of employed RNs over the age of 50 worked in hospitals (see Appendix A,
Table 22).
In most employment settings, the majority of nurses had an associate or baccalaureate degree as their
highest nursing or nursing-related educational preparation (see Chart 18 and Appendix A, Table 23).
Seventy-six percent of the nurses working in hospitals had an associate (37.7 percent) or baccalaureate
degree (38.3 percent). Nursing homes and extended care facilities were less likely than other patient care
service settings to have nurses with baccalaureate and higher degrees. Less than a quarter (24.1 percent)
of nurses employed in nursing home/extended care facilities had baccalaureate degrees, while these
settings drew 68.4 percent of their nurses from among those whose highest preparation was that of a
diploma (21.5 percent) or associate degree (46.9 percent). The majority of those in nursing education
(52.9 percent) had a master’s or doctoral degree. Nursing education had the largest proportion of RNs
with baccalaureate degrees or higher (76.0 percent), while nursing homes/extended care facilities had the
least (30.8 percent).
Registered Nurses in Nursing Faculty Positions
One issue that has received considerable attention in recent years is the shortage of nurses in faculty
positions involved with the educational preparation of registered nurses. Based on the setting and
principal nursing position categories used in the 2004 NSSRN, the faculty position is being defined for
those nurses with principal position titles of dean, professor or instructor involved with nursing education
of RNs in diploma, associate, baccalaureate, and/or higher nursing degree program settings. It is estimated
that 30,470 RNs in March 2004 were employed as nursing faculty in principal nursing positions within
these RN programs settings. Of these faculty nurses, 4.8 percent were in diploma programs, 39.4 percent
were in associate degree programs, and 55.8 percent were in baccalaureate and/or higher degree
programs. The average age of faculty nurses was 51.6 years, but the estimated average age of faculty
nurses with doctorates in nursing or a related field was 55.4 years. However, the age group with the
highest percent of faculty was the 50 to 54 year age group with 24.9 percent of faculty in this age group.
An additional 27.2 percent were in the age groups 40 to 50 and 5.4 percent of RNs in faculty positions
were in the age group 25 to 34 years. Although only 8.0 percent of faculty nurses were in the under 40
age group, 39.4 percent were over age 55.

42

Chart 18. Distribution of employed registered nurses by
highest nursing or nursing-related educational
preparation for selected employment settings,
March 2004*
100

6.8

9.4

18.8

21.1

24.1

80
70

13.5

13.1

90

40.5
52.9

38.3

33.7

38.1

60

29.1

40.7

50

23.2

46.9
40
30

23.1

37.7

32.2

27.0

36.8
21.9

20.1

20

17.4
10

21.5

14.1

15.1

15.4

Community/public
health setting

School Health
Service

21.4

15.5

19.5

6.3

0
Hospital

Nursing
Nursing education
home/extended care
facility

Occupational Health

Ambulatory care
(nurse owned)

Ambulatiory care
(not nurse owned)

*The totals for the distribution percents of all employment settings in nursing may not equal 100 percent due to
iincomplete information provided by respondents on employment setting or educational preparation, as well as the
effects of rounding.

Diploma

Associate Degree

Baccalaureate Degree

Masters/Doctoral Degree

Base of Employment
The vast majority of employed RNs (90.2 percent or 2,184,921) were employees of the facility in which
they worked. About 5.5 percent of RNs were self-employed, and 2.3 percent worked in their principal
nursing position through a temporary employment service (see Appendix A, Table 24).
Approximately 54,493 nurses were employed in their principal position through a temporary employment
service in 2004, and 3,039 of these nurses were employed in both a principal and secondary nursing
position through this kind of agency. This temporary employment principal position level reflects a 37.9
percent increase in the comparable number in 2000 (39,505) and continues the increasing trend which the
NSSRN first observed in 1996. In 2004, an additional 37,263 RNs were employed by a temporary
agency for a secondary position aside from their primary nursing position. Considered together, the total
number of nurses employed through temporary employment services in 2004 was 91,756, or 3.2 percent
of all RNs. RNs employed through temporary services for their primary nursing position worked an
average of 35.6 hours per week. The majority of RNs employed through temporary services for secondary
nursing positions (58.9 percent) worked less than 500 hours per year.

43

Position Levels
Over fifty-nine percent (59.1 percent), or 1,431,053 of the 2,421,351 employed nurses in 2004 were in
staff nurse positions. This category included charge nurse, float nurse, public health nurse, school nurse,
travel nurse, and team leader positions (see Appendix A, Tables 25 and 26). Although the number of staff
nurses increased by 5.4 percent from 1,357,349 in 2000, their proportion of the total nurse workforce has
declined from 61.6 percent in 2000 and 66.9 percent in 1988. A total of 222,411, or 9.2 percent of
employed RNs, were in head nurse or supervisory positions in 2004 and 125,011 or 5.2 percent were in
administrative positions.
Charts 19a and 19b illustrate the shifts that have occurred in the distribution of RNs by selected position
titles since the late 1980s. In addition to the decline in the percentage of employed nurses who are staff
nurses, there has been a notable decline in the percentage of those with the position title of supervisor
(from 5.6 percent to 3.1 percent during the period from 1988 to 2004). At the same time, significant
increases have occurred in the percentage of those with the position title of nurse practitioner, growing
from 1.3 percent of employed RNs in 1988 to 3.5 percent in 2004.

44

Chart 19a. Distribution of registered nurses by
selected position titles, 1988-2004*
100

90
1.2
80

70

0.6

5.6
1.1
3.9

5.0
1.3
3.5

5.3

4.6

0.8
4.5
1.4
3.5

0.5
3.6
1.5
2.8
4.8

0.5
3.1
1.4
2.6

61.9

61.6

59.1

1996
Year

2000

2004

5.8

Percent

60

6.1

50

40
66.9

66.6

30

20

10

0

1988

1992

*The totals for the distribution percents of all positions in nursing may not equal 100 percent due to incomplete
information provided by respondents and the effects of rounding.
**In 2004, the definition of instructor included some subcategories outside of traditional nursing programs.

General Duty/Staff Nurse
Instructor **
Supervisor

Head Nurse
Nurse Clinician
Private Duty Nurse

45

Chart 19b. Distribution of registered nurses by
selected position titles, 1988-2004*
30

0.3
1.1
0.2
1.3
20

5.2
5.7

0.2
0.9
Percent

0.3
1.5

0.2
1.1

6.1
10
0.3
1.3
1.0
1.8

6.2
0.4
1.2
1.0
1.9

0.8

5.3
0.7
0.6
1.9
1.0
1.7

3.5

2.8
1.1
1.9

10.0

10.6

1996

2000

1.1
1.2

11.9

6.5
4.0
0
1988

1992

2004

Year

*The totals for the distribution percents of all positions in nursing may not equal 100 percent due to
incomplete information provided by respondents and the effects of rounding.

Other

Clinical Nurse Specialist

Nurse Anesthetist

Nurse Practitioner

Researcher

Administrator

Consultant

Nurse Midwife

The variation in educational preparation according to position title is illustrated in Charts 20a and 20b and
Table 27 in Appendix A. The majority of those with each of the following respective position titles had
less than baccalaureate preparation: private duty nurse (65.8 percent), supervisor (61.6 percent), staff
nurse (58.3 percent), and home health nurse (58.6 percent). Nearly half of head nurses (47.4 percent) had
less than baccalaureate preparation. In Chart 20b, about 50 percent of those reporting principal positions
as a CNS do not also report having at least a master’s degree, which is usually required in most States to
fully practice as a CNS. See also footnote 17 for past acknowledgment of this perceived inconsistency in
reporting of CNS education and position title.

46

Chart 20a. Distribution of registered nurses with selected
position titles by highest nursing or nursingrelated
educational preparation, 1988-2004*
100

0.6

3.6
7.9

12.7

13.3

90
33.2

32.3

80

37.6

29.6

57.5

70
39.5

43.9
60

50

27.4
44.3

40

43.4
41.9
31.6

30

28.4

28.3

28.1
20

10

15.8

10.2

10.4

21.5
13.6

16.4

18.2

Staff nurse

Supervisor

3.9

0
Administration

Head Nurse

Instructor

Nurse
clinician

Private duty

*The totals for the distribution percents of all positions in nursing may not equal 100 percent due to incomplete
information provided by respondents and the effects of rounding. Only those who provided position and
educational preparation information are included in the calculations used for this chart.

Diploma

Associate Degree

Baccalaureate

47

Masters/Doctorate

Chart 20b. Distribution of registered nurses with selected
position titles by highest nursing or nursingrelated educational preparation, 1988-2004*
100
90

20.4

11.2

28.8
80
50.8

49.8

70

34.5
78.5

60

86.0

45.4
36.7

50
40

20.3

21.0
30.1

30
8.9
20

20.8

20.3

13.8

13.9

Consultant

Research

21.1
14.3

10

7.3

19.5
8.0

3.6
3.6

3.9
2.8

CNS

NM

NP

0
Nurse
Anesthetist

20.5

Other

*The totals for the distribution percents of all positions in nursing may not equal 100 percent due to incomplete
information provided by respondents and the effects of rounding. Only those who provided position and
educational preparation information are included in the calculations used for this chart.

Diploma

Associate Degree

Baccalaureate

Masters/Doctorate

Functions During Usual Workweek
Overall, the aggregate percent of time RNs spent in direct patient care was 60 percent in 2004, with
significant percents of overall time spent in supervision (10.8 percent) and administration (8.3 percent).
(See Chart 21). These are slight reductions from 2000 for two of these functions, where the direct patient
care percentage of time was 63 percent and administration was 11 percent.
In 2004, an estimated 65.4 percent of RNs (1,584,615) employed in nursing spent at least 50 percent of
their usual workweek in direct patient care activities; down from the 2000 estimate of 68.6 percent of RNs
spending at least 50 percent of their workweek in direct patient care, and down from the 1996 estimate of
66.9 percent of all RNs spending their workweek in this manner. Nearly half of RNs employed in
nursing, 49.8 percent (1,205,389) spent at least 75 percent of their time in direct patient care activities
(see Appendix A, Table 28). Nurses with less than a master’s degree averaged 60.8 to 64.5 percent of
their usual workweek in direct patient care activities, and from 10.6 to 11.4 percent of their workweek on

48

supervisory activities (see Appendix A, Table 29). Nurses with master’s degrees averaged 44.5 percent
of their time in direct patient care, 15.6 percent of their time in administration, and 11.4 percent in
teaching. Nurses with doctorates averaged 16.5 percent of their time in direct patient care, 27.7 percent of
their time in teaching, and 23.4 percent in administration. Doctorally prepared nurses were the only
group that spent significant time (e.g., over 10 percent) in research. In 2004, they averaged 12.8 percent
of their usual workweek in research, a slight increase over the 2000 average of 11.4 percent and the 1996
average of 9.5 percent.

Chart 21. Average percent of time in work week spent by
registered nurses in each function, March 2004*
2.1%

Administration
10.8%

Consultation
4.7%
60.0%

Direct patient care
8.3%

Research
8.1%

Supervision
*The totals for the distribution percents of the predominant functions in the
workforce may not equal 100 percent due to rounding. Only those who
responded with function distribution information are included in the calculations
used for this chart.

Teaching

Recent Indices of Annual Salaries/Earnings Trends
In March 2004, the overall average annual earnings of full-time employed registered nurses in their
principal nursing positions was $57,785 (see Appendix A, Table 30). This is a 23.5 percent actual
increase in earnings from the 2000 NSSRN average of $46,782. However, as noted in Chapter II, there
was a change in the context of the question from 2000 to 2004. In 2000, the question asked for income in
the year 2000, requiring the RN to estimate income or report for the previous year. In 2004 the question
did not ask for income in a specific year, only for annual income without respect to the time of the
response 20 . The 2004 question text also specified that RNs should include overtime and bonuses but
exclude sign on bonuses. The 2000 questionnaire text did not address this kind of income. As indicated
below and in the respective Appendix A Tables, annual earnings varied by level of nursing education,
position, employment setting, and geographic location.
20

The 2004 questionnaire text was “Please estimate your current gross annual earnings (pre-tax) from your principal
nursing position, include overtime and bonuses, but exclude sign on bonuses.” In 2000 the questionnaire text was
“Please specify the annual salary/earnings for your principal nursing position only. What is your gross annual salary
before deductions for taxes, social security, etc.? If you do not have a set annual salary (for example, you are parttime, private duty, or self-employed), estimate your annual earnings for 2000.”

49

Average annual earnings varied according to the highest level of nursing or nursing-related educational
preparation (see Appendix A, Table 31). The pattern of earnings is predictable in most instances, with
nurses with advanced degrees achieving higher earnings. For almost all positions where master’sprepared RNs were employed in significant numbers, their average earnings were higher than those with
diploma, associate, or baccalaureate degrees. The earnings of master’s-prepared nurses averaged
$74,377. Nurses educated at the doctoral level averaged slightly higher earnings at $80,795.
In those categories where the educational preparation was less than the master’s level, the average
earnings were noticeably lower. The overall average annual earnings for those whose highest nursing or
nursing-related educational preparation was a diploma was $56,504. Those whose highest nursing
education was a baccalaureate degree had slightly higher average annual earnings than for those who held
a diploma ($57,081). Earnings for those with diplomas and baccalaureate degrees as their highest nursing
or nursing-related educational preparation were about 7.4 and 8.5 percent higher, respectively, than the
average earnings for those with associate degrees ($52,610) as the highest nursing or nursing-related
education. Earnings and education patterns appear to be more complex than simply assuming that higher
levels of education automatically translate to higher earnings. Earnings and education patterns are
complex and subject to many variables. For example, larger proportions of diploma nurses in the
workforce have more years of experience than do those with baccalaureate or associate degrees. These
circumstances of the workforce may at least partly explain why diploma earnings appear to be
competitive with baccalaureate earnings.
Comparisons of nurses’ earnings from 2000 and 2004 were made among each of the levels of nursing
education, to determine whether the increases were consistent across degree of highest preparation.
Increases were also adjusted for changes in the CPI, 21 to determine the real increase in RN earnings.
Adjustments for changes in the CPI were made based on average annual CPI rate of increase of 2.3
percent, with a resulting 13.9 percent real increase between 2000 and 2004.
The average annual increase in RN salaries overall was estimated at 5.4 percent from 2000 to 2004, based
on an overall actual average earnings increase of 23.5 percent from 2000 to 2004. However, with an
adjustment for the average yearly increase of CPI through this time period (2.3 percent), the real average
annual rate of increase was 3.1 percent. There was a wide range in the rate of increases in earnings across
the levels of highest nursing or nursing-related educational preparation, as RNs with baccalaureate and
doctoral degrees experienced the largest increases. Nurses whose highest nursing or nursing-related
education was either a diploma or associate degree received average annual increases of 4.9 percent and
5.4 percent (e.g., CPI adjusted average annual earnings increases of 2.6 and 3.1 percent), respectively.
RNs with baccalaureate degrees as their highest nursing or nursing-related education had average annual
earnings increases of 5.2 percent (2.9 percent when adjusted for the CPI). Those with nursing or nursingrelated master’s degrees received average annual increases of 5.0 percent (CPI-adjusted real earnings
were at a 2.7 percent rate of increase), and those with doctoral degrees experienced the biggest average
actual annual earnings increase with 6.2 percent overall (3.9 percent when adjusted for the CPI).

21

Adjustments for changes in the CPI were made based on average annual rates of increase (2.3 percent) and an
overall real percent increase between 2000 and 2004 of about 14 percent. When an average annual increase is
adjusted for CPI, the average increase is calculated and the average annual increase in the CPI is subtracted from
this number. When an overall percent increase is adjusted for CPI, the percent increase is calculated, and then the
percent increase in CPI is subtracted from it.

50

There are large variations in actual earnings by position type from 2000 to 2004. Staff nurses, the largest
group of employed nurses, had average earnings of $53,086 in 2004. The staff nurse earnings level is
about 8 percent below the overall average earnings for all RNs with full-time employment in nursing.
However, this is an improvement over 2000, when staff nurses earned $42,133, on average 10 percent less
than RNs as a whole.
APNs had earnings that were higher than the average for RNs overall. Nurse anesthetists had the highest
average earnings ($129,530) among RNs in all employment settings and position types. Nurse midwives
had average earnings of $73,254; NPs had average earnings of $70,581; and CNSs with master’s degrees
had average earnings of $70,470 22 . Nurse anesthetists experienced a 38.1 percent increase in average
earnings from the 2000 survey, with NPs reporting the second largest increase at 17.4 percent.
Annualized growth rates in actual earnings from 2000 and 2004 were compared for selected positions.
While the average reported earnings for all full-time nurses increased by 5.4 percent on an annual basis
between 2000 and 2004, there was a broad range to the level of increase across positions. Categories of
nursing positions that experienced annual rate increases which were higher than the average rate of
increase include: certified nurse anesthetist (8.4 percent) clinical nurse specialist (6.2 percent), and staff
nurse (5.9 percent). For staff nurses, this is a difference from the 2000 NSSRN when staff nurses
experienced among the lowest annual increases (at 2.2 percent). Staff nurse earnings in hospitals
increased by 6.1 percent. The greater increases for staff nurses than RNs in general (whose earnings
increased by 5.4 percent) may indicate that demand for staff nurses is beginning to be reflected in the
compensation for these RNs.
Annual earnings varied according to the setting in which the RN was employed. At $59,963, the average
annual earnings for those working full-time in the hospital setting were higher than the overall full-time
earnings average across all types of settings. Those settings where RNs earned less than the overall
average included public health settings, at $52,347; nursing homes, at $53,796; and school health
services, with the lowest average annual earnings of $42,249. However, the average earnings of RNs
employed in nursing homes increased by 22.9 percent between 2000 and 2004.
The hospital setting earnings average of $59,963 in 2004, when compared to the 2000 average of $47,759,
reflect a substantive real increase of 16.1 percent over the CPI, based on a 25.6 percent actual increase.
The average annual rate of increase of 5.9 percent is also greater than the overall 5.4 percent annual rate
of increase for RNs in general. Of note, the information in Appendix A, Table 30 indicates that hospitalbased RNs of each position type generally average higher earnings than their position counterparts in
other employment settings such as public health nursing, nursing homes, ambulatory care, occupational
health services, and student health services.
Looking at the full-time earnings of staff nurses working in the hospital setting across the country, RNs
with associate degrees as the highest nursing or nursing-related education had average earnings of
$53,514. For those whose highest nursing or nursing-related education was a diploma, the average
earnings were $58,413. For the baccalaureate-prepared hospital staff nurse, the average earnings were
$55,392. It is important to note that these numbers do not take into account years of experience in
nursing, an important factor to be considered when conducting an analysis of earnings and differences in
education.
22

Due to the mandated educational requirements for CNSs (see footnote 17) this analysis was run on the average
earnings of CNSs with master’s degrees only.

51

A significant percent of employed nurses work either part-time in their principal job or work more than
one job in nursing. An estimated 14.5 percent of all employed RNs held other paid nursing positions in
addition to their principal nursing position. For all RNs employed in nursing (regardless of whether they
had more than one position and if they worked full-time or part-time in their principal position), the
average total annual earnings were $52,080. This is lower then the $57,749 for nurses employed full-time
in their principal nursing position and only slightly greater than the average annual earnings of those with
only one full-time or part-time position ($50,452). If RNs were employed in more than one nursing
position, the average earnings increased to $61,111. Those RNs employed part-time in nursing only had
overall average earnings of $34,184; those who worked in more than one part-time position earned
$44,633; and those who worked only one part-time position earned $32,002 (see Appendix A, Table 32).
Job Satisfaction
The level of job satisfaction indicates the general attitude of RNs toward their work. There is a wealth of
empirical literature linking job satisfaction and other important workplace features, such as employee
turnover. Correspondingly, there is an emerging body of work linking job satisfaction with quality of
patient care.
The 2004 survey also examined job satisfaction and reasons for not working in nursing or for changing
positions, of the nurses currently employed in nursing. Across the entire sample, just over three-quarters
of nurses (76.4 percent) reported being either extremely satisfied (26.9 percent) or moderately satisfied
(49.5 percent) in their current position (see Appendix A, Table 33). Only 13.5 percent of nurses employed
in nursing were dissatisfied (2.8 percent extremely dissatisfied and 10.7 percent moderately dissatisfied).
The 76.4 percent of RNs moderately or extremely satisfied with their jobs is greater than the 69.5 percent
of RNs who were moderately or extremely satisfied in 2000, 23 but is lower than levels seen in the
employed general population. Data from the General Social Survey of the National Opinion Research
Center indicate that in 2002 24 , 89.1 percent of employed individuals in the U.S were moderately or
extremely satisfied with their jobs.
Levels of job satisfaction vary by employment (see Chart 22). Nurses working in nursing homes/extended
care facilities reported the lowest levels of job satisfaction, with 73.8 percent saying they were extremely
satisfied (23.6 percent) or moderately satisfied (50.2 percent) with their jobs. RNs working in hospital
and insurance claims/benefits settings also reported lower levels of overall job satisfaction at 74.9 percent
each, although there were differences in the levels of moderate or extreme job satisfaction. For RNs
working in hospitals, 52.5 percent were moderately satisfied with their jobs compared with 46.1 percent
of RNs working in insurance claims/benefits settings. Comparatively, 22.4 percent of RNs working in
hospitals were extremely satisfied with their jobs, compared with 28.8 percent of RNs working in
23

Comparisons with the 2000 questionnaire should be made with caution, as the wording of the question was
changed between 2000 and 2004 such that the 2000 questionnaire measured change in job satisfaction, while the
2004 questionnaire measured satisfaction at that point in time. In 2000 the question asked: “Compared to a year
ago, how would you best describe your feeling about your nursing job”; in 2004 the question asked “How would
you best describe your feelings about your principal nursing position”.
24

Davis, James A., Tom W. Smith, and Peter V. Marsden. General Social Surveys, 1972-2004: [Cumulative File]
[Electronic file]. 2nd ICPSR version. Chicago, IL: National Opinion Research Center [producer], 2005. Storrs, CT:
Roper Center for Public Opinion Research, University of Connecticut /Ann Arbor, MI: Inter-university Consortium
for Political and Social Research / Berkeley, CA: Computer-assisted Survey Methods Program
(http://sda.berkeley.edu), University of California [distributors], 2005.

52

insurance claims/benefits. The highest job satisfaction rates came from RNs working in school health
settings (85.7 percent either moderately or extremely satisfied, 44.8 percent and 40.9 percent
respectively), ambulatory care settings (83.9 percent either moderately or extremely satisfied, 46.6
percent and 37.4 percent respectively), and occupational health settings (82.4 percent either moderately or
extremely satisfied, 42.1 percent and 40.3 percent respectively).

Percent

Chart 22.

100
90
80
70
60
50
40
30
20
10
0

52.5

Percent of registered nurses who reported being
moderately or extremely satisfied with their jobs
by employment setting, March 2004*

50.2
43.2

g
sin
r
Nu

m
Ho

44.8
33.9

40.9 42.1 40.3

46.6
37.4

42.3 40.1

46.1

Ca
t.
x
E
e/

re
g
in
rs
u
N

41.2
28.8

23.6

22.4

l
ta
pi
s
Ho

47.4
38.1

34.6

l
s
d)
d)
gu
im
te
te
e
a
a
a
l
R
c
er
er
S
.
c.
m
h
ce
op
at
op
Li
t
o
/
/
l
n
p
d
d
C
a
u
e
e
ea
ing
b/
ur
cc
wn
wn
lH
nn
O
ns
Pu
o
o
I
o
a
N
N
Pl
ho
(R
tR
Sc
o
e
(n
ar
re
lC
a
u
b
lC
Am
bu
m
A

.
uc
Ed

th
al
He

e
vic
er

th
al
He

*Only those who reported with both employment setting and satisfaction level information for the principal
position in nursing are included in the calculations used for this chart.

Moderately satisfied

Extremely satisfied

Across employment settings, two factors appear to play powerful roles in level of job satisfaction:
education level and position (such as whether the respondent is a staff nurse or not). In general, fewer
staff nurses reported being moderately or extremely satisfied with their jobs than non-staff nurses overall
(74.1 percent versus 82.0 percent). Nearly 16 percent (15.9 percent) of staff nurses report being
moderately or extremely dissatisfied with their jobs. This difference holds true across employment
settings; fewer staff nurses report being moderately or extremely satisfied with their jobs across
employment settings (see Appendix A, Table 33 and Chart 23).

53

Chart 23. Percent of staff nurses and non staff
nurses satisfied in their jobs by
employment setting, March 2004*
100
90
80

Percent

70
60

53.6

49.5 48.7

49.1
50
40

31.9 33.0

30
20

44.0

42.5 43.0

19.2 16.9

32.2

49.6 51.4
43.3 43.7

47.1

34.3
28.0

22.1

10
0
Staff nurse

Non staff nurse

Staff nurse

Extremely satisfied

Non staff nurse

Moderately satisfied

*Only those who reported the employment setting, position, and level of satisfaction information for the
principal position in nursing are included in the calculations used for this chart.
Hospital

Nursing Home/Extended Care

Nursing Education

Ambulatory Care (non Nurse owned)

Public Community Health

Job satisfaction also varies by level of nursing or nursing-related education, with associate degree nurses
reporting the lowest overall level of job satisfaction (75.7 percent) and master’s/doctorally-prepared
nurses reporting the highest level (83.2 percent; see Appendix A, Table 34).
In each educational group, staff nurses report lower levels of job satisfaction compared to their
counterparts who are not staff nurses. This finding was true across all levels of educational preparation
(see Chart 24). For example, 81.7 percent of non-staff nurses whose highest educational preparation was
diploma reported being either extremely satisfied (34.4 percent) or moderately satisfied (47.3 percent)
with their jobs, while only 75.0 percent of staff nurses with the same educational preparation reported the
same (25.2 percent extremely satisfied, 49.8 percent moderately satisfied).

54

Chart 24. Percent of staff and non-staff RNs satisfied in their
jobs by highest nursing or nursing-related
educational preparation, March 2004*
100
90
80

Percent

70

63.0

60

49.851.9

50

53.352.1

41.543.3

40

34.432.6

30 25.2

47.347.6

50.4
43.7

40.6

31.5

22.021.022.0
14.8

20
10
0
Staff nurse

Non staff nurse

Staff nurse

Extremely satisfied

Non staff nurse

Moderately satisfied

*Only those who reported the educational preparation, principal position in nursing, and level of satisfaction with
that position were included in the calculations used for this chart.

Diploma

Associate Degree

Baccalaureate Degree

Master's Degree

Doctorate

Position appears to be a greater factor regarding job satisfaction than function. Non-staff nurses who
spend more than 50 percent of their time in direct patient care report higher moderate/extreme job
satisfaction (84.3 percent) than staff nurses spending similar amounts of time with patients (74.9 percent).

REGISTERED NURSES NOT EMPLOYED IN NURSING
In March 2004, 16.8 percent (488,006) of the 2,909,357 individuals with a license to practice nursing in
the United States were not employed in nursing. This estimate represents both a percentage and a
numerical decrease from 2000 (1.6 percent or 6,721 decrease) among those not employed in nursing.
About 6.2 percent of these RNs (30,278) were looking for employment in nursing (see Appendix A, Table
35). RNs not employed in nursing were older than RNs overall. On average, RNs not employed in
nursing were 54.1 years old, much older than the average age for RNs employed in nursing at 45.4 years
of age.
In 2004, 204,006 or 41.8 percent of RNs who were not employed in nursing had been employed in
nursing at some time within the 5-year period preceding the survey. Both the number and proportion of
RNs not employed in nursing with the past 5 years has declined from 2000, when 263,856 or 53.3 percent
of RNs were not employed in nursing within the 5-year period preceding the survey. The proportion of
RNs not currently employed in nursing and who have never worked in nursing remained similar; 1.4
percent in 2000 and 1.3 percent in 2004 (see Appendix A, Table 35). In the last two surveys (e.g. 2000

55

and 2004) a little over 22 percent of those not currently employed in nursing had not worked in nursing
for more than 10 years. Furthermore, only 9.1 percent of those not working in nursing for more than 10
years were currently seeking employment in nursing (see Appendix A, Table 35).
RNs who had most recently not worked in nursing were most likely to be actively seeking employment in
nursing. Nearly 19 percent (18.9 percent) of RNs who had left the nursing workforce within the year
preceding the survey were actively seeking nursing employment at the time of the survey (see Appendix
A, Table 35). This estimate is unchanged from the 2000 survey. The average age of RNs recently not
employed in nursing, 51.2 years of age, was younger than RNs not employed in nursing overall (54.1
years of age). Of the estimated 14 percent of RNs (488,006) who are not working in nursing, and
allowing for multiple responses, 49.3 percent were estimated to have left nursing for personal or family
reasons, 49.5 percent for personal career reasons, 42.7 percent for reasons connected with the workplace,
and 33.8 percent due to retirement.
Further analysis, by age distribution, of RNs not employed in nursing was undertaken (see Appendix A,
Table 36). Of those RNs not employed in nursing and over 65 years of age, the period of time since they
have been employed in nursing is well-distributed across all ranges, particularly between 1 and 19 years.
For all other age groupings between 30 and 64 years, the largest numbers of nurses were in the 1-to-4 year
range since last nursing employment compared to any of the other ranges of time since last nursing
employment. Of those nurses not employed in nursing, 250,769 (51.4 percent) were 55 years or older and
56.0 percent of the nurses not employed in nursing for 5-or-more years (115,103 RNs) are over 55 years
of age.

Nurses Seeking Nursing Employment
The 30,278 RNs not employed in nursing yet actively seeking nursing employment represent 1.0 percent
of all RNs in the United States. This percentage has not changed since the 2000 survey. These RNs were
more likely to have been employed in nursing more recently than other RNs not working in nursing.
Nearly 67 percent (66.5 percent) of RNs not employed in nursing but actively seeking nursing
employment at the time of the survey had been employed in nursing within the 5 years prior to the survey,
with most (41.3 percent) having been employed in nursing less than a year prior (see Appendix A, Table
35).
The majority of RNs not employed in nursing seeking employment as RNs are searching for part-time
employment (15,918 or 52.6 percent). Twenty-six percent of RNs actively seeking employment in
nursing are seeking full-time employment (see Appendix A, Table 37). Just over 18 percent (18.1
percent) were looking for either full or part-time employment.
Nurses Employed in Non-Nursing Occupations
An estimated 120,512 (4.1 percent) of all licensed RNs were employed in non-nursing occupations in
March 2004. This represents an 11.2 percent decrease in the number of RNs employed in non-nursing
occupations in 2000, reversing a trend of increased employment in non-nursing occupations that began in
1992. The RNs employed in non-nursing occupations include 2,209, or 1.8 percent, who have never
worked in nursing.
Over half (52.3 percent) of RNs employed in non-nursing occupations were working in health-related
occupations; almost 44 percent (43.9) reported working in non-health-related occupations (see Appendix
A, Table 38). This is different from 2000, when these percentages were reversed.

56

The most often reported health-related occupations outside of nursing were administration/management
(at 25.2 percent) and health-related service providers (21.1 percent). Pharmaceutical and medical
hardware services employed the third greatest portion of RNs in health-related occupations at 12.4
percent. RNs employed outside of nursing in non-health-related occupations were most often employed in
retail sales/services (19.7 percent), and administration/management (14.6 percent; see Appendix A, Table
39).
Like the 2000 survey, RNs employed in health-related non-nursing occupations were more likely to be
employed full-time. Nearly 71 percent (70.6 percent) of RNs employed in non-nursing health-related
occupations were employed full-time. In contrast, 45.5 percent of RNs employed in non-nursing nonhealth-related occupations were employed full-time (see Appendix A, Table 38).
RNs employed in non-nursing occupations predominantly cited career change (65.8 percent),
burnout/stressful work environment (44.9 percent), and scheduling problems/working too many hours
(41.4 percent) as the reasons why they were not employed in nursing at the time of the survey.
Significant portions also cited salary/pay better outside of nursing (34.0 percent), inadequate staffing
(33.3 percent), and taking care of home and family (29.6 percent) and physical demands of the job (28.1
percent; see Appendix A, Table 40).
Registered Nurses Not Employed in Nursing and Not Seeking Nursing Employment
The largest segment of RNs not employed in nursing were RNs neither employed in nor seeking
employment in nursing, which for the purposes of this study will be referred to as non-active RNs. This
group constituted 326,526 RNs, or 66.9 percent of all RNs not employed in nursing and 11.2 percent of
all RNs. Most of the non-active RNs were older nurses, at 55.3 years of age on average, compared to the
54.1 average age for all RNs not employed in nursing and 46.8 average age for all RNs overall. Slightly
less than half (46.4 percent) were at least 60 years of age. Only 14.5 percent were under the age of 40.
Overall, 75.1 percent of non-active RNs were married. However, of the non-active RNs younger than 40,
88.2 percent were married. Nearly 30 percent (29.9 percent) of all non-active RNs had children under
the age of 18 in their household. This was particularly true of married non-active RNs younger than 40.
An estimated 72.1 percent of these married RNs had children younger than age 6. An additional 15.9
percent only had children over age 6 but younger than age 18 (see Appendix A, Table 41). Twelve
percent of non-active RNs were caring for other adults in their home, and 15.3 percent were caring for
others outside of their home (see Appendix A, Table 42). Overall, 24.7 percent of non-active RNs were
providing care for someone inside or outside their home.
GEOGRAPHIC AND EMPLOYMENT MOBILITY
The survey instrument provided for the exploration of a number of changes that registered nurses might
experience during the course of their careers in nursing and the reasons for such changes. Among the
changes assessed were geographic location, movement in and out of the nursing workforce, and changes
in employment setting or employer within the field of nursing.
Location of Initial Nursing Education
One third (903,206 RNs or 33.3 percent) of RNs with current licenses to practice nursing in the United
States had received their initial nursing education in a different State than the State in which they were
located at the time of the survey (see Appendix A, Table 43).

57

As would be expected, the longer the time lapse since graduation from the initial nursing education
program, the more likely that the RN had moved to a different State. Nearly thirty-nine percent (38.7
percent) of the nurses who had graduated more than 15 years prior to the survey were in a different
location compared to 22.5 percent of those who had graduated within the past 5 years.
There were noticeable differences among the graduates from the different types of initial nursing
educational programs. Associate degree graduates were most likely to be located in the State where they
received their initial nursing education (74.0 percent). Sixty-one percent of both diploma and
baccalaureate graduates (61.0 percent) were located in the same State in which they had received their
initial nursing education (see Appendix A, Table 43).

Registered Nurses Educated Outside the United States
The number of RNs who received their initial RN education outside the United States increased about 1.3
percent, from 99,456 in 2000 to 100,791 in 2004. 25 Most foreign educated RNs were educated in the
Philippines (50.2 percent), followed by Canada (20.2 percent) and the United Kingdom (8.4 percent; see
Appendix A, Table 44). The same pattern was present in 2000, where 40.1 percent of foreign trained RNs
came from the Philippines, followed by Canada (16.6 percent), and the United Kingdom (9.3 percent).
Fully 59.5 percent (59,972) of foreign educated RNs were from an ethnic or racial minority background,
31.3 percent were white non-Hispanic (31,514), while 9.2 percent (9,305) did not report a race/ethnicity.
The most often represented minority group among foreign educated RNs was Asian non-Hispanic (48.9
percent or 49,297). The second most common was Black or African American non-Hispanic (6,707 or
6.7 percent) and Hispanic or Latino (2,110 or 2.1 percent). Not surprisingly, about 68.5 percent of
foreign-educated RNs speak at least one language other than English, most often Filipino (47.9 percent of
foreign-educated RNs). Over half of the foreign-educated nurses (54.7 percent) speak only one language
other than English, 12.1 percent speak two languages, and 1.6 percent speak three or more languages. A
large number (4.3 percent) speak Spanish, and almost equal numbers speak French or an Asian language
other than Filipino (3.7 percent and 3.6 percent, respectively).
The majority of foreign educated RNs received baccalaureate degrees as their initial nursing education
(48,781 or 48.4 percent) followed by diplomas (41,898 or 41.6 percent). In contrast, 30.5 percent of all
RNs received their initial nursing education in baccalaureate programs, and 42.2 percent of RNs received
their initial nursing education in associate degree program. Over half of the foreign-educated RNs were
estimated to have baccalaureate or higher degrees (59.2 percent), two percent of whom have doctorate
degrees. Over two percent of foreign-educated nurses in the 2004 survey (an estimated 2,446) were
APNs, of whom 65.8 percent were NPs, another 13.1 percent were CNSs, 11.1 percent were NP/CNS,
and 10 percent were NMs.
Nearly 90 percent (89.2 or 89,860 RNs) of foreign educated RNs were employed in nursing. Although all
States employ foreign educated RNs, the majority were concentrated in a handful of States in 2004.
Nearly seventy percent (69.7 percent) of foreign educated RNs worked in six States; California (28.6
percent), Florida (10.7 percent), New York (10.4 percent), Texas (7.5 percent), New Jersey (6.9 percent),
and Illinois (5.6 percent; see Appendix A, Table 45). Overall, foreign educated RNs are more likely than
RNs overall to be employed in hospitals (64.7 percent versus 56.2 percent of employed RNs overall) and

25

This excludes 3,083 RNs educated in U.S. territories such as Guam, Puerto Rico, and the U.S. Virgin Islands.

58

more likely to be staff nurses (72.6 percent versus 59.1 percent of employed RNs overall; see Appendix
A, Table 46).
Residence in March 2004 and 2003
At the time of the survey, most nurses were in same State in which they lived in 2003 (89.2 percent).
Only about 3 percent (2.6 percent) had changed their State of residence in the past year (between 2004
and 2003) (8.1 percent did not report if they had changed their State of residence). The youngest nurses
and the oldest nurses were the least likely to have changed their State of residence. Eight percent of the
nurses who changed their State of residence were less than 25 years old. Over 9 percent (9.3 percent) of
RNs aged 55-59, 5.3 percent of RNs age 60-64, and 3.3 percent of RNs over age 65 had changed their
State of residence between 2003 and 2004 (see Appendix A, Table 47).
Employment Status in 2004 and 2003
Among the 2,909,357 RNs living in the United States in 2004, most had the same employment status in
2003 and March 2004. Over nine out of ten (90.9 percent) of those employed full-time in nursing in 2004
were also employed full-time in nursing in 2003 (1,455,968 RNs). Over 13.2 percent of the 712,770 RNs
employed part-time in 2003 had changed their nursing employment status to full-time in 2004 and 5.5
percent of RNs employed full-time in nursing in 2003 had changed their status to part-time in 2004 (see
Appendix A, Table 48). Among the 480,831 RNs who were not employed in nursing in March 2003,
about 23.3 percent (112,954) were employed in nursing in March 2004. However, if those who were
newly licensed in 2003 or 2004 are excluded (60,853 or 12.7 percent of those not employed in nursing in
2003 and 2.1 percent of all RNs), only 52,101 (10.8 percent) of the RNs licensed before 2003 were not
employed in nursing in 2003 had become employed in 2004.
Employment Setting Changes
The majority of nurses were employed in the same setting in 2004 as they were in 2003. Eighty-nine
percent (88.8 percent) of registered nurses who were working in a hospital in 2004 were also working in a
hospital in 2003 (see Appendix A, Table 49).
In order to get more data on job market conditions for RNs, the NSSRN asked the nurses whether they
had changed employers or positions between 2003 and 2004 and if so, why. As Chart 25 shows, 62.4
percent of those in the RN population in March 2004 were employed both years in the same position.
Sixteen percent of nurses (16.1 percent or 467,566) were employed both years but changed employers
and/or positions. The remaining 21.5 percent were either unemployed in 2003 and/or 2004 or their status
was unknown in 2003. The majority of these nurses who were employed in the same positions in both
2003 and 2004 were moderately satisfied (51.0 percent) or extremely satisfied (27.6 percent) with their
principal nursing position; only 13.3 percent were estimated to be moderately or extremely dissatisfied
with their positions. In addition, of the nurses who changed employers, 73.2 percent (202,283) were
satisfied with their current position (47.5 percent were moderately satisfied and 25.7 percent were
extremely satisfied). RNs who switched employer and or positions in the past year were asked to report
the reasons for the change. Of all RNs who reported making an employer or position change within the
past year, a large proportion, 82.7 percent, cited a workplace issue as a reason for the change. The second
most common reason for changing employers/positions was for career considerations (57.4 percent; see
Appendix A, Table 50).

59

Chart 25. Changes in registered nurses’ employment status,
2003 to 2004*
Employed in 2004
and 2003, different
position/employer,
16.1%
Employed in 2004
and 2003, same
position/employer,
62.4%

Unknown
employment in 2003
and 2004, 12.6%
Employed in 2003
not 2004, 0.4%
Employed in 2004
not 2003, 0.6%
Employed in 2003
and 2004,
position/employer
unknown, 4.0%

Not employed in
2003 or 2004, 3.9%

*The totals for the distribution percents of the various combinations of 2003/2004
employment in nursing may not equal 100 percent due to the effects of rounding.

GEOGRAPHIC DISTRIBUTION OF THE REGISTERED NURSE POPULATION
The country as a whole had a 5.5 percent increase in the ratio of employed RNs to population ratio from
782 per 100,000 in 2000 to 825 per 100,000 in 2004. In 2004, as was true in 2000, the New England
region of the country had the highest concentration of employed nurses in relation to the area’s
population, with 1,107 employed RNs per 100,000 population. The West North Central area had the next
greatest concentration with 1,026 employed RNs per 100,000 population. The West South Central area
had one of the lowest concentrations, 677 RNs per 100,000 population. The Pacific region had the lowest
comparative concentration, with 645 employed RNs per 100,000 population in 2004. This largely reflects
the impact of the low ratio present in California, which had 589 RNs per 100,000 in 2004, up from 544
RNs per 100,000 in 2000. By comparison, the next lowest State ratio within the Pacific region was
Hawaii, with 739 RNs per 100,000 in 2004 and 703 RNs per 100,000 in 2000. The distribution of the
State-by-State ratios of employed nurses per 100,000 population is shown in Appendix A, Table 51.
Comparison of the ratios for each of the nine geographic regions or areas of the country shows that New
England had 71.6 percent more employed nurses per 100,000 population than did the Pacific area. In
terms of overall gains, the Pacific region ratio had the second largest increase (8.2 percent) since 2000
(when the ratio was 596 per 100,000). The East North Central region had the largest increase at 9.3
percent (from 831 RNs per 100,000 to 908 RNs per 100,000).
Distribution by State
The number of employed nurses per 100,000 residents varied by State in 2004 from a low of 589 in
California to a high of 2,093 in the District of Columbia. The proportion of the RN population employed
in nursing in each State in 2004 (i.e., the ratio of employed nurses in that State to the number of RNs

60

residing in that State) ranged from a low of 76.3 percent in Connecticut to a high of 95.6 percent in the
District of Columbia. However it should be noted that the District of Columbia has a large number of
RNs who do not reside in the District of Columbia, but are employed there. (Note: Approximately 4.3
percent of employed RNs, or 105,136 RNs, were employed in a State other than the one in which they
resided; a disproportionately large number of these RNs, 10,039 (9.6 percent), were employed in the
District of Columbia).
The RN population in each State ranged from a low of an estimated 4,498 in Wyoming to a high of
255,858 in California. Eight States had nurse populations of over 100,000 while six States had fewer than
10,000 nurses (see Appendix A, Table 51). The States with more than 100,000 nurses were New York,
Pennsylvania, Texas, Florida, Illinois, Ohio, Michigan, and California. The States with fewer than 10,000
nurses were Wyoming, Delaware, North Dakota, Montana, Alaska, and Vermont. The RN population
increased in all but four States between 2000 and 2004. The four States are Massachusetts, Pennsylvania,
Louisiana, and Wyoming. In one other State, West Virginia, there were marginal changes between 2000
and 2004. California, the State with the largest RN population, and part of the Pacific area, had a 13.0
percent increase in RN population (translating to an additional 29,506 RNs).
As shown in Table 52 of Appendix A, the proportion of employed nurses who worked on a part-time
basis also varied considerably from State to State. The proportion of nurses employed on a part-time
basis varied from a low of 17.9 percent in Arkansas to a high of 44.6 percent in Vermont. Five additional
states had high proportion of part-time employed RNs; Minnesota (44.2 percent), Massachusetts (42.3
percent), Wisconsin (41.5 percent), Oregon (41.0 percent), Washington (39.5 percent). All six of these
States had high proportions of part-time employed RNs in 2000.
Metropolitan Areas
The majority of RNs (83.9 percent) resided in metropolitan areas. This proportion varied across
geographic areas of the country as would be expected given the distribution of metropolitan areas across
the Nation. The highest concentrations of RNs living in metropolitan areas were found in the Middle
Atlantic (91.0 percent) and Pacific regions (90.2 percent), while the lowest were in the West North
Central (69.6 percent; see Appendix A, Table 53). As Table 53 further illustrates, RNs who were located
in metropolitan areas were slightly more likely than those in non-metropolitan areas (83.3 percent versus
82.4 percent) to be employed in nursing. This difference was particularly strong in the East North Central
region, where 87.1 percent of the RNs in metropolitan areas were employed versus 81.7 percent of RNs in
non-metropolitan areas.
Educational Background
RNs in the New England and the Middle Atlantic regions (at 21.7 and 21.2 percent respectively) were
more likely to report a diploma as their highest nursing or nursing-related education relative to other
regions. In fact, over one quarter of Pennsylvania RNs (27.5 percent) and 25.0 percent of Connecticut
RNs reported a diploma as their highest degree. RNs in the East South Central region were most likely to
report having an associate degree as their highest educational preparation (46.6 percent of all RNs in this
region held this as their highest degree). This is mainly from the high percentage of RNs with associate
degrees located in Mississippi (53.4 percent), and Kentucky (52.2 percent), far above the United States
average. On the other hand, North Dakota had the lowest percentage (16.0 percent) of RNs with an
associate degree as the highest educational preparation.
With respect to baccalaureate degrees, the regions were relatively similar, ranging from 31.0 percent of
RNs in the East South Central region to 38.2 percent in the Pacific region. However, there was great
variation between the States; ranging from 23.2 percent of RNs in Iowa to 51.6 percent in North Dakota.

61

New England had the most RNs with master’s and doctoral degrees (at 16.5 percent, compared with the
lowest rates in the West North and West South Central regions (both at 10.7 percent; see Appendix A,
Table 54).
Racial/Ethnic Background
The Pacific area had the highest proportion of minority (that is, non-white, Hispanic, or Latino) nurses at
19.0 percent. The predominant minority nurse group in the Pacific area were those of Asian background;
9.0 percent of the nurse population. In addition to the Pacific area, Asian nurses were also more likely to
be a part of the nurse population in the Middle Atlantic and West South Central areas (3.3 and 3.0 percent
respectively) than in other parts of the country. Black or African American (non-Hispanic) nurses were
more prevalent among the nurse populations in the South Atlantic (7.3 percent), West South Central (6.4
percent), and East South Central (6.3 percent) areas than elsewhere. Hispanic or Latino nurses, although
a relatively small proportion of any area’s nurse population, were more likely to be found among the
nurses in the Pacific (3.6 percent), West South Central (3.5 percent) and Mountain (2.7 percent) areas (see
Appendix A, Table 55).
Age Distribution
Nurses in the East South Central area of the country were more likely to be younger than were those in
other parts of the country, with an average age of 44.3 (compared to 46.8 for the Nation overall). New
England and Middle Atlantic RNs were the oldest at an average of 48.3 and 48.2 years old respectively
(see Chart 26). About 34.4 percent of East South Central RNs were less than 40 years old, compared with
22 to 30 percent of nurses in other areas of the country. New England and Middle Atlantic region nurses
were the least likely to be in this younger age group; in both areas, only 22 percent were less than 40
years old (see Appendix A, Table 56).

62

Chart 26. Chart
Average
age of registered
nursesnurses
by region
26. Average
age of registered
by region, March 2004*
Age
50
49

48.3

48.2

48.0

48
47.0

46.8

47

46.2

46

45.5

45.7

45

44.3

44
43
42
41
40
New
England

Middle
Atlantic

South
Atlantic

East
South
Central

West
South
Central

East North
Central

West
North
Central

Mountain

Pacific

*Only those who reported age information are included in the calculations used for this chart.

Employment Settings
As expected, the predominant employment setting for the nurses in each area was a hospital setting. The
proportion of the nurse supply working in hospitals in each area ranged from a low of 50.3 percent of
New England RNs to a high of 59.0 percent in the Pacific region. The New England and West North
Central areas were more likely than the other areas to have higher proportions of their nurses employed in
nursing homes or other extended care facilities (9.8 and 8.4 percent respectively). At 12.2 percent, New
England had the highest proportion of nurses employed in public/community health settings, the West
North Central and Pacific regions had the least (at 9.8 percent each). New England also had the highest
percentage of RNs employed in school health settings at 6.3 percent, while the East South Central region
had the least (1.9 percent). Every region but New England (9.8 percent) had more than 10 percent of their
registered nurses employed in ambulatory care settings. Compared with the other regions, the Mountain
region, at 13.0 percent, had the highest proportion of RNs employed in ambulatory care (see Appendix A,
Table 57).
Changes in Employers and/or Positions
As reported previously, 16.1 percent of the entire RN population was employed in both 2003 and 2004
but changed employers and/or positions between those dates. Nurses from the Mountain (19.6 percent)
and West South Central (19.1 percent) sections of the country were more likely to have changed
employers or positions than other regions. Nurses in New England were the least likely to have made a
change (14.6 percent). Nurses in different regions of the country gave approximately the same
percentages of reasons for changing employers or positions. The top reason cited overall was an interest

63

in another position or job, with 51.4 percent of all RNs that changed jobs citing that reason. This is a
large increase from 2000, when only 17.8 percent of RNs who changed jobs cited that reason. (However,
this may be partly due to the change in questionnaire specifications where the 2004 question allowed
multiple categories to be chosen by the respondent for the first time.) The other top reason listed by
nurses overall was burnout/stressful work environment, with 46.0 percent of all RNs that changed jobs
naming this as their principal reason for change (see Appendix A, Table 50).
Average Earnings within Geographic Area for Staff Nurses
The average annual earnings of full-time staff nurses in each of the nine geographic regions were
examined to get some indication of variations in earnings across the country. The average earnings for
full-time staff nurses in their principal positions ranged from $46,108 in the West North Central area to
$64,685 in the Pacific area (see Appendix A, Table 58). The areas where earnings reached above the
national average for full-time staff nurses, $53,086, included the Middle Atlantic ($56,960), New England
($57,451), and Pacific regions ($64,685).
There were some geographic variations in the rate at which earnings increased among the nine regions.
Earnings of full time staff nurses in the Mountain (6.9 percent) and Pacific (6.7 percent) regions increased
at a higher annual rate than those in the remaining regions.
Compact States
By 2004, a total of 17 States had entered into a formal arrangement, called the “Nurse Licensure
Compact”, or “Compact” such that RNs who are living and licensed in one Compact State, can practice in
other Compact States without needing additional license(s). An estimated 22.9 percent of RNs reported
permanent residency and licensure in Compact States. The seven largest States, which together cover
more than three-quarters of the nurses eligible under Compacts, are: Texas (24.5 percent of the 665,593
nurses in Compacts), North Carolina (13.3 percent), Wisconsin (9.4 percent), Tennessee (8.8 percent),
Maryland (7.9 percent), Arizona (6.8 percent), and Iowa (5.6 percent).

64

APPENDIX A

APPENDIX A

TABLES

A-1
46.8
47.0

61,778
171,659
243,182
289,525
408,248
508,708
463,565
338,078
210,196
185,254
29,165

2.1
5.9
8.4
10.0
14.0
17.5
15.9
11.6
7.2
6.4
1.0

81.8
4.2
2.9
0.2
0.3
1.7
1.4
7.5

5.8
94.2
0.0

100.0

588
1,981
2,794
3,280
4,481
5,718
5,160
3,361
1,667
928
275

45.4
46.0

59,592
159,676
221,052
256,967
360,249
449,797
406,748
271,264
136,191
75,305
24,511

24,958 1,966,330
1,146 106,644
863
75,943
55
4,613
141
8,347
450
42,262
451
35,554
2,169 181,658

1,937 148,642
28,283 2,271,717
13
993

30,233 2,421,351

2.5
6.6
9.1
10.6
14.9
18.6
16.8
11.2
5.6
3.1
1.0

81.2
4.4
3.1
0.2
0.3
1.7
1.5
7.5

6.1
93.8
0.0

100.0

21
136
259
366
515
689
656
738
810
1,157
55

4,603
151
100
10
16
62
68
392

229
5,171
2

5,402

54.1
55.0

2,186
11,983
22,130
32,557
47,999
58,910
56,817
66,814
74,006
109,949
4,655

414,199
15,850
8,440
981
1,106
5,747
5,690
35,993

19,539
468,427
40

488,006

0.4
2.5
4.5
6.7
9.8
12.1
11.6
13.7
15.2
22.5
1.0

84.9
3.2
1.7
0.2
0.2
1.2
1.2
7.4

4.0
96.0
0.0

100.0

Employment status
Employed in nursing
Not employed in nursing
Number
Number
Estimated
Estimated
in sample Number
Percent in sample Number
Percent

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Average age
Median age

609
2,117
3,053
3,646
4,996
6,407
5,816
4,099
2,477
2,085
330

29,561 2,380,529
1,297 122,495
963
84,383
65
5,594
157
9,453
512
48,009
519
41,244
2,561 217,651

Racial/ethnic background
White (non-hispanic)
Black/African American (non-hispanic)
Asian (non-hispanic)
Native Hawaiian/Pacific Islander (non-hisp)
American Indian/Alaska Native (non-hisp)
Hispanic/Latino (any race)
Two or more races (non-hispanic)
Not known

Age group
Less than 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 and over
Not known

2,166 168,181
33,454 2,740,144
15
1,033

35,635 2,909,357

Number
in sample

Total
Estimated
Number
Percent

Gender
Male
Female
Not known

Total

Gender, racial/ethnic background
and age group

Table 1. Registered nurse population, by employment status, gender, racial/ethnic background, and age group: March 2004

APPENDIX A

A-2
A
All Graduates
29.6
31.0
31.0
28.4
23.8

3,103 265,243
4,968 386,296
4,971 383,182
4,157 336,771
17,780 1,483,436
656
54,430

35,635 2,909,357

9.1
13.3
13.2
11.6
51.0
1.9

100.0

Total
Number
Estimated
in sample Number* Percent

Diploma
31.8
30.2
28.9
25.5
22.0

7,377
22,360
32,629
43,476
623,368
4,169

733,377

1.0
3.0
4.4
5.9
85.0
0.6

12.3
17.8
18.8
14.2
36.1
0.8

100.0

Associate Degree
31.8
33.3
33.2
31.0
26.7

151,005
218,476
230,913
173,976
442,643
10,244

100.0 1,227,256

11.7
16.0
13.1
13.0
45.6
0.5

100.0

Baccalaureate and Higher
26.3
27.5
27.2
25.5
23.4

105,922
144,766
118,072
117,783
411,283
4,800

902,625

Type of Initial Nursing Education
Baccalaureate
and higher degree
Diploma
Associate Degree
Number
Percent
Number
Percent
Number
Percent

* Includes 14,979 nurses whose initial nursing education was in a master's degree program, 532 in a doctoral degree program, and 46,098
for whose initial nursing education was not known.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Average age at graduation
by year of graduation
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier

Year of graduation from
initial nursing education
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier
Not known

Total

Year of graduation/age at graduation
from initial nursing education

Table 2. Year of graduation from initial nursing education and the average age at graduation
for the registered nurse population, by type of initial nurse education: March 2004

THE REGISTERED NURSE POPULATION

100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

12,631
4,729
2,327
455
2,574
490
190
226
123
131
122
176
56
491

Nursing Aide
Licensed practical/vocational nurse
Allied health
Manager in health care setting
Clerk in health care setting
Allied health position
Volunteer
Home health/personal services aide
Student nurse
Counselor/social worker/activity therapists/Chaplain
Other services or support aide personnel in health care
Armed services medic/corpsman or similar role
Other non-health related work
Other health

A-3

186,929
28,644
19,886
3,712
26,110
5,896
7,786
1,868
1,447
856
3,555
2,088
1,042
6,379

257,530
19.1
7.9
10.8
9.6
12.5
15.3
47.5
9.5
14.8
8.0
39.8
15.5
22.8
15.8

17.0

460,759
292,365
115,161
25,125
117,074
20,215
4,014
10,265
1,901
5,431
2,642
7,377
2,318
19,152

797,925

47.1
80.2
62.5
66.1
56.1
52.6
24.5
52.0
19.5
50.9
29.6
54.7
49.4
47.6

52.8

326,650
41,927
48,427
8,921
64,973
12,070
4,565
7,606
6,328
4,162
2,664
3,919
1,328
14,481

451,499

33.4
11.5
26.3
23.5
31.1
31.4
27.8
38.5
64.8
39.0
29.8
29.1
28.3
36.0

29.9

Type of Initial Nursing Education
Baccalaureate
Diploma
Associate Degree
and higher degree
Number
Percent
Number
Percent
Number
Percent

*Includes 5,304 nurses whose initial education was unknown
**Health occupation entries may add to more than the total because more than one occupation may have been named by an individual RN
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

977,354
364,527
184,266
37,922
208,797
38,429
16,392
19,739
9,772
10,667
8,934
13,486
4,687
40,260

100.0

19,160 1,512,066

Total

Health occupation prior to initial nursing education**

Total
Estimated
Number
in sample Number* Percent

Table 3. Health occupation prior to initial nursing education, by type of initial nursing education: March 2004

APPENDIX A

A-4

740
1,017
1,252
1,049
2,036
92

6,186

Average age
33.9
35.2
34.8
32.7
27.6

53,273
72,399
86,635
83,038
182,414
7,050

484,809

11.0
14.9
17.9
17.1
37.6
1.5

100.0

Total
Number
Estimated
in sample Number* Percent

Average age
42.3
36.0
33.9
28.7
25.1

533
2,879
3,852
6,260
31,539
570

45,633

1.2
6.3
8.4
13.7
69.1
1.2

100.0

Average age
34.0
35.3
35.2
34.0
29.4

47,931
61,745
71,823
63,501
111,488
5,558

362,046

13.2
17.1
19.8
17.5
30.8
1.5

100.0

Average age
32.5
34.2
32.3
27.9
24.3

4,760
7,557
10,906
12,780
38,570
488

75,061

6.3
10.1
14.5
17.0
51.4
0.7

100.0

Type of Initial Nursing Education
Baccalaureate
and higher degree
Diploma
Associate Degree
Number
Percent
Number
Percent
Number
Percent

* Includes an estimated 62,340 nurses who are also included in Table 3, and an estimated 2,070 nurses for whom type of basic education was not reported.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Average age at graduation
by year of graduation
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier

Year of graduation from
initial nursing education
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier
Not known

Total

Year of graduation/age at graduation
from initial nursing education after being
LPN/LVN

Table 4. Registered nurses who were ever licensed as practical/vocational nurse,
by type of initial nursing education: March 2004

THE REGISTERED NURSE POPULATION

A-5

1,544
1,019
548
469
1,805
24
43
109
162
852
1,381
1,165
734
1,613
62

Major field of study before initial nursing ed
Health related field
Biological or physical science
Business management
Education
Liberal arts
Law
Computer science
Social work
Other non-health-related field

Year of graduation from initial nursing education
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier
Not known
Average age
32.6
32.9
33.8
31.5
27.8

69,977
107,784
89,163
61,737
137,915
5,027

126,083
79,921
45,012
38,655
150,821
1,718
2,976
8,489
11,210

247,962
236,871
19,441
1,413
3,170

14.8
22.9
18.9
13.1
29.2
1.1

26.7
16.9
9.5
8.2
32.0
0.4
0.6
1.8
2.4

52.6
50.2
4.1
0.3
0.7

Average age
32.8
33.1
32.9
30.2
26.6

2,084
6,579
5,693
5,820
22,121
83

11,472
6,396
3,895
4,243
13,909
40
646
197
677

20,840
22,379
1,582
38
203

4.9
15.5
13.4
13.7
52.2
0.2

27.1
15.1
9.2
10.0
32.8
0.1
1.5
0.5
1.6

49.2
52.8
3.7
0.1
0.5

Average age
34.2
34.3
35.3
32.9
29.2

37,555
55,734
51,704
33,410
63,883
3,197

67,090
33,746
28,093
23,962
75,702
1,188
1,547
5,130
5,802

153,255
98,363
9,616
814
2,891

* Includes 2,413 RNs for whom type of initial nursing education was not reported
NOTE: The number of degrees may add to more than the totals because more than one degree may have been named
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Average age at graduation by year of graduation
2000 or later
1995-1999
1990-1994
1985-1989
1984 or earlier

2,994
2,944
250
21
55

Degree obtained before initial nursing education
Associate degree
Baccalaureate
Master's degree
Doctorate
Other

Total

Characteristics of nurses with prior degrees

15.3
22.7
21.1
13.6
26.0
1.3

27.3
13.7
11.4
9.8
30.8
0.5
0.6
2.1
2.4

62.4
40.1
3.9
0.3
1.2

Average age
30.7
31.0
31.4
29.7
26.5

29,766
45,006
31,408
22,373
51,328
1,443

47,213
39,121
12,929
10,137
60,568
490
783
2,944
4,551

72,785
114,885
8,121
561
67

16.4
24.8
17.3
12.3
28.3
0.8

26.0
21.6
7.1
5.6
33.4
0.3
0.4
1.6
2.5

40.1
63.4
4.5
0.3
0.0

Type of Initial Nursing Education
Total
Baccalaureate
Number
and higher degree
Estimated
Diploma
Associate Degree
in sample Number* Percent
Number
Percent
Number
Percent
Number
Percent
5,807 471,603
100.0
42,380
100.0 245,484
100.0 181,325
100.0

Table 5. Characteristics of registered nurses with post-high school academic degree before entering
initial nursing education, by type of initial nursing education: March 2004

APPENDIX A

A-6
63,581

268,747
9,131
18,657
2,854
234,208
3,897

526,370
13,300
137,283
14,683
355,309
5,795

2.2

9.2
0.3
0.6
0.1
8.1
0.1

18.1
0.5
4.7
0.5
12.2
0.2

70.5
7.8
22.4
5.6
34.2
0.6

448

2,348
82
182
24
2,034
26

4,284
127
1,275
143
2,708
31

38,399

200,166
7,480
15,184
2,172
173,018
2,311

342,527
9,902
102,696
11,992
215,502
2,435

14,116 1,115,716
1,351 106,620
4,698 369,212
1,012
75,269
6,967 557,527
88
7,087

21,196 1,696,807

2.3

11.8
0.4
0.9
0.1
10.2
0.1

20.2
0.6
6.1
0.7
12.7
0.1

65.8
6.3
21.8
4.4
32.9
0.4

100.0

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

734

3,147
106
223
33
2,743
42

Never married
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown

Not known

6,415
173
1,675
184
4,321
62

25,339 2,050,659
2,774
225,572
8,074
650,793
2,099
162,791
12,192
994,588
200
16,916

100.0

170

451
22
29
6
389
5

1,135
32
248
33
812
10

14,333

36,591
1,552
2,517
405
31,706
411

92,121
2,183
20,678
2,175
66,124
960

7,237 577,238
1,087 88,714
2,496 202,398
809 63,202
2,798 219,749
47
3,175

8,993 720,283

2.0

5.1
0.2
0.3
0.1
4.4
0.1

12.8
0.3
2.9
0.3
9.2
0.1

80.1
12.3
28.1
8.8
30.5
0.4

100.0

8

2
0
0
0
2
0

7
0
3
0
4
0

27
4
8
2
12
1

44

1,000

142
0
0
0
142
0

566
0
350
0
216
0

2,553
275
778
304
1,181
15

4,261

23.5

3.3
0.0
0.0
0.0
3.3
0.0

13.3
0.0
8.2
0.0
5.1
0.0

59.9
6.5
18.2
7.1
27.7
0.4

100.0

108

346
2
12
3
318
11

989
14
149
8
797
21

9,849

31,848
99
956
277
29,342
1,175

91,156
1,214
13,558
516
73,468
2,400

3,959 355,154
332 29,963
872 78,405
276 24,016
2,415 216,131
64
6,639

5,402 488,006

2.0

6.5
0.0
0.2
0.1
6.0
0.2

18.7
0.2
2.8
0.1
15.1
0.5

72.8
6.1
16.1
4.9
44.3
1.4

100.0

Employment status
Employed in nursing
Employed in nursing
Employed in nursing
Total
full-time
part-time
full-time/part-time unknown
Not employed in nursing
Number
Number
Number
Number
Estimated
Estimated
Estimated
Estimated
Estimated
Number Percent in sample Number Percent in sample Number Percent in sample Number Percent in sample Number Percent

35,635 2,909,357

Number
in sample

Widowed/separated/divorced
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown

Married
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown

Total

Marital status and presence of
children

Table 6. Marital status and presence of children, by employment status
in principal nursing position: March 2004

THE REGISTERED NURSE POPULATION

A-7
63,581

268,747
17,359
247,491
3,897

526,370
82,689
437,886
5,795

2.2

9.2
0.6
8.5
0.1

18.1
2.8
15.1
0.2

200,166
28,744
169,110
2,311

342,527
70,507
269,585
2,435

448

2,348
143
2,179
26

4,284
727
3,526
31

38,399

200,166
12,482
185,373
2,311

342,527
57,989
282,103
2,435

14,116 1,115,716
2,538 200,216
11,490 908,412
88
7,087

2,348
308
2,014
26

4,284
822
3,431
31

14,116 1,115,716
2,424 204,921
11,604 903,707
88
7,087

21,196 1,696,807

2.3

11.8
0.7
10.9
0.1

20.2
3.4
16.6
0.1

65.8
11.8
53.5
0.4

11.8
1.7
10.0
0.1

20.2
4.2
15.9
0.1

65.8
12.1
53.3
0.4

100.0

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

734

3,147
203
2,902
42

Never married
Other living elsewhere
No other elsewhere
Unknown if other

Not known

6,415
1,020
5,333
62

Widowed/separated/divorced
Other living elsewhere
No other elsewhere
Unknown if other

70.5
12.0
57.9
0.6

Marital status/care for others living elsewhere
Married
25,339 2,050,659
Others living elsewhere
4,308 350,292
No others elsewhere
20,831 1,683,452
Unknown if others
200
16,916

18.1
3.4
14.5
0.2
9.2
1.3
7.8
0.1

3,147
407
2,698
42

Never married
Adults at home
No adults at home
Not known if adults at home

526,370
98,303
422,271
5,795

70.5
11.2
58.7
0.6

100.0

268,747
37,716
227,134
3,897

6,415
1,113
5,240
62

25,339 2,050,659
3,809 326,689
21,330 1,707,054
200
16,916

35,635 2,909,357

36,591
5,396
30,783
411

92,121
15,151
76,010
960

170

451
31
415
5

1,135
157
968
10

14,333

36,591
2,273
33,907
411

92,121
12,543
78,618
960

7,237 577,238
1,115 90,152
6,075 483,911
47
3,175

451
62
384
5

1,135
162
963
10

7,237 577,238
870 72,779
6,320 501,283
47
3,175

8,993 720,283

2.0

5.1
0.3
4.7
0.1

12.8
1.7
10.9
0.1

80.1
12.5
67.2
0.4

5.1
0.7
4.3
0.1

12.8
2.1
10.6
0.1

80.1
10.1
69.6
0.4

100.0

8

2
0
2
0

7
0
7
0

27
5
21
1

2
0
2
0

7
1
6
0

27
3
23
1

44

1,000

142
0
142
0

566
0
566
0

2,553
607
1,931
15

142
0
142
0

566
159
407
0

2,553
323
2,214
15

4,261

23.5

3.3
0.0
3.3
0.0

13.3
0.0
13.3
0.0

59.9
14.2
45.3
0.4

3.3
0.0
3.3
0.0

13.3
3.7
9.6
0.0

59.9
7.6
52.0
0.4

100.0

31,848
3,576
27,097
1,175

91,156
12,486
76,269
2,400

108

346
29
306
11

989
136
832
21

9,849

31,848
2,604
28,069
1,175

91,156
12,157
76,598
2,400

3,959 355,154
650 59,317
3,245 289,198
64
6,639

346
37
298
11

989
128
840
21

3,959 355,154
512 48,666
3,383 299,849
64
6,639

5,402 488,006

2.0

6.5
0.5
5.8
0.2

18.7
2.5
15.7
0.5

72.8
12.2
59.3
1.4

6.5
0.7
5.6
0.2

18.7
2.6
15.6
0.5

72.8
10.0
61.4
1.4

100.0

Employment status
Employed in nursing
Employed in nursing
Employed in nursing
Total
full-time
part-time
full-time/part-time unknown
Not employed in nursing
Number
Number
Number
Number
Number
Estimated
Estimated
Estimated
Estimated
Estimated
in sample Number Percent in sample Number Percent in sample Number Percent in sample Number Percent in sample Number Percent

Widowed/separated/divorced
Adults at home
No adults at home
Not known if adults at home

Marital status/presence of adults
Married
Adults at home
No adults at home
Not known if adults at home

Total

Marital status and caring for
adults at home or others
elsewhere

Table 7. Marital status and caring for other adults at home or others elsewhere,
by employment status in principal nursing position: March 2004

APPENDIX A

A-8
122
223
579
2,061
5,859
6,802
5,886
2,516
1,291

370
640
1,325
4,499
9,436
8,046
6,416
2,693
2,210

9,676
17,429
44,507
157,010
447,802
549,292
493,862
221,349
109,732

30,676
54,302
103,379
354,601
739,763
658,044
541,889
237,572
189,130

0.3
0.6
1.5
5.4
15.4
18.9
17.0
7.6
3.8

1.1
1.9
3.6
12.2
25.4
22.6
18.6
8.2
6.5

100.0

Total
Estimated
Number
Percent

35,635 2,909,357

Number
in sample

6
16
125
931
3,402
4,233
3,748
1,196
459

12
41
399
2,670
6,375
5,226
4,167
1,330
976

267
860
8,343
68,737
253,115
335,411
310,755
101,275
36,953

977
3,545
29,123
206,593
492,525
421,851
348,209
113,103
80,882

21,196 1,696,807

0.0
0.1
0.5
4.1
14.9
19.8
18.3
6.0
2.2

0.1
0.2
1.7
12.2
29.0
24.9
20.5
6.7
4.8

100.0

Employed in nursing
full-time
Estimated
Number
in sample Number
Percent

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

$ 15,000 or less
$ 15,001 - $ 25,000
$ 25,001 - $ 35,000
$ 35,001 - $ 50,000
$ 50,001 - $ 75,000
$ 75,001 - $100,000
$100,001 - $150,000
More than $150,000
Not reported

Married

$ 15,000 or less
$ 15,001 - $ 25,000
$ 25,001 - $ 35,000
$ 35,001 - $ 50,000
$ 50,001 - $ 75,000
$ 75,001 - $100,000
$100,001 - $150,000
More than $150,000
Not reported

Total

Marital status and household
income

40
83
193
628
1,699
1,897
1,573
720
404

99
247
445
1,086
2,084
2,050
1,630
741
611

8,993

2,926
5,627
13,943
44,839
129,391
153,898
131,506
61,986
33,122

7,423
18,332
32,448
82,163
160,498
167,119
137,260
64,182
50,858

720,283

0.4
0.8
1.9
6.2
18.0
21.4
18.3
8.6
4.6

1.0
2.5
4.5
11.4
22.3
23.2
19.1
8.9
7.1

100.0

0
1
1
3
2
9
3
3
5

0
1
1
6
8
9
3
3
13

44

0
102
122
186
230
781
309
412
411

0
102
122
395
730
781
309
412
1,411

4,261

0.0
2.4
2.9
4.4
5.4
18.3
7.2
9.7
9.6

0.0
2.4
2.9
9.3
17.1
18.3
7.2
9.7
33.1

100.0

76
123
260
499
756
663
562
597
423

259
351
480
737
969
761
616
619
610

6,483
10,840
22,099
43,248
65,066
59,202
51,293
57,677
39,246

22,276
32,324
41,686
65,449
86,011
68,294
56,111
59,876
55,980

5,402 488,006

1.3
2.2
4.5
8.9
13.3
12.1
10.5
11.8
8.0

4.6
6.6
8.5
13.4
17.6
14.0
11.5
12.3
11.5

100.0

Employment status
Employed in nursing
Employed in nursing
part-time
full-time/part-time unknown
Not employed in nursing
Estimated
Estimated
Estimated
Number
Number
Number
in sample Number Percent in sample Number Percent in sample Number Percent

Table 8. Distribution of registered nurses according to total household income,
by marital and employment status: March 2004

THE REGISTERED NURSE POPULATION

A-9
6,422
1,730

Non-government
scholarship, loan or grant

Other sources
41,563

136,916

495,006

1.4

4.7

17.0

18.2

13.2
22.1

8.2

48.2

53.0

2,202

40,697

122,544

80,326

51,854
71,651

32,483

483,948

270,866

0.3

5.5

16.7

11.0

7.1
9.8

4.4

66.0

36.9

2,793

50,434

160,518

229,723

182,204
274,093

151,087

335,719

833,475

0.2

4.1

13.1

18.7

14.8
22.3

12.3

27.4

67.9

1,389

44,102

207,039

214,961

145,419
289,296

53,550

570,848

421,972

* Source of fundings may add to more than the total because more than one financial resource may be named
**Includes an estimated 46,098 for whom initial nursing degree not known
NOTE: Estimated numbers may not equal total and percents may not add to 100 because of rounding

479

6,699

State or local government
scholarship, loan or grant

Unknown sources

384,303
643,097

5,088
8,527
529,382

239,588

3,074

16,816 1,401,009

Family resources
Employer tuition,
reimbursement plan
Federal traineeship,
scholarship or grant
Federally assisted loan

19,245 1,541,250

Personal resources

Total*

Financial resources used

0.2

5.0

23.3

24.2

16.4
32.6

6.0

64.3

47.6

0

551

3,566

2,839

3,561
5,848

1,559

5,958

9,841

0.0

3.6

23.0

18.3

23.0
37.7

10.1

38.4

63.4

Type of Initial Nursing Education
Total
Diploma
Associate Degree
Baccalaureate
Masters/Doctorate
Number
Estimated
Estimated
Estimated
Estimated
Estimated
in sample Number** Percent Number Percent
Number
Percent Number Percent Number Percent
35,635 2,909,357
100.0 733,377
100.0 1,227,256
100.0 887,114
100.0
15,511
100.0

Table 9. Financial resources used for tuition and fees for initial nursing education, by type of initial nursing degree: March 2004

APPENDIX A

4,527
10,709
646
9,976
891
2,784
124
128
448
5,402
1,520
1,339
192
1,530
264
398
45
18
96

Diploma
Associate degree
Baccalaureate in related field
Baccalaureate in nursing
Masters in related field
Masters in nursing
Doctorate in related field
Doctorate in nursing
Not known

Total not employed in nursing

A-10

Diploma
Associate degree
Baccalaureate in related field
Baccalaureate in nursing
Masters in related field
Masters in nursing
Doctorate in related field
Doctorate in nursing
Not known

28.8
24.4
3.6
27.7
4.8
7.5
1.1
0.3
1.9

100.0

15.3
35.6
2.2
32.5
2.9
9.1
0.4
0.4
1.6

100.0

17.5
33.7
2.5
31.7
3.2
8.8
0.5
0.4
1.6

1,520
22
116
182
104
106
18
4
9

2,081

4,527
81
360
831
233
461
37
44
5

6,579

6,047
103
476
1,013
337
567
55
48
14

140,468
2,310
10,583
16,519
9,874
9,387
2,005
184
1,106

192,436

369,741
7,270
30,459
68,810
19,482
36,802
3,813
4,110
454

540,941

510,209
9,579
41,042
85,329
29,357
46,189
5,818
4,294
1,560

73.0
1.2
5.5
8.6
5.1
4.9
1.0
0.1
0.6

100.0

68.4
1.3
5.6
12.7
3.6
6.8
0.7
0.8
0.1

100.0

69.6
1.3
5.6
11.6
4.0
6.3
0.8
0.6
0.2

0
970,752
30,106
145,797
22,770
51,318
2,472
990
3,051

0
1,315
73
192
61
53
10
2
8

1,714

0
10,619
285
1,620
228
579
20
12
23

0
116,761
6,667
18,226
5,329
5,200
1,331
186
932

154,631

0
853,991
23,439
127,571
17,442
46,117
1,142
804
2,120

13,386 1,072,626

0
11,934
358
1,812
289
632
30
14
31

0.0
75.5
4.3
11.8
3.4
3.4
0.9
0.1
0.6

100.0

0.0
79.6
2.2
11.9
1.6
4.3
0.1
0.1
0.2

100.0

0.0
79.1
2.5
11.9
1.9
4.2
0.2
0.1
0.2

0
0
0
1,153
97
215
17
10
0

1,492

0
0
0
7,517
427
1,579
65
62
0

9,650

0
0
0
8,670
524
1,794
82
72
0

0
0
0
100,095
7,982
19,899
1,846
738
0

130,560

0
0
0
590,525
33,651
123,214
4,353
4,811
0

756,554

0
0
0
690,620
41,633
143,113
6,198
5,549
0

* Includes 14,979 nurses whose initial nursing education was in a master's degree program, 532 in a doctoral degree program, and 46,098 whose initial
nursing education was not known. Also includes 170 initial masters in nursing updated to doctorate in nursing, of which all are employed in nursing.
In addition, includes 13 initial masters in nursing upgraded to non-nursing doctorates, of which all are employed in nursing
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

140,468
119,290
17,601
135,121
23,449
36,492
5,181
1,305
9,098

488,006

369,741
861,949
53,979
787,575
70,937
219,924
9,371
10,243
37,634

30,233 2,421,351

Total employed in nursing

510,209
981,238
71,580
922,696
94,386
256,415
14,552
11,548
46,733

6,047
12,048
838
11,506
1,155
3,182
169
146
544

Diploma
Associate degree
Baccalaureate in related field
Baccalaureate in nursing
Masters in related field
Masters in nursing
Doctorate in related field
Doctorate in nursing
Not known

0.0
0.0
0.0
76.7
6.1
15.2
1.4
0.6
0.0

100.0

0.0
0.0
0.0
78.1
4.4
16.3
0.6
0.6
0.0

100.0

0.0
0.0
0.0
77.9
4.7
16.1
0.7
0.6
0.0

Type of Initial Nursing Education
Highest nursing or nursing-related
Total
Diploma
Associate Degree
Baccalaureate
education
Number
Number
Number
Number
Estimated
Estimated
Estimated
Estimated
in sample Number* Percent in sample Number Percent in sample Number
Percent in sample Number Percent
Total
35,635 2,909,357
100.0
8,660 733,377
100.0
15,100 1,227,256
100.0
11,142 887,114
100.0

Table 10. Registered nurse population, by initial nursing and highest nursing or nursing-related education: March 2004

THE REGISTERED NURSE POPULATION

APPENDIX A

Table 11. Primary focus of post-RN master's and doctoral degree*: March 2004

Primary focus of degree

Total
Clinical practice***
Education
Supervision/administration
Research
Law
Informatics
Business
Public health
Social science
Humanities
Basic sciences
Computer science
Social work
Other
Not known

Master's degree**
Number
Estimated
in sample
Number
Percent

Doctoral degree**
Number
Estimated
in sample
Number
Percent

4,802

391,472

100.0

465

40,038

100.0

2,132
633
670
15
3
19
220
272
57
40
35
10
41
256
399

171,320
52,359
56,788
960
270
1,404
18,998
20,849
4,995
3,069
2,813
789
3,228
20,577
33,053

43.8
13.4
14.5
0.2
0.1
0.4
4.9
5.3
1.3
0.8
0.7
0.2
0.8
5.3
8.4

25
106
39
87
51
0
5
13
22
6
2
0
0
35
74

2,330
8,530
3,794
7,106
4,538
0
512
942
2,079
454
167
0
0
3,146
6,441

5.8
21.3
9.5
17.7
11.3
0.0
1.3
2.4
5.2
1.1
0.4
0.0
0.0
7.9
16.1

* Includes degrees in nursing or nursing-related areas
**Nurses may have reported multiple masters or doctorate degrees. In such cases the
masters/doctorate in nursing takes precedence and is the only degree at that level shown here.
***Excludes 14,797 nurses whose initial education was in a master's degree program and
532 in a doctoral degree program, which are all in clinical practice.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-11

THE REGISTERED NURSE POPULATION

Table 12. Current enrollment of registered nurses in nursing or nursing-related
academic degree educational programs*, by employment status
and student status: March 2004
Employment and student status
Total
Employed in nursing full-time
Total
Full-time student
Part-time student
Student status not known
Employed in nursing part-time
Total
Full-time student
Part-time student
Student status not known
Employed in nursing ft/pt unknown
Total
Full-time student
Part-time student
Student status not known
Not employed in nursing
Total
Full-time student
Part-time student
Student status not known

Number
in sample
2,125

Current enrollment
Estimated
Number
172,150

Percent
100.0

1,524
363
1,121
40

124,256
27,753
92,916
3,587

72.2
22.3
74.8
2.9

452
146
290
16

35,068
11,202
22,664
1,202

20.4
6.5
13.2
0.7

3
1
1
1

403
122
159
122

0.2
0.1
0.1
0.1

146
58
78
10

12,422
4,083
7,484
855

7.2
2.4
4.4
0.5

*Of the approximately 220,000 RNs pursuing formal educational programs, this table excludes the 24,446 currently
enrolled in certificate programs, the 27,960 whose certificate or academic programs were in a field
not related to nursing, and those whose failed to indicate the type of formal program being pursued.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-12

APPENDIX A
Table 13. Distribution of advanced practice nurses by employment status, and by national certification
and State nursing board recognition: March 2004
Type of advanced practice
nurse and employment
status
Total Nurses with advanced
practice nurse preparation

Total
Estimated
Number*,**
Percent

National Certification
Number
Percent

State Board of
Nursing Recognition
Number
Percent

240,460

100.0

168,546

100.0

148,647

100.0

Clinical nurse specialists
Total
Employed in nursing
With position title
Without position title
Not employed in nursing

72,521
61,735
11,988
49,747
10,786

100.0
85.1
16.5
68.6
14.9

32,385
29,224
7,267
21,957
3,161

100.0
90.2
22.4
67.8
9.8

27,379
25,684
6,890
18,793
1,695

100.0
93.8
25.2
68.6
6.2

Nurse practitioners
Total
Employed in nursing
With position title
Without position title
Not employed in nursing

141,209
123,857
81,433
42,425
17,352

100.0
87.7
57.7
30.0
12.3

109,582
99,762
73,812
25,950
9,820

100.0
91.0
67.4
23.7
9.0

102,142
92,540
68,895
23,646
9,601

100.0
90.6
67.5
23.1
9.4

Nurse anesthetists
Total
Employed in nursing
With position title
Without position title
Not employed in nursing

32,523
29,150
26,761
2,389
3,373

100.0
89.6
82.3
7.3
10.4

30,446
27,734
26,116
1,618
2,712

100.0
91.1
85.8
5.3
8.9

24,168
22,350
21,377
973
1,818

100.0
92.5
88.5
4.0
7.5

Nurse midwives
Total
Employed in nursing
With position title
Without position title
Not employed in nursing

13,684
12,217
7,037
5,181
1,466

100.0
89.3
51.4
37.9
10.7

12,820
11,466
7,010
4,457
1,353

100.0
89.4
54.7
34.8
10.6

10,296
9,363
5,934
3,429
933

100.0
90.9
57.6
33.3
9.1

* Estimated numbers of individual specialties of advanced practice nurses and their percents may add up to more
than the total numbers of nurse who have achieved advanced practice nurse status because registered
nurses may have had preparation in more than one advanced practice nurse specialty.
** The most frequent pairings of APN specialties are nurse practitioners with clinical nurse specialists and nurse
practitioners with nurse midwives. The table below shows the weighted number and percent of nurses who have
various combinations of specialties. Note that each pairing includes, but is not limited to, the specialties listed
Total
Number
Percent
14,689
100.0
13,717
93.4
8,990
66.1
776
5.7
3,842
28.2
972
6.6

Total Nurse practitioners and clinical nurse specialists
Employed in nursing
With nurse practitioner position title
With clinical nurse specialist position title
With other position title
Not employed in nursing
Total Nurse practitioners and nurse midwives
Employed in nursing
With nurse practitioner position title
With nurse midwive position title
With other position title
Not employed in nursing

2,892
2,326
684
865
655
567

Total Nurse practitioner, clinical nurse specialist and nurse
midwife
Total Nurse practitioner, clinical nurse specialist and nurse
anesthetist
Total Nurse midwife and clinical nurse specialist
Total Clinical nurse specialist and nurse anesthetist

A-13

48
205
433
679

100.0
80.4
31.0
39.2
29.7
19.6

THE REGISTERED NURSE POPULATION

Table 14. Distribution of registered nurses with specialties in advanced practice
nursing preparation and credentials: March 2004
Advanced practice nurses
Estimated
Number*
Percent

Type of primary specialty completed at
advanced practice level
Total number of advanced practice nurses
Acute/Critical care
Adult health/medical surgical
Anesthesia
Cardiac care
Community health
Family
Geriatric/gerontology
Home health
Maternal-child health
Neonatal
Nurse-midwifery
Obstetrics/gynecology
Occupational health
Oncology
Palliative care
Pediatric
Psychiatric/mental health
Rehabilitation
School health
Womens health
Other

240,460

100.0

15,873
34,268
31,521
1,115
5,825
60,146
11,250
193
5,784
3,422
12,164
4,969
523
2,573
135
19,419
19,693
1,163
1,686
11,488
519

6.6
14.3
13.1
0.5
2.4
25.0
4.7
0.1
2.4
1.4
5.1
2.1
0.2
1.1
0.1
8.1
8.2
0.5
0.7
4.8
0.2

* The number of advanced practice nurse specialty educational preparations will exceed the
total number of advanced practice nurses because each may have completed educational
requirements in one or more specialties. If specialty educational preparations were
completed or certifications received across disciplines, both specialty subjects are included in
these distributions. Nurses are counted once for each type of specialty listed.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100,
because of rounding

A-14

APPENDIX A

Table 15. Distribution of registered nurses with National
certifications in advanced practice nursing: March 2004

Primary type of national certification

Advanced practice nurses with certification
Estimated
Number*
Percent

Total number of nationally certified
advanced practice nurses
Acute care/critical care
Adult
Anesthesia
Community health
Family
Geriatric/gerontology
Home Health
Medical or surgical
Midwifery
Neonatal
Occupational health
Oncology
Pediatric
Palliative care
Psychiatric/mental health
School health
Womens health (OB-GYN)
No exam available
Other

168,546

100.0

8,758
16,956
30,548
708
48,367
6,186
290
3,646
12,807
2,138
145
681
12,928
159
11,986
586
11,540
1,411
770

3.6
7.1
12.7
0.3
20.1
2.6
0.1
1.5
5.3
0.9
0.1
0.3
5.4
0.1
5.0
0.2
4.8
0.6
0.3

* Advanced practice nurses may have completed educational requirements or certification in one or more
specialties in advanced practice nursing. If specialty educational certifications were received across
disciplines, both specialty subjects are included in these distributions.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-15

THE REGISTERED NURSE POPULATION

Table 16. Employment setting of primary positions of registered nurses
employed in nursing: March 2004
Number
in sample
30,233

Employment setting
Total
Hospital
Non-Federal, short-term hospital
Non-Federal, long-term hospital
Non-Federal psychiatric hospital
Federal Government hospital
Other type of hospital
Nursing home/extended care facility
Nursing home unit in hospital
Other nursing home
Facility for mentally retarded
Residential living facilities
Assisted living
Other type of extended care facility
Nursing education & other health education
LPN/LVN program
Diploma program (RN)
Associate degree program
Certified nurse aide/nurse assistant program
Bachelor’s and/or higher degree program
Other program
Community/public health setting
State Health Department
State Mental Health Agency
City or County Health Department
Combination nursing service
Visiting Nursing Service (VNS/NA)
Home health service unit (hosp-based)
Home health agency (non-hosp based)
Community mental-health facility
Substance abuse center/clinic
Community/neighborhood health center
Planned Parenthood/family planning ctr
Day care center
Rural health care center
Retirement community center
Hospice
Blood bank or plasma center
Other
School Health Service
Public school system
Private or parochial school
College or university
Other

A-16

Estimated
Number
Percent
2,421,351
100.0

16,805
13,559
1,153
507
963
623

1,360,847
1,099,147
99,420
39,544
70,358
52,377

56.2
45.4
4.1
1.6
2.9
2.2

1,997
180
1,403
89
39
61
225

153,172
12,090
109,656
7,748
3,316
4,387
15,977

6.3
0.5
4.5
0.3
0.1
0.2
0.7

826
91
64
264
27
313
67

63,444
6,939
5,367
19,814
1,989
23,788
5,545

2.6
0.3
0.2
0.8
0.1
1.0
0.2

3,292
295
93
338
9
184
318
816
152
57
178
47
55
69
34
370
56
221

259,011
19,328
6,575
28,557
901
13,804
25,307
66,678
12,444
4,593
12,847
3,203
4,627
4,406
2,653
30,681
4,734
18,574

10.7
0.8
0.3
1.2
0.0
0.6
1.0
2.8
0.5
0.2
0.5
0.1
0.2
0.2
0.1
1.3
0.2
0.8

974
699
66
167
42

78,022
55,924
5,482
13,175
3,442

3.2
2.3
0.2
0.5
0.1

APPENDIX A

TableTable
16. (cont.)
Employment
setting
primary
positionsofofregistered
registerednurses
nurses
16. Employment
setting
ofof
primary
positions
employed
inin
nursing:
March
2004
employed
nursing:
March
2004

Number
in sample
30,233
277
175
70
32

Employment setting
Total
Occupational Health
Private industry
Government
Other
Ambulatory care setting
Solo practice (physician)
Solo practice (nurse)
Partnerships (physicians)
Partnerships (nurses)
Group practice (physicians)
Group practice (nurses)
Partnership or group practice
Freestanding clinic (physicians)
Freestanding clinic (nurses)
Ambulatory surgical center
Dialysis center/clinic
Dental practice
Hospital owned off-site clinics
Health Maintenance Organization
Federally supported clinics
Other

Estimated
Number
Percent
2,421,351
100.0
22,447
0.9
14,917
0.6
5,121
0.2
2,408
0.1

3,569
401
68
255
18
657
30
409
184
58
575
227
11
366
146
64
100

277,774
32,901
5,100
21,233
1,016
51,850
2,277
29,899
12,032
4,106
46,212
18,872
1,136
27,304
12,663
3,333
7,837

11.5
1.4
0.2
0.9
0.0
2.1
0.1
1.2
0.5
0.2
1.9
0.8
0.0
1.1
0.5
0.1
0.3

Insurance claims/benefits
Government
State or local agencies
Insurance company
Private industry/organization

563
36
35
327
165

43,641
2,702
2,209
26,054
12,676

1.8
0.1
0.1
1.1
0.5

Policy, planning, regulatory, or licensing agency
Central or regional Federal agency
State Board of Nursing
Nursing or health prof. membership assn
Health planning agency, non-Federal
Other

114
23
35
13
32
11

8,733
1,426
2,596
905
2,918
887

0.4
0.1
0.1
0.0
0.1
0.0

1,229
218
103
148
68
57
76
559

103,310
17,602
9,754
12,090
6,625
4,584
6,423
46,231

4.3
0.7
0.4
0.5
0.3
0.2
0.3
1.9

587

50,052

2.1

Other
Correctional facility
Private duty in a home setting
Home-based self-employment
Pharmaceutical, durable medical equipment, devi
Telephone triage/advice (call center)
Clinical research, clinical trials
Other*
Not known

*Includes law/legal nursing/forensics, consultants, transport ambulance, and other settings
NOTE: Estimated numbers may not equal totals, and percents may not add to 100,

A-17

THE REGISTERED NURSE POPULATION

Table 17. Type of patient treated in organization or unit
for principal position in nursing, by employment status: March 2004
Total
Estimated
Number*
Percent

Employment status
Full-time
Part-time
Number
Percent
Number
Percent

2,421,351

100.0

1,696,807

100.0

720,283

100.0

No patient care

127,436

5.3

97,060

5.7

30,334

4.2

Addictions/substance abuse/detox
Adolescent
Adult care (general)
Cardiovascular
Chronic care
Critical care/trauma/ER
Diabetic/endocrinology
Employee/occupational health
Family
Gastrointestinal/endoscopy
Geriatrics/elderly
Hospice/terminally ill
Infectious diseases/HIV/communicable diseases
Medical-Surgical (general)
Neurological
Newborn
Obstetrics/gynecologic
Oncology
Opthalmalogic/eye
Orthopedic
Pediatric
Psychiatric
Pulmonary/respiratory
Rehabilitation
Renal
Spec. needs/dev. disability/mental retardation

4,055
5,271
513,834
171,219
35,215
9,769
3,842
6,561
4,054
10,274
41,113
13,636
4,695
31,141
22,802
76,145
158,847
68,332
4,080
42,438
176,698
90,765
5,626
41,458
33,681
6,630

0.2
0.2
21.2
7.1
1.5
0.4
0.2
0.3
0.2
0.4
1.7
0.6
0.2
1.3
0.9
3.1
6.6
2.8
0.2
1.8
7.3
3.7
0.2
1.7
1.4
0.3

2,204
3,243
356,650
126,484
23,021
6,488
2,475
4,633
2,466
7,427
29,392
10,041
4,245
19,759
16,755
46,454
100,444
51,382
2,033
31,305
109,524
68,330
4,140
29,893
28,149
4,651

0.1
0.2
21.0
7.5
1.4
0.4
0.1
0.3
0.1
0.4
1.7
0.6
0.3
1.2
1.0
2.7
5.9
3.0
0.1
1.8
6.5
4.0
0.2
1.8
1.7
0.3

1,851
2,027
157,133
44,735
12,084
3,281
1,367
1,928
1,449
2,847
11,619
3,595
451
11,382
6,048
29,690
57,924
16,901
2,047
11,134
67,174
22,435
1,487
11,485
5,532
1,980

0.3
0.3
21.8
6.2
1.7
0.5
0.2
0.3
0.2
0.4
1.6
0.5
0.1
1.6
0.8
4.1
8.0
2.3
0.3
1.5
9.3
3.1
0.2
1.6
0.8
0.3

Work with specific, multiple patient types
Other**

608,940
42,363

25.1
1.7

439,579
28,607

25.9
1.7

168,497
13,757

23.4
1.9

60,431

2.5

39,975

2.4

18,110

2.5

Type of patient treated

Total

Not known

* Includes an estimated 4,261 who are working in nursing, but full-time/part-time status is unknown.
** Includes advice/telephone triage, Alzheimer's/dementia, blood donation/apheresis, dermatology, ENT/allergy/asthma, pain
management, plastic/cosmetic surgery, public/community health/immunizations, transplant, urology, wounds/burns, and other
patient types
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-18

APPENDIX A

Table 18. Type of hospital work unit where hospital-employed registered
nurses spent more than half their direct patient care time,
by employment status in principal nursing position: March 2004
Type of work unit
Total

Employment status
Full-time
Part-time
Number
Percent
Number
Percent

Total
Estimated
Number
Percent
1,350,687

100.0

945,091

100.0

404,735

100.0

229,914
7,552
117,637
382,331
5,105
3,801
95,800
116,927
123,166
62,747
13,680
92,826
20,329
797

17.0
0.6
8.7
28.3
0.4
0.3
7.1
8.7
9.1
4.6
1.0
6.9
1.5
0.1

164,324
6,441
85,789
263,035
3,426
1,927
61,218
91,435
83,497
37,455
9,106
68,666
15,960
88

17.4
0.7
9.1
27.8
0.4
0.2
6.5
9.7
8.8
4.0
1.0
7.3
1.7
0.0

65,557
1,111
31,725
119,198
1,679
1,874
34,244
25,492
39,669
25,157
4,574
24,160
4,370
708

16.2
0.3
7.8
29.5
0.4
0.5
8.5
6.3
9.8
6.2
1.1
6.0
1.1
0.2

Multiple units, none over 50%
No specific area
Other specific area

38,719
16,401
5,941

2.9
1.2
0.4

27,333
10,733
4,101

2.9
1.1
0.4

11,378
5,543
1,840

2.8
1.4
0.5

Not known

17,015

1.3

10,559

1.1

6,456

1.6

Critical care
Dialysis
Emergency department
General/specialty inpatient unit
Home health care
Hospice unit
Labor/delivery room
Operating room
Outpatient department
Perioperative unit
Radiologic
Step-down, transitional unit
Sub-acute care unit
Telephone triage/advice/call cente

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-19

A-20

1,360,847
153,172
63,444
259,911
78,022
22,447
277,774
43,641
8,733
103,310
50,052

2,421,351
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0

Estimated
Number Percent

1,907
1,921
1,687
1,785
1,360
1,761
1,771
2,026
2,070
1,801
1,762

1,848

Average annual
hours worked

968,817
110,086
42,757
181,759
48,679
15,067
181,701
38,168
7,436
68,842
33,495

1,696,807
71.2
71.9
67.4
69.9
62.4
67.1
65.4
87.5
85.2
66.6
66.9

70.1
2,179
2,262
2,089
2,145
1,722
2,124
2,106
2,172
2,293
2,204
2,276

2,160

390,856
42,826
20,687
77,992
29,344
7,379
95,599
5,473
1,296
33,898
14,934

720,283

28.7
28.0
32.6
30.0
37.6
32.9
34.4
12.5
14.8
32.8
29.8

29.7

935
817
938
711
895
644
861
779
**
747
691

873

Employment status
Full-time
Part-time
Average annual
Average annual
Estimated
Estimated
Number Percent
hours worked
Number Percent
hours worked

*Calculations of the average number of hours worked exclude those nurses who have reported any on-call hours as well as all their hours of work.
**Too few cases to compute average hours (fewer than 50 cases unweighted)
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

Total

Table 19. Registered nurses employed in each employment setting, by
employment status and average annual hours worked*: March 2004

THE REGISTERED NURSE POPULATION

A-21

43.9
45.4
44.4
43.3
39.4
43.2
43.0
43.1
45.5
44.5
44.4

43.7
312,158
30,350
4,864
30,156
1,955
2,403
36,441
1,566
1,123
10,902
3,028

434,947
7.6
8.3
8.5
7.6
***
***
5.3
***
***
10.7
8.4

7.5
27.3
26.1
27.1
23.8
27.5
27.9
24.4
23.8
***
25.1
28.2

26.3

78,208
6,202
1,550
7,107
370
487
6,058
114
180
1,833
1,094

103,202

5.8
4.4
***
5.2
***
***
3.7
***
***
7.1
5.5

5.6

* Calculations of the average number of hours worked and overtime hours worked exclude those nurses who have reported any on-call hours as
well as all their hours of work.
** Excludes an estimated 4,261 who are working in nursing, but full-time/part-time status is unknown.
***Too few cases to compute average hours (fewer than 50 cases unweighted)
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

Employment status
Employed full-time
Employed part-time
Average hours Worked overtime Average overtime Average hours Worked overtime Average overtime
worked/week
Number
hours/week
worked/week
Number
hours/week

Table 20. Average hours worked per week* and overtime hours per week of
employed registered nurses in their principal nursing position**,
by employment setting: March 2004

APPENDIX A

A-22

312,158
30,350
4,864
30,156
1,955
2,403
36,441
1,566
1,123
10,902
3,028

434,947

Estimated
Number**

7.6
8.3
8.5
7.6
****
****
5.3
****
****
10.7
8.4

7.5

Average
overtime
hours**

31.0
36.6
24.0
37.4
****
****
42.7
****
****
26.8
****

32.5

Percent of
overtime hours
that were
mandatory***

7.5
8.9
****
7.6
****
****
5.3
****
****
10.9
****

7.5

Average
overtime
hours**

29.4
39.3
****
44.3
****
****
46.1
****
****
27.8
****

31.7

7.9
7.3
****
7.6
****
****
5.5
****
****
****
****

7.5

Average
overtime
hours**

39.4
33.0
****
33.1
****
****
36.5
****
****
****
****

35.5

Percent of
overtime hours
that were
mandatory***

Position Title
All other positions

Percent of
overtime hours
that were
mandatory**

Staff nurse

*Calculations of the average number of overtime hours worked exclude those nurses who have reported any on-call hours as well as all
their hours of work.
**Excludes an estimated 1,261,860 full time nurses who did not report any overtime hours
***Includes an estimated 175,563 full time nurses who reported mandatory hours
**** Too few cases to compute hours (fewer than 50 cases unweighted)
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

Total full time
employed nurses

Table 21. Average overtime and mandatory overtime hours* for full time nurses
by employment setting and position title: March 2004

THE REGISTERED NURSE POPULATION

A-23

16,805 1,360,847
1,997 153,172
826
63,444
3,292 259,911
974
78,022
277
22,447
3,569 277,774
563
43,641
114
8,733
1,229 103,310
587
50,052

30,233 2,421,351

Total
Number Estimated
in sample Number*

51,850
741
466
1,087
422
0
3,688
0
0
560
779

59,592

Under
25

118,218
6,589
2,909
9,997
1,350
526
13,914
719
415
2,818
2,221

159,676

25-29

146,347
12,616
3,827
16,290
4,764
1,175
23,940
1,703
633
6,308
3,448

221,052

30-34

164,467
12,858
4,103
22,743
5,531
1,509
27,723
3,664
577
8,723
5,069

256,967

35-39

* Includes an estimated 24,511 nurses for whom age was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

214,165
18,747
8,207
34,283
10,145
2,440
45,026
7,002
1,014
14,718
4,502

360,249

40-44

248,181
23,337
9,494
50,424
18,868
4,427
57,469
10,736
1,626
18,181
7,053

449,797

45-49

Age Group

206,154
27,746
14,033
49,685
15,317
3,847
51,550
9,221
1,668
20,110
7,417

406,748

50-54

Table 22. Employed registered nurses, by employment setting and age group: March 2004

125,383
20,199
10,685
39,340
10,862
3,632
32,354
6,310
1,404
16,151
4,944

271,264

55-59

58,406
16,115
5,205
19,531
5,471
2,719
12,931
3,058
947
8,765
3,043

136,191

60-64

20,651
12,871
3,783
14,085
4,582
2,013
8,282
1,049
447
5,688
1,854

75,305

65 and
over

APPENDIX A

A-24

16,805 1,360,847
1,997 153,172
826
63,444
3,292 259,911
974
78,022
277
22,447
3,569 277,774
563
43,641
114
8,733
1,229 103,310
587
50,052

30,233 2,421,351
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0

Total
Estimated
Number
in sample Number* Percent

191,921
32,986
4,023
39,161
12,034
4,811
53,706
8,846
797
16,466
4,989

369,741
14.1
21.5
6.3
15.1
15.4
21.4
19.3
20.3
9.1
15.9
10.0

15.3

Diploma
Number Percent

513,294
71,860
11,032
95,608
17,083
6,058
87,918
12,682
2,139
34,023
10,252

861,949
37.7
46.9
17.4
36.8
21.9
27.0
31.7
29.1
24.5
32.9
20.5

35.6
521,292
36,965
14,686
87,550
31,745
8,543
80,113
16,449
2,123
33,586
8,501

841,554

38.3
24.1
23.1
33.7
40.7
38.1
28.8
37.7
24.3
32.5
17.0

34.8

123,420
10,241
23,676
32,977
15,583
3,035
53,978
5,390
3,430
15,775
3,356

290,860

9.1
6.7
37.3
12.7
20.0
13.5
19.4
12.4
39.3
15.3
6.7

12.0

Highest nursing or nursing-related educational preparation
Associate Degree
Baccalaureate
Master's
Number Percent Number
Percent
Number
Percent

* Includes an estimated 37,634 nurses for whom highest educational preparation was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

Table 23. Employment setting, by highest nursing or nursing-related educational preparation
of registered nurses employed in nursing: March 2004

4,627
223
9,872
1,141
834
0
815
274
244
1,333
251

19,614

0.3
0.1
15.6
0.4
1.1
0.0
0.3
0.6
2.8
1.3
0.5

0.8

Doctorate
Number
Percent

THE REGISTERED NURSE POPULATION

A-25

16,805 1,360,847
1,997 153,172
826
63,444
3,292 259,911
974
78,022
277
22,447
3,569 277,774
563
43,641
114
8,733
1,229 103,310
587
50,052

30,233 2,421,351
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0

Total
Number
Estimated
in sample Number* Percent

15,475 1,264,512
1,870 143,002
784
60,142
2,991 233,458
903
71,461
209
16,838
3,238 253,280
515
39,796
102
7,906
881
73,321
245
21,206

27,213 2,184,921
92.9
93.4
94.8
89.8
91.6
75.0
91.2
91.2
90.5
71.0
42.4

90.2

Employee of organization
Number
Estimated
in sample Number Percent

* Includes an estimated 47,787 nurses for whom work basis was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

535
29
10
62
13
33
25
8
1
45
7

768

34,389
2,285
847
5,527
1,455
2,970
2,004
763
31
3,935
287

54,493

2.5
1.5
1.3
2.1
1.9
13.2
0.7
1.7
0.4
3.8
0.6

2.3

Work basis
Temporary agency
Number
Estimated
in sample Number Percent

694
87
25
195
44
29
281
37
10
263
29

1,694

53,173
7,289
1,790
16,829
3,986
2,259
20,280
2,861
637
22,497
2,548

134,150

3.9
4.8
2.8
6.5
5.1
10.1
7.3
6.6
7.3
21.8
5.1

5.5

Self-employed
Number
Estimated
in sample Number
Percent

Table 24. Employment setting of registered nurses in principal nursing position, by work basis: March 2004

APPENDIX A

Table 25. Position titles in primary nursing jobs for registered
nurses employed in nursing: March 2004
General and specific position titles
Total

Number
in sample
30,233

Administration
Administrator/assistant org/facil/agency
Administrator/assistant nursing
Dean/director/asst director nursing ed
Nursing staff development director
Certified nurse anesthetist
Clinical nurse specialist
Consultant
Head nurse or assistant head nurse
Head nurse/assistant head nurse
Nurse coordinator
Nurse manager
Informatics nurse
Instruction
Instuctor at a school of nursing
Nursing staff development instructor
Professor, assistant/associate prof
Instructor in a non-RN health program
Nurse clinician
Nurse midwife
Nurse practitioner
Patient coordinator
Case manager
Discharge planner/outcomes manager
Patient care coordinator
Patient educator
Advice/triage nurse
Private duty nurse
Researcher
Staff nurse
Charge nurse
Float nurse
Public health nurse
School nurse
Staff nurse
Team leader
Traveling nurse
Supervisor
Surveyor/auditor/regulator
Visiting nurse/Home health
Other
Healthcare related business rep
Infection control nurse
Insurance reviewer
Quality improvement nurse
No position title specified
Other (miscellaneous) title specified
Not known

1,609
517
873
118
101
399
362
435
1,867
309
604
954
114
803
389
222
165
27
382
98
1,093
1,700
1,256
41
203
96
104
124
233
17,808
2,215
467
347
808
13,495
208
268
902
147
584
1,020
35
94
117
367
245
162
553

Estimated
Number
Percent
2,421,351
100.0
125,011
41,669
65,842
9,667
7,832
27,287
28,623
35,617
148,210
26,955
46,743
74,512
8,570
62,255
29,525
17,793
12,598
2,339
32,954
7,274
84,042
138,404
101,177
3,789
16,458
8,085
8,895
11,762
19,263
1,431,053
168,827
37,132
26,527
64,610
1,100,538
17,664
15,756
74,201
12,097
45,621
82,352
3,154
7,074
9,260
28,034
21,332
13,498
46,753

5.2
1.7
2.7
0.4
0.3
1.1
1.2
1.5
6.1
1.1
1.9
3.1
0.4
2.6
1.2
0.7
0.5
0.1
1.4
0.3
3.5
5.7
4.2
0.2
0.7
0.3
0.4
0.5
0.8
59.1
7.0
1.5
1.1
2.7
45.5
0.7
0.7
3.1
0.5
1.9
3.4
0.1
0.3
0.4
1.2
0.9
0.6
1.9

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-26

A-27

Employment setting

1,265
0
95
996
0
0
4,753
0
64
0
101

21,778
0
78
100
0
203
4,116
0
301
261
450

27,287

21,075
3,688
84
11,260
3,051
1,142
40,349
580
62
1,859
893

84,042
46,566
6,275
750
38,953
204
3,227
11,202
20,817
301
8,506
1,603

138,404

Nurse
Patient
Practitioner coordinator

35,079
28,753
5,488
25,413
2,319
1,171
15,445
2,366
1,480
6,326
1,170

125,011

359
793
0
3,938
141
133
127
0
0
6,001
271

11,762

Private
duty

17,443
540
176
1,916
32
260
5,959
73
277
1,323
625

28,623
78,666
15,428
1,553
17,157
1,669
2,123
23,759
2,273
111
4,297
1,173

148,210

6,715
0
632
667
722
261
3,851
488
0
5,929
0

19,263

Research

1,311
354
31
40,335
27
57
167
0
0
2,928
410

45,621

Home
health

1,017,641
63,681
13,936
75,069
63,056
9,352
140,617
1,066
2,042
30,026
14,567

1,431,053

31,979
16,829
696
14,553
628
980
3,210
1,440
199
3,310
379

74,201

Staff nurse Supervisor

Position title

6,793
4,416
765
5,802
270
981
2,149
2,093
974
11,125
250

35,617

* Includes an estimated 46,753 nurses for whom type of position was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

7,274

Nurse
midwife

Total

1,360,847
153,172
63,444
259,911
78,022
22,447
277,774
43,641
8,733
103,310
50,052

2,421,351

Total
Position Title
Estimated
Admin
Cert. nurse Clin. nurse
Head nurse
Number* or assistant anesthetist specialist Consultant or assistant

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

2,321
1,321
277
2,956
0
151
471
1,558
1,771
1,271
0

12,097

Surveyor/
auditor

5,058
225
284
736
0
0
513
446
0
1,137
171

8,570

Informatic
nurse

29,168
7,611
841
12,085
1,010
1,593
9,444
9,932
1,101
8,274
1,291

82,352

Other

13,213
2,101
36,615
2,305
4,110
383
1,031
0
0
1,908
589

62,255

Instruction

Table 26. Employment setting and type of principal nursing position of employed registered nurses: March 2004

17,305
130
389
2,776
397
286
9,279
253
26
1,602
511

32,954

Nurse
clinician

APPENDIX A

A-28

100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

1,867 148,210
584
45,621
114
8,570
803
62,255
382
32,954
98
7,274
1,093
84,042
1,700 138,404
124
11,762
233
19,263
17,808 1,431,053
902
74,201
147
12,097
1,020
82,352
553
46,753

100.0

125,011
27,287
28,623
35,617

1,609
399
362
435

30,233 2,421,351

Total
Estimated
Number
in sample Number* Percent

23,459
9,787
1,201
2,408
4,476
263
2,364
24,255
2,529
2,685
235,225
13,477
1,417
16,844
3,771

13,043
5,321
2,304
4,912

369,741

15.8
21.5
14.0
3.9
13.6
3.6
2.8
17.5
21.5
13.9
16.4
18.2
11.7
20.5
8.1

10.4
19.5
8.0
13.8

15.3

Diploma
Number Percent

46,798
16,917
2,232
6,322
9,334
261
3,270
49,086
5,206
3,902
599,630
32,217
3,867
24,772
7,108

35,165
2,415
6,048
7,399

861,949

31.6
37.1
26.0
10.2
28.3
3.6
3.9
35.5
44.3
20.3
41.9
43.4
32.0
30.1
15.2

28.1
8.9
21.1
20.8

35.6

58,554
16,222
2,747
17,660
14,467
1,041
6,106
53,340
3,796
8,748
538,341
21,990
3,928
28,416
7,382

34,201
5,538
6,011
13,067

841,554

39.5
35.6
32.0
28.4
43.9
14.3
7.3
38.5
32.3
45.4
37.6
29.6
32.5
34.5
15.8

27.4
20.3
21.0
36.7

34.8

18,388
2,441
2,391
28,443
4,180
5,684
71,428
10,572
73
3,234
50,140
5,747
2,835
8,450
3,543

36,430
13,579
13,942
9,361

290,860

12.4
5.4
27.9
45.7
12.7
78.1
85.0
7.6
0.6
16.8
3.5
7.7
23.4
10.3
7.6

29.1
49.8
48.7
26.3

12.0

Highest nursing or nursing-related educational preparation
Associate Degree
Baccalaureate
Master's
Number Percent
Number
Percent
Number
Percent

* Includes an estimated 37,634 nurses for whom educational preparation was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Administration
Certified nurse anesthetist
Clinical nurse specialist
Consultant
Head nurse or assistant
head nurse
Home health
Informatic nurse
Instruction
Nurse clinician
Nurse midwife
Nurse practitioner
Patient coordinator
Private duty
Research
Staff nurse
Supervisor
Surveyor/auditor/regulator
Other
Not known

Total

Type of position

Table 27. Type of principal nursing position and highest nursing or nursing-related educational preparation of
registered nurses employed in nursing: March 2004

381
141
0
7,345
212
26
874
584
0
695
1,598
141
50
769
145

5,176
281
318
878

19,614

0.3
0.3
0.0
11.8
0.6
0.4
1.0
0.4
0.0
3.6
0.1
0.2
0.4
0.9
0.3

4.1
1.0
1.1
2.5

0.8

Doctorate
Number
Percent

THE REGISTERED NURSE POPULATION

A-29
24,746
4,156
290
143
181
717

None
1-24
25-49
50-74
75-100
Not known

64.4
20.6
6.3
4.0
2.1
2.5

100.0

1,978,375
331,752
23,457
11,910
14,588
61,269

2,421,351
81.7
13.7
1.0
0.5
0.6
2.5

100.0

Research
Estimated
Number
Percent

1,558,504
499,864
152,986
96,788
51,940
61,269

2,421,351
1,227,939
894,981
155,426
47,283
34,453
61,269

2,421,351
50.7
37.0
6.4
2.0
1.4
2.5

100.0

17,374
7,379
2,238
1,546
979
717

30,233

1,387,231
593,979
177,239
121,509
80,124
61,269

2,421,351

57.3
24.5
7.3
5.0
3.3
2.5

100.0

Functional Area
Supervision
Number
Estimated
in sample
Number
Percent

15,133
11,427
1,928
604
424
717

30,233

Functional Area
Consultation
Number
Estimated
in sample
Number
Percent

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

30,233

Total

Number
in sample

19,341
6,374
1,978
1,179
644
717

None
1-24
25-49
50-74
75-100
Not known

Percentage of time spent during
usual workweek

30,233

Administration
Number
Estimated
in sample
Number
Percent

Total

Percentage of time spent during
usual workweek

21,632
6,336
666
382
500
717

30,233

Number
in sample

4,603
2,865
2,207
4,757
15,084
717

30,233

15.5
9.3
7.2
15.7
49.8
2.5

100.0

1,733,761
501,003
55,280
31,363
38,675
61,269

2,421,351

71.6
20.7
2.3
1.3
1.6
2.5

100.0

Teaching
Estimated
Number
Percent

375,858
224,773
174,836
379,226
1,205,389
61,269

2,421,351

Direct patient care
Number
Estimated
in sample
Number
Percent

Table 28. Percentage of time spent in each functional area in principal nursing position
during usual work week for employed registered nurses: March 2004

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 29. Average percent of time in work week in principal nursing position
spent by employed registered nurses in each function, by highest
nursing or nursing-related educational preparation: March 2004
Highest educational preparation
Total
Diploma
Associate degree
Baccalaureate
Masters
Doctorate
Not known
Highest educational preparation
Total
Diploma
Associate degree
Baccalaureate
Masters
Doctorate
Not known

Average percent of time spent in
Administration
Consultation
Direct patient care
8.3

8.1

60

6.7
6.7
7.8
15.6
23.4
10.1

7.6
7.3
8.4
10.3
8.8
9.1

62.5
64.5
60.8
44.5
16.5
56.9

Average percent of time spent in
Research
Supervision
Teaching
2.1
10.8
4.7
1.8
1.8
2.2
2.8
12.8
2.1

10.7
11.4
10.6
10.1
6.8
14.3

2.8
3.1
4.4
11.4
27.7
3.6

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-30

A-31
**
**
**
**
**
**
**
**
**
**
**

$73,254

Nurse
midwife

59,963
53,796
57,808
52,347
42,249
58,343
56,265
58,839
66,852
60,583
58,487

$57,785

Overall
average*

131,826
**
**
**
**
**
**
**
**
**
**

$129,530

75,514
**
**
64,288
**
**
70,335
**
**
**
**

$70,581
57,890
49,939
**
48,354
**
**
50,862
55,021
**
61,162
**

$53,837

Nurse
Patient
Practitioner coordinator

90,470
59,272
74,182
65,255
**
**
74,087
**
**
74,471
**

$74,165

**
**
**
**
**
**
**
**
**
**
**

$49,070

Private
duty

68,347
**
**
**
**
**
58,677
**
**
**
**

$64,627
67,034
53,558
**
53,094
**
**
54,293
**
**
**
**

$61,595

57,767
**
**
**
**
**
**
**
**
**
**

$59,220

Research

**
**
**
51,030
**
**
**
**
**
**
**

$51,596

Home
health

55,171
48,870
54,891
46,723
39,343
54,600
46,649
**
**
53,099
57,771

$53,086

62,783
53,062
**
52,307
**
**
**
**
**
**
**

$58,065

Staff nurse Supervisor

Position title

**
**
**
**
**
**
**
**
**
63,926
**

$61,432

Position Title
Admin
Cert. nurse Clin. nurse
Head nurse
or assistant anesthetist specialist Consultant or assistant

* Excludes an estimated 99,701 nurses who did not provide a response to income
** Too few cases to compute salaries (fewer than 50 cases unweighted)
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total

Employment setting

**
**
**
**
**
**
**
**
**
**
**

$56,710

Surveyor/
auditor

**
**
**
**
**
**
**
**
**
**
**

$61,139

Informatic
nurse

Table 30. Average annual earnings in principal nursing position for registered nurses employed full time,
by employment setting and position title: March 2004

**
**
**

**
**

**

48,313
53,498

48,208

60,380
49,966

$55,688

Other

63,848
**
55,271
**
**
**
**
**
**
**
**

$57,676

Instruction

58,144
**
**
**
**
**
50,590
**
**
**
**

$55,090

Nurse
clinician

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 31. Average annual earnings in principal nursing position of nurses
employed full-time, by type of position and
highest nursing or nursing-related educational preparation: March 2004
Type of position
Total
Administration
Consultant
Supervisor
Instruction
Head nurse or assistant head nurse
Staff nurse
Nurse practitioner
Nurse midwife
Clinical nurse specialist
Nurse clinician
Certified nurse anesthetist
Research
Private duty
Informatic nurse
Home health
Surveyor/auditor/regulator
Patient coordinator
Other
Not known

Overall
average*

Highest nursing or nursing-related educational preparation
Associate
BaccaDiploma
Degree
laureate
Master's
Doctorate

$57,785

$56,504

$52,610

$57,081

$74,377

$80,795

74,165
61,432
58,065
57,676
61,595
53,086
70,581
73,254
64,627
55,090
129,530
59,220
49,070
61,139
51,596
56,710
53,837
55,688
61,812

63,478
**
59,903
**
57,438
54,277
**
**
**
**
115,042
**
**
**
50,975
**
53,061
52,154
**

60,442
56,194
54,379
**
55,791
51,477
**
**
56,526
52,734
**
**
**
**
48,290
**
50,600
50,477
**

68,696
61,536
60,716
55,877
63,486
54,003
65,459
**
60,357
54,499
122,479
59,820
**
**
54,837
**
55,846
58,516
**

92,831
65,295
57,821
**
74,376
59,436
71,265
73,460
70,470
**
134,479
**
**
**
**
**
61,251
64,972
**

97,275
**
**
66,217
**
**
**
**
**
**
**
**
**
**
**
**
**
**
**

* Excludes an estimated 99,701 nurses who did not provide a response to income
** Too few cases to compute salaries (fewer than 50 cases unweighted)
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-32

A-33
4,608
24,919

30,233

Number
in sample

352,027
2,010,151

2,421,351
14.5
83.0

100.0

Total
Estimated
Number*
Percent

61,111
50,452

$52,080

Avg total
earnings**

233,149
1,422,403

1,696,807

13.7
83.8

100.0

69,418
57,749

$59,422

118,290
586,270

720,283

16.4
81.4

100.0

Employment status in principal position
Full-time
Part-time
Avg total
Estimated
Estimated
Number
Percent earnings**
Number
Percent

* Includes an estimated 4,261 nurses for whom full-time/part-time status was not known and 59,173 nurses for whom it was not known whether
they held more than one job in nursing
** Averages exclude an estimated 171,183 nurses who did not provide a response to income
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Principal and secondary positions
Principal positions only

Total

Positions held

Table 32. Distribution of employed registered nurses with one and more than one nursing position,
by employment status and average total earnings: March 2004

44,633
32,002

$34,184

Avg total
earnings**

APPENDIX A

A-34

Employment setting

9,678
16,212
2,047
3,902
1,017
97

16,091
13,272
3,940
1,744
498
71

35,617

15,035
9,804
732
1,179
373
165

27,287
6,759
8,772
1,550
1,583
526
73

19,263

Cert. Nurse
anesthetist Research

48,057
58,537
5,706
8,455
3,046
1,209

125,011

3,722
4,995
2,014
850
182
0

11,762

Private
duty

19,742
38,121
5,604
8,072
2,465
198

74,201
45,558
77,113
8,580
12,917
3,242
800

148,210

3,084
3,961
924
298
303
0

8,570

14,312
22,044
3,611
4,202
1,293
159

45,621

Position title
Informatic
Home
nurse
health

25,405
28,467
2,388
3,749
1,724
521

62,255

* Includes an estimated 46,753 nurses for whom type of position was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Extremely satisfied
Moderately satisfied
Neither satisfied nor dissatisfied
Moderately dissatisfied
Extremely dissatisfied
Not known

32,954

Nurse
clinician

Total

651,386
1,197,997
194,844
259,147
68,175
49,802

2,421,351

Extremely satisfied
Moderately satisfied
Neither satisfied nor dissatisfied
Moderately dissatisfied
Extremely dissatisfied
Not known

Total

Level of job satisfaction

35,588
36,928
3,715
5,647
1,496
667

84,042

4,411
5,152
881
1,122
341
190

12,097

42,674
66,707
11,071
12,302
4,675
975

138,404

Surveyor/
Patient
auditor
coordinator

316,343
744,673
132,399
182,774
44,276
10,588

1,431,053

Total
Position title
Estimated
Admin
Head nurse
Nurse
Number or assistant Consultant Supervisor Instruction or assistant Staff nurse Practitioner

23,530
38,849
6,969
6,791
1,302
4,913

82,352

Other

3,494
2,892
300
294
135
159

7,274

Nurse
midwife

Table 33. Job satisfaction of RNs employed in nursing, by position title in principal nursing position: March 2004

11,839
12,685
1,041
2,063
871
124

28,623

Clin. nurse
specialist

THE REGISTERED NURSE POPULATION

APPENDIX A

Table 34 Job satisfaction of RNs employed in nursing,
by highest nursing or nursing-related educational preparation: March 2004

Level of job satisfaction
Total
Extremely satisfied
Moderately satisfied
Neither satisfied nor dissatisfied
Moderately dissatisfied
Extremely dissatisfied
Not known

Total
Estimated
Number

Highest educational preparation
Associate
BaccaMasters/
Diploma
Degree
laureate
Doctorate

2,421,351

369,741

861,949

841,554

310,474

651,386
1,197,997
194,844
259,147
68,175
49,802

105,340
180,370
28,868
39,907
10,783
4,472

217,113
435,068
74,850
103,040
25,117
6,760

207,565
439,097
72,066
92,576
22,983
7,266

118,717
139,735
18,032
22,536
8,816
2,637

* Includes 37,634 nurses for whom highest nursing or nursing-related educational preparation was
not known
NOTE: Estimated numbers may not equal totals because of rounding

A-35

A-36
844
1,576
1,017
756
331
64
814

5,402
66,114
137,892
95,397
77,051
33,223
6,261
72,067

488,006
13.5
28.3
19.5
15.8
6.8
1.3
14.8

100.0
12,505
7,618
3,308
2,204
538
451
3,655

30,278
41.3
25.2
10.9
7.3
1.8
1.5
12.1

100.0

Seeking nursing
employment
Number Percent

4,494
15,642
13,359
17,042
7,394
697
4,424

63,052

7.1
24.8
21.2
27.0
11.7
1.1
7.0

100.0

6,497
15,078
11,341
10,291
5,389
1,512
2,839

52,946

12.3
28.5
21.4
19.4
10.2
2.9
5.4

100.0

Employment status outside of nursing
Has other healthHas other nonrelated occupation
health related occup
Number
Percent
Number
Percent

64
1,263
406
2,081
596
0
104

4,513

1.4
28.0
9.0
46.1
13.2
0.0
2.3

100.0

Has other unknown
occupation
Number
Percent

*Total includes an estimated 12,871 nurses who did not report whether they were seeking a nursing position, and 11,576 who did not report about any
employment outside of nursing, and 5,045 who were both seeking a nursing position and had other occupation.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Less than a year
1-4 years
5-9 years
10-19 years
20 years or more
Never worked
Not known

Total

Length of time since worked

Total
Number
Estimated
in sample Number* Percent

Table 35. Distribution of registered nurses not employed in nursing, by length of time since last
worked as a nurse and whether or not nurse was seeking nursing position
or had other occupation: March 2004

THE REGISTERED NURSE POPULATION

A-37

488,006
2,186
11,983
22,130
32,557
47,999
58,910
56,817
66,814
74,006
109,949
4,655

5,402
21
136
259
366
515
689
656
738
810
1,157
55

490
4,416
4,506
5,420
5,613
6,993
6,365
10,450
11,580
9,795
479

66,114
0.7
6.7
6.8
8.2
8.5
10.6
9.6
15.8
17.5
14.8
0.7

100.0

Total
Number Estimated
Less than 1 year
in sample Number* Number Percent

108
4,105
9,014
11,284
11,830
13,526
15,000
19,521
28,368
25,070
64

137,892
0.1
3.0
6.5
8.2
8.6
9.8
10.9
14.2
20.6
18.2
0.0

100.0
0
187
3,288
7,274
9,374
12,044
8,819
12,843
13,032
28,229
308

95,398

0.0
0.2
3.5
7.6
9.8
12.6
9.2
13.5
13.7
29.6
0.3

100.0

0
0
0
3,091
10,144
12,375
12,747
8,565
8,008
21,979
142

77,051

0.0
0.0
0.0
4.0
13.2
16.1
16.5
11.1
10.4
28.5
0.7

100.0

Length of time not working in nursing
1-5 years
6-10 years
11-15 years
Number Percent
Number
Percent
Number
Percent

* Includes an estimated 9,537 nurses whose length of time not working in nursing was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Total
Age group
Less than 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 and over
Not known

Age of nurse not
employed in nursing

0
0
54
395
0
3,784
6,133
5,960
6,051
10,436
411

33,224

0.0
0.0
0.2
1.2
0.0
11.4
18.5
17.9
18.2
31.4
1.2

100.0

16 years or more
Number
Percent

Table 36. Age distribution of RNs not employed in nursing, by length of time not working in nursing: March 2004

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 37. Registered nurses not employed in nursing
actively seeking employment in nursing, by type of employment
sought and number of weeks looking: March 2004
Type of employment sought
and weeks looking

Number in
sample

Number*

378

30,278

100.0

Type of employment
Full-time
Part-time
Either
Not known

103
190
73
12

7,868
15,918
5,494
998

26.0
52.6
18.1
3.3

Number of weeks looking
Less than a week
1-4 weeks
5-9 weeks
10-14 weeks
15-34 weeks
35 weeks or more
Not known

85
109
49
31
45
42
17

7,372
8,296
3,859
2,394
3,538
3,220
1,598

24.3
27.4
12.7
7.9
11.7
10.6
5.3

Total

Estimated

Percent

*Of the 190,157 nurses seeking new positions in nursing, only the characteristics of nurses who
were not currently employed in nursing at the time of the survey are shown in this table.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of
rounding

A-38

APPENDIX A

Table 38. Type of employment of registered nurses in
non-nursing occupations: March 2004
Type of non-nursing
employment
Total

Number in
sample*
1,321

Number**
120,512

Health related occupation
Full-time
Part-time
Not known

672
480
189
3

63,052
44,534
18,268
250

52.3
37.0
15.2
0.2

Not health related occupation
Full-time
Part-time
Not known

599
276
319
4

52,946
24,104
28,487
355

43.9
20.0
23.6
0.3

Unknown if health related

50

4,513

3.7

Estimated

Percent
100.0

*The number in sample excludes nurses who are employed in nursing but have other
employment outside of nursing
**Includes an estimated 5,045 nurses employed in a non-nursing field but were actively seeking
nursing employment
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of
rounding

A-39

A-40

55
244
84
64
62
185
83
58
153
221
112

4,796
23,857
7,207
6,374
5,523
15,999
7,952
5,537
12,708
20,269
10,290

4.0
19.8
6.0
5.3
4.6
13.3
6.6
4.6
10.5
16.8
8.5

2,179
15,896
3,224
4,258
972
13,293
7,800
1,388
2,057
7,064
4,922

3.5
25.2
5.1
6.8
1.5
21.1
12.4
2.2
3.3
11.2
7.8

2,617
7,755
3,984
2,116
4,373
2,706
153
4,149
10,443
13,011
1,639

4.9
14.6
7.5
4.0
8.3
5.1
0.3
7.8
19.7
24.6
3.1

*The number in sample excludes nurses who are employed in nursing but have other employment outside of nursing
**Includes an estimated 4,513 nurses who did not report whether the position was health related or not.
***Includes artist/horticulturalist, faculty/instructor, farming/animal husbandry, government, homemaker/childcare, recreation
services, religious/musical services, and other non-nursing employment
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Accounting/bookkeeping/Computr svcs
Administration/Management
Administrative/Clerical Support
Consultant/legal work
Elem&Sec Education
Health-related svc provider
Pharmaceutical and Medical Hardware Svcs
Real estate/Financial/Insurance Svcs
Retail sales/services
Other***
Not known

Total

Type of non-nursing employment

Total
Type of position outside of nursing
Number in
Estimated
Health related
Not health related
sample* Number** Percent
Number
Percent
Number
Percent
1,321 120,512
100.0
63,052
100.0
52,946
100.0

Table 39. Detailed type of employment of registered nurses in
non-nursing occupations: March 2004

THE REGISTERED NURSE POPULATION

APPENDIX A

Table 40. Reasons for registered nurses to have occupation
other than nursing: March 2004
Reasons for other occupation
Total
Burnout/stressful work environment
Career change
Difficult to find a nursing position
Disability
Illness
Inability to practice on a professional level
Inadequate staffing
Lack of advancement opportunities
Lack of collaboration/communication
Liability concerns
Physical demands of job
Retired
Salaries too low/better pay elsewhere
Scheduling/too many hours
Skills are out-of-date
Taking care of home and family
Volunteering in nursing
Went back to school
Other**
Summary of reasons for other occupations
Personal/family reasons
Personal career reasons
Workplace reasons
Retirement reasons
Other reasons

Number in
sample*
1,321

Number**
120,512

591
859
58
65
60
118
425
230
274
273
366
160
434
550
269
380
56
134
29

54,079
79,274
4,951
5,612
5,955
11,192
40,162
19,862
24,718
24,609
33,833
13,745
41,007
49,873
24,827
35,724
4,153
11,238
2,279

44.9
65.8
4.1
4.7
4.9
9.3
33.3
16.5
20.5
20.4
28.1
11.4
34.0
41.4
20.6
29.6
3.4
9.3
1.9

554
1,089
906
160
8

50,510
99,807
82,275
13,745
434

41.9
82.8
68.3
11.4
0.4

Estimated

Percent
100.0

*The number in sample excludes nurses who are employed in nursing but have other employment outside
of nursing
**Includes moved/relocated/difficult commute, employment instability/termination, taking time off, and
other reasons
NOTE: Estimated numbers and percents may not add up to totals because registered nurses may have
answered to more than one reason

A-41

A-42
19,191
99
385
139
17,523
1,045

Never married
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown
0.6

5.9
0.0
0.1
0.0
5.4
0.3

18.5
0.2
2.0
0.1
15.4
0.6

75.1
7.2
14.3
5.8
46.3
1.5

15

3,625
80
67
139
3,338
0

1,949
140
1,096
344
369
0

41,709
18,773
6,623
11,318
4,803
192

0.0

7.7
0.2
0.1
0.3
7.1
0.0

4.1
0.3
2.3
0.7
0.8
0.0

88.2
39.7
14.0
23.9
10.2
0.4

287

3,087
19
191
0
2,718
159

6,244
51
3,171
80
2,942
0

49,283
2,911
29,684
6,789
9,434
465

0.5

5.2
0.0
0.3
0.0
4.6
0.3

10.6
0.1
5.4
0.1
5.0
0.0

83.7
4.9
50.4
11.5
16.0
0.8

273

4,089
0
0
0
3,751
338

11,273
258
1,211
15
9,274
515

51,971
917
9,333
455
40,663
602

0.4

6.0
0.0
0.0
0.0
5.5
0.5

16.7
0.4
1.8
0.0
13.7
0.8

76.9
1.4
13.8
0.7
60.1
0.9

838

8,139
0
127
0
7,464
548

40,625
267
1,194
0
37,637
1,527

101,763
903
1,109
290
96,130
3,331

* Total reflects those not employed and not seeking nursing employment. Also includes an estimated 1,355 nurses whose age was not known.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

1,974

60,250
716
6,672
440
50,381
2,042

Widowed/separated/divorced
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown

Not known

245,110
23,505
46,805
18,851
151,196
4,753

0.6

5.4
0.0
0.1
0.0
4.9
0.4

26.8
0.2
0.8
0.0
24.9
1.0

67.2
0.6
0.7
0.2
63.5
2.2

Age Group
Total
Estimated
60 and over
Less than 40
40-49
50-59
Number* Percent Number Percent Number Percent
Number
Percent
Number
Percent
326,526
100.0
47,299
100.0
58,901
100.0
67,606
100.0 151,365
100.0

Married
Children under 6 only
Children 6-18 only
Children in both age groups
No children
Children unknown

Total

Marital status and presence of
children

Table 41. Marital status and presence of children at home of nurses who were not employed at all and not
seeking nursing employment, by age group: March 2004

THE REGISTERED NURSE POPULATION

A-43
0.6

5.9
0.5
5.1
0.3

18.5
2.4
15.4
0.6

15

3,625
74
3,551
0

1,949
387
1,562
0

41,709
2,264
39,254
192

3,625
309
3,316
0

1,949
0
1,949
0

41,709
1,335
40,183
192

0.0

7.7
0.2
7.5
0.0

4.1
0.8
3.3
0.0

88.2
4.8
83.0
0.4

7.7
0.7
7.0
0.0

4.1
0.0
4.1
0.0

88.2
2.8
85.0
0.4

287

3,087
27
2,901
159

6,244
812
5,432
0

49,283
11,046
37,772
465

3,087
487
2,441
159

6,244
867
5,378
0

49,283
6,774
42,044
465

0.5

5.2
0.0
4.9
0.3

10.6
1.4
9.2
0.0

83.7
18.8
64.1
0.8

5.2
0.8
4.1
0.3

10.6
1.5
9.1
0.0

83.7
11.5
71.4
0.8

273

4,089
630
3,120
338

11,273
1,778
8,981
515

51,971
14,409
36,960
602

4,089
764
2,987
338

11,273
1,681
9,077
515

51,971
10,446
40,923
602

0.4

6.0
0.9
4.6
0.5

16.7
2.6
13.3
0.8

76.9
21.3
54.7
0.9

6.0
1.1
4.4
0.5

16.7
2.5
13.4
0.8

76.9
15.5
60.5
0.9

838

8,139
845
6,745
548

40,625
4,625
34,472
1,527

101,763
12,910
85,522
3,331

8,139
423
7,167
548

40,625
4,571
34,527
1,527

101,763
11,651
86,781
3,331

* Total reflects those not employed and not seeking nursing employment. Also includes an estimated 1,355 nurses whose age was not known.
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

1,974

19,191
1,577
16,569
1,045

Never married
Other living elsewhere
No other elsewhere
Unknown if other

Not known

60,250
7,760
50,448
2,042

75.1
12.4
61.2
1.5

Marital status/care for others living elsewhere
Married
245,110
Others living elsewhere
40,629
No others elsewhere
199,728
Unknown if others
4,753

Widowed/separated/divorced
Other living elsewhere
No other elsewhere
Unknown if other

5.9
0.6
5.0
0.3

19,191
1,983
16,163
1,045

Never married
Adults at home
No adults at home
Not known if adults at home

18.5
2.2
15.6
0.6

60,250
7,118
51,090
2,042

Widowed/separated/divorced
Adults at home
No adults at home
Not known if adults at home

75.1
9.3
64.4
1.5

245,110
30,205
210,152
4,753

0.6

5.4
0.6
4.5
0.4

26.8
3.1
22.8
1.0

67.2
8.5
56.5
2.2

5.4
0.3
4.7
0.4

26.8
3.0
22.8
1.0

67.2
7.7
57.3
2.2

Total
Age Group
Estimated
Less than 40
40-49
50-59
60 and over
Number* Percent Number Percent Number Percent
Number
Percent
Number
Percent
326,526
100.0
47,299
100.0
58,901
100.0
67,606
100.0 151,365
100.0

Marital status/presence of adults
Married
Adults at home
No adults at home
Not known if adults at home

Total

Marital status and others cared for

Table 42. Marital status and presence of others provided care by nurses who were not employed at all and not
seeking nursing employment, by age group: March 2004

APPENDIX A

A-44

5,158
3,535
1,623
4,016
2,686
1,330
8,653
5,320
3,333
10,756
5,537
5,219

6-10 years
Located in same State
Located in different State

11-15 years
Located in same State
Located in different State

16-25 years
Located in same State
Located in different State

26 years or more
Located in same State
Located in different State

885,804
506,160
379,645

713,025
473,756
239,268

311,721
224,864
86,857

398,908
292,632
106,277

395,770
306,632
89,137

100.0
57.1
42.9

100.0
66.4
33.6

100.0
72.1
27.9

100.0
73.4
26.6

100.0
77.5
22.5

487,128
277,741
209,387

120,519
84,660
35,859

24,756
18,011
6,745

25,737
19,783
5,954

12,941
9,255
3,686

100.0
57.0
43.0

100.0
70.2
29.8

100.0
72.8
27.2

100.0
76.9
23.1

100.0
71.5
28.5

188,623
120,928
67,695

348,170
247,733
100,437

191,754
144,725
47,028

234,574
180,471
54,103

228,958
187,935
41,023

100.0
64.1
35.9

100.0
71.2
28.8

100.0
75.5
24.5

100.0
76.9
23.1

100.0
82.1
17.9

206,129
104,891
101,239

242,052
139,900
102,152

94,225
61,738
32,487

137,470
91,423
46,047

152,999
108,680
44,319

100.0
50.9
49.1

100.0
57.8
42.2

100.0
65.5
34.5

100.0
66.5
33.5

100.0
71.0
29.0

* Excludes an estimated 100,792 nurses who graduated in a foreign country, 3,083 nurses who graduated in a U.S. territory (Guam,
U.S. Virgin Islands or Puerto Rico) and an estimated 90,278 nurses for whom the State of graduation is unknown
** State of location is the State in which employed, if employed in nursing, or State of residence if not employed in nursing
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

4,798
3,500
1,298

5 years or less
Located in same State
Located in different State

Type of Initial Nursing Education
Number of years since graduation
Baccalaureate
from initial nursing education
Total
Diploma
Associate degree
and above
program and State of location
Estimated
Estimated
Estimated
Estimated
Number
in sample Number* Percent Number Percent Number Percent Number Percent
Total**
33,508 2,715,206
100.0 672,415
100.0 1,198,792
100.0 834,733
100.0
Located in same State
20,672 1,812,000
66.7 410,390
61.0
887,181
74.0 508,260
60.9
Located in different State
12,836
903,206
33.3 262,025
39.0
311,612
26.0 326,473
39.1

Table 43. Comparison between State of location* of registered nurses as of March 2004 and State of graduation,
by type of initial nursing education and number of years since graduation: March 2004

THE REGISTERED NURSE POPULATION

A-45
29

All US territories

3,083

50,605
20,345
8,444
2,363
1,518
1,271
1,176
1,081
1,006
12,982

100,791

*

50.2
20.2
8.4
2.3
1.5
1.3
1.2
1.1
1.0
12.9

100.0

Total
Estimated
Number
Percent

24

451
214
72
28
13
12
10
7
7
120

934

2,687

46,988
17,668
6,997
2,363
1,010
1,131
997
922
865
10,918

89,860

87.2

92.9
86.8
82.9
100.0
66.6
89.0
84.7
85.3
86.0
84.1

89.2

Employed in nursing
Number
in sample Number
Percent

*Counts from U.S. territories are provided to complement the information for foreign-educated nurses, but are not
included in the totals at the top of the columns
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

481
249
83
28
17
13
12
8
8
142

1,041

Number
in sample

Phillipines
Canada
United Kingdom
Nigeria
Ireland
India
Hong Kong
Jamaica
Israel
All other countries

Total (excluding US Territories)

Country where received initial
nursing education

*

52.3
19.7
7.8
2.6
1.1
1.3
1.1
1.0
1.0
12.2

100.0

Percent of
all employed foreigneducated nurses

Table 44. Top countries where nurses received initial nursing education, by employment status: March 2004

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 45. Top States employing foreign-educated nurses: March 2004
State employing foreign-educated nurses

Number
in sample

Total

Employed in nursing Percent of
Estimated
all employed
Number
Percent
nurses

934

89,860

100.0

3.7%

California
Florida
New York
Texas
New Jersey
Illinois

180
75
61
51
47
37

25,717
9,627
9,337
6,738
6,160
5,060

28.6
10.7
10.4
7.5
6.9
5.6

12.2%
7.3%
5.4%
4.6%
8.4%
4.4%

All other states

483

27,221

30.3

1.7%

NOTE: Estimated numbers may not equal total and percents may not add to 100 because of rounding

A-46

APPENDIX A

Table 46. Employment setting of foreign-educated nurses,
by position of employment: March 2004
Employment setting of foreigneducated nurses
Total
Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/reg/lic agency
Other
Not known

Total
Employed foreigneducated nurses
Number
Percent

Staff nurse
Number
Percent

All other
positions
Number
Percent

89,860

100.0

65,254

100.0

22,993

100.0

58,116
9,962
2,811
4,550
621
634
4,130
745
73
4,003
4,212

64.7
11.1
3.1
5.1
0.7
0.7
4.6
0.8
0.1
4.5
4.7

47,683
6,816
1,817
1,037
568
543
1,968
34
58
1,639
3,093

73.1
10.4
2.8
1.6
0.9
0.8
3.0
0.1
0.1
2.5
4.7

9,923
3,062
968
3,513
53
92
2,149
711
16
1,546
961

43.2
13.3
4.2
15.3
0.2
0.4
9.3
3.1
0.1
6.7
4.2

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-47

THE REGISTERED NURSE POPULATION

Table 47. Comparison between resident States in 2003 and 2004 for the
registered nurse population, by age group: March 2004

Age group
Total
Less than 25 years
25-29 years
30-34 years
35-39 years
40-44 years
45-49 years
50-54 years
55-59 years
60-64 years
65 years and over
Not known

Number
in sample
35,635
609
2,117
3,053
3,646
4,996
6,407
5,816
4,099
2,477
2,085
330

Total
Estimated
Number*
Percent
2,909,357
100.0
61,778
171,659
243,182
289,525
408,248
508,708
463,565
338,078
210,196
185,254
29,165

2.1
5.9
8.4
10.0
14.0
17.5
15.9
11.6
7.2
6.4
1.0

Resident State same
in 2003 and 2004
Number
Percent
2,596,578
100.0
52,581
151,412
219,063
263,713
372,093
459,095
418,020
303,334
185,969
163,747
7,552

2.0
5.8
8.4
10.2
14.3
17.7
16.1
11.7
7.2
6.3
0.3

Resident State different
in 2004 than 2003**
Number
Percent
76,004
100.0
6,100
10,889
11,175
8,428
7,466
8,771
9,404
7,052
4,032
2,505
182

* Includes an estimated 236,775 cases where 2003 vs. 2004 comparison could not be made
** Residence in 2003 may be in a different State, as well as having been in a foreign country or US territory
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-48

8.0
14.3
14.7
11.1
9.8
11.5
12.4
9.3
5.3
3.3
0.2

A-49
18,289
1,164
7
698

20,158
1,455,968
88,803
768
56,210

1,601,748
90.9
5.5
0.0
3.5

100.0
1,206
7,014
7
661

8,888
93,948
564,881
466
53,475

712,770
13.2
79.3
0.1
7.5

100.0

*Excludes an estimated 56,521 nurses whose employment status was not known in 2003
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Employed full-time
Employed part-time
Employed but FT/PT unknown
Not employed in nursing

Total

Employment status in 2004

569
198
12
35

814

44,892
14,895
1,180
2,450

63,417

70.8
23.5
1.9
3.9

100.0

801
492
9
3,923

5,225

70,712
41,410
832
367,877

480,831

14.7
8.6
0.2
76.5

100.0

Employment status in 2003*
Employed full-time
Employed part-time
Employed but FT/PT unknown
Not employed in nursing
Number
Number
Number
Number
Estimated
Estimated
Estimated
Estimated
in sample Number
Percent in sample Number Percent in sample Number Percent in sample Number Percent

Table 48. Comparison of employment status of registered nurse population
in 2003 and 2004: March 2004

APPENDIX A

A-50
16,805
1,997
826
4,543
3,569
1,906
5,402

35,635

Number
in sample

1,360,847
153,172
63,444
360,379
277,774
155,683
488,006

2,909,357
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0
88.8
4.4
5.6
4.5
6.9
6.5
4.4

44.2
0.7
81.2
1.1
1.3
0.7
1.6
1.1

5.1
0.2
0.3
80.0
0.1
0.1
0.2
0.4

2.0

0.9
2.7
1.7
83.0
2.1
4.2
2.3

11.7

Employment setting in 2003
Nursing
Public or
home/
Nursing community
Hospital
ext. care education
health**

0.9
1.3
1.5
1.6
82.2
1.8
1.6

8.9

Ambul.
care

0.4
1.3
0.9
1.1
0.6
72.8
0.9

4.5

Other

* Includes an estimated 50,052 nurses whose employment setting was unknown for 2004 and 150,090 for whom it was unknown for 2003
** Includes student and occupational health
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

Hospital
Nursing home/extended care
Nursing education
Public or community health**
Ambulatory care
Other
Not employed

Total

Employment setting in 2004

Total
Estimated
Number*
Percent

Table 49. Percent distribution of registered nurses in each employment setting in 2004,
by employment setting in 2003: March 2004

3.5
2.3
0.8
0.4
1.1
0.7
0.5

2.1

New
graduate

2.9
4.5
5.0
4.0
2.9
6.0
75.0

15.4

Not
employed

THE REGISTERED NURSE POPULATION

100.0%

Percent distribution of employment
change across geographic areas

A-51
20.9
56.5
81.9
3.8
1.0

Summary of reasons for employment change
Percent reporting any of the following:
24.0
Personal/family reasons
57.4
Personal career reasons
82.7
Workplace reasons
3.9
Retirement reasons
1.1
Other reasons

17.3
54.4
86.3
3.4
0.4

46.7
28.3
1.6
2.8
48.8
31.1
14.0
32.5
33.4
15.2
12.9
3.4
30.6
3.7
0.4

13.5%

63,241

Middle
Atlantic

27.0
57.9
78.6
3.7
0.8

44.4
29.2
2.8
4.4
51.1
28.7
7.1
31.0
31.0
8.9
20.1
3.7
27.5
5.7
0.8

20.0%

93,711

South
Atlantic

20.2
59.0
84.0
2.8
1.2

47.1
29.8
3.2
4.0
53.9
30.5
5.0
34.0
36.2
8.0
14.6
2.8
33.7
2.6
1.2

6.9%

32,270

25.1
53.9
81.8
4.9
1.5

46.4
30.3
2.3
5.3
48.5
29.8
10.4
29.9
37.9
9.5
18.7
4.9
31.0
8.1
1.5

10.7%

49,884

Geographic Area
East
West
South
South
Central
Central

22.7
58.6
85.1
4.2
0.8

46.8
34.2
3.4
5.1
51.8
31.0
9.5
34.5
36.1
10.1
14.7
4.2
33.4
6.5
0.8

15.6%

72,931

East
North
Central

18.1
61.9
81.7
3.7
1.8

46.2
30.0
2.5
3.4
56.4
31.1
10.9
34.8
31.7
10.8
13.9
3.7
29.5
3.0
1.8

8.1%

37,850

West
North
Central

* Includes an estimated 6,082 nurses whose reasons for employment change were not known
NOTE: Estimated numbers and percents may not add up to totals because registered nurses may have answered to more than one reason

44.5
30.7
3.2
3.9
50.6
31.4
7.7
33.7
34.5
11.6
13.4
3.8
28.6
4.5
1.0

5.9%

27,744

New
England

46.0
30.4
2.9
4.1
51.4
30.1
9.3
33.2
34.7
10.3
17.8
3.9
29.6
5.9
1.1

Detailed reason(s) for employment change
Percent reporting any of the following:
Burnout/stressful environment
Career advancement/promotion
Disability
Illness
Interested in other position/job
Lack of collaboration/communication
Laid off/downsizing of staff
Opp'y to do kind of nursing I like
Pay/benefits better
Reorganization that shifted positions
Relocated to different area
Retired
Scheduling/inconvenient hours
Sign-on bonus offered
Other

467,565

Estimated RNs who changed employer
or position

Reason for employment change

Total
United
States*

Table 50. Percent distribution of the registered nurse population in each geographic area who changed
employer or position between March 2003 and 2004, by principal reason for change

30.3
59.3
84.4
2.6
1.1

46.1
31.6
2.8
3.8
53.7
31.7
9.2
32.1
38.0
8.8
24.6
2.6
29.5
8.8
1.1

7.0%

32,692

Mountain

31.3
57.0
82.4
5.4
1.4

46.2
29.5
4.3
3.7
50.9
27.9
8.5
37.9
36.9
9.5
25.2
5.4
24.5
8.8
1.4

12.2%

57,243

Pacific

APPENDIX A

3,492
597
540
937
464
521
433
3,405
685
1,418
1,302
6,149
522
365
1,368
700
728
771
606
719
370
2,210
542
529
549
590
2,897
578
477
570
1,272

Middle Atlantic
New Jersey
New York
Pennsylvania

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

East South Central
Alabama
Kentucky
Mississippi
Tennessee

West South Central
Arkansas
Louisiana
Oklahoma
Texas

35,635

Number
in sample

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

United States

State and geographic area

A-52
260,903
23,818
39,449
29,268
168,368

175,434
42,894
42,971
27,303
62,266

541,752
9,352
12,118
169,460
78,898
53,061
92,391
35,204
73,526
17,742

472,167
92,425
215,309
164,433

189,494
42,894
17,785
89,358
18,473
13,847
7,137

2,909,357

Total
Estimated
Number

225,252
20,115
35,369
24,433
145,336

152,517
36,538
37,631
24,009
54,338

446,850
8,633
11,583
132,758
66,512
47,124
76,761
30,711
56,726
16,042

374,201
72,980
174,208
127,013

157,676
32,718
15,077
75,398
16,670
11,368
6,444

2,421,351

86.3
84.5
89.7
83.5
86.3

86.9
85.2
87.6
87.9
87.3

82.5
92.3
95.6
78.3
84.3
88.8
83.1
87.2
77.2
90.4

79.3
79.0
80.9
77.2

83.2
76.3
84.8
84.4
90.2
82.1
90.3

83.2

Employed in nursing
Number
Percent

35,651
3,703
4,080
4,835
23,032

22,917
6,356
5,340
3,294
7,927

94,902
718
535
36,702
12,386
5,937
15,630
4,493
16,800
1,700

97,966
19,445
41,101
37,420

31,818
10,175
2,708
13,960
1,803
2,479
693

488,006

13.7
15.5
10.3
16.5
13.7

13.1
14.8
12.4
12.1
12.7

17.5
7.7
4.4
21.7
15.7
11.2
16.9
12.8
22.8
9.6

20.7
21.0
19.1
22.8

16.8
23.7
15.2
15.6
9.8
17.9
9.7

16.8

Not employed in nursing
Number
Percent

Table 51. Registered nurse population in each State and geographic area
by activity status: March 2004

677
731
783
693
646

873
807
908
827
921

810
1,040
2,093
763
753
848
899
732
760
884

928
839
906
1,024

1,107
934
1,145
1,175
1,283
1,052
1,037

825

Employed
nurses per
100000*

THE REGISTERED NURSE POPULATION

A-53

4,533
691
687
813
683
548
584
527
4,648
583
709
561
610
559
469
655
502
4,075
494
1,851
529
503
698

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

Pacific
Alaska
California
Hawaii
Oregon
Washington

369,278
7,567
255,858
11,146
34,946
59,761

166,388
48,284
43,719
11,068
9,416
16,206
15,027
18,169
4,498

232,648
37,777
29,892
60,214
66,551
20,026
7,966
10,223

501,293
138,092
64,396
103,697
133,064
62,044

Total
Estimated
Number

306,914
6,777
211,531
9,335
30,850
48,421

137,980
39,136
34,654
8,753
7,914
14,095
13,570
15,778
4,079

202,106
32,664
24,869
51,914
57,365
18,532
7,484
9,278

417,855
113,779
54,624
84,967
112,806
51,679

83.1
89.6
82.7
83.8
88.3
81.0

82.9
81.1
79.3
79.1
84.0
87.0
90.3
86.8
90.7

86.9
86.5
83.2
86.2
86.2
92.5
94.0
90.8

83.4
82.4
84.8
81.9
84.8
83.3

Employed in nursing
Number
Percent

62,365
790
44,327
1,811
4,096
11,340

28,408
9,148
9,065
2,315
1,502
2,111
1,457
2,391
419

30,542
5,113
5,023
8,300
9,186
1,493
482
945

83,438
24,313
9,772
18,730
20,258
10,365

16.9
10.4
17.3
16.2
11.7
19.0

17.1
18.9
20.7
20.9
16.0
13.0
9.7
13.2
9.3

13.1
13.5
16.8
13.8
13.8
7.5
6.0
9.2

16.6
17.6
15.2
18.1
15.2
16.7

Not employed in nursing
Number
Percent

645
1,034
589
739
858
781

697
681
753
628
854
604
713
660
805

1,026
1,106
909
1,018
997
1,061
1,180
1,204

908
895
876
840
984
938

Employed
nurses per
100000*

* Population data were based on July 1, 2004 estimates of resident population of States from Census Bureau Press Release NST-EST2004-01

4,226
1,034
615
856
1,106
615

Number
in sample

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

State and geographic area

Table 51. (cont.) Registered nurse population in each State and geographic area
by activity status: March 2004

APPENDIX A

2,974
463
459
794
428
428
402
2,704
541
1,148
1,015
5,183
479
345
1,073
594
639
641
534
545
333
1,932
464
466
482
520
2,500
489
428
483
1,100

Middle Atlantic
New Jersey
New York
Pennsylvania

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

East South Central
Alabama
Kentucky
Mississippi
Tennessee

West South Central
Arkansas
Louisiana
Oklahoma
Texas

30,233

Number
in sample

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

United States

State and geographic area

A-54
225,252
20,115
35,369
24,433
145,336

152,517
36,538
37,631
24,009
54,338

446,850
8,633
11,583
132,758
66,512
47,124
76,761
30,711
56,726
16,042

374,201
72,980
174,208
127,013

157,676
32,718
15,077
75,398
16,670
11,368
6,444

2,421,351

100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0

Total employed
Estimated
Number*
Percent

178,036
16,521
28,996
18,971
113,548

118,072
27,094
29,239
19,575
42,165

334,833
5,755
8,804
102,542
51,322
32,327
59,298
23,131
39,447
12,207

257,523
46,542
123,892
87,089

95,844
20,751
10,552
43,384
10,666
6,924
3,567

1,696,807

79.0
82.1
82.0
77.6
78.1

77.4
74.2
77.7
81.5
77.6

74.9
66.7
76.0
77.2
77.2
68.6
77.3
75.3
69.5
76.1

68.8
63.8
71.1
68.6

60.8
63.4
70.0
57.5
64.0
60.9
55.4

70.1

Employed full-time
Estimated
Number
Percent

47,115
3,594
6,373
5,360
31,787

34,235
9,284
8,392
4,385
12,174

111,229
2,878
2,779
29,810
15,175
14,796
17,463
7,579
16,913
3,835

115,465
26,297
49,522
39,646

61,592
11,894
4,493
31,906
6,005
4,418
2,877

720,283

20.9
17.9
18.0
21.9
21.9

22.4
25.4
22.3
18.3
22.4

24.9
33.3
24.0
22.5
22.8
31.4
22.7
24.7
29.8
23.9

30.9
36.0
28.4
31.2

39.1
36.4
29.8
42.3
36.0
38.9
44.6

29.7

Employed part-time
Estimated
Number
Percent

Table 52. Supply of registered nurses in each State and geographic area according to whether employed in nursing
on a full-time or part-time basis: March 2004

201,594
18,318
32,183
21,651
129,442

135,190
31,736
33,435
21,768
48,252

390,448
7,194
10,194
117,447
58,910
39,725
68,030
26,921
47,904
14,125

315,256
59,691
148,653
106,912

126,640
26,698
12,799
59,337
13,669
9,133
5,006

2,056,949

Estimated
full-time
equivalent**

THE REGISTERED NURSE POPULATION

A-55

4,011
598
583
703
591
506
552
478
3,968
478
570
451
512
503
424
573
457
3,440
444
1,540
440
446
570

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

Pacific
Alaska
California
Hawaii
Oregon
Washington

306,914
6,777
211,531
9,335
30,850
48,421

137,980
39,136
34,654
8,753
7,914
14,095
13,570
15,778
4,079

202,106
32,664
24,869
51,914
57,365
18,532
7,484
9,278

417,855
113,779
54,624
84,967
112,806
51,679

100.0
100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0
100.0
100.0
100.0

100.0
100.0
100.0
100.0
100.0
100.0

Total employed
Estimated
Number*
Percent

198,159
4,921
139,297
6,620
18,140
29,181

101,042
31,115
23,882
6,049
5,126
11,371
10,083
10,333
3,083

135,260
22,237
17,829
28,994
40,983
13,447
5,297
6,472

278,038
77,462
38,729
56,640
74,979
30,228

64.6
72.6
65.9
70.9
58.8
60.3

73.2
79.5
68.9
69.1
64.8
80.7
74.3
65.5
75.6

66.9
68.1
71.7
55.9
71.4
72.6
70.8
69.8

66.5
68.1
70.9
66.7
66.5
58.5

Employed full-time
Estimated
Number
Percent

108,078
1,836
71,771
2,715
12,638
19,117

36,718
7,841
10,772
2,704
2,788
2,724
3,456
5,445
988

66,768
10,427
6,998
22,920
16,381
5,086
2,187
2,769

139,083
36,055
15,895
27,980
37,701
21,451

35.2
27.1
33.9
29.1
41.0
39.5

26.6
20.0
31.1
30.9
35.2
19.3
25.5
34.5
24.2

33.0
31.9
28.1
44.2
28.6
27.4
29.2
29.8

33.3
31.7
29.1
32.9
33.4
41.5

Employed part-time
Estimated
Number
Percent

*Total includes an estimated 4,261 for whom full-time/part-time status is unknown
** Nurses working full-time plus one-half of working part-time. Excludes 4,261 for whom full-time/part-time status is unknown.

3,521
849
521
699
940
512

Number
in sample

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

State and geographic area

Table 52. (cont.) Supply of registered nurses in each State and geographic area according to whether employed in nursing
on a full-time or part-time basis: March 2004

252,198
5,839
175,183
7,978
24,459
38,740

119,401
35,036
29,268
7,401
6,520
12,733
11,811
13,056
3,577

168,644
27,451
21,328
40,454
49,174
15,990
6,391
7,857

347,580
95,490
46,677
70,630
93,830
40,954

Estimated
full-time
equivalent**

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 53. Registered nurse population, by activity status
and geographic location: March 2004
Total
Estimated
number*
Total
New England
Middle Atlantic
South Atlantic
East South Central
East North Central
West South Central
West North Central
Mountain
Pacific

In metropolitan
statistical area
Employed
Not employed
in nursing
in nursing

Not in metropolitan
statistical area
Employed
Not employed
in nursing
in nursing

2,909,357

2,033,439

407,252

376,021

80,307

189,494
472,167
541,752
175,434
260,903
501,293
232,648
166,388
369,278

135,208
341,382
381,597
107,000
192,727
347,105
141,825
109,116
277,479

27,613
88,495
79,249
16,287
28,631
69,035
20,112
22,152
55,680

21,199
31,258
63,413
44,856
31,367
69,270
59,843
28,303
26,512

4,206
9,270
15,495
6,630
7,020
14,403
10,389
6,210
6,685

* Includes an estimated 12,339 nurses for whom metropolitan/non-metropolitan area status was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

A-56

2,974
463
459
794
428
428
402
2,704
541
1,148
1,015
5,183
479
345
1,073
594
639
641
534
545
333
1,932
464
466
482
520
2,500
489
428
483
1,100

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

Middle Atlantic
New Jersey
New York
Pennsylvania

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

East South Central
Alabama
Kentucky
Mississippi
Tennessee

West South Central
Arkansas
Louisiana
Oklahoma
Texas

United States

State and geographic area

A-57
225,252
20,115
35,369
24,433
145,336

152,517
36,538
37,631
24,009
54,338

446,850
8,633
11,583
132,758
66,512
47,124
76,761
30,711
56,726
16,042

374,201
72,980
174,208
127,013

157,676
32,718
15,077
75,398
16,670
11,368
6,444

26,136
3,484
3,854
2,259
16,538

13,744
3,544
3,080
1,098
6,022

66,077
1,550
935
20,241
8,442
7,756
9,937
4,465
10,654
2,096

79,381
15,662
28,786
34,933

34,280
8,183
2,698
16,684
3,754
1,932
1,030

11.6
17.3
10.9
9.2
11.4

9.0
9.7
8.2
4.6
11.1

14.8
18.0
8.1
15.2
12.7
16.5
12.9
14.5
18.8
13.1

21.2
21.5
16.5
27.5

21.7
25.0
17.9
22.1
22.5
17.0
16.0

92,440
9,396
13,226
11,180
58,637

71,010
13,955
19,628
12,830
24,597

166,135
2,363
2,442
55,437
24,354
13,474
31,009
12,875
17,085
7,096

107,404
19,372
59,407
28,624

41,887
8,304
4,822
17,453
5,310
3,678
2,320

41.0
46.7
37.4
45.8
40.3

46.6
38.2
52.2
53.4
45.3

37.2
27.4
21.1
41.8
36.6
28.6
40.4
41.9
30.1
44.2

28.7
26.5
34.1
22.5

26.6
25.4
32.0
23.1
31.9
32.4
36.0

78,449
5,341
13,154
8,877
51,078

47,229
12,965
11,196
6,892
16,176

146,426
3,360
4,188
38,071
24,229
17,193
24,286
8,916
21,052
5,131

129,081
27,013
56,781
45,288

53,779
10,444
5,434
26,536
4,972
4,238
2,155

34.8
26.5
37.2
36.3
35.1

31.0
35.5
29.8
28.7
29.8

32.8
38.9
36.2
28.7
36.4
36.5
31.6
29.0
37.1
32.0

34.5
37.0
32.6
35.7

34.1
31.9
36.0
35.2
29.8
37.3
33.4

Table 54. Registered nurses employed in nursing in each State and geographic area,
by highest nursing or nursing-related educational preparation: March 2004
Highest nursing or nursing-related educational preparation
Total
Number Estimated
Diploma
Associate Degree
Baccalaureate
in sample Number*
Number
Percent
Number
Percent
Number
Percent
30,233 2,421,351
369,741
15.3
861,949
35.6
841,554
34.8

24,033
1,376
4,298
1,760
16,599

17,153
5,296
3,132
2,747
5,978

60,328
1,260
3,645
16,516
8,101
7,656
10,645
3,939
7,080
1,487

51,787
8,966
25,983
16,838

26,014
5,498
1,935
13,846
2,487
1,339
909

10.7
6.8
12.2
7.2
11.4

11.2
14.5
8.3
11.4
11.0

13.5
14.6
31.5
12.4
12.2
16.2
13.9
12.8
12.5
9.3

13.8
12.3
14.9
13.3

16.5
16.8
12.8
18.4
14.9
11.8
14.1

Masters and
doctorate
Number
Percent
310,474
12.8

APPENDIX A

A-58

4,011
598
583
703
591
506
552
478
3,968
478
570
451
512
503
424
573
457
3,440
444
1,540
440
446
570

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

Pacific
Alaska
California
Hawaii
Oregon
Washington

306,914
6,777
211,531
9,335
30,850
48,421

137,980
39,136
34,654
8,753
7,914
14,095
13,570
15,778
4,079

202,106
32,664
24,869
51,914
57,365
18,532
7,484
9,278

417,855
113,779
54,624
84,967
112,806
51,679

30,253
1,045
20,564
1,041
3,387
4,216

15,924
5,213
4,675
563
1,146
1,603
1,426
846
451

38,152
8,175
4,116
7,077
10,954
5,071
1,476
1,281

65,795
17,289
6,492
10,728
23,951
7,336

9.9
15.4
9.7
11.1
11.0
8.7

11.5
13.3
13.5
6.4
14.5
11.4
10.5
5.4
11.1

18.9
25.0
16.6
13.6
19.1
27.4
19.7
13.8

15.7
15.2
11.9
12.6
21.2
14.2

109,067
1,670
74,918
2,372
12,637
17,470

51,991
16,227
8,910
3,953
2,345
5,782
5,227
7,486
2,061

70,504
14,283
8,451
18,802
20,396
3,640
1,200
3,731

151,510
39,049
23,656
35,848
36,656
16,301

* Includes an estimated 37,634 nurses for whom highest nursing education was not known
NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

3,521
849
521
699
940
512

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

State and geographic area

35.5
24.6
35.4
25.4
41.0
36.1

37.7
41.5
25.7
45.2
29.6
41.0
38.5
47.4
50.5

34.9
43.7
34.0
36.2
35.6
19.6
16.0
40.2

36.3
34.3
43.3
42.2
32.5
31.5

117,329
2,627
80,906
4,549
9,754
19,493

51,706
12,564
15,634
3,277
3,543
5,534
4,604
5,476
1,074

69,666
7,584
9,251
19,649
18,236
7,473
3,861
3,614

147,887
41,034
18,911
26,904
39,068
21,971

38.2
38.8
38.2
48.7
31.6
40.3

37.5
32.1
45.1
37.4
44.8
39.3
33.9
34.7
26.3

34.5
23.2
37.2
37.8
31.8
40.3
51.6
38.9

35.4
36.1
34.6
31.7
34.6
42.5

Table 54. (cont.) Registered nurses employed in nursing in each State and geographic area,
by highest nursing or nursing-related educational preparation: March 2004
Highest nursing or nursing-related educational preparation
Total
Number Estimated
Diploma
Associate Degree
Baccalaureate
in sample Number*
Number
Percent
Number
Percent
Number
Percent

45,520
1,379
32,178
1,251
4,179
6,534

16,344
4,321
4,946
871
810
1,033
2,105
1,808
449

21,536
2,406
2,926
5,766
7,044
2,014
857
521

47,760
14,990
4,933
10,627
11,750
5,460

14.8
20.3
15.2
13.4
13.5
13.5

11.8
11.0
14.3
9.9
10.2
7.3
15.5
11.5
11.0

10.7
7.4
11.8
11.1
12.3
10.9
11.4
5.6

11.4
13.2
9.0
12.5
10.4
10.6

Masters and
doctorate
Number
Percent

THE REGISTERED NURSE POPULATION

A-59

81.8
4.2
2.9
0.2
0.3
1.7
1.4
7.5

2,909,357

NOTE: Percents may not add to 100 because of rounding

Racial/ethnic background
White (non-hispanic)
Black/African American (non-hispanic)
Asian (non-hispanic)
Native Hawaiian/Pacific Islander (non-hisp)
American Indian/Alaska Native (non-hisp)
Hispanic/Latino (any race)
Two or more races (non-hispanic)
Not known

Estimated RN population in area

Racial/ethnic background

Total
United
States

89.3
1.8
1.0
0.0
0.1
0.7
1.0
6.1

189,494

New
England

82.6
4.2
3.3
0.2
0.2
1.1
0.9
7.5

472,167

Middle
Atlantic

79.6
7.3
1.9
0.0
0.4
1.4
1.3
8.0

541,752

South
Atlantic

83.9
6.3
0.7
0.0
0.2
0.8
1.8
6.3

175,434
75.3
6.4
3.0
0.2
0.7
3.5
2.3
8.6

260,903

Geographic Area
East
West
South
South
Central
Central

86.7
3.0
1.7
0.1
0.1
0.8
0.9
6.6

501,293

East
North
Central

89.7
2.1
0.6
0.0
0.4
0.5
1.3
5.5

232,648

West
North
Central

Table 55. Racial/ethnic background distribution (percents) of registered nurses, by geographic area: March 2004

84.2
1.2
2.6
0.2
0.6
2.7
1.6
6.9

166,388

Mountain

71.2
2.7
9.0
0.9
0.5
3.6
2.3
9.8

369,278

Pacific

APPENDIX A

A-60
46.8
47

Average age
Median age

48.3
49

1.7
4.6
5.3
10.4
13.9
18.1
17.2
12.3
7.8
8.5
0.3

189,494

New
England

NOTE: Percents may not add to 100 because of rounding

2.1
5.9
8.4
10.0
14.0
17.5
15.9
11.6
7.2
6.4
1.0

2,909,357

Age group
Less than 25 years
25-29 years
30-34 years
35-39 years
40-44 years
45-49 years
50-54 years
55-59 years
60-64 years
65 years and over
Not known

Estimated RN population in area

Age group

Total
United
States

48.2
48

1.2
3.7
6.8
10.4
14.4
17.3
15.6
11.9
8.0
8.0
2.7

472,167

Middle
Atlantic

46.8
47

1.9
6.0
8.7
10.4
14.0
17.0
15.4
11.7
7.4
6.4
1.2

541,752

South
Atlantic

44.3
45

3.1
8.6
11.0
11.7
14.9
17.2
14.3
9.7
4.9
4.2
0.4

175,434

45.7
47

2.3
7.4
10.4
9.5
13.4
18.5
16.2
11.2
6.5
4.6
0.1

260,903

Geographic Area
East
West
South
South
Central
Central

46.2
47

2.5
6.6
8.8
9.9
14.9
17.7
14.8
10.7
7.0
5.8
1.3

501,293

East
North
Central

45.5
46

4.2
6.4
9.0
9.7
15.1
17.7
16.4
9.8
6.7
4.7
0.3

232,648

West
North
Central

Table 56. Age distribution (percents) and average age of registered nurses, by geographic area: March 2004

47.0
48

2.2
6.4
8.1
9.0
13.4
17.2
17.0
12.7
7.6
6.0
0.3

166,388

Mountain

48.0
49

1.4
5.5
7.9
8.6
12.3
17.2
17.9
13.9
7.8
7.4
0.2

369,278

Pacific

THE REGISTERED NURSE POPULATION

A-61

1,362,937
153,366
63,833
260,730
78,539
22,569
278,093
43,641
8,774
103,310
50,073

Hospital
Nursing home/extended care facility
Nursing education
Community/public health setting
School Health Service
Occupational Health
Ambulatory care setting
Policy/planning/reg/lic agency
Insurance claims/benefits
Other
Not known

79,382
15,529
3,228
19,183
9,864
1,906
15,504
3,103
236
6,750
2,991

157,676

New
England

196,249
28,162
9,481
43,857
18,986
3,469
39,218
7,543
1,457
17,220
8,558

374,201

Middle
Atlantic

257,124
18,876
12,059
50,134
10,524
3,897
50,497
8,992
3,037
20,168
11,541

446,850

South
Atlantic

88,696
8,240
4,499
16,504
2,866
1,093
18,041
2,660
439
5,784
3,695

152,571
130,834
9,817
9,089
22,451
9,784
2,279
24,948
3,565
112
7,943
4,431

225,252

Geographic Area
East
West
South
South
Central
Central

NOTE: Estimated numbers may not equal totals, and percents may not add to 100, because of rounding

2,421,351

Total
United
States

Estimated RN population in area

Employment setting of principal nursing
position

235,466
32,856
10,707
43,093
10,148
4,551
49,480
6,004
1,372
16,571
7,607

417,855

East
North
Central

113,348
17,010
5,610
19,792
5,159
1,318
25,468
3,513
618
7,741
2,530

202,106

West
North
Central

78,577
7,486
2,782
14,709
3,397
981
17,969
3,151
487
6,263
2,177

137,980

Mountain

Table 57. Employment setting of principal nursing position for registered nurses in each geographic area: March 2004

181,170
15,195
5,990
30,187
7,294
2,953
36,648
5,109
975
14,871
6,522

306,914

Pacific

APPENDIX A

THE REGISTERED NURSE POPULATION

Table 58. Average annual earnings from principal nursing position
of registered nurses in full-time staff nurse
positions in each geographical area: March 2004
Geographic area of employment

Number
in sample

Total
New England
Middle Atlantic
South Atlantic
East South Central
West South Central
East North Central
West North Central
Mountain
Pacific

Full-time staff nurses
Estimated
Annual
Number*
earnings

11,609

934,653

$53,086

957
980
2,062
820
1,093
1,253
1,512
1,637
1,295

50,924
136,903
182,283
64,865
98,025
152,242
76,457
58,537
114,416

$57,451
$56,960
$51,137
$46,583
$50,521
$50,028
$46,108
$51,938
$64,685

*Excludes an estimated 42,612 full-time staff nurses who did not report annual earnings
NOTE: Estimated numbers may not equal totals because of rounding

A-62

APPENDIX B

APPENDIX B

SURVEY METHODOLOGY

APPENDIX B

APPENDIX B

SURVEY METHODOLOGY

The eighth cycle of the National Sample Survey of
Registered Nurses (NSSRN) followed the same
basic sample design as its predecessors. The
sample design was originally developed by Westat,
Inc. under a contract with the Division of Nursing,
BHPr, HRSA in 1975-76 and can be best described
as a systematic sample of alphabetic clusters of
names in each State using a ‘nested alpha segment
design’. Prior to sampling, each State was ranked
by the sampling rate such that the highest priority
States were those with the highest sampling rate
(for the most part, small States). As a result, the
alphabetic clusters of names for lower priority
States are ‘nested’, or included, within those of
higher priority States. This means that a sample
name selected in one State (such as California) will
also have been selected in every State with a
higher priority (in the case of California, this is all
other States).
This design approach takes into account two key
characteristics of the sampling frame. First, no
single list of all individuals with licenses to
practice as registered nurses in the United States
exists, although lists of those who have licenses in
any one State are available. Second, a nurse may
be licensed in more than one State. The advantage
of the nested alpha-segment design is that one can
determine the probabilities of selection and
appropriate multiplicity adjusted weights for those
nurses that are listed in more than one State. In
addition, the design also permits the use of each

sample registered nurses’ data for State estimates
of each of her/his States of licensure.
This appendix provides a brief summary of the
methodology of the NSSRN including the
sampling frame, sample design and the statistical
techniques used in summarizing the data. It also
includes a discussion of sampling errors, provides
the standard errors for key variables in the study
and presents a simplified methodology for
estimating standard errors.

Sampling Frame
The target population for the eighth NSSRN
included all registered nurses with an active license
in the United States as of March 2004. A sampling
frame was required to select a probability sample
of nurses from which valid inferences could be
made to the target population. The sampling frame
for the eighth NSSRN consisted of all registered
nurses who are currently eligible to practice as an
RN in the U.S. This sampling frame included RNs
who have received a specialty license or have been
certified by a State agency as an advanced
practiced nurse (APNs) such as nurse practitioner,
certified nurse midwives, certified registered nurse
anesthetist, or clinical nursing specialist and
excluded licensed practical nurses (LPNs)/licensed
vocational nurses (LVNs).

B-1

THE REGISTERED NURSE POPULATION

State Boards of Nursing in the 50 States and in the
District of Columbia (hereafter also referred to as a
State) provided files containing the name, address,
and license number of every RN currently holding
an active license in that State. These files formed
the basis of the sampling frame from which the
RNs for each State were selected. The licensure
files provided by the States were submitted on
diskette or compact disk (twenty States), or
electronically as an attachment to an e-mail
message (twenty-seven States). Three States sent
the data via FTP and another provided the data on
their website. For this study, States were also
asked to identify nurses for whom the State
provided advanced practice nurse (APN) status. In
some cases, the State identified these nurses on the
basic list provided. However, some APNs were
identified on separate lists and their APN status
was appended to the information on the RN
sampling frame.
Each of the 51 State files was checked for
consistency, names were standardized, and
duplicates and ineligible records were removed
from the State list to prepare the list for sampling.

Sample Design
The NSSRN 2004, the eighth in the series,
continued to oversample nurses in small States in
order to better support HRSA’s National Center for
Health Workforce Analysis’ State level supply and
demand projections for registered nurses. The
basic design was enhanced by using sample design
optimization methodology developed by Chromy 1
to determine the sample allocation to the States
that would simultaneously satisfy variance
constraints defined by the 51 States and the total
U.S.
In the original sample design, and in the 1988
redesign, the universe of RNs was sorted
alphabetically by last name and approximately
equal-sized clusters of RNs were constructed by
partitioning the alphabetically ordered list into 250
alpha-segment clusters with equal (or nearly equal)
1 Chromy, James R. “Design Optimization with Multiple
Objectives”. American Statistical Association of the Section
on Survey Research Methods, Arlington, VA., pp A4-199

numbers of RNs. An alpha-segment was defined
as all alphabetically adjacent names falling within
pre-specified boundaries. For example, all names
beginning with the lower boundary, up to but not
including the name that defined the upper
boundary.
From the frame of 250 equally divided alphasegments, a total of 40 alpha-segments were
randomly selected, representing a 16 percent
sampling rate overall. Registered nurses are
selected in the sample based on their name, with an
RN being included in the sample if the name of
licensure falls into one of the alphabetic segments
that are in sample for that State.
Although each State had 40 sample segments, the
sample size of each State differed in size
depending on the State’s sampling rate. While
uniform-sampling rates would have produced the
best national estimates, the resulting sample sizes
for the smallest States would have been inadequate
to support State-level estimates.
Since both
national and State-level estimates are required for
the 2004 NSSRN, as was done is prior surveys,
sampling rates were increased in the smaller States
to obtain larger State-level sample sizes. While
this disproportionate sampling improved the
precision of estimates in the smaller States, it also
reduced precision of national estimates due to
unequal weighting effects. .
To accommodate the differing State sampling
rates, a planned variation in the size of the
segments, i.e., “portions of alpha segments” was
used. Each of the 40 alpha-segments selected for
sample was divided into ½-, ¼-, 1/8-, 1/16-, and
1/32- portions. These fractions indicate the size of
the alpha segment portion relative to the size of the
basic alpha-segment.
The sampling rate for a particular State was
achieved using a combination of the alpha-segment
portions. As a result, each State contains some
sample (i.e., a portion) from each of the 40 alphasegments, depending on the sampling rate for the
State.
For example, selecting the entire 40
complete alpha segments on a State list is expected
to constitute a 16 percent sampling rate (40 ÷ 250
= 0.16) in the State. This is because each alpha
segment contained an expected 0.4% of the State’s

B-2

APPENDIX B

RN names (40 X 0.4 percent = 16 percent).
Likewise, the sample for a State with an 8 percent
sampling rate consisted of the 40 ½ portion
selections.
Several sampling rates use a
combination of portions for each alpha-segment in
sample (rather than one fractional portion for all
alpha-segments).
For example, a 5 percent
sampling rate was achieved by first randomly
dividing the 40 alpha-segments into two groups,
the first containing 30 alpha-segments and the
other containing 10; and by using the ¼ portions
from the first group and the ½ portions from the
second group (0.4 percent x [(30 x ¼) + (10 x ½)]
= 5 percent).
To identify and account for nurses appearing in
more than one of the 51 State lists, the portions
were constructed such that each portion was
“nested” (or included) in the boundaries of the
larger portion. As a result, the alpha segment
clusters from the States with lower sampling rates
(typically larger States) were automatically
included in the alpha segment clusters selected
from the States with higher sampling rates
(typically smaller States).
As a result, a RN who was licensed under the same
name in two States with identical sampling rates
was selected (or not selected) for both States, since
the alphabetic name boundaries defining the
portions are the same for both States. However, if
the RN was licensed under the same name in two
States that are sampled with different sampling
rates, then, if the RN was sampled in the State with
a lower sampling rate, they were also included in
the sample for the State with the higher sampling
rate (as the alphabetic name boundaries defining
the portions for the State with the lower sampling
rate are nested within those of the State with the
higher sampling rate). This nesting property of the
sample design maximizes the chances that the RN
will be selected in all States that they have an
active license in. A nurse that is licensed in two or
more States under the same name will have a
probability of selection corresponding to the State
with the highest sampling rate.
Sample design optimization techniques developed
by Chromy (1996) were used to determine how to
allocate the sample of 54,000 RNs to the 51 State
lists. This sample size was then converted to a

sampling rate, and the rate was rounded to one of
the admissible rates for the nesting design. For
example, the original rate for the State of
Washington was 1.59%, the closest admissible rate
was 1.5%. Rates were rounded down only such
that the change in sampling rate still left their
effective sample size at or above the 1996 NSSRN
level.
After determination of frame sizes and expected
sampling rates, the States were assigned a priority
order to properly determine selection probabilities
for nurses appearing on more than one of the 51
State lists. Traditionally, States were ordered by
size, with larger States having lower sampling rates
and smaller States having higher sampling rates.
However, as in the 2000 NSSRN, States were
priority ordered based on their sampling rate. As
such, it is mostly, but not necessarily, the case that
States with larger RN populations had lower
sampling rates.
Essentially the same procedure was followed for
sample selection for all States. Once a State
provided a licensure file containing all appropriate
names of individuals with active RN licenses and
meeting all specifications, the required sample
names in that file were selected. Regardless of the
way a State alphabetized and standardized the
names in its files, the sample names were selected
according to the standards established by the
survey design. That is, sample selections ignored
blanks and punctuation in the last names (except a
dash in hyphenated names) and ignored titles
(e.g.,”Sister”).
Registered nurses were selected in the sample on
the basis of name, with an RN being included in
the sample if the name of licensure fell within a
specific alpha-segment portion as defined by the
State sampling rate. In other words, the sample for
a given State consisted of all RN names falling into
any one of the State’s pre-designated 40 alphabetic
portions that corresponded to the State sampling
rate (one portion from each of the complete 40
alpha-segments in sample).
The pairs of names that defined the alpha-segment
portion constituted the lower and upper boundaries
corresponding to the sampling rate. Thus, the
membership of the alpha-segment portion was

B-3

THE REGISTERED NURSE POPULATION

defined by all names, beginning with the lower
boundary (i.e., the last name in alphabetical order
of all the names included in that segment), up to
but not including a name that defined the upper
boundary. This latter name fell into the next alphasegment. As was done in the NSSRN 2000, any
deviations of more than 8 percent were candidates
for either an increased or decreased rate.
Because the survey is longitudinal in nature, a
panel structure was constructed to allow for several
of the sample alpha-segments to be systematically
replaced each survey. Under the original survey
design, the 40 sample alpha-segments were
arranged in alphabetical order and then partitioned
into eight groups of five successive alpha-segments
each. One segment from each group was randomly
assigned to each panel, so that each panel consisted
of segments that spanned the entire alphabet. For
each successive survey, a new panel (consisting of
eight new alpha-segments or 20 percent of the
sample) was entered into the sample, replacing one
of the five panels from the previous survey. Under
this scheme, a nurse who maintained an active
license in the same State(s) could be retained in the
sample for up to five surveys.

distribution of nurses’ names. States are priority
ordered by sampling rate and size.
Because many nurses are licensed in more than one
State, their names could be selected in the sample
more than once. In accordance with the sample
design, we ensured that each sampled RN was
retained in the outgoing sample file exactly once to
avoid multiple questionnaires being sent to nurses.
If we identified an exact duplicate, the nurse in the
lower priority State was coded as a duplicate of the
sample member in the higher priority State. For
example, an Alaska record was coded as a
duplicate to the sample record in Wyoming.
Following data collection, these expected
duplicates were reviewed to ensure that the nurse
reported a license in both of the States.

The planned NSSRN 2004 sample size was 54,000
cases, similar to that of the NSSRN 2000, and up
from the 45,000 used in previous studies. Planned
sampling rates ranged from 1.125 percent in
several of the largest States to 15 percent in
Wyoming. This translated into planned sample
sizes ranging from 3,225 RNs in California to
approximately 796 in Wyoming. The initial round
of sampling, however, yielded a much smaller
sample than expected due to the variable size of
the alpha-segments in each State. Thus, a second
round of sampling was done by increasing the
sampling rates from 1 to 1.125 in the eleven largest
States and “adding to” the sample selected in the
first round, yielding a total of 56,917 sample cases.
After eliminating cross-State duplications, the
expected the sample size to be fielded was still
approximately 54,000 cases.
Table B-1 in Appendix B shows the sampling rates
and sample sizes that were planned and actually
obtained for the 51 States in the survey.
Differences between planned and actual sampling
rates result from State-specific variation in the

B-4

APPENDIX B

Table B-1. State Sampling Rates and Sample Sizes (Priority Ordered)
Sampling Rate Percentage

State
TOTAL
Wyoming
Alaska
Vermont
District of Columbia
North Dakota
Delaware
Montana
South Dakota
Idaho
Hawaii
Nevada
Rhode Island
New Mexico
New Hampshire
Utah
Maine
Nebraska
Arkansas
West Virginia
Mississippi
Oklahoma
Kansas
Iowa
South Carolina
Oregon
Louisiana
Colorado
Connecticut
Alabama
Kentucky
Arizona
Maryland
Washington
Minnesota
Wisconsin
Tennessee
Indiana
Missouri
Georgia
Virginia
North Carolina
Massachusetts
New Jersey

Priority
Order
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43

Frame Size
3,252,548
5,309
7,389
8,728
17,104
8,139
10,407
10,885
10,773
12,769
13,548
19,201
17,203
17,544
19,108
19,210
19,869
20,100
27,878
21,295
31,734
32,185
34,047
40,312
38,265
38,453
43,299
48,586
52,364
46,974
47,123
51,482
56,922
66,397
66,434
63,865
65,827
70,488
74,508
86,369
85,705
96,877
105,206
109,726

Planned

Actual 2

15.00%
13.00%
10.00%
10.00%
9.00%
9.00%
8.00%
7.00%
7.00%
7.00%
7.00%
5.50%
5.00%
5.00%
4.50%
4.50%
3.50%
3.50%
3.50%
3.00%
3.00%
3.00%
2.50%
2.50%
2.00%
2.00%
2.00%
2.00%
1.75%
1.75%
1.75%
1.50%
1.50%
1.50%
1.25%
1.25%
1.25%
1.25%
1.25%
1.25%
1.125%
1.125%
1.125%

15.60%
11.88%
9.53%
9.71%
9.74%
8.87%
8.15%
6.88%
6.75%
7.44%
6.25%
5.37%
4.98%
4.71%
4.97%
4.50%
3.56%
3.52%
3.13%
3.13%
2.93%
3.10%
2.31%
2.47%
1.95%
1.75%
2.14%
1.96%
1.81%
1.77%
1.72%
1.47%
1.44%
1.59%
1.24%
1.29%
1.23%
1.28%
1.26%
1.21%
1.146%
1.350%
1.067%

2

Actual
Sample
Size
56,917
828
878
832
1,661
793
923
887
741
862
1,008
1,200
923
874
900
954
894
716
982
667
994
944
1,057
933
944
750
757
1,042
1,025
852
832
887
835
954
1,056
793
849
867
953
1,086
1,036
1,110
1,420
1,171

Since the actual distribution of names differs for each State from the frame distribution used to develop the 250 alpha-segments,
some variation occurs between the planned and actual sampling rates.

B-5

THE REGISTERED NURSE POPULATION

Sampling Rate Percentage

State
Michigan
Ohio
Illinois
Texas
Pennsylvania
Florida
New York
California

Priority
Order
44
45
46
47
48
49
50
51

Frame Size
117,360
140,689
154,572
176,652
191,628
201,113
244,288
286,639

Planned
1.125%
1.125%
1.125%
1.125%
1.125%
1.125%
1.125%
1.125%

B-6

Actual 2
1.161%
1.124%
1.124%
1.066%
1.037%
1.086%
1.061%
1.018%

Actual
Sample
Size
1,363
1,581
1,738
1,883
1,988
2,184
2,592
2,918

APPENDIX B

Weighting Procedures
^

The probability sample design of the survey
permits the computation of unbiased estimates of
characteristics of the RN population at the National
and State level. These estimates are based on
weights that reflect the complex design and
compensate for the potential risk of nonresponse
bias to the extent feasible. The weights that are
assigned to each sample nurse may be interpreted
as the number of nurses in the target population
that the sample nurse represents. The sampling
weight for an RN is the reciprocal of the nurse’s
probability of selection in her/his priority State,
adjusted to account for nonresponse and multiple
licenses.
Before computing the weights, the original State
frame sizes (shown above) were adjusted to
account for duplicate licenses within States and
ineligible licenses (i.e., frame errors) found in the
sample.
Most within-State duplicates were
identified at the time of initial list processing, but a
few were identified after sample selection. The
ineligible licenses were identified in the process of
reconciling the State and nurse reported licenses.
Some of the inconsistencies between the State
reported data and the nurse reported data are due to
the time period that elapsed between frame
construction and data collection (a period during
which changes and license expirations naturally
occur). Other differences are due to errors in either
the State list or the nurse’s questionnaire. Cases
that could not be reconciled by Gallup were sent to
the State Boards of Nursing for resolution.

E i = the estimated number of frame errors in
State i (e.g., licenses listed by State that were not
reported by a responding nurse).
Each responding nurse was assigned a weight
corresponding to their unique ‘priority State’; that
is, the State with the highest sampling rate from
which he or she was licensed and selected into the
sample. In other words, the weight is reflective of
the probability of selecting the sampled nurse in
their “priority” State. All nurses with the same
priority State have an equal probability of being
selected and, consequently, have equal initial
sampling weights. The sum of the weights for all
nurse respondents assigned to a specific priority
State will equal, approximately, the total number
of active licenses on the list (at the time the sample
was drawn) less the number of those licenses
assigned to higher priority lists.
The weights were computed sequentially for each
State A, B, etc., where A was the highest-priority
State, and B the next-highest-priority State. The
weight for an RN sampled from the highest priority
State, State A, was the ratio of the adjusted count
of licenses in the sampling frame for State A to the
number of eligible respondents licensed in State A.
For State B, and the remaining States, the
numerator and denominator of this ratio were
adjusted to account for State A and other higherpriority States. To describe the basic method, the
following terms are defined:

In both cases, the frame total is computed by
subtracting the estimated number of ineligible and
duplicate licenses from the State’s original frame
count. The adjusted frame total used to compute
the resulting weights for State i can be computed
as:
^

^

N 'i = N i − D i − E i
where:
Ni = the total number of licenses on State i list,
^

D i = the estimated number of within-State
duplicates in State i,and
B-7

N(i) =

total number of licenses for State i
(adjusted for within-State duplicates
and frame errors)

m(i) =

number of eligible respondents for
State i that did not have a license in a
higher-priority State

n(i,j) =

number of eligible respondents with a
license in both State i and State j [note
n(i,i) denotes the number of eligible
respondents with a license only in
State i]

THE REGISTERED NURSE POPULATION

W(i) =

the adjusted weight for eligible
respondents who were assigned to the
higher priority State i

Xk =
=

1 if nurse k worked in a particular State,
0 otherwise.

The desired estimated total may then be written as
The weight for State A was computed as follows:

ˆ = Wk Xk ,
X
∑

W(A) = N(A) / m(A).

k

the sum being over all sample nurses.
For the State B weight, W(B), the numerator was
the adjusted frame count of licenses for State B,
N(B), after removing the estimated total count of
State B nurses who were also licensed in State A
(i.e., W(A) n(A,B)). Similarly, the numerator of
W(C) excluded State C nurses who were also
licensed in either State A or State B (i.e., W(A)
n(A,C) + W(B) n(B,C)). That is, for the State B
weight and the State C weight, the computations
were:
W(B) = [N(B) - W(A) n(A,B)] / m(B)
W(C) = [N(C) - W(A) n(A,C) - W(B) n(B,C)] /
m(C) .
In either case, the denominator was the number
(m(B) or m(C)) of respondents in the State not
licensed in a higher-priority State.
In general, the numerator of a State I weight, W(I),
was the total adjusted frame count of RN licenses
in State I after removing the estimated total count
of State I nurses also licensed in higher-priority
States. The denominator, m(I), was the number of
State I respondents not licensed in a higher-priority
State. This weighting scheme incorporated both a
nonresponse adjustment that inflated the
respondents’ data to account for those that did not
respond to the survey and a duplication adjustment
to account for duplication in the sampling frame
across States. These final analysis weights will
serve to differentially weight responding nurses to
reflect the level of disproportionality in the final
respondent sample relative to the population.

Estimation Procedure
Final NSSRN estimates can be computed using the
final set of sampling weights, Wk (for sample
nurse k). For example, an estimate of the total
number of RNs working in a particular State is
based on the following indicator variable, Xk:

Estimates of ratios and averages are obtained as the
ratio of estimated totals.

Sampling and Nonsampling Errors
To the extent that samples are sufficiently large,
relatively precise estimates of characteristics of the
licensed RN population of the United States can be
made because of the underlying probability
structure of the sample data. Such estimates are,
sometimes, an imperfect approximation of the
truth. Several sources of error could cause sample
estimates to differ from the corresponding true
population value. These sources of error are
commonly classified into two major categories:
sampling errors and nonsampling errors.
A probability sample such as the one used in this
study is designed so that estimates of the
magnitude of the sampling error can be computed
from the sample data. In addition, nonsystematic
components of nonsampling error are also reflected
in the sampling error estimates.

Nonsampling Errors
Some sources of error, such as unusable responses
to vague or sensitive questions; no responses from
some nurses; and errors in coding, scoring, and
processing the data are, to a considerable extent,
beyond the control of the sampling statistician.
They are called “nonsampling errors” and also
occur in cases where there is a complete
enumeration of a target population, such as the
U.S. Census. Among the activities that were
directed at reducing nonsampling errors to the
lowest level feasible for this survey included
careful planning, keeping nonresponses to the
lowest feasible level, and coding and processing of
the sample data.

B-8

APPENDIX B

If nonsampling errors are random, in the sense that
they are independent and tend to be compensating
from one respondent to another, then they do not
cause bias in estimates of totals, percents, or
averages. Furthermore, the contribution from such
nonsampling errors will automatically be included
in the sampling errors that are estimated from the
sample data.
However, correlations or
relationships in cross-tabulations are often
decreased by such errors, and sometimes
substantially. Thus, random errors that tend to be
compensated for in estimates of simple aggregates
or averages may (but not necessarily will)
introduce systematic errors or biases in measures
of relationships or cross-tabulations.
Nonsampling errors that are systematic (rather than
random and compensating) are a source of bias for
sample estimates. Such errors are not reduced by
increasing the size of the sample, and the sample
data do not provide an assessment of the
magnitude of these errors. Systematic errors are
reduced in this study by such efforts as careful
wording of questionnaire items, respondent
motivation, and well-designed data-collection and
data-management procedures.
However, such
errors sometimes occur in subtle ways and are less
subject to design control than is the case for
sampling errors.
Nonresponse to the survey is one of the largest
sources of nonsampling error because a
characteristic being estimated may differ, on
average, between respondents and nonrespondents.
For this reason, considerable effort has been
expended in this survey to obtain a high response
rate by respondent motivation and follow-up
procedures. A high response rate reduces both
random and systematic nonsampling errors. After
taking into account duplicates and frame errors, the
overall response rate to this survey was 70.47
percent. State-level response rates ranged from
61.98 percent to 81.57 percent except for the
District of Columbia where the response rate
(46.12 percent) was significantly lower.
Sampling Errors
All sample survey estimates are subject to
sampling error. The magnitude of the sampling
error for an estimate, as indicated by measures of

variability such as its variance or its standard error
(the square root of its variance), provides a basis
for judging the precision of the sample estimates.
Systematic sampling, which was the selection
procedure used in choosing the alpha-segments for
this study, is convenient from certain practical
points of view, including providing for panel
rotation. However, it does not permit unbiased
estimation of the variability of survey estimates
unless some assumptions are made. Thus, standard
errors were estimated based upon the assumption
that the systematic sample of 40 alpha-segments is
equivalent to a stratified random sample of two
alpha-segments from each of 20 strata of adjacent
alpha-segments.
Ordinarily, this assumption
should lead to overestimates of the sampling error
for systematic sampling, but in this case (with
alpha-segments as the sampling units) the
magnitude of the overestimate is believed to be
trivial.
Regarding the sample as consisting of 20 pairs of
alpha-segments (thus obtaining 20 degrees of
freedom) for variance estimation, the probability is
approximately 0.95 that the statistic of interest
differs from the value of the population
characteristic that it estimates by not more than
2.086 standard deviations.
Specifically, a 95 percent confidence interval for
an estimated statistic xˆ takes the form:

xˆ ± 2.086 σˆ xˆ ,
where σˆ xˆ is the estimated standard error for xˆ .

Direct Variance Estimation
Similar to prior cycles of the NSSRN, direct
estimates of sampling variance were obtained for a
set of important variables for each State and for the
United States using the jackknife variance
estimation procedure with 20 replicates of the
sample. Variance estimates using the jackknife
approach require the computation of a set of
weights for the full sample and a set for each
replicate using the established weight computation
procedure (i.e., 20 additional sets of weights).

B-9

THE REGISTERED NURSE POPULATION

Having 20 sets of weights permits construction of
20 replicate estimates to compare with the estimate
produced from all of the data; each replicate
estimate is based on about 39/40ths of the data.
Each replicate was formed from 19 pairs of alphasegments (38 alpha-segments total) and 1 alphasegment from the 20th pair. Alpha-segments were
randomly removed from each pair to form the
replicate estimates. This procedure was performed
20 times, once for each pair of alpha-segments.
Thus, actual respondent count in the included
segments for a particular replicate was
approximately 39/40ths of the full respondent
sample and was weighted to represent the full
population.
The variance of xˆ , Var (xˆ) , is estimated by
computing:

ˆ =
Var(x)

20

ˆ
∑[xˆ - (x)]

2
.

i

i =1

ˆ i = an estimated total for replicate i
X
associated with alpha-segment pair i,
and
= an estimated total obtained over the full
sample.

If the estimate of interest is a ratio of two estimated
totals (e.g., the total number of RNs resident in
Florida between 25 and 29 years old to the total
number of RNs resident in Florida), the variance
estimate for the estimated ratio would be of the
following form:

⎛ xˆ ⎞
Var⎜⎜ ⎟⎟ =
⎝ yˆ ⎠

20

The generalized variance is a model-based
approximation of the sampling variance estimate,
which is less computationally complex than the
direct variance estimator but is also less accurate.
The generalized variance equations use the
national-level or State-level estimates of the design
effect and, for some estimates, the coefficient of
variation (CV) to estimate the sampling variance.
The design effect, F, for an estimated proportion pˆ
is determined by taking the ratio of the estimated
2
sampling variance, σˆ pˆ , obtained by the jackknife
method, to the sampling variance of the pˆ in a
simple random sample of the same size. This
design effect, F, can be computed as follows:
2
ˆ,
F = nσˆ pˆ / [pˆ (1 - p]

2

⎛ xˆi xˆ ⎞

∑⎜⎜⎝ yˆ - yˆ ⎟⎟⎠
i =1

Direct estimates of the variance were computed for
a variety of variables. These variables were
chosen not only due to their importance, but also to
represent the range of expected design effects. The
average of these design effects (on a State-by-State
basis) provides the basis for the variance estimate
for variables not included in the set for which
direct variance estimates were computed. Table B2 in Appendix B presents direct estimates of the
standard error (the square root of the variance) for
a selected set of variables. Table B-3 in Appendix
B shows the estimated population of nurses in each
State and the standard error of these population
totals.
Design Effects and Generalized Variances

where:

ˆ
X

The jackknife variance estimator can use either the
full sample estimate, xˆ, or the average of the
replicate estimates. While usually little difference
exists between the two estimates, the estimator, xˆ
was used which tends to provide more
conservative estimates of variance.

.

i

where n is the unweighted number of respondents
used to determine the denominator of pˆ .

Following the example, the xˆ and xˆi measurements
would be full sample and replicate estimates,
respectively, of the number of RNs resident in
Florida who were 25 to 29 years old, while
yˆ and yˆi would be the corresponding estimates of
the total number of RNs resident in Florida. The
variance of any other statistic, simple or complex,
can be similarly estimated by computing the
statistic for each replicate.
B-10

APPENDIX B

Direct estimates of the design effect were
computed for a set of variables for each State. The
median of the design effects was then computed
for each State and the nation. These median design
effects can be used in formulas for estimating
generalized variances or standard errors. This
procedure uses median design effects for a class of
estimates instead of calculating direct estimates
(with a resulting economy in time and costs), at the
sacrifice generally of some accuracy in the
variance estimates.

Then, from the relative variance of the ratio, one
can approximate the relative variance of the
ˆ , denoted V2 , by using:
total Y

A generalized standard error estimate for an
ˆ /X
ˆ , for a State or for
estimated proportion, pˆ = Y
the United States, is provided by the equation:

ˆ can be
Finally, the standard error of the total Y
estimated by multiplying the estimate by the
square root of the relative variance defined above.
ˆ , σ Yˆ , is thus estimated as:
The standard error of Y

ˆ /X
ˆ ) ⋅ (1 - Y
ˆ /X
ˆ )/n
σYˆ/Xˆ = F ⋅ (Y

yˆ

VY2ˆ = VY2ˆ /Xˆ + (C.V.Xˆ ) 2 .
This approximation is based on the first-order
Taylor series approximation to the variance of a
product and the assumption of zero correlation
between the estimate of ratio and the denominator
of the ratio.

(1)
ˆ V
ˆ 2ˆ
σ Yˆ = Y
Y

where n is the number of survey respondents used
ˆ . The multiplier F, the
to determine the estimate X
²
median design effect, depends upon the State for
which the estimated proportion was generated.
The median design effects are listed on Table B-4
in Appendix B.

(2)

The standard error of an estimated percentage for a
region of the United States depends upon a linear
combination of the variance of the same estimated
percentages for the States making up that particular
region. The estimated proportion for the region is:

∑ Yˆ
h

Generalized estimates of standard errors can also
be computed for estimated numbers (or totals) of
ˆ,
RNs in a State with a particular characteristic Y
(such as those employed in hospitals). The
ˆ , is a subtotal of the estimate X
ˆ , the
estimate Y
estimated total of RNs working and/or living in the
State. Note that the standard error and coefficient
ˆ (represented by C.V. ˆ ) were
of variation of X
x
determined for the nation and for each State (see
Table B-3).

s

ˆ /X
ˆ =
Y
R
R

VYˆ2/Xˆ =

The relative variance can be
ˆ /X
ˆ)
F(1 - Y
,
ˆ /X
ˆ)
n(Y

where F is the design effect for the State of interest
and n is the number of respondents to the survey
ˆ
that were weighted to obtain the estimate X.

∑ Xˆ

s

s =1

ˆ
Here, h is the number of States in region R, and Y
s
ˆ , are estimates for a particular State. The
and X
s

formula used to approximate the standard error of
an estimated proportion for a region is:

To calculate the standard error of a total, one must
first compute the relative variance (or square of the
ˆ to X
ˆ
coefficient of variation) of the ratio of Y
(called VYˆ2/Xˆ ) .
calculated as:

s =1
h

σ YˆR / Xˆ R

h

=

h

∑ (Xˆ s2σY2ˆ /Xˆ s ) /(∑ Xˆ s )2
s =1

s

(3)

s =1

where σ Yˆs / Xˆ s represents the standard error of the
estimated proportion Ys /X s for the States and the
standard errors are estimated from equation (1) or
from direct estimation.
The direct standard error for an estimated number
for a region of the United States also depends upon
a linear combination of the variance of the same

B-11

THE REGISTERED NURSE POPULATION

estimated numbers for the States that make up the
region. The formula used is
h

σ YˆR =

∑σ

2
ˆ
Y

(4)

s

s =1

where the standard error (σ Yˆ ) of the estimated
ˆ is available either from the direct
number Y
s
procedures or from equation (2).

___________________________________________________________________________
²

The median design effect was based on all design effects for
estimates of proportions computed on selected variables.
Using a median instead of mean value avoids the effects of
extreme estimates of standard errors, which can occur for
some relatively rare attributes. In prior years, an average
(mean) design effect was computed for selected variables.
Given that the distribution of design effects is skewed to the
right, it is expected that the true median be less than the true
mean.

B-12

APPENDIX B
Table B-2. Estimates and Standard Errors (S.E.) For Selected Variables of U.S. Registered Nurse Population

Estimated
Number

Description

UNITED STATES, Total Number Of Nurses

S.E. of
S.E. of
Estimated Estimated Estimated
Number
Percent
Percent

2,909,357

7,000

733,377
1,227,256
887,114
14,979
532
46,098

9,749
16,571
13,366
1,412
271
2,568

25.21
42.18
30.49
0.51
0.02
1.58

0.32
0.54
0.47
0.05
0.01
0.09

2,421,351
488,006

10,124
7,792

83.23
16.77

0.27
0.27

2,380,529
122,495
84,383
9,453
5,594
41,244
38,530
2,924
3,096
3,460
217,651

28,004
16,737
15,540
972
1,091
2,641
7,745
633
741
921
5,689

81.82
4.21
2.90
0.32
0.19
1.42
1.32
0.10
0.11
0.12
7.48

0.89
0.57
0.54
0.03
0.04
0.09
0.27
0.02
0.03
0.03
0.19

1,696,807
720,283
4,261
488,006

12,210
11,059
523
7,793

58.32
24.76
0.15
16.77

0.44
0.35
0.02
0.27

150,147
146,805
203,313
300,072
378,607
385,145
321,070
406,125
367,557

4,332
4,047
4,150
7,685
7,543
7,064
6,472
5,902
6,094

5.16
5.05
6.99
10.31
13.01
13.24
11.04
13.96
12.63

0.15
0.14
0.14
0.26
0.25
0.24
0.22
0.22
0.20

Basic Nursing Education
Diploma Program
Associate Degree
Baccalaureate Degree
Master’s Degree
Doctorate
Not Reported
Employed in Nursing
Yes
No
Racial/Ethnic Background
White (non-hispanic)
Black/African American (non-hispanic)
Asian (non-hispanic)
American Indian/Alaskan Native (non-hispanic)
Native Hawaiian/Pacific Islander (non-hispanic)
Two or more races (non-hispanic)
Hispanic/Latino (White)
Hispanic/Latino (Black/African American)
Hispanic/Latino (Two or more races)
Hispanic, Other
Not Reported
Employment Status in 2004
Employed In Nursing Full Time
Employed In Nursing Part Time
Employed In Nursing, Full/Part Time Unknown
Not Employed In Nursing
Graduation Year
Before 1961
1961 To 1965
1966 To 1970
1971 To 1975
1976 To 1980
1981 To 1985
1986 To 1990
1991 To 1995
1996 To 2000

B-13

THE REGISTERED NURSE POPULATION

Estimated
Number

Description

After 2000
Not Reported

S.E. of
S.E. of
Estimated Estimated Estimated
Number
Percent
Percent

196,086
54,430

5,069
2,524

6.74
1.87

0.17
0.09

1,360,847
153,172
63,444
259,911
78,022
22,447
265,273
12,500
43,641
8,733
103,310
538,058

13,063
3,369
2,879
4,347
3,095
1,820
5,346
1,112
1,976
933
3,974
8,227

46.77
5.26
2.18
8.93
2.68
0.77
9.12
0.43
1.50
0.30
3.55
18.49

0.43
0.12
0.10
0.15
0.10
0.06
0.18
0.04
0.07
0.03
0.13
0.29

125,011
35,617
74,201
62,255
148,210
1,431,053
84,042
7,274
28,623
32,954
27,287
19,263
11,762
8,570
45,621
12,097
138,404
82,352
534,760

2,522
1,707
2,976
2,403
3,880
11,735
3,424
990
1,900
1,908
1,452
1,250
1,280
929
1,834
1,031
3,205
3,226
7,774

4.30
1.22
2.55
2.14
5.09
49.19
2.89
0.25
0.98
1.13
0.94
0.66
0.40
0.29
1.57
0.42
4.76
2.83
18.38

0.08
0.06
0.10
0.08
0.13
0.39
0.12
0.03
0.07
0.07
0.05
0.04
0.04
0.03
0.06
0.04
0.11
0.11
0.27

510,209
981,238
922,696
71,580
256,415

8,062
14,852
12,963
1,946
5,251

17.54
33.73
31.71
2.46
8.81

0.27
0.49
0.45
0.07
0.18

Employment Setting
Hospital
Nursing Home Extended Care
Nursing Education
Public Health/Community Health
School Health Service
Occupational Health
Ambulatory Care (Except Nurse Owned/Operated)
Nurse Owned/Operated Ambulatory Care Setting
Insurance Claims/Benefits
Planning/ Regul /Licensing Agency
Other
Not Reported
Type of Position
Administrator Or Assistant Administrator
Consultant
Supervisor
Instructor/Faculty
Head Nurse Or Assistant Nurse
Staff Nurse
Nurse Practitioner
Nurse Midwife
Clinical Specialist
Nurse Clinician
Certified Nurse Anesthetist
Research
Private Duty
Informatic Nurse
Home Health
Survey Or Auditors/Regulator
Patient Coordinator
Other
Not Reported
Highest Nursing Education
Diploma In Nursing
Associate Degree In Nursing Or Related Field
Baccalaureate In Nursing
Baccalaureate In Related Field
Masters In Nursing

B-14

APPENDIX B

Estimated
Number

Description

Masters In Related Field
Doctorate In Nursing
Doctorate In Related Field
Not Reported

S.E. of
S.E. of
Estimated Estimated Estimated
Number
Percent
Percent

94,386
11,548
14,552
46,733

3,057
645
1,192
2,300

3.24
0.40
0.50
1.61

0.10
0.02
0.04
0.08

61,778
171,659
243,182
289,525
408,248
508,708
463,565
338,078
210,196
185,254
29,165

1,486
3,751
5,572
6,598
6,721
7,695
9,646
6,534
5,764
5,092
1,525

2.12
5.90
8.36
9.95
14.03
17.49
15.93
11.62
7.22
6.37
1.00

0.05
0.13
0.19
0.23
0.23
0.26
0.32
0.22
0.20
0.17
0.05

225,572
650,793
162,791
994,588
16,916
13,300
137,283
14,683
355,309
5,795
9,131
18,657
2,854
234,208
3,897
63,581

5,474
8,062
3,393
10,942
1,275
1,023
4,514
898
8,582
817
1,063
1,606
609
5,167
680
2,497

7.75
22.37
5.60
34.19
0.58
0.46
4.72
0.50
12.21
0.20
0.31
0.64
0.10
8.05
0.13
2.19

0.19
0.28
0.11
0.34
0.04
0.04
0.15
0.03
0.29
0.03
0.04
0.06
0.02
0.18
0.02
0.09

57,784.86

180.85

2,160.00

5.63

38.55

0.13

Age of Nurse
<25
25 To 29
30 To 34
35 To 39
40 To 44
45 To 49
50 To 54
55 To 59
60 To 64
65+
Not Reported
Marital Status and Children
Married, Children < 6
Married, Children > = 6
Married, Children All Ages
Married, No Children
Married, Children Unknown
Widowed/ Separated/ Divorced, Children < 6
Widowed/ Separated/ Divorced, Children > = 6
Widowed/ Separated/ Divorced, Children All Ages
Widowed/ Separated/ Divorced, No Children
Widowed/ Separated/ Divorced, Children Unknown
Never Married, Children < 6
Never Married, Children > = 6
Never Married, Children All Ages
Never Married, No Children
Never Married, Children Unknown
Not Reported
Mean Gross Annual Salary for Full-Time RNs
Mean Hours Worked per year
Mean Hours Worked in Last Full Workweek

B-15

THE REGISTERED NURSE POPULATION

Table B-3. Direct Estimates of State Nurse Population,
Standard Error, and Coefficient of Variation by State, 2000

State
United States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
DC
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee

2004
Estimated
State Nurse
Population
2,909,357
42,894
7,567
48,284
23,818
255,858
43,719
42,894
9,352
12,118
169,460
78,898
11,146
11,068
138,092
64,396
37,777
29,892
42,971
39,449
17,785
53,061
89,358
103,697
60,214
27,303
66,551
9,416
20,026
16,206
18,473
92,425
15,027
215,309
92,391
7,966
133,064
29,268
34,946
164,433
13,847
35,204
10,223
62,266

Standard
Error
7,001
472
420
910
569
1,734
695
1,199
324
675
2,168
1,070
387
256
1,236
858
614
790
812
731
465
759
972
1,406
621
517
973
149
604
427
493
1,476
435
2,377
1,238
206
1,224
574
713
1,834
337
741
213
989

Coefficient
of Variation
(in Percent)
0.24
1.10
5.54
1.89
2.39
0.68
1.59
2.80
3.47
5.57
1.28
1.36
3.47
2.32
0.90
1.33
1.63
2.64
1.89
1.85
2.61
1.43
1.09
1.36
1.03
1.89
1.46
1.58
3.01
2.63
2.67
1.60
2.89
1.10
1.34
2.58
0.92
1.96
2.04
1.12
2.44
2.11
2.09
1.59

B-16

APPENDIX B

State
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

2004
Estimated
State Nurse
Population
168,368
18,169
7,137
73,526
59,761
17,742
62,044
4,498

Standard
Error
1,363
413
254
1,361
913
452
640
122

Coefficient
of Variation
(in Percent)
0.81
2.27
3.56
1.85
1.53
2.55
1.03
2.72

B-17

THE REGISTERED NURSE POPULATION

Table B-4. Median Design Effects for Percentages
Estimated from the Eighth National Sample Survey
of Registered Nurses, 2004
State
United States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
DC
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas

Median Design
Effect
1.63
1.06
1.24
1.01
0.98
1.11
1.04
1.05
0.97
1.33
1.08
1.03
0.99
0.98
1.01
1.02
1.10
0.98
1.08
1.04
1.04
1.16
1.02
0.95
1.01
1.01
1.05
0.99
0.99
1.07
1.09
1.00
1.04
1.04
1.01
0.97
1.05
1.02
1.03
0.98
1.00
1.03
1.06
0.98
1.04

B-18

APPENDIX B

State
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Median Design
Effect
1.02
0.98
1.13
1.07
0.93
1.07
0.95

B-19

APPENDIX C

APPENDIX C

QUESTIONNAIRE

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
Health Resources and Services Administration

2004 National Sample Survey
of Registered Nurses
Conducted by
The Gallup Organization
The 2004 National Sample Survey of Registered Nurses is being conducted for the Health Resources and Services Administration of the U.S.
Department of Health and Human Services in compliance with Title VIII, Public Law 94-63, the Nurse Training Act of 1975, section 951; and
Public Law 105-392, section 806(f), the Health Professions Education Partnerships Act of 1998; 42 USC 295k, section 792 of the U.S. Public
Health Service Act. Strict confidentiality of all information obtained from individuals surveyed in NSSRN is assured by current Federal
laws and regulations. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. The OMB control number for this project is 0915-0276. Public reporting burden for this collection
of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching data sources, gathering or
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to the HRSA Reports Clearance Officer, 5600 Fishers
Lane, Room 14-45, Rockville, Maryland, 20857. The Gallup Organization will process all personal data you provide and will use such information
for statistical and research purposes. By completing and returning this survey, you give your consent to process and transfer your personal data to the
United States.

Please complete only one questionnaire and return any extra copies you receive, preferably in the
same envelope (see Instructions on page 1).
Please correct any errors in the name/address
information and States where you are actively licensed.
Corrections to First Name

[First Name M.I. Last Name]
[Address 1]
[Address 2]
[City, State ZIP Code]

Corrections to M.I.

Corrections to Last Name

Corrections to Number and Street

Corrections to City/Town

Corrections to State

State(s) Where Actively Licensed:
[State 1, State 2, State 3]

Corrections to ZIP Code

Corrections to State(s) Where Actively Licensed (If there are any
corrections to the list in the box to the right, please re-list ALL of the States
where you are actively licensed.)

C-i

Web Site URL:

https://gx.gallup.com/nurse.gx

Access Code:

[XXXXXX]

Quex # [X]

OMB No. 0915-0276
Expiration Date: 8/31/2005

Instructions
How do I complete the survey electronically?
On your Web browser, log onto https://gx.gallup.com/nurse.gx and type in your unique Access Code that
is printed in the box in the lower right corner of the questionnaire cover page. If you complete the survey
online, you do not need to return this paper questionnaire.
What if I received more than one questionnaire?
We may not have been able to eliminate all of the duplications in our list of nurses who have more than one
license, so you may receive more than one questionnaire. Please complete only one questionnaire but return
any extra copies you receive, preferably in the same envelope as your completed survey. Please write
“DUPLICATE” at the top of these blank surveys. By returning extra surveys: we can avoid unnecessary
follow-up mailings to you. (For those who receive duplicate questionnaires, if you choose to respond by the
Web, you will be asked to enter a unique code from each of the duplicate surveys you receive.)
What if I have questions about this survey?
If you have any questions about this survey or about how to complete it electronically, please call Gallup
Client Support (toll-free) at 1-888-297-8999, or send an e-mail to galluppoll@gallup.com.

Section A. Eligibility and Education
Please mark an “X” in the box corresponding to your answer in each question, or supply the requested
information. Use blue or black ink.
� �������
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��
�
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l

1

2

2

3

As of March 10, 2004, were you actively licensed
to practice as a registered nurse (RN) in any U.S.
State or the District of Columbia (whether or
not you were employed in nursing at that time)?
the appropriate box.)
(Please mark

In what month and year did you graduate from this
program?
Month

Yes (You are eligible to complete this
questionnaire. Please continue to the next
question.)
No (You do not need to complete this
questionnaire. Please stop here and return this
questionnaire to Gallup so we know you are not
eligible.)

Year

4

In which U.S. State (including the District of
Columbia), U.S. Territory, or foreign country was
this program located?

5

In what U.S. State (or District of Columbia) were
you issued your first RN license?

Which initial educational program qualified you to
sit for the RN licensure exam? (Mark one box.)
1
Diploma Program
2
Associate Degree
3
Bachelor’s Degree
4
Master’s Degree
5
Doctorate (N.D.)
Page
C-1 1

State:
Year:
(PLEASE CONTINUE TO PAGE 2)

6 How did you finance your initial nursing education?
(Mark all that apply.)
1
Personal resources (you or your spouse)
2
Family resources (parents or other relatives)
3
Employer tuition reimbursement plan (including
Veterans Administration employer tuition plan)
4
Federal traineeship, scholarship, or grant
5
Federally-assisted loan
6
State/local government scholarship, loan, or
grant
7
Non-government scholarship, loan, or grant
8
Other resources

9 Indicate all degrees you received before starting
your initial RN educational program.
(Mark all that apply.)

7

10 What was the field of study for your highest degree
identified in Question 9? (Mark one box.)

At any time, have you ever been licensed as a
practical or vocational nurse (LPN/LVN)?
1
2

8

1
2
3

4
5
6

None (Skip to Question 11, page 3)

1

Associate Degree
Bachelor’s Degree
Master’s Degree
Doctorate
Other (Specify)

2
3
4
5

Yes
No
Before starting your initial RN educational
program, were you ever employed as any of the
following: (Mark all that apply.)

0

0

1

Health-related field
or
Non-Health related field

2

Biological or Physical Science
Business or Management
Education
Liberal Arts, Social Science, or Humanities
Law
Computer Science
Social Work
Other non-health-related field
(Please specify below.)

3
4

No

5

Nursing Aide
Licensed Practical/Vocational Nurse (LPN/LVN)
Allied Health technician/technologist (e.g.,
radiologic technician)
Manager in health care setting
Clerk in health care setting
Another type of health-related position
(Please specify below.)

Page
C-22

6
7
8

9

(PLEASE CONTINUE TO PAGE 3)

11 Did you earn any additional academic degrees AFTER graduating from your initial registered nurse education
program that you described in Question 2? (Do not include degrees you are currently working towards.)
1
2

Yes (Please complete all columns for each degree you earned.)
No (Skip to Question 12, page 4)
A
Did you
receive
this
degree?
Type of Degree

(Mark all
that apply.)

B

C

D

E

If so, did the degree
enhance your
nursing career?
(Mark yes or no.)

Which two-digit
code from the
table below best
describes the
primary focus of
this degree?

In what
state or
country did
you receive
the degree?

In what
year
did you
receive
the
degree?

a. Associate Degree in nursing
b. Associate Degree in another
field

1

Yes

2

No

1

Yes

2

No

1

Yes

2

No

1

Yes

2

No

c. Bachelor’s degree in
nursing
d. Bachelor’s degree in
another field
e. Master’s in nursing
(after any initial MSN
mentioned in Question 2)
f. Additional Master’s in
nursing
g. Master’s in another field
h. Doctorate in nursing
i.

Doctorate in another field

For Column C, enter the appropriate twodigit code for each Bachelor’s (other),
Master’s, or Doctorate degree above.
Primary Focus of Degree
01 Clinical Practice
02 Education
03 Supervision/Administration
04 Research
05 Law
06 Informatics
07 Business
08 Public Health
09 Social Science
10 Humanities
11 Basic Sciences (i.e., Biology)
12 Computer Science
13 Social Work
14 Other
Page
C-33

12

Since graduating from the initial nursing program you described in Question 2, have you completed a formal
educational program preparing you for advanced practice nursing (APN) as a clinical nurse specialist, nurse
anesthetist, nurse-midwife, or nurse practitioner?
Yes (Please complete columns on pages 4-6 for each specialty you have obtained.)
No (Skip to Question 13, Page 6)

1
2

Information on
Advanced Practice Nurse
Preparation and Credentials
12a Did you receive advance practice
preparation as a …?
(Mark each column if yes.)
12b What was the length of the program?
1. Less than 3 months
2. 3 through 8 months
3. 9 months or more
12c What was the highest credential you
received in that program?
1. Certificate/Award
2. Bachelor’s Degree
3. Master’s Degree
4. Post-Master’s Certificate
5. Doctorate

A

B

C

D

Clinical
Nurse
Specialist
(CNS)

Nurse
Anesthetist
(NA)

NurseMidwife
(NM)

Nurse
Practitioner
(NP)







(Mark one)

(Mark one)



(Mark one)

(Mark one)

1

1

1

1

2

2

2

2

3

3

3

3

(Mark one)

(Mark one)

(Mark one)

(Mark one)

1

1

1

1

2

2

2

2

3

3

3

3

4

4

4

4

5

5

5

5

12d In what year did you receive this APN
credential?
12e Which one of these was the primary
specialty you studied?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

Acute Care/Critical Care
Adult Health/Medical Surgical
Anesthesia
Community Health
Family
Geriatric/Gerontology
Home Health
Maternal-Child Health
Neonatal
Nurse-Midwifery
Obstetric/Gynecology
Occupational Health
Oncology
Palliative Care
Pediatrics
Psychiatric/Mental Health
Rehabilitation
School Health
Women’s Health
Other (Specify in appropriate
column.)

(Mark one)

(Mark one)

(Mark one)

(Mark one)

01

01

01

01

02

02

02

02

03

03

03

03

04

04

04

04

05

05

05

05

06

06

06

06

07

07

07

07

08

08

08

08

09

09

09

09

10

10

10

10

11

11

11

11

12

12

12

12

13

13

13

13

14

14

14

14

15

15

15

15

16

16

16

16

17

17

17

17

18

18

18

18

19

19

19

19

20

20

20

20

(Specify)

(Specify)

(Specify)

(Specify)

C-44
Page

Information on Advanced Practice Nurse
Preparation and Credentials
(Question 12 continued from previous page.)

12f Is your current APN status certified by
any of these national bodies?
1. American Association of Critical Care
Nurses Certification Corp.
2. American Academy of Nurse Practitioners

A

B

C

D

Clinical
Nurse
Specialist
(CNS)

Nurse
Anesthetist
(NA)

NurseMidwife
(NM)

Nurse
Practitioner
(NP)

3. American Association of Nurse Anesthetists
4. ACNM Certification Council, Inc. (ACC)
(including previous ACNM certification)
5. American Nurses Credentialing Center
(ANCC)
6. National Certification Board of Pediatric
Nurse Practitioners & Nurses (NCPNP/N)
7. National Certification Corporation for the
Obstetric, Gynecologist, and Neonatal
Nursing Specialties (NCC)

1
2

Yes
No

1
2

Yes
No

Yes
No

1
2

1
2

Yes
No

�

������������
������

������������
������

������������
������

������������
������

(Mark one)

(Mark one)

(Mark one)

(Mark one)

8. Other (Specify in appropriate column.)

12g If Yes above, what is the primary type of
national certification you have?
1. Acute Care NP
2. Acute Care/Critical Care (Adult) CNS
3. Acute Care/Critical Care (Pediatric or
Neonatal) CNS
4. Adult NP
5. Certified Registered Nurse Anesthetist
(CRNA)
6. Certified Nurse-Midwife (CNM)
7. Community Health CNS
8. Family NP
9. Gerontological CNS or NP
10. Home Health CNS
11. Medical Surgical CNS
12. Neonatal NP
13. Occupational Health NP
14. Pediatric CNS or NP
15. Palliative Care CNS or NP
16. Psychiatric & Mental Health–Adult NP or
CNS
17. Psychiatric & Mental Health (Family) NP
18. Psychiatric & Mental Health Child/
Adolescent CNS
19. School NP
20. Women’s Health Care NP (Ob-Gyn NP)
21. No National Certificate Exam Available
22. Other (Specify in appropriate column.)

01

01

01

01

02

02

02

02

03

03

03

03

04

04

04

04

05

05

05

05

06

06

06

06

07

07

07

07

08

08

08

08

09

09

09

09

10

10

10

10

11

11

11

11

12

12

12

12

13

13

13

13

14

14

14

14

15

15

15

15

16

16

16

16

17

17

17

17

18

18

18

18

19

19

19

19

20

20

20

20

21

21

21

21

22

22

22

22

(Specify)

(Specify)

(Specify)

(Specify)

C-55
Page

Information on Advanced Practice Nurse
Preparation and Credentials
(Question 12 continued from previous page.)

A

B

C

D

Clinical
Nurse
Specialist
(CNS)

Nurse
Anesthetist
(NA)

Nurse Midwife
(NM)

Nurse
Practitioner
(NP)

12h Do you have any current certification,
licensure, or other official recognition of your
APN status from any State Board of Nursing?

2

13 Please identify any professional certifications
in nursing you have received (e.g., critical care,
emergency, oncology, case management, etc.). Do
not include advanced practice nursing certifications
reported above.
0

None
Specify:

Yes
No

1

1
2

2

Specify:
3

None (Skip to Question 15)

1

Biological attack
Chemical attack
Nuclear/radiologic attack
Infectious disease epidemics
Natural disaster or other public health
emergencies

2
3
4
5

1
2

1
2

Yes
No

Yes
No (Skip to Question 19, page 7)

In nursing
In a non-nursing field useful to enhance your
career in nursing
In another field to allow you to pursue career
opportunities outside of nursing
Full-time student
Part-time student

18 What type of degree/award are you currently
working toward in this program? (Mark one box.)
1
2
3
4
5

Associate Degree
Bachelor’s Degree
Master’s Degree
Doctorate
Certificate

(PLEASE CONTINUE TO PAGE 7)

Hours in training
14b Pertaining to the training in emergencies
you marked above, will the training enable
you to effectively participate in an organized
multidisciplinary response to such an emergency?
2

2

Yes
No

17 Are you a full-time or part-time student?

14a (If you have marked any of the above types of
training:) Please specify the TOTAL number of
hours spent in the above training(s) since January
2000.

1

1

16 Is this formal education program…?
(Mark one box.)
1

0

2

Yes
No

15 Are you currently enrolled in a formal education
program leading to an academic degree or
certificate?

Specify:

14 Since January 2000, please indicate if you have
received training in recognizing or responding to
the following emergencies. (Mark all that apply.)

1

Yes
No

C-66
Page

Section B. Primary Nursing Employment
24 Which one of the following best corresponds to the
position title for your principal nursing position?
(Mark one box.)

19 Are you employed or self-employed in nursing?
(Employment also includes: being on a temporary
leave of absence from your nursing position; on
vacation; being on sick leave; or working through a
temporary employment service or practicing private
duty nursing and not on a case at the moment.)
1
2

01

02

Yes
No (Skip to Question 41, page 9)

20 Are you required to maintain an active RN license
in order to hold your principal nursing position?
(If you hold more than one nursing position, your
principal nursing position is the one at which you work
the most hours during your regular work year.)
1
2

07

11
12
13
14
15
16
17

County:

18

State (or country if not USA):

19
20

21

(if available)

22

22 In your principal nursing position, are you…?
(Mark one box.)

3

06

10

City/Town:

2

05

09

21 Where is the location of your principal nursing
position? This information is critical for developing
State employment estimates and supply and
demand projections. (If you are not employed in a
fixed location, enter the geographic area where you
spend most of your working time.)

1

04

08

Yes
No

ZIP+4 code:

03

23
24

An employee of the organization or facility for
which you are working
Employed through an employment agency
Self-employed, per diem, or on as-needed basis

25
26
27
28
29

23 Using the list of NURSING EMPLOYMENT
SETTINGS on page 15, write in the code that best
describes your principal nursing employment
setting. (If you work in more than one setting, indicate
the one setting in which you spend most of your
working time.)
Code for employment
setting from page 15
If this code is labeled as “Other,” please specify
the setting below.

30
31
32
33
34
35
36
37

Page 7

C-7

Administrator of organization/facility/agency or
assistant administrator
Administrator of nursing or assistant (e.g., vice
president for nursing, director or assistant director
of nursing services)
Case manager
Certified nurse anesthetist (CRNA)
Charge nurse
Clinical nurse specialist
Consultant
Dean, director, or assistant/associate director of
nursing education program
Float nurse
Discharge planner/outcomes manager
Head nurse or assistant head nurse
Infection control nurse
Informatics nurse
Instructor at a school of nursing
Insurance reviewer
Nurse clinician
Nurse coordinator
Nurse manager
Nurse-midwife
Nurse practitioner
Nursing staff development director
Nursing staff development instructor
Patient care coordinator
Private duty nurse
Professor or assistant/associate professor
Public health nurse
Quality improvement nurse
Researcher
School nurse
Staff nurse
Supervisor or assistant supervisor
Surveyor/auditor/regulator
Team leader
Traveling nurse
Visiting nurse/home health nurse
No position title
Other (Specify)

28 What type of patient is primarily treated in the unit/
organization in which you work? (Mark one box.)

25 For your principal nursing position, estimate the
percentage of your time spent in the following
activities during a usual workweek. (The total
should equal 100%. Do not use decimal places.)
a. Administration ......................................
b. Consultation with agencies and/or
professionals ........................................

%
%
%

d. Research ................................................

%

e. Supervision/Management .....................

%

f. Teaching nursing or other health
profession students (include class
preparation time) ...................................

02
03

04
05
06
07
08
09
10
11
12

13
14
15

Adult care (general)
Cardiovascular
Chronic care
Neurological
Newborn
Obstetrics/gynecologic
Oncology
Orthopedic
Pediatric
Psychiatric
Rehabilitation
Renal

04

%

g. Other ....................................................

%

06

07
08
09
10
11
12
13

14

Work with multiple patient types

15

Other (Specify)

29 In your principal nursing position, do you work…?
(Mark one box.)
1

Yes
No (Skip to Question 28)

2

27 During a typical workweek in your principal
nursing position, in what type of unit do you spend
the majority of your patient care time?
(Mark one box.)
01

02

05

c. Direct patient care not including
staff supervision ....................................

26 In a typical week in your principal nursing position,
do you provide direct patient care in a hospital
setting? (Exclude nursing home units. Include all
clinics and other services of the hospitals.)
2

No patient care – Unit/organization does not
provide patient care

03

TOTAL (confirm sum is 100%) ............ �������� %

1

01

Critical care unit (ICU/CCU)
Emergency department
General/specialty inpatient unit (other than critical
care or step-down)
Home health care
Hospice unit
Labor/delivery room
Operating room
Outpatient department
Perioperative unit
Radiologic (diagnostic or therapeutic)
Step-down, transitional, progressive, telemetry unit
Sub-acute care unit

The entire calendar year or school/academic year
Only part of the calendar year or school/academic
year

30 When you work at this principal nursing position,
do you work…? (Mark one box.)
1
2

Full-time
Part-time

31 How many weeks do you normally work per year in
this job? (Enter a number from 01 to 52.)
weeks
32 How would you best describe your feelings about
your principal nursing position? (Mark one box.)

Multiple units, none over 50%
No specific assigned type of area
Other specific area (Specify)

Page
C-88

1
2
3
4
5

Extremely dissatisfied
Moderately dissatisfied
Neither satisfied nor dissatisfied
Moderately satisfied
Extremely satisfied

38 What type of work setting best describes where you
work for your other nursing position(s)?
(Mark one box. Refer to categories on page 15 for
further clarification.)

33 Please provide information about the number of
hours you worked in your last full workweek at
your principal nursing position.
a) Number of hours worked in your last full
workweek (including paid hours of oncall duty and overtime) ........................

100
200

b) Number of hours reported in Item
33a that were paid on-call
(Enter 00 if none) .................................

300
400
500

c) Number of hours reported in Item
33a that were paid as overtime
(Enter 00 if none) .................................

600
700
800

d) Number of overtime hours
reported in Item 33c that were mandatory/
unscheduled
(Enter 00 if none) .................................

900
950

34 Please estimate your current, gross annual earnings
(pre-tax) from your principal nursing position.
Include overtime and bonuses, but exclude sign-on
bonuses.

$ ������������

.00 per year

35 Are you represented by a labor union in your
principal nursing position?
1
2

39 Which of the following categories best describes
the amount you work in all of your other nursing
position(s)? Your best estimate is fine. (Note that
2,000 hours per year is full-time year-round. 1,000
hours per year is half-time year-round or full-time for
half a year. 500 hours per year is 10 hours per week
year round, or full-time for 3 months of the year.)
(Mark one box.)
1
2

Yes
No

3
4
5
6

Section C. Secondary Employment
in Nursing
36 Aside from the principal nursing position you
just described, do you hold any other positions in
nursing for pay?
1
2

7
8

$ ����������� �

Yes
No (Skip to Question 43, page 10)

2
3

An employee of the organization or facility for
which you are working
Employed through an employment agency
Self-employed, per diem, or on as-needed basis

Less than 500 hours per year
500 hours per year
501-999 hours per year
1,000 hours per year
1,001-1,499 hours per year
1,500 hours per year
1,501-1,999 hours per year
2,000 hours per year or more

40 Please estimate your current, gross annual earnings
(pre-tax) from your other nursing position(s).
.00 per year

Section D. Employment Outside
of Paid Nursing

37 In your other nursing position(s), are you...?
(Mark all that apply.)
1

Hospital
Nursing home/extended care facility
Nursing education program
Public or community health setting
School health service
Occupational health
Ambulatory care setting
Insurance claims/benefits
Policy/planning/regulatory/licensing agency
Other

If you are currently working for pay in nursing, please
skip to Question 43, Page 10.
41 If you are not working for pay in nursing, how long
has it been since you last were employed or selfemployed as a registered nurse?
0
1

Mark here if you never worked as a registered nurse
Mark here if less than one year
Write in number of years if one or more

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C-9

46 Do you work full-time or part-time in this principal
position outside of nursing?

42 What are the primary reasons you are not working
in a nursing position for pay? (Mark yes or no for
each item.)
Yes
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.

o.
p.
q.
r.

Burnout/stressful work environment ...
Career change ....................................
Difficult to find a nursing position .....
Disability ............................................
Illness .................................................
Inability to practice nursing on a
professional level ...............................
Inadequate staffing .............................
Lack of advancement opportunities ...
Lack of collaboration/communication
between health care professionals......
Liability concerns ..............................
Physical demands of job ....................
Retired ...............................................
Salaries too low/better pay elsewhere...
Scheduling/inconvenient hours/too
many hours .........................................
Skills are out-of-date ..........................
Taking care of home and family ........
Volunteering in nursing .....................
Went back to school ...........................

1

No

2

1

2

1

2

1

2

1

2

1

2

47 What is the average number of hours you work per
week in your principal position outside of nursing?
hours per week
48 Please estimate your current, gross annual earnings
(pre-tax) from your principal position outside of
nursing.

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

1

2

2

1

2

1

2

$ ������������

49 Are you actively seeking employment as a registered
nurse? (Include seeking employment as an advanced
practice nurse.)

0

Yes
No (Skip to Question 49)

2

51 Are you looking for a position that is…?
1
2
3

Yes
No

45 Please provide a job title that best describes the
nature of your principal position outside of nursing.
(Write in job title in the space below.)

Mark here if less than one week
Write in number of weeks if one or more

44 Is this employment with a health-related
organization or in a health-related position?
1

Yes
No (Skip to Question 52)

50 How long have you been actively seeking a nursing
position?

43 Are you currently employed in an occupation other
than nursing?
2

.00 per year

Section E. Plans for Employment in
Nursing

s. Other (Specify)

1

Full-time
Part-time

Full-time
Part-time
Either

Section F. Prior Nursing
Employment
52 Since receiving your first RN license, how many
years have you worked in nursing?(Only count years
when you worked at least half the year in nursing.)
0

Mark here if less than one year
Write in number of years if one or more

Page 10

C-10

59 Were any of the following the primary reason(s)
for this change? (Mark yes or no for each item.)

53 Were you employed in nursing one year ago?
1
2

Yes
No (Skip to Question 61, page 12)

Yes
a.
b.
c.
d.
e.
f.

Burnout/stressful work environment
Career advancement/promotion ........
Disability ...........................................
Illness ................................................
Interested in another position/job .....
Lack of collaboration/communication
between health care professionals.....
g. Laid off/downsizing of staff..............
h. Opportunity to do the kind of nursing
that I like ...........................................
i. Pay/benefits better .............................
j. Reorganization that shifted positions
k. Relocated to different geographic area
l. Retired ...............................................
m. Scheduling/inconvenient hours/too
many hours .......................................
n. Sign-on bonus offered .......................

54 In your principal nursing position one year ago, did
you work…? (Mark one box.)
1
2

The entire calendar year or school/academic year
Only part of the calendar year or school/academic
year

55 When you worked at this principal nursing position
one year ago, did you work…? (Mark one box.)
1
2

Full-time
Part-time

56 What was the location of your principal nursing
position one year ago? (If you were not employed in
a fixed location enter the geographic area where you
spent most of your working time.)
City/Town:
County:

ZIP+4 code:
(if available)
57 In your principal nursing position one year ago, did
you spend the majority of your working hours in
inpatient units?
2

2
3

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

60 Using the list of NURSING EMPLOYMENT
SETTINGS on page 15, write in the code that best
describes your principal nursing employment
setting one year ago. (If you worked in more than
one setting, indicate the one setting in which you
spent most of your working time.)

Yes
No

Code for employment
setting from page 15
If this code is labeled as “Other,” please specify
the setting below.

58 How would you describe your principal nursing
position one year ago?
1

2

1

o. Other (Specify)

State (or country if not USA):

1

No
1

Same position/same employer as current principal
nursing position (Skip to Question 61, page 12)
Different position/same employer as current one
Different employer than current one

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(PLEASE CONTINUE TO PAGE 12)

Section G. General Information
Answers to the following questions will be used only to
statistically interpret your responses.

67 What is your racial background? (Mark one or more
races.)
1

61 Where do you currently reside? This information is
critical for producing State estimates.

2
3

City/Town:

4
5

County:

6

State (or country if not USA):

68 What languages do you speak fluently other than
English? (Enter all that apply.)

ZIP+4 code:
(if available)
62 Did you reside in the same city/town a year ago?
1
2

Yes (Skip to Question 64)
No

63 Where did you reside a year ago? This information
is critical for producing State estimates.

1

Language #1

2

Language #2

3

Language #3

2

3

ZIP+4 code:
(if available)

1
2

Male
Female

3
4

65 What is your year of birth?

5

��
66 What is your ethnic background?
1
2

Hispanic or Latino
Not Hispanic or Latino

Now married
Widowed, divorced, or separated
Never married

70 Describe the children/parents/dependents who
either live at home with you or for whom you
provide a significant amount of care. (Mark all that
apply.)

64 What is your gender?
2

No other languages

1

County:

1

0

69 Which best describes your current marital status?

City/Town:

State (or country if not USA):

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other (Specify)

No children/parents/dependents at home
Child(ren) less than 6 years old at home
Child(ren) 6 to 18 years old at home
Other adults at home (i.e., parents or dependents)
Others living elsewhere (i.e., children, parents or
dependents)

71 What is your current, gross annual household
income (pre-tax)?
1
2
3
4
5
6
7
8

Page 12

C-12

$15,000 or less
$15,001 to $25,000
$25,001 to $35,000
$35,001 to $50,000
$50,001 to $75,000
$75,001 to $100,000
$100,001 to $150,000
More than $150,000

Section H. Licensure Information
Answers to the following questions will be kept strictly confidential under Federal Law 42 USC 295k, section 792 of
the U.S. Public Health Service (PHS) Act and will only be used to develop accurate estimates of the number of RNs
in the country and in each State.
72 Please provide the information on the State(s) in which you hold an active RN license. This information is
critical to confirm that you are the individual we intended to complete the survey, not just someone with a
similar name, and that you still hold an active license.
A

State of
licensure

B

Permanent number on
certificate of registration

What is the last name on
the license?

C

D

What is the first name on
the license?

What
is the
middle
initial
on the
license?

1.

2.

3.

4.

5.

Section I. Contact Information/Comments
73 If we need to contact you about any of your responses, please provide your e-mail address and telephone
number, as well as the best time of day to reach you.
E-mail address:
Telephone No.:

)

(

-

Area Code Telephone Number
Home

Work

Cell

Time of day/week best
to contact you by phone:

Page 13

C-13

74 Do you have any recommendations for how this survey could be improved? Please print clearly.

Thank you! Please return this survey and any duplicate surveys
in the enclosed postage-paid envelope.

Page 14

C-14

NURSING EMPLOYMENT SETTINGS & CODES
(Use this list for Questions 23 and 60)

CODE
Hospital (Exclude nursing home units and all off-site
units of hospitals, but include all on-site clinics and other
services of the hospitals.)
Non-Federal, short-term hospital, except
psychiatric (for example, acute care hospital) ..110
Non-Federal, long-term hospital, except
psychiatric .........................................................120
Non-Federal psychiatric hospital ...........................130
Federal Government hospital .................................140
Other type of hospital ............................................150
Nursing Home/Extended Care Facility
Nursing home unit in hospital ................................210
Other nursing home................................................220
Facility for mentally retarded.................................230
Other type of extended care facility .......................240
Nursing Education Program
LPN/LVN program ................................................310
Diploma program (RN) ..........................................320
Associate degree program ......................................330
Bachelor’s and/or higher degree
nursing program ................................................340
Other program .......................................................350
Public or Community Health Setting
Official State Health Department ...........................402
Official State Mental Health Agency .....................405
Official City or County Health Department ...........410
Combination (official/voluntary) nursing service ..415
Visiting nurse service (VNS/NA) ..........................420
Home health service unit (hospital-based) .............422
Home health agency (non-hospital based) .............425
Community mental-health organization or facility
(including freestanding psychiatric outpatient
clinics) ...............................................................430
Substance abuse center/clinic ................................431
Community/neighborhood health center................435
Planned Parenthood/family planning center ..........440
Day care center ......................................................445
Rural health care center .........................................450
Retirement community center ................................455
Hospice ..................................................................460
Other .....................................................................465

CODE
School Health Service
Public school system ............................................... 510
Private or parochial elementary or secondary school ... 520
College or university ............................................... 530
Other ...................................................................... 540
Occupational Health (Employee Health Service)
Private industry ....................................................... 610
Government............................................................. 620
Other ...................................................................... 630
Ambulatory Care Setting
Solo practice (physician)......................................... 710
Solo practice (nurse) ............................................... 715
Partnerships (physicians) ........................................ 720
Partnerships (nurses) ............................................... 725
Group practice (physicians) .................................... 730
Group practice (nurses) ........................................... 735
Partnership or group practice (mixed group of
professionals) ................................................... 740
Freestanding clinic (physicians) ............................. 750
Freestanding clinic (nurses) .................................... 755
Ambulatory surgical center ..................................... 760
Dialysis center/clinic............................................... 761
Dental practice ........................................................ 770
Hospital owned off-site clinics .............................. 775
Health Maintenance Organization (HMO) ............. 780
Other ...................................................................... 790
Insurance Claims/Benefits
Government............................................................. 810
State or local agencies............................................. 820
Insurance company ................................................. 830
Private industry/organization .................................. 840
Policy, Planning, Regulatory, or Licensing Agency
Central or regional Federal agency ......................... 910
State Board of Nursing............................................ 920
Nursing or health professional membership
association .......................................................... 930
Health planning agency, non-Federal ..................... 940
Other ...................................................................... 945
Other
Correctional facility ................................................ 950
Private duty in a home setting................................. 955
Home-based self-employment ................................ 960
Other ...................................................................... 965

Page
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