Florence Nightingale as Economic Indicator?

Today’s Wall Street Journal puts an atypical spin on the economic weakness in the U.S. financial markets: an anemic economy means a boon for the nursing profession.  The reports of new entrants to the nursing workforce, as well as reverse migrations from professionals who may have left the field in recent years, should be warmly received by hospitals that rely on qualified caregivers to staff their facilities as well as to the patients they will ultimately serve.

Some of the data the Journal uses to support its claims appears sound.  According to the U.S. Department of Labor, the economy lost 20,000 jobs in April, but healthcare employment increased by 37,000 jobs and has shown a net gain of 365,000 positions in the last year.  It should be noted, of course, that not all of those 37,000 jobs were nursing-related, so perhaps it would be more accurate to say that some of the “sound data” the Journal uses to support its argument is actually sound.

And it’s really on the level of argument where the analysis inaccurately diagnoses causes and symptoms.

The article begins with an apparently benign claim: “With house prices falling and the cost of gasoline and food rising, many nurses are going back to work, in some cases to make up for the income of a spouse who has lost a job.”  The article later quotes Vanderbilt University academic Peter Buerhaus who notes: “In bust periods, unemployment is rising, which means there is a lot of pressure on married RNs to be working."  Both of these assertions may be true of the nursing field.  They are also generic descriptors of financial pressures that face countless U.S. households today, regardless of whether a wage earner works in the healthcare field at all.  Might not the two sentiments above be more concisely summarized: in tough economic times, more families need two people to bring home the bacon?  Or: if the sole breadwinner in a family loses his or her job and cannot find work, someone else needs to fill that void.

The more tenuous claim comes when the Journal posits that nursing is a type of reverse economic indicator.  In recessionary-esque periods, the rolls of full-time nurses grew at an annual average rate of 3.5 percent.  In rosier times, that growth rate averaged only 2.4 percent.  These statistics, taken from Buerhaus’ analysis of the nursing workforce, are surely measurable.  But is a 1.1 percent spread between champagne & caviar and bread & water really significant enough to declare nursing an economic indicator?

The article’s conclusion, to the detriment of the Journal’s argument, neatly answers that question.  Its final paragraph reads: “But over the long term the nursing shortage is expected to continue and eventually worsen, as retiring baby boomers ramp up demand for care. In their book, Messrs. Buerhaus, Staiger and Auerbach use Census data to project that the nursing work force will plateau in 2015. By 2025, they estimate there will be a shortage of almost 500,000 nurses, representing a vacancy rate of 40% or higher.”

These forecasts are ominous.  But they also exist in a vacuum outside of any reliable macroeconomic predictions for the U.S. economy writ large.  In other words, the coming nursing shortage—and corollary employment growth rates—will unfold regardless of whether the U.S. economy heads north or south.  Either that—or Buerhaus and friends’ calculations are false.

So is the new class of Florence Nightingales a useful economic indicator?  Perhaps.  But so then, too, is the new class of Flos.  You remember Flo.  All Polly Holliday twang and sass on the TV series Alice.  Well kiss my grits.