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Paid Work: Nursing Workers
NURSING WORKERS BY SECTOR(a)
NURSING WORKFORCE CHARACTERISTICS
Nursing has traditionally been a female sphere of employment. In 1986, 93% of nursing workers were female. While gender segregation of occupations has generally been dissipating over recent decades, nursing has remained an overwhelmingly female activity with 91% of nursing workers in 2001 being female.
Between 1985 and 1993, changes were made to training and accreditation for nurses, with a move from hospital based training to university accreditation. These measures were designed to standardise the quality of nursing to ensure a high standard of health care delivery. These changes were reflected in the nursing workforce, with 80% of nursing workers in 1986 identifying as nursing professionals, increasing to 90% by 2001.
With increasing proportions of nurses working part-time, nursing shortages may be exacerbated as more nurses are required to provide the same level of nursing supply. (endnote 1) In 2001, 49% of nursing workers worked part-time, compared with 37% in 1986. The hospital sector has seen the greatest increase of part-time workers, with 29% of nursing workers working part-time in 1986 rising to 47% in 2001.
While the proportions of full-time nursing workers have generally been falling since 1986, the proportion of nursing workers working long hours has increased slightly. Between 1986 and 2001 the proportion of nursing workers who were working 49 hours or more a week increased from 2% to 6%.
The most recent ABS Working Arrangements Survey indicated that in 2003, 67% of nursing workers worked shift work in the previous four weeks compared to 16% for the general population. With regard to overtime, 30% of nursing workers worked overtime on a regular basis compared to 38% of all workers.
SELECTED CHARACTERISTICS OF NURSING WORKERS
Concern about a continuation of nursing shortages has arisen in part from the ageing profile of the nursing workforce over the 1980s and 90s. In 2001, census data showed 40% of all nursing workers were aged 45 years and over, an increase from 18% in 1986. Conversely, the proportion of nursing workers who were aged 15-24 years fell from 21% in 1986 to 5% in 2001. The fall in nursing workers aged less than 25 years may be related to the change in nursing training.
There were similar changes for full-time nursing workers. In 2001, 41% of full-time nursing workers were aged 45 years or older, up from 17% in 1986.
In 2001, 65% of nursing workers lived in Major Cities, compared with 22% in Inner Regional areas, 10% in Outer Regional and the remaining 2% in Remote and Very Remote areas. This is similar to the total population distribution in 2001. The location of specialist medical services in cities or larger regional centres attracts large numbers of nursing workers to these areas.
The profile of the nursing workforce appears to be ageing more rapidly in regional areas. Between 1991 and 2001, while the proportion of nursing workers aged 45 years and over increased in all geographic areas, the increase was greatest outside Major Cities. For example, in Major Cities the 45 years or over age group increased by 17 percentage points compared with 20 percentage points in Very Remote areas. Similarly, while the proportion of nursing workers aged 15-34 years decreased in all geographic areas over this period, the largest decreases were outside of Major Cities, with the 15-24 years age group falling by 10 percentage points in Very Remote areas.
In response to nursing shortages outside the metropolitan areas, the Australian Government implemented the Rural and Remote Nurse Scholarship Program in 1998 to assist professional development and skill training for registered and enrolled nurses working in remote and rural areas as well as those wishing to train and practice in these areas. (endnote 4)
Distribution of nursing workers across remoteness areas(a) - 2001
Individual earnings for employees tend to vary widely according to the number of hours worked, the type of work done, the level of experience and the level of responsibility associated with a job. For this reason, the ordinary time earnings of full-time adult non-managerial employees are used to examine earnings of nursing workers. These are sourced from the ABS Survey of Employee Earnings and Hours.
In 2004, full-time adult non-managerial nursing professionals earned $1028.30 per week on average excluding overtime, and enrolled nurses earned $715.30 per week. In comparison, the average earnings per week across all full-time adult non-managerial employees was $867.50.
The future supply of nurses depends on a number of factors. These include the numbers of people undergoing nursing training, the retention of nurses in the nursing workforce, the enticement of qualified nurses either working elsewhere or not in the labour force to return to the nursing workforce, and international migration.
...people starting nursing study
The number of nursing workers in coming years will be influenced by the number of people who start at higher education institutions in courses for initial registration as nurses. The Department of Education, Science and Training estimates that commencements for nursing study declined from 1995 to 2000 but generally increased over the period 2001 to 2003. (Endnote 5) In 2003 there were 8,500 people starting courses for initial registration as nurses, an increase from 8,100 in 2001. Between 2001 and 2003, Queensland experienced the largest increase (29%) in new commencements of all states. All other states had smaller increases or remained the same over this period.
LABOUR FORCE STATUS OF FEMALES(a) WITH NURSING QUALIFICATIONS(b) - 2001
ALL COMMENCING STUDENTS ENROLLED IN COURSES FOR INITIAL REGISTRATION AS NURSES(a)
...people with a nursing qualification
One means of alleviating a current or anticipated nursing shortage is to entice people with nursing qualifications back to nursing work through programs such as the Australian government funded Metropolitan Nurse Re-entry Scheme providing 80 scholarships to encourage suitably qualified nurses to return to the field of nursing. (endnote 6)
In 2001, according to the ABS Survey of Education and Training, 84% of women aged 15-64 years with a Bachelor degree or higher in a nursing field (155,000 women) were in the labour force. This is similar to the labour force participation of women with a Bachelor degree or higher in any field and much higher than the labour force participation of all women (69%). Women with nursing qualifications also experienced lower unemployment rates compared with all women (1.2% and 6.3% respectively). Of women with nursing qualifications who were not in the labour force, 37% belonged to a family with at least one child aged less than 15 years.
Nearly three quarters (73%) of employed women with a Bachelor degree or higher in a nursing field were working as Nursing professionals, with the remainder working in other occupations. The retention of women with nursing qualifications in nursing jobs decreases with age. For example, of women aged 25-34 years with a nursing qualification, 92% were employed as Nursing professionals. However this had decreased to 66% for women in both the age groups of 35-44 years and 45-64 years.
Future supply will also be affected by employers being able to retain existing workers in Australia and attract new nurses from overseas into the workforce. Local health care providers may face a difficult task in attracting nurses since they are sometimes competing against overseas employers. In this competitive environment, moves have been made to attract overseas nurses into the Australian workforce.
Along with permanent settlers, another group of interest to the nursing workforce are long-term visitors. Long-term visitors to Australia with nursing qualifications can obtain a working visa to gain employment while on a working holiday.
On balance, Australia's supply of nursing workers was depleted by permanent and long-term international movement of nursing workers in the last ten years according to the ABS Overseas Arrivals and Departures Collection. However, since 2002, there has been a turn around in this trend with more arrivals than departures on a permanent or long-term basis. Approximately 800 nurses arrived from overseas to work during 2001 - a small addition to the total population of 191,000 nursing workers for that year.
International arrivals and departures of nurses(a)(b)
1 Report of the Inquiry into Nursing, June 2002, The Patient Profession: A time for action.
2 Shah, C & Burke, G 2001 Job Growth and Replacement Needs in Nursing Occupations, Department of Education, Science and Training <http://www.dest.gov.au/archivehighered/eippubs/eip01_18/2.htm> accessed 26 May 2005.
3 Commonwealth Department of Education, Science and Training. <http://www.dest.gov.au/>, accessed 4 November 2004.
4 Australian Government Department of Health and Ageing <http://www.health.gov.au/> accessed 17 November 2004.
5 Commonwealth Department of Education, Science, and Training, Students 2003, Selected Higher Education Statistics
6 E-mail, Nursing and Rural Workforce Strategies, 21 June 2004.
7 Department of Immigration and Multicultural and Indigenous Affairs 2005, <http://www.immi.gov.au/migration/skilled/ modl.htm> accessed 15 June 2005.