RNs on the Job
Employment Settings
Five major employment settings were identified for RNs: hospitals; nursing homes and extended care facilities; community and public health settings; nursing education; and ambulatory care settings.
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. In March 2004, out of an estimated 2,421,460 RNs employed in nursing, 56.2 percent (1,360,956) worked in hospital settings compared to 59 percent (1,300,323) in March 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. 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).
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. The remaining RNs employed in nursing reported working in such settings as nursing education, f ederal administrative agencies, s tate 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. 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.