LIHUE — Advanced Practice Registered Nurses can work as primary-care providers thanks to laws passed in 2009, and because of that Hawaii has experienced a sharp uptick in APRNs, health officials say.
But a dip in the number of licensed practical nurses (LPNs) is forecast to develop into a statewide LPN shortage, which could present hiring challenges in the future.
Kauai’s workforce has followed the trends, according to the Hawaii State Center for Nursing.
“In general, the numbers in Kauai County follow the same general pattern as the state, though the rate of change has not always been as rapid,” said Carrie Oliveira, associate specialist for workforce research with the Hawaii State Center for Nursing.
APRNs are registered nurses with graduate education, specialized certifications and advanced nursing licenses.
Since 2005, the number of APRNs in the state has increased by nearly 60 percent, according to the newly released 2017 Nursing Workforce Report issued by the Hawaii State Center for Nursing.
That number on Kauai has jumped 73 percent over the past 12 years, from 30 APRNs in 2005 to 48 in 2015 and then to 52 in 2017.
In total, 977 nursing licenses were issued to Kauai residents in 2017, a net increase of 31 percent over the last 12 years, but there was no significant change in the total number of nursing licenses issued between 2015 and 2017.
And while APRNs are on the rise, the number of LPNs has been on the decline statewide. LPNs work under a supervising registered nurse (RN).
The number of LPNs has decreased by 2 percent annually since, to a total of 16 percent since 2005, according to the report.
On Kauai in 2017, LPNs accounted for 17 percent of all nursing licenses, and there were 22 percent fewer LPN licenses in Kauai in 2017 than in 2005. Between 2015 and 2017, Kauai County had an 11 percent decrease in LPN licenses.
“Declining LPN numbers have already begun to create recruitment and retention challenges for facilities that rely heavily on LPNs for staffing,” the 2017 Nursing Workforce Report said. “Staffing challenges are likely to be exacerbated as a result of the size and acuity of the long-term and post-acute problem.”
The decline in LPNs is most likely due to LPNs leaving the workforce for retirement and due to the transitional nature of LPN status, as many LPNs are on their way toward becoming RNs.
Statewide, APRNs are working in the more remote and rural areas, according to the report, and are taking on many of the primary-care responsibilities in these areas.
About 10 percent of APRNs report working in a practice specifically related to mental or behavioral health.