More Great Information from the HR Advisory Group

HR Advisory Group stated that the Wisconsin nurse residency program has boosted retention rates! "
To better prepare the region’s new nurses to practice, 40 Wisconsin hospitals have collaborated with Milwaukee-based Marquette University to develop a nurse residency program, the Milwaukee Journal Sentinel reports. Through the Wisconsin Nurse Residency Program, which is funded by $2 million in federal grants, new nurses are paired with mentors who answer questions about daily work and help create professional development plans; the program also organizes monthly meetings for new nurses to receive specialized training and share experiences. Thus far, the program touts a retention rate of 90% for new nurses, compared with the 50% of novice nurses nationally who quit within their first two years. Some nursing supervisors, for instance, note that, after just one year on the job on the job, nurses in the program function at the level of second- or third-year nurses. Noting that hospitals spend approximately $65,000 to replace just one nurse, the program’s director states that the roughly $52,000 it costs to annually operate the residency program for 10 nurses can be recouped if it prevents just one in 10 nurses from quitting (Dresang, Sentinel, 10/14/07). For more information about how hospitals can develop nurse residency programs, Nursing Executive Center members can see the 2006 practice brief, Transitioning New Graduates to Hospital Practice: Profiles of Nurse Residency Program Exemplars. "

Recommendations from the Honor Society of Nursing, Sigma Theta Tau International

The Honor Society of Nursing, Sigma Theta Tau International has noted that the nursing shortage is a major threat to the future of the world's health care system. They have recommended the steps listed below as a possible means to reverse the trend:

• Demonstrate to health care leaders that nurses are the critical difference in America's health system.
• Reposition nursing as a highly versatile profession where young people can learn science and technology, customer service, critical thinking and decision-making skills.
• Construct practice environments that are interdisciplinary and build on relationships among nurses, physicians, other health care professionals, patients and communities.
• Create patient care models that encourage professional nurse autonomy and clinical decision-making.
• Develop additional evaluation systems that measure the relationship of timely nursing interventions to patient outcomes.
• Establish additional standards and mechanisms for recognition of professional practice environments.
• Develop career enhancement incentives for nurses to pursue professional practice.
• Evaluate the effects of the nursing shortage on the preparation of the next generation of nurse educators, nurse administrators and nurse researchers and take strategic action.
• Implement and sustain a marketing effort that addresses the image of nursing and the recruitment of qualified students into nursing as a career.
• Promote higher education to nurses of all educational levels.
• Develop and implement strategies to promote the retention of RNs and nurse educators in the workforce.

Thank you for this great information! We need to continue to share ideas and strategies as professionals and to educate the public on the value of the nursing profession.
More great information can be found on the web site (This site is also available in many other languages.) http://www.nursingsociety.org/Media/Pages/shortage.aspx

Information from the HR Advisory Group

Efforts to address nursing faculty shortage through legislation, grants intensify
07/25/2007
Even as new reports continue to raise concern over the nursing faculty shortage, both national and local efforts to expand the teaching pool have mounted. Three bills currently before Congress would put millions of dollars toward faculty recruitment and training, while state governments and health care providers increasingly are offering grants to back new nursing programs and pursuing innovative solutions to the faculty deficit.Among the more recent reports measuring the effect of the faculty shortage was a brief released last week by the Association of Academic Health Centers (AAHC) that surveyed CEOs at 31 academic institutions nationwide and concluded that faculty shortages have prompted program and enrollment cuts. Similarly, a report released by PriceWaterhouseCoopers Health Research Institute this month revisits how the faculty shortage hampers training capacity, finding that while nursing enrollments have increased at double-digit rates since 2003, the number of qualified applicants turned away has grown even faster.

To some extent, the faculty shortage is traditionally ascribed to changing demographics and somewhat unfavorable conditions for nurse educators; the AAHC report cites retirement among baby boomers, heavy faculty workloads, salary disparities between academic and private practice positions, and waning interest in academic careers among students entering health professions. Yet an oft-overlooked driver of the shortage is that public nursing schools have limited financial incentive to expand their nursing programs. According to the acting provost of one Virginia community college, the school “lose[s] $8,000 per year for every nurse” it trains; as public colleges’ tuition rates are set by the state, many schools are unable to raise student fees to cover these higher costs and instead incur significant losses. For example, North Carolina community colleges—which provide the state with nearly one-half of its RNs and more than 80% of its LPNs—say that they annually lose $30 million in training nurses. As a result, many administrators are calling for increased subsidization of nurse educational programs (PwC report, July 2007; Simmons, Raleigh News & Observer, 6/16/07).
Pending federal spending bills could boost funding for nurse education…
While Congress has touched on the faculty shortage before, such as by amending last year’s defense appropriations bill with a $500,000 measure designed to encourage former military nurses to become faculty in nursing schools, several new pieces of legislation offer far greater scope and funding, should they be approved. For example, the Senate Appropriations Committee last month approved the Labor, Health and Human Services and Education 2008 spending bill, which would earmark $169 million for nursing programs, a $20 million increase over last year’s allocation, and would support new initiatives to boost faculty numbers, such as $1 million for the University of Maryland-Baltimore to establish a Nursing Institute dedicated to training nurse educators. The bill currently awaits the full vote of the Senate (Schultz, Baltimore Business Journal, 6/22/07; House website, accessed 7/17/07). Two other bills proposed last month also hold promise to address faculty shortage concerns. In the Senate, Sens. Hillary Clinton (D-N.Y.) and Gordon Smith (R-Ore.) introduced the Nursing Education and Quality of Health Care Act of 2007, which would establish grants and programs to improve nurse training, recruitment, and retention in rural areas. The bill—endorsed by the American Nurses Association, the American Organization of Nurse Executives and the American Association of Colleges of Nursing, according to a release from Sen. Clinton’s office—also would fund demonstration projects that integrate patient safety practices into nursing education and bolster nurse leadership in hospital-based patient safety initiatives. Meanwhile, in the House, Rep. Ed Pastor (D-Ariz.) proposed the America’s Partnership for Nursing Education Act of 2007, which would allocate $20 million annually during fiscal years 2008 through 2012 and grant eligible states a minimum of $2 million annually to increase capacity in nursing education programs. To qualify, states must have federal data projecting both a population increase of more than 50% between 1990 and 2025 and fewer than 555 employed RNs per 100,000 residents by 2020, in addition to sponsoring other programs to increase the number of nursing faculty (AHA News Now, 6/13/07; 7/9/07; Clinton release, 6/13/07; Arizona Hospital and Healthcare Association release, 7/3/07; GovTrack, accessed 7/17/07).
…but states, hospitals backing new initiatives in the interim
However, some experts are pessimistic that either act will be passed, noting that similar legislation was proposed during the previous session of Congress and failed to progress to a vote. Instead, they note that rather than wait on uncertain federal funds and a national solution, states and local health care providers instead have taken the lead on addressing the faculty shortage, spawning a “patchwork” variety of new initiatives (Watch interview, 7/18/07).

For their part, many states are seeking evidence that their grants will offer instant relief for nurse training shortfalls, such as a $1.23 million state grant made this week to Arizona Western College in Yuma; the funds will be used to hire 10 nursing faculty members, acquire new lab supplies, and introduce Web-based virtual training components—measures that immediately will increase enrollment from 80 to 96 students. Similarly, many hospitals and health care systems are recognizing the potential downstream staffing benefits of underwriting nurse faculty efforts. For example, the University of South Carolina last month received a $1 million grant from nearby Piedmont Medical Center; the grant will allow USC to fund new faculty positions and nearly double enrollment in the school’s BSN program. Meanwhile, USC nursing students will have the opportunity to participate in clinical rotations at Piedmont, better positioning that facility to hire the new nurses upon graduation (Reynolds, Yuma Sun, 7/17/07; Clay, Rock Hill Herald, 6/28/07).

Retaining the New Graduate RN

In the September issue of the American Journal of Nursing, an article on retaining newly licensed RN's stated that, "while the majority of newly licensed registered nurses (RNs) were “generally pleased” with their jobs, the 13% who left their positions within the first year of employment most often cited poor management and stressful working conditions as the top reasons for their departure". These findings, the researchers say could help guide hospitals in their efforts to improve retention rates. The researchers from New York University and the University of Buffalo analyzed survey data from a random sample of 3,266 RNs in 35 states and the District of Columbia who had passed the licensing exam within the past 18 months and had obtained their license between Aug. 1, 2004, and July 31, 2005. The researchers found that newly licensed RNs reported a mean job satisfaction score of 5.2 out of a possible 7 points, although more than 41% said they would want another position if they were “free to go into any type of job.” In addition, nearly one-fourth of respondents said they planned to switch jobs within two years of accepting their first position, and 37% said they planned to seek a new role within one year—statistics the researchers say are “alarming” and indicate that newly licensed RNs are “not finding what they want in the first year of work.” The researchers add that RNs whose first professional degree was an associate’s degree appeared to be more likely than those with a bachelor’s degree to say they intended to leave their current role.Further highlighting the work conditions that may contribute to nurse turnover, more than half of respondents said they had worked voluntary overtime, and nearly 13% said they had worked mandatory overtime. More than 60%, meanwhile, said they had worked night or evening shifts, while roughly one-fourth said they had sustained at least one needle-stick injury across the last year, and more than 60% reported experiencing on-the-job verbal abuse. One of the study authors says the findings indicate that “the work environment for newly licensed RNs has both positive and negative aspects.” Noting that their future research will aim to develop predictive models of newly licensed RNs’ turnover rates, the researchers conclude that hospitals should invest in “better orientation and management of newly licensed RNs” in an effort to ensure long-term retention (Kovner et al., American Journal of Nursing, September 2007; American Journal of Nursing release, 8/29; University of Buffalo release, 8/29).

Back from vacation with a renewed mission.

I returned to work this week feeling rested after my time off. Unfortunately, the rested feeling was short lived. The hospital was extremely busy with a large volume of acutely ill patients. Although the nursing staff was tired and stressed, they continue to provide superb care to our patients. I am always humbled when I watch the Infirmary's nurses deliver patient care in such a kind, compassionate, and professional manner. Summer vacation time on the nursing units always seems to bring to light staffing issues especially now in this time of a growing nursing shortage. I have renewed my dedication to researching, developing, and sharing strategies to effectively deal with the nursing shortage. I have started to read, From Silence to Voice: What Nurses Know And Must Communicate to the Public, by Bernice Buresh and Suzanne Gordon and I feel even more committed to our wonderful profession of nursing.

Vacation!!

Well, it is vacation for me! The past week was very busy and staffing was a daily challenge. As I think about the future and the increasing nursing shortage, it really worries me. I will continue my quest to search for information on the nursing shortage and to share more strategies to effectively deal with the shortage. But for now, I am looking forward to some quiet, relaxing time with my family in the mountains of Vermont.

Thursday August 2, 2007 was the first anniversary of Paul Levy's Running a Hospital Blog, congratulations to him. He shares wonderful information on his blog and if you haven't checked it out, I encourage you to do so.

Dartmouth-Hitchcock Medical Center's Department of Nursing Utilizes Patient Simulation Training

Dartmouth-Hitchcock Medical Center's Department of Nursing has incorporated Patient Simulation Training into their nurse residency program. There is evidence that simulation training programs are effective in improving practitioner performance and confidence as well as improving clinical skills. As we continue to search for ways to recruit and retain nurses, this approach to education is well worth the investment. Kudos to Dartmouth- Hitchcock's Department of Nursing. Read more about it in the link blow.

http://www.dhmc.org/webpage.cfm?site_id=2&org_id=152&gsec_id=42639&sec_id=42640&item_id=42653