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American Journal of Nursing: Issues Update
September, 2004 - Volume 104, Issue 09
 Other ANA Columns This MonthAll 2004 ANA Columns
Peaks and Valleys
Nursing centers work to ensure a stable RN workforce
By Susan Trossman, RN
Most nurses have either heard of—or experienced
firsthand—the cyclical nature of the nursing profession. Some years,
health care recruiters are beating down RNs’ doors with offers of
sign-on bonuses and tuition-reimbursement programs. Other years,
health care administrators are pursuing reengineering plans that result in
some nurses being shown the door.
However, over the past several years nursing
“centers” have been engaged in different activities to ensure a
stable nursing workforce, and in turn, a solid health care system.
One major force in the formation of 19 nursing
workforce centers between 1995 and 2003 was the Colleagues in Caring (CIC)
project, which was funded by the Robert Wood Johnson Foundation.
Today there are more than 40 centers or workforce
initiatives funded by various sources. Generally, their mission is to
gather and evaluate workforce data, develop recruitment and retention
strategies, educate the public and policymakers about the vital role RNs
play in the health care system, and promote initiatives that will stabilize
the nursing workforce in their states and regions. (The ANA and its
constituent member associations have supported many of these centers,
either through funding, lobbying, or other partnership initiatives.)
Becky Rice, former CIC deputy director and a Virginia
Nurses Association member, says the centers have had a huge effect on
nursing.
“Now policymakers understand the importance of
collecting certain data on nurses to project a state’s or
region’s future health care workforce needs,” Rice says.
“And nurses realize the importance of using evidence-based data to
address nursing issues.
“Also through the centers, we brought many people
from different backgrounds together to address health care,” Rice
says. “These groups have stayed together and have become very
powerful.”
A snapshot of six centers
North Carolina is currently not considered a shortage
state, says Brenda Cleary, PhD, RN, FAAN, executive director of the
state-funded North Carolina Center for Nurses (NCCN). Created in 1991,
it’s considered the gold standard of nursing centers.
“Our challenge now is to deal fairly quickly
with the issue of educational capacity, including building the number of
nurse faculty,” says Cleary, a North Carolina Nurses Association
member. “We have a pipeline problem—60% of nurses entering the
profession have associate degrees, and few go on for future
education.”
One way in which the NCCN is beginning to make a
difference on this front involves its collection of
“evidence.”
Cleary explains that for years, part-time nursing
students were ineligible to receive state scholarships.
“Using our data, we convinced the Nurse Scholars
Commission that we need to have nurses continue with their education to
fill certain vital nursing roles,” she says. “Now, working
nurses can afford to go back to school because they qualify for state
scholarships.”
Cleary also points to the success of its recruitment
campaign, “Nursing: The Power to Make a Difference,” which
targets young people.
“Since that campaign started, we’ve had a
lot more students expressing an interest in nursing careers and graduating
from nursing programs,” she says. And hits on the campaign Web site,
which features information about nursing roles and resources, have
increased from about 40 to 1,000 a week.
The NCCN is launching some promising new programs,
including an initiative to develop a standardized orientation program for
new nurses, so they can make a smoother transition from school to
workplace.
Created in 2002, the nonprofit New Mexico Center for
Nursing Excellence (NMCNE) used its workforce data to influence
policymakers to boost nursing faculty salaries and grant funding for
nursing programs, so student enrollment could expand, according to NMCNE
president Fran A’Hern Smith, DNSc, RN. Like other states, New Mexico
wants to attract more nurses into faculty positions to offset its shortage
of nurse educators.
The NMCNE also created an articulation committee with
representatives from every community college to develop a standard
curriculum for associate nursing degree programs, according to A’Hern
Smith, a New Mexico Nurses Association board member.
In two upcoming nurse retention–focused projects,
the NMCNE wants to establish a clinical teaching institute and conduct a
nurse satisfaction survey, which will examine issues ranging from
ergonomics to the voice of nurses in the workplace.
“The concept of the clinical training institute
initially is to provide staff nurses and nurse managers with the training
they need to become effective mentors to new nurses,” A’Hern
Smith says.
The Nursing Career Center of Connecticut (NCCC)
was launched through a partnership of the
Connecticut Nurses Association (CNA) and the Connecticut League
for Nurses about five years ago. One of its greatest successes has been in
changing the way middle school and high school counselors view the nursing
profession, according to Mary Jane Williams, PhD, RN, the vice president of
NCCC and a former CNA president.
“What we learned through meeting with school
counselors was that they didn’t view nursing as a profession,”
Williams says. “So they didn’t recommend it to their students,
especially those who were high achievers.”
In a strong retention initiative, the NCCC offers
career counseling mostly for practicing nurses.
“Nurses can meet with career counselors who help
them see where they are in their career, where they want to be, and how to
get there,” Williams says. This service will help nurses stay in the
profession, rather than leave because they’re dissatisfied with their
current jobs or working conditions.
Williams says the NCCC has also made great strides in
coalition building and has been active politically to address nursing
shortage issues.
Other efforts
Nurse leaders at the Iowa Center of Health Workforce
Planning are working with health care groups to prevent the huge turnover
of experienced nurses who are expected to retire over the next few years.
“We want to develop strategies that will allow
them to stay longer—either in their current positions or in new roles
where their expertise can be used to improve patient care,” says
Eileen Gloor, MSN, RN, the center’s director and an Iowa Nurses
Association member.
Center leaders also are collaborating with long-term
care professionals to increase the number of new nurses who value the
“culture of aging,” according to Gloor. Most new nurses want to
work in acute care, yet Iowa has a huge need for nurses willing to provide
care to its large population of residents over the age of 80.
Gloor says that a significant role of the center
continues to be the identification and promotion of best practices that
help in the recruitment and retention of nurses. It recently released its
2004 report, which provides updates on several demonstration projects and
mentoring programs being implemented in Iowa facilities. A retention
strategy at one home care agency, for example, involves staff using
computers instead of frequently redundant and time-consuming handwritten
documentation.
Oregon is also grappling with ways to meet the future
health care needs of its residents.
“Nursing programs statewide need to triple, or at
least double, their enrollment to produce sufficient numbers of nurses to
meet demand,” says Deborah Burton, PhD, RN, director of the Oregon
Center for Nursing (OCN).
To address these needs, the OCN supports creative
partnerships with nurse educators to implement long-distance learning,
which helps stretch faculty’s reach and students’ access to
programs. The OCN also is promoting simulation technology to augment
students’ clinical opportunities. Furthermore, the OCN is
collaborating with a consortium of community colleges and baccalaureate
nursing programs to create standardized curriculum throughout the state,
making it easier for students to obtain bachelor’s degrees in
nursing, and to increase capacity overall.
The OCN is tackling another barrier to solving the
nursing shortage: the lack of diversity in the workforce.
“We continue to chip away at the public’s
perception of what it means to be a nurse through our ongoing media
campaigns,” says Burton, an Oregon Nurses Association member.
The campaigns feature real nurses—men and those from diverse ethnic
backgrounds—potential nurses can relate to. “Are You Man Enough
to be a Nurse?” has received national acclaim for shattering tired,
inaccurate images of contemporary nursing.
The two-year-old Massachusetts Center for Nursing
(MCN) also is developing strategies to fill the state’s growing need
for nurses.
“One noteworthy initiative for MCN was its
recent collaboration with the National Youth Leadership Forum (NYLF) to
bring 397 high-achieving high school students to Massachusetts to introduce
them to the world of nursing,” says MCN vice president Marie Tobin,
MPH, RN, also a member of the Massachusetts Association of Registered
Nurses. “Because this inaugural nursing forum was so successful, NYFL
added nursing to its annual list of career workshops, which include
diplomacy, law, and medicine.”
The MCN also offers a comprehensive Web site (www.nursema.org) that
features information and resources on the profession, including educational
and scholarship opportunities.
Susan Trossman is the senior reporter for the
American Nurse, published by the ANA.
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