Category Archives: Education and training
In the latest installment in its “Quest for Care” series that looks at the country’s shortage of health care providers, NBC News reported over the weekend on the nursing workforce. As the nation struggles to train enough nurses to care for an aging population and the influx of patients who will be newly insured because of health care reform, one thing is holding them back: a shortage of nurse faculty.
“Just as the country needs nurses the most, a shortage of professors is curbing the capacity of nursing schools to crank out graduates with advanced degrees,” the story says, citing data from the American Association of Colleges of Nursing that nursing schools are turning away tens of thousands of qualified applicants because they lack the faculty to teach them.
The College of Nursing at the University of South Carolina is turning away a few hundred students each year for that very reason, its dean, Jeanette Andrews, told NBC. Andrews, PhD, RN, is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program.
But nurse faculty are hard to find: they need advanced degrees, and leaving the field for the classroom often requires nurses to take a pay cut. Hospitals and other care settings are competing for the same skilled nurses that colleges need, experts say.
“I have five faculty positions open right now,” Andrews added. “It is really hard to find qualified, doctorally prepared faculty who are willing to relocate or to move out of a higher-paying salary in the field.”
The news media has recently covered some innovative programs that are influencing the choices and attitudes of the next generation of doctors.
American Medical News reports on the Buddy Program, which pairs first-year medical students with early-stage Alzheimer’s patients and their caregivers. The program empowers patients, and also serves as a valuable learning tool for the students, heightening “their sensitivity and empathy toward people with the disease.” The program was developed at the Northwestern University Alzheimer’s Disease Center in Chicago; Boston University, Dartmouth College, and Washington University have replicated it.
NPR reports on a program at the University of Missouri School of Medicine that is encouraging more young doctors to pursue primary care in rural areas. During the summers, the school has been sending medical students to work alongside country doctors. While school officials caution they can’t be sure about the reasons, they have discovered that students who took part in the summer program were more likely to become primary care doctors who practice family medicine. Some 46 percent of participants are choosing to work in the country after completing their medical training.
Ariel Eby is a scholar in the new ADN-to-BSN bridge program at California State University, Los Angeles, which is funded by the California Action Coalition through a grant from the Robert Wood Johnson Foundation (RWJF) Academic Progression in Nursing (APIN) initiative. The California Action Coalition is a part of the Future of Nursing: Campaign for Action, a collaborative effort backed by RWJF and AARP to transform nursing and improve health and health care.
I never thought it was possible to be so exhausted and so grateful at the same time. These last few years have proven to be the most challenging of my life, but the most rewarding at the same time.
"I want to spend the rest of my life eating, drinking, living, learning, and teaching nursing."
When I say I'm exhausted, I'm not exaggerating. When I first heard about the debut of the ADN-to-BSN bridge program at California State University-Los Angeles, I didn’t think there was any way I could make it work. I have three jobs. I’m already in a program getting my associate degree in nursing (ADN)—and am getting married later this summer, the day after the first quarter ends. “There's no way!” I thought.
But where there's a will there’s a way, I'd soon find out.
Robyn Williams is a scholar in the new ADN-to-BSN bridge program at California State University, Los Angeles, which is funded by the California Action Coalition through a grant from the Robert Wood Johnson Foundation (RWJF) Academic Progression in Nursing (APIN) initiative. The California Action Coalition is a part of the Future of Nursing: Campaign for Action, a collaborative effort backed by RWJF and AARP to transform nursing and improve health and health care.
When I first heard about the accelerated ADN-to-BSN program at California State University, Los Angeles, my ears perked up and I was instantly very interested. Having the chance to pursue my bachelor’s degree in nursing (BSN) while finishing my associate degree in nursing (ADN) at Long Beach City College was ideal.
I had already planned to start working toward obtaining my bachelor’s soon after I graduated and had even looked into some programs. So, the option to join this accelerated program at Cal State LA, as we call it out here, was a no-brainer.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of RWJF’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other critically important nursing issues. These are some of the stories in the August issue:
Nurses Advocate for Health System Change
Like so many others, nurses, too, have bad personal experiences with the health care system—but several RWJF Scholars have turned those challenges into efforts to make positive change. They are using their experiences with violence, bullying, poor care coordination, and other health problems to advocate for more access, better care, and other reforms.
Nurse Leader Combats Cancer Among African Immigrant Women
After a difficult experience trying to get care for her mother, RWJF Community Health Leader Ifeanyi (Ify) Anne Nwabukwu’s eyes were opened to the difficulties immigrants face accessing health care in the United States. Nwabukwu founded the African Women’s Cancer Awareness Association, which aims to address disparities in awareness, prevention, and access to quality health care services. The Association opens its doors to all people, but targets African immigrant women, and especially those who are underserved or uninsured.
A Fast Track to Bachelor’s Degrees in Nursing
A new initiative designed to ease the transition between associate and baccalaureate degree nursing programs opened its doors to its first class of students this summer. Based at the School of Nursing at California State University, Los Angeles, the program enables students with associate degrees in nursing to earn baccalaureate degrees in nursing in 12 months. Supporters say the program will eliminate redundant coursework, enhance diversity in the nursing workforce, and help develop more nurse leaders.
First-year surgical interns are getting less experience performing or assisting with surgeries as a result of the 16-hour workday cap enacted in July 2011 by the Accreditation Council for Graduate Medical Education, according to a study in JAMA Surgery.
In a review of 10 West Coast general surgery residency programs, researchers found 2011-2012 interns recorded a 25.8 percent decrease in total operative cases as compared with the preceding four years before the cap was enacted. There was also a 31.8 percent decrease in cases performed primary by the interns, under faculty supervision, and a 46.3 percent decrease in cases in which the interns assisted a faculty member.
“The decline in operative case volume in our present study is in some respects surprising given that the new duty-hour changes did not mandate a reduction in an overall 80-hour work week for interns,” the researchers write. “Thus, interns were presumably working the same number of total hours.” The program directors surveyed in the study reported that their predominant solution to the 16-hour rule was to expand the “night-float” system, meaning interns are increasingly working overnight when there are fewer intern-level, elective surgeries taking place.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of RWJF’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other critically important nursing issues. These are some of the stories in the July issue:
Public Health Nurses Satisfied With Their Jobs, In High Demand
“It was so fulfilling to be seen as that kind of community resource and be able to have an impact on the lives of so many people at once,” RWJF Executive Nurse Fellows program alumna Joy Reed, EdD, RN, FAAN, president of the Association of Public Health Nurses, says of her first job with a local health department. A report from RWJF finds that public health nurses are satisfied with their jobs and feel they are making a difference in their communities, but they have concerns about job stability, compensation, and career growth in light of budget-tightening at many state and local health departments.
Nurse Historian Helps Build “Nest” for Nurse Scholars
A nurse, a nurse educator, a historian of nursing, and a nurse administrator at the University of Pennsylvania School of Nursing, Julie Fairman, PhD, RN, FAAN, is now adding another title to her lengthy resume: co-director of the Future of Nursing Scholars program, a new $20 million initiative launched by the RWJF that will support some of the best and brightest nurse scholars as they pursue research-focused doctorates in nursing.
In a hopeful sign, an annual survey from the National League for Nursing (NLN) finds that fewer qualified applicants were turned away from schools of nursing in the 2011-2012 school year than in recent years. The percentage of nursing programs that turned away qualified applicants dropped “substantially” for every program type except baccalaureate degree programs in the survey, and the percentage of students turned away also declined. The percentage of programs that could not fill available seats fell in 2012 as well.
In a news release, NLN President Judith Halstead, PhD, RN, FAAN, ANEF, called the trend “encouraging.” She noted that, “just two years ago the percentage of nursing programs that turned away qualified applicants was peaking across all types of nursing education programs, including almost two thirds of baccalaureate programs.”
The NLN Annual Survey of Schools of Nursing finds that the nurse faculty shortage continues to be the main obstacle to expansion for graduate programs, although that shortage is easing some as well. According to the new survey, 73 percent of responding schools reported hiring new nurse faculty in the past 12 months. More than two-thirds of those new hires have a master’s degree; 16 percent have PhDs; and 7 percent have DNPs.
Noting that doctoral nursing programs rejected 37 percent of qualified applicants in 2012, NLN CEO Beverly Malone, RN, PhD, FAAN, said in the news release: “With the importance of academic progression and a continuing need for doctorally prepared nurse faculty, we are pleased to note that this rejection rate has now dropped from 43 to 37 percent, though clearly we still have a long way to go.”
An increasing number of associate degree nurse and practical nurse programs cite a shortage of clinical sites as an obstacle to expansion, the survey reports.
Mary E. Burman, PhD, FAANP, is dean and professor of nursing at the University of Wyoming (UW). She was a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow from 2007 to 2010 and coordinates a nurse education and leadership project that is supported by Partners Investing in Nursing’s Future (PIN), an initiative of RWJF and the Northwest Health Foundation.
Human Capital Blog: The Institute of Medicine (IOM) calls for a more highly educated nursing workforce and, in particular, for 80 percent of nurses to have bachelor’s degrees by 2020. What is the educational level of nurses in Wyoming? Do the state’s health care organizations prefer or require that nurses hold baccalaureate degrees?
Mary Burman: Wyoming, like many other states, and especially like many rural states, faces significant challenges in obtaining the IOM goal that 80 percent of nurses hold bachelor’s degrees by 2020. The Wyoming Center for Nursing and Health Care Partnerships (WCNHCP), home of the state’s nursing workforce center and Action Coalition, has developed estimates for the current number of nurses with baccalaureate degrees (BSN) and has made projections over the next four years.
We estimate that 36.9 percent of registered nurses (RNs) in Wyoming currently have baccalaureate or higher degrees. However, that percentage will not increase significantly over the next four years; in fact it may actually drop, given the number of new RNs with associate degrees in nursing (ADNs) and the number of nurses who are preparing to retire.
Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action.
On Thursday, New York Times blogger Pauline Chen, MD, took a fresh look at the disagreements over the services that advanced practice registered nurses should be authorized to provide, reporting on a primary care meeting at which a doctor dared to raise “the unmentionable” topic with his colleagues. The room, she reports, erupted into discord and chaos.
The same divide was documented in a survey reported by the New England Journal of Medicine in May. It is a terrible shame. What we need, now more than ever, is open and reasoned conversation within and between health care fields about the best way to provide high quality care and improve our population’s health.
These are challenging times for our health care system. Millions of Americans are about to gain insurance through the Affordable Care Act. Our population is getting older and living with more chronic illnesses. And we have an urgent need to promote prevention, improve quality, and contain costs.
There is no question that we need more physicians and more primary care physicians in particular. There is no question that physicians should treat the sickest patients and those with the most complex health problems. But there also is no question that we need nurse practitioners to be able to practice to the full extent of their education and training.