Category Archives: Medical, dental and nursing workforce
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 the Foundation’s nursing programs, and the latest news, research, and trends related to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the June 2014 issue.
Campaign for Action Is Chalking Up Successes that Will Improve Patient Care
Three years after it launched, the Future of Nursing: Campaign for Action is making steady progress on nurse education, practice, interprofessional collaboration, data collection, and diversity, according to a series of indicators released last month. Led by RWJF and AARP, the Campaign has created Action Coalitions in all 50 states and the District of Columbia that are working to implement recommendations from the Institute of Medicine. “Because of the Campaign, there’s more awareness about the importance of preparing the nursing workforce to address our nation’s most pressing health care challenges: access, quality, and cost,” says RWJF Senior Program Officer Nancy Fishman, MPH.
Pioneering Nurse Scientist Addresses Asthma-Related Disparities
Kamal Eldeirawi, PhD, RN, a pioneering scientist with expertise in immigrant health, was born in the Gaza Strip in Palestine, where he saw the profound impact of poverty and disadvantage on health in his own community. A career in nursing, the RWJF Nurse Faculty Scholar believed, would allow him to make a difference at both the individual and population-wide levels. Today, Eldeirawi, is researching risk factors that contribute to asthma in Mexican American children living in the United States, and the effects of immigration and acculturation on children’s health.
For more than a decade, the percentage of newly licensed nurse practitioners who chose to work in primary care was on the decline. But that trend is changing, according to a survey released last month by the Health Resources and Services Administration (HRSA).
Fifty-nine percent of nurse practitioners (NPs) who graduated in 1992 or earlier went into primary care, and 42 percent of those who graduated between 2003 and 2007 did so, according to the survey. But 47 percent of the very newest NPs—those graduating between 2008 and 2012—opted to work in primary care, reversing the downward trend.
“We are encouraged by the national growth of primary care nurse practitioners, and HRSA is committed to continuing this trend to ensure an adequate supply and distribution of nurses for years to come,” HRSA Administrator Mary K. Wakefield, PhD, RN, said in a statement.
Susan Schrand, MSN, CRNP, a family nurse practitioner and executive director of the Pennsylvania Coalition for Nurse Practitioners, agreed. “We’re excited,” she said. “It’s good to hear that nurses, and especially new graduates, are staying in primary care.”
For National Nurses Week, two nurses who serve in the U.S. House of Representatives share their views on nurse leadership with the Robert Wood Johnson Foundation (RWJF) Human Capital Blog. Lois Capps, D-Calif., has served in the House since 1998; and Diane Black, R-Tenn., since 2011.
Capps: We Must Increase Our Nursing Workforce
Human Capital Blog: Prior to running for Congress, you worked as a nurse and a nursing instructor. How does your background as a nurse help shape your agenda on Capitol Hill?
Rep. Lois Capps: When I began my career as a nurse, I never imagined I would become a member of Congress. But when my husband passed away shortly into his first term in Congress, I was encouraged by my friends and neighbors to run, and I won the seat in a special election. Despite the fact that nurses and other health care professionals often never think about engaging in policy-making careers, I knew my experience as a nurse would make me a great advocate for the health community in Congress. Just as nurses are the best advocates on behalf of our patients, we are naturally inclined to be the best advocates on behalf of our patients in the Capitol.
HCB: You have made addressing the nursing shortage a priority. What has Congress done so far to address past shortages, and what needs to be done to curb future ones?
This is part of the April 2014 issue of Sharing Nursing’s Knowledge.
ICU Staffing’s Impact on Patient Outcomes
A nurse-led study from the United Kingdom has found that higher numbers of doctors and nurses in intensive care units (ICUs) have a positive effect on survival rates for high-risk patients.
A research team led by Elizabeth West, PhD, MSc, RN, Director of Research in the School of Health and Social Care at the University of Greenwich, used data on 38,000 patients in 65 ICUs in the United Kingdom, correlating patient outcomes with staffing levels for doctors, nurses, and support staff. They found that “higher numbers of nurses per bed ... and higher numbers of ‘consultants’ [senior hospital-based physicians or surgeons] were associated with higher survival rates. Further exploration revealed that the number of nurses had the greatest impact on patients at high risk of death.”
“It seems reasonable to argue,” the researchers conclude, “that skilled nurses, who have the time to observe patients closely, to intervene or mobilise the team if they begin to deteriorate, would be most important to patients who are at the greatest risk. This study is the first to produce evidence that this is the case.” Their findings are published in the May 2014 issue of the International Journal of Nursing Studies.
Nurses are “the backbone of efforts” to expand New Mexico’s primary care workforce, according to Gov. Susana Martinez, and they help ensure that people living in the state’s rural and underserved communities can get the high quality care they need and deserve. A video from the governor helped open the Robert Wood Johnson Foundation Academic Progression in Nursing meeting in Washington, D.C., this week, which brought together nurse leaders from around the country. In her remarks, Governor Martinez explains why New Mexico has implemented a common statewide nursing curriculum, made it easier for nurses in the state to further their education, and placed “a strong emphasis on nurses.”
This is part of the March 2014 issue of Sharing Nursing’s Knowledge.
It took Arnold S. Relman, MD, one of the nation’s foremost medical thinkers, nine decades and a full-blown medical catastrophe to fully appreciate the value of nurses, according to an essay he penned in the Feb. 6 edition of the New York Review of Books.
Relman, 90, a doctor, a professor emeritus at Harvard Medical School, and a former editor of the New England Journal of Medicine, learned this lesson the hard way: as a patient. Last summer, Relman fell down the stairs and suffered life-threatening injuries—and discovered the critical role nurses play in health and health care during his lengthy recovery.
He shared his late-in-life epiphany in his recent essay: “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled,” he wrote. “This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.”
Relman’s remarks spawned a surprise reaction from Lawrence K. Altman, MD, who begged the following question in a post on the New York Times Well Blog: “How is it that a leading medical professor like Dr. Relman—who has taught hundreds of young doctors at Boston University, the University of Pennsylvania (where he was chairman of the department of medicine) and Harvard—might not have known about the value of modern-day Florence Nightingales?”
What do you think? Do medical educators and scholars fully appreciate the contributions nurses make? Register and leave a comment.
This is part of the March 2014 issue of Sharing Nursing’s Knowledge.
Comparing Nurse and Physician Performance on Colonoscopies
A new study finds that colonoscopies performed by nurse and physician endoscopy trainees are comparable in terms of quality and safety.
Researchers in The Netherlands studied 15 endoscopy trainees—seven nurses and eight physicians—at two medical centers over the course of three-and-a-half years. At the beginning of the study, none had experience in endoscopy. All were trained according to the applicable regulations of the Dutch Society of Gastroenterology, performing a minimum of 100 colonoscopies. After completing their training, each performed 135 consecutive colonoscopies under the supervision of a gastroenterologist, with their work evaluated for safety and quality.
The nurse group and the physician group had comparable results on both measures, with the nurse group producing marginally better scores in some areas. Each group detected the same percentage of adenomas (benign polyps), and had the same low rate of complications. The nurses had slightly higher rates of cecal intubation (successfully passing the colonoscope to a key part of the colon), and slightly higher rates of completing the procedure without assistance.
This is part of the February 2014 issue of Sharing Nursing’s Knowledge.
Nurses’ Perceptions of Their Workplaces
A new survey offers insights into how hospital nurses perceive their workplace and profession. Jackson Healthcare, a health care staffing company, surveyed 1,333 hospital nurses. Among the findings:
- Nearly two-thirds of surveyed nurses (64 percent) say they are satisfied or very satisfied with their jobs.
- Sixty-seven percent say they have less time at patients’ bedsides than they wish because they must perform activities that other hospital personnel could be doing, including looking for equipment and supplies, and restocking supply areas.
- Sixty-six percent cite inadequate staffing levels in their hospitals, saying that limited coverage and clinical support force nurses to divide their time between more patients.
- Almost half of nurses surveyed reported a nursing shortage at one or more of the units in their hospitals, with 35 percent citing the medical-surgical department as short-staffed, 18 percent pointing to critical care, and 17 percent to the emergency department.
Nearly 40 percent of the country’s 100 most promising employment opportunities are in health care, according to the Best Jobs of 2014 list recently published by U.S. News & World Report.
Although the health care sector dominates the list, it did lose the No. 1 spot (to technology) for the first time since U.S. News launched the annual rankings in 2012. The top 10 jobs include dentist (at No. 3), nurse practitioner (4), pharmacist (5), registered nurse (6), physical therapist (7), physician (8), and dental hygienist (10).
Other health care jobs on the list include occupational therapist, phlebotomist, physical therapy assistant, diagnostic medical sonographer, respiratory therapist, licensed practical and licensed vocational nurse, optician, home health aide, and paramedic.
Enrollment in registered nurse (RN) programs has increased for the 13th consecutive year, according to preliminary data from the fall 2013 nursing school enrollment survey conducted by the American Association of Colleges of Nursing (AACN). But with a 2.6 percent enrollment increase from 2012 to 2013, entry-level baccalaureate nursing programs saw their lowest growth rate in five years.
Though interest in nursing careers remains strong, AACN said in a news release, many qualified individuals seeking to enter the profession can’t be accommodated in nursing programs. The preliminary data show that 53,667 qualified applications were turned away from 610 entry-level baccalaureate programs in 2013, and AACN expects that number to increase when final data are released in March.
The primary barriers to accepting all qualified nursing school applicants continue to be a shortage of faculty, clinical placement sites, and funding, AACN reports.
The 2013 survey shows stronger growth rates for RN-to-BSN programs, at 12.4 percent, as well as master’s programs (4.4 percent) and doctor of nursing practice programs (21.6 percent).