The Valued People Project: users' views on learning disability nursing.

PubMed

Gates, Bob

A well-educated and trained workforce is undoubtedly crucial to the development of quality care for people with learning disabilities. Notwithstanding this, and unsure as to the need to continue to commission educational programmes for one part of this workforce-pre-registration learning disability nursing-South Central Strategic Health Authority commissioned the Valued People Project to undertake a detailed strategic review of educational commissioning, along with a review of the specialist learning disability health workforce more generally. This project has recently been completed, and provides a unique evidence-based expert evaluation of the future strategic direction of education commissioning and leadership for workforce issues in specialist learning disability services, as well as the wider NHS workforce. This is the first in a series of articles that reports on one aspect of the project: the focus group work undertaken with parents and relatives of people with learning disabilities, and people with learning disabilities themselves, as to the need and type of health workforce needed to support them in the future. The article concludes by identifying the key messages of importance from parents and people with learning disabilities concerning the future specialist and wider NHS workforce.

Succession Planning for Nursing Leaders in a College of Nursing

ERIC Educational Resources Information Center

Tucker, Cheryl A.

2017-01-01

The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous…

ACCCN national nursing workforce survey of intensive care units.

PubMed

Williams, S; Ogle, K R; Leslie, G

2001-05-01

A descriptive study was designed and implemented by the Australian College of Critical Care Nurses (ACCCN) Workforce Planning Advisory Committee to capture data pertaining to workforce issues of intensive care nurses. All intensive care units (ICUs) within Australia were mailed a self reporting survey. Despite a low response rate (52 per cent) and difficulty reported by respondents in gaining the appropriate data requested, the results revealed an interesting snapshot of the intensive care nursing workforce. Types of services offered by units varied considerably; paid overtime hours were low (< 2 per cent of total hours worked) and use of both part-time and agency staff was also low (10 per cent of total hours worked). Private hospitals utilised a greater proportion of part-time and agency nursing staff than public hospitals (20:10 per cent). The turnover rate for registered nursing staff was estimated at 18 per cent, with education, skill acquisition and improved communication reported as the major incentives used by managers to attract and retain staff. This study demonstrated that valuable data are currently uncaptured and recommends a more refined process of a national database to record and manage this important information for future workforce planning.

Public perceptions of nursing careers: the influence of the media and nursing shortages.

PubMed

Donelan, Karen; Buerhaus, Peter; DesRoches, Catherine; Dittus, Robert; Dutwin, David

2008-01-01

The high public regard for nurses has not necessarily translated into an adequate supply of individuals who are willing to be nurses. The expected future demand for nurse labor challenges us to look more closely at the public's perceptions of nursing and nursing careers, and consider how they are shaped by personal experience, media messages, and socio-demographic factors. As part of ongoing efforts to examine factors shaping the future of the nursing workforce, a national survey of Americans was conducted to probe attitudes toward the nursing profession and their experiences with nurses. The data in this national survey of the public about nursing demonstrate that the nursing profession is highly respected and that the vast majority of the general public would recommend nursing careers to qualified students. If the profession is so well thought of and so highly recommended, why are there persistent concerns that not enough people are becoming RNs to avoid or at least slow down the development of future shortages? A prolonged and persistent effort is needed to educate people about nursing careers, to stimulate the expanded production of nursing faculty, and to bring creative approaches to financing nursing education and workforce improvements to convert the large number of seriously interested candidates into the nursing profession.

An Undergraduate Research Fellowship Program to Prepare Nursing Students for Future Workforce Roles

PubMed Central

Slattery, Mary Jo; Logan, Bridget; Mudge, Bridget; Secore, Karen; Von Reyn, LInda J.; Maue, Robert A.

2016-01-01

It is important for nurses today and for those joining the workforce in the future to have familiarity and training with respect to interprofessional research, evidence-based practice, and quality improvement. In an effort to address this need, we describe a 10-week summer research program that immerses undergraduate nursing students in a broad spectrum of clinical and translational research projects as part of their exposure to advanced nursing roles. In doing so, the program increases the ability of the students to participate in research, effectively interact with academic medical center researchers, and incorporate elements of evidence-based practice into future nursing interventions. Their mentors are nurses practicing in roles as nurse researcher, advanced practice nurses involved in evidence-based practice or quality improvement, and clinical trials research nurses. Each student is matched with 3 of these mentors and involved in 3 different projects. Through this exposure, the students benefit from observing multiple nursing roles, taking an active role in research-related activities participating in interdisciplinary learning experiences. Overall, the program provides benefits to the students, who demonstrate measured improvement with respect to the program objectives, and to their mentors and each of the participating organizations. PMID:27964811

Nursing student plans for the future after graduation: a multicentre study.

PubMed

Palese, A; Falomo, M; Brugnolli, A; Mecugni, D; Marognolli, O; Montalti, S; Tameni, A; Gonella, S; Dimonte, V

2017-03-01

When modelling the nursing workforce, estimations of the numbers and characteristics of new graduates over the forecast period are assumed on the basis of previous generations; however, new graduates may have different plans for their future than those documented previously in different socio-economical contexts. To explore (a) nursing student plans after graduation and factors influencing their plans, and (b) factors associated with the intention to emigrate. A survey questionnaire was developed and distributed to students attending their final third year of nursing education in seven universities in Italy in 2015. Nine hundred and twenty-three (90.4%) students participated. Four different plans after graduation emerged: about two-thirds reported an intention to look for a nursing job in Italy; the remaining reported (a) an intention to emigrate, looking for a nursing job abroad, (b) an intention to search for a nursing job in both Italy and abroad, and (c) while a few an intention to continue nursing education in Italy. Having previous experience abroad, the need to grow and be satisfied, trusting the target country and a desire to increase knowledge encouraged an intention to emigrate, whereas the desire to stay in a comfortable environment and nurture personal relationships prevented the desire to migrate. Nursing students may have different plans after graduation, and this should be considered when modelling the nursing workforce of the future. Policymakers should be aware of different plans after graduation to guide healthcare human resource strategies. Knowing these trajectories allows policymakers to estimate the appropriate nursing workforce, and also to act at both macro- and meso-levels, on work environments and opportunities for professional development, according to the different levels of expectations. © 2016 International Council of Nurses.

An Assessment of the Current US Radiation Oncology Workforce: Methodology and Global Results of the American Society for Radiation Oncology 2012 Workforce Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vichare, Anushree; Washington, Raynard; Patton, Caroline

Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results ismore » presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for future studies, as many changes in the healthcare field exert pressure on the workforce.« less

An assessment of the current US radiation oncology workforce: methodology and global results of the American Society for Radiation Oncology 2012 Workforce Study.

PubMed

Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna; Olsen, Christine; Fung, Claire Y; Hopkins, Shane; Pohar, Surjeet

2013-12-01

To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for future studies, as many changes in the healthcare field exert pressure on the workforce. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

The nursing workforce in Kuwait to the year 2020.

PubMed

Al-Jarallah, K F; Moussa, M A A; Hakeem, S K; Al-Khanfar, F K

2009-03-01

The study addresses the supply and demand for nurses in Kuwait in the light of emerging variables such as increasing population, economic growth, changes in healthcare strategies and expansion of healthcare facilities. To project the future demand for nurses in Kuwait for the years 2007-2020 based on the period 1994-2006. Population projections were derived using the average annual natural increase rate of the 1994-2006 populations. The future demand for nurses was projected using the average nurse to population ratios for the years 1994-2006. The number of Kuwaiti indigenous nurses is declining at an average decrement rate of 3.3% per annum. There is a gap between the numbers of native and migrant nurses, which will be wider with time. In 2006, native nurses constituted only 6.6% of the nursing workforce; this affects the quality of provided health care owing to language, religions and socio-cultural barriers between foreign nurses and patients. The supply of indigenous nurses in Kuwait should be increased in order to deliver effective nursing care with shared culture and language in the modern healthcare system of Kuwait. This can be achieved through an improvement in recruitment and retention of indigenous nurses and nursing students.

Academic-correctional health partnerships: preparing the correctional health workforce for the changing landscape-focus group research results.

PubMed

Hale, Janet Fraser; Haley, Heather-Lyn; Jones, Judy L; Brennan, Allyson; Brewer, Arthur

2015-01-01

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce. © The Author(s) 2014.

Scoping the role and education needs of practice nurses in London.

PubMed

Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P

2017-07-01

Aims To identify education priorities for practice nursing across eight London Clinical Commissioning Groups (CCGs); to identify the education, training, development and support needs of practice nurses in undertaking current and future roles. The education needs of practice nurses have long been recognised but their employment status means that accessing education requires the support of their GP employer. This study scopes the educational requirements of the practice nurse workforce and working with educational providers and commissioners describes a coherent educational pathway for practice nurses. A survey of practice nurses to scope their educational attainment needs was undertaken. Focus groups were carried out which identified the education, training, development and support needs of practice nurses to fulfil current and future roles. Findings A total of 272 respondents completed the survey. Practice nurses took part in three focus groups (n=34) and one workshop (n=39). Findings from this research indicate a practice nurse workforce which lacked career progression, role autonomy or a coherent educational framework. Practice nurses recognised the strength of their role in building relationship-centred care with patients over an extended period of time. They valued this aspect of their role and would welcome opportunities to develop this to benefit patients. This paper demonstrates an appetite for more advanced education among practice nurses, a leadership role by the CCGs in working across the whole system to address the education needs of practice nurses, and a willingness on the part of National Health Service education commissioners to commission education which meets the education needs of the practice nurse workforce. Evidence is still required, however, to inform the scope of the practice nurse role within an integrated system of care and to identify the impact of practice nursing on improving health outcomes and care of local populations.

Continuing challenges for the mental health consumer workforce: a role for mental health nurses?

PubMed

Cleary, Michelle; Horsfall, Jan; Hunt, Glenn E; Escott, Phil; Happell, Brenda

2011-12-01

The aim of this paper is to discuss issues impacting on consumer workforce participation and challenges that continue to arise for these workers, other service providers, and the mental health system. The literature identifies the following issues as problematic: role confusion and role strain; lack of support, training, and supervision structures; job titles that do not reflect actual work; poor and inconsistent pay; overwork; limited professional development; insufficient organizational adaptation to expedite consumer participation; staff discrimination and stigma; dual relationships; and the need to further evaluate consumer workforce contributions. These factors adversely impact on the emotional well-being of the consumer workforce and might deprive them of the support required for the consumer participation roles to impact on service delivery. The attitudes of mental health professionals have been identified as a significant obstacle to the enhancement of consumer participation and consumer workforce roles, particularly in public mental health services. A more comprehensive understanding of consumer workforce roles, their benefits, and the obstacles to their success should become integral to the education and training provided to the mental health nursing workforce of the future to contribute to the development of a more supportive working environment to facilitate the development of effective consumer roles. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

A supply model for nurse workforce projection in Malaysia.

PubMed

Abas, Zuraida Abal; Ramli, Mohamad Raziff; Desa, Mohamad Ishak; Saleh, Nordin; Hanafiah, Ainul Nadziha; Aziz, Nuraini; Abidin, Zaheera Zainal; Shibghatullah, Abdul Samad; Rahman, Ahmad Fadzli Nizam Abdul; Musa, Haslinda

2017-08-18

The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model. In fact, the training model is for predicting the number of newly registered nurses after training is completed. Furthermore, the population model is for indicating the number of registered nurses in the nation and the FTE model is useful for counting the number of registered nurses with direct patient care. Each model is described in detail with the logical connection and mathematical governing equation for accurate forecasting. The supply model is validated using error analysis approach in terms of the root mean square percent error and the Theil inequality statistics, which is mportant for evaluating the simulation results. Moreover, the output of simulation results provides a useful insight for policy makers as a what-if analysis is conducted. Some recommendations are proposed in order to deal with the nursing deficit. It must be noted that the results from the simulation model will be used for the next stage of the Needs-Based Nurse Workforce projection project. The impact of this study is that it provides the ability for greater planning and policy making with better predictions.

International nurse migration: impacts on New Zealand.

PubMed

North, Nicola

2007-08-01

As a source and destination country, nurse flows in and out of New Zealand (NZ) are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyze secondary data on nurses added to the register, NZ nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of NZ-registered nurses (RNs) by overseas authorities coincided with an equivalent increase in international RNs (IRNs) added to the NZ nursing register-a pattern that has been sustained to the present. Movement of NZ RNs to Australia is expedited by the Trans-Tasman Agreement, whereas entry of IRNs to NZ is facilitated by nursing being an identified Priority Occupation. Future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.

Tackling Nurse Shortages in OECD Countries. OECD Health Working Papers, No. 19

ERIC Educational Resources Information Center

Simoens, Steven; Villeneuve, Mike; Hurst, Jeremy

2005-01-01

There are reports of current nurse shortages in all but a few OECD countries. With further increases in demand for nurses expected and nurse workforce ageing predicted to reduce the supply of nurses, shortages are likely to persist or even increase in the future, unless action is taken to increase flows into and reduce flows out of the workforce…

The Impact of Out-Migration on the Nursing Workforce in Kenya

PubMed Central

Gross, Jessica M; Rogers, Martha F; Teplinskiy, Ilya; Oywer, Elizabeth; Wambua, David; Kamenju, Andrew; Arudo, John; Riley, Patricia L; Higgins, Melinda; Rakuom, Chris; Kiriinya, Rose; Waudo, Agnes

2011-01-01

Objective To examine the impact of out-migration on Kenya's nursing workforce. Study Setting This study analyzed deidentified nursing data from the Kenya Health Workforce Informatics System, collected by the Nursing Council of Kenya and the Department of Nursing in the Ministry of Medical Services. Study Design We analyzed trends in Kenya's nursing workforce from 1999 to 2007, including supply, deployment, and intent to out-migrate, measured by requests for verification of credentials from destination countries. Principle Findings From 1999 to 2007, 6 percent of Kenya's nursing workforce of 41,367 nurses applied to out-migrate. Eighty-five percent of applicants were registered or B.Sc.N. prepared nurses, 49 percent applied within 10 years of their initial registration as a nurse, and 82 percent of first-time applications were for the United States or United Kingdom. For every 4.5 nurses that Kenya adds to its nursing workforce through training, 1 nurse from the workforce applies to out-migrate, potentially reducing by 22 percent Kenya's ability to increase its nursing workforce through training. Conclusions Nurse out-migration depletes Kenya's nursing workforce of its most highly educated nurses, reduces the percentage of younger nurses in an aging nursing stock, decreases Kenya's ability to increase its nursing workforce through training, and represents a substantial economic loss to the country. PMID:21413982

77 FR 36549 - Nursing Workforce Diversity Invitational Summit-“Nursing in 3D: Workforce Diversity, Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Nursing Workforce Diversity Invitational Summit--``Nursing in 3D: Workforce Diversity, Health Disparities, and..., Division of Nursing, will host an invitational summit that focuses on Nursing Workforce Diversity (NWD...

After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.

PubMed

Beauvais, Audrey Marie; Kazer, Meredith Wallace; Aronson, Barbara; Conlon, Suzanne E; Forte, Pamela; Fries, Kathleen S; Hahn, Judith M; Hullstrung, Russell; Levvis, Meg; McCauley, Paula; Morgan, Patricia Padula; Perfetto, Linda; Rebeschi, Lisa M; Solernou, Sheila B; Span, Patricia; Sundean, Lisa J

The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.

Can New Zealand achieve self-sufficiency in its nursing workforce?

PubMed

North, Nicola

2011-01-01

This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing workforce. © 2010 Blackwell Publishing Ltd.

Six-part series on the state of the RN workforce in the United States.

PubMed

Buerhaus, Peter I

2005-01-01

This series on the state of the nursing workforce focuses on describing the results of the national surveys of RNs. The series begins with an analysis of RNs' perceptions of the current nursing shortage and whether they perceive the shortage has gotten better or worse over the past few years. Future topics will include RNs' perceptions of being a nurse and how they perceive certain aspects of their jobs; RNs' awareness of the J&J Campaign and whether they think it has been effective; RNs' perceptions of the impact of the shortage on the quality of patient care in hospitals; and various issues related to the age and diversity of the nursing profession.

The impact of an emergency hiring plan on the shortage and distribution of nurses in Kenya: the importance of information systems

PubMed Central

Gross, JM; Riley, PL; Kiriinya, R; Rakuom, C; Willy, R; Kamenju, A; Oywer, E; Wambua, D; Waudo, A

2010-01-01

Abstract Objective To analyse the effect of Kenya’s Emergency Hiring Plan for nurses on their inequitable distribution in rural and underserved areas. Methods We used data from the Kenya Health Workforce Informatics System on the nursing workforce to determine the effect of the Emergency Hiring Plan on nurse shortages and maldistribution. The total number of nurses, the number of nurses per 100 000 population and the opening of previously closed or new heath facilities were recorded. Findings Of the 18 181 nurses employed in Kenya’s public sector in 2009, 1836 (10%) had been recruited since 2005 through the Emergency Hiring Plan. Nursing staff increased by 7% in hospitals, 13% in health centres and 15% in dispensaries. North Eastern province, which includes some of the most remote areas, benefited most: the number of nurses per 100 000 population increased by 37%. The next greatest increase was in Nyanza province, which has the highest prevalence of HIV infection in Kenya. Emergency Hiring Plan nurses enabled the number of functioning public health facilities to increase by 29%. By February 2010, 94% of the nurses hired under pre-recruitment absorption agreements had entered the civil service. Conclusion The Emergency Hiring Plan for nurses significantly increased health services in Kenya’s rural and underserved areas over the short term. Preliminary indicators of sustainability are promising, as most nurses hired are now civil servants. However, continued monitoring will be necessary over the long term to evaluate future nurse retention. The accurate workforce data provided by the Kenya Health Workforce Informatics System were essential for evaluating the effect of the Emergency Hiring Plan. PMID:21076563

Employers' and employees' views on responsibilities for career management in nursing: a cross-sectional survey.

PubMed

Philippou, Julia

2015-01-01

To examine nurse employees' and employers' views about responsibilities for managing nurses' careers. Career management policies are associated with cost savings, in terms of workforce recruitment and retention and an increase in job and career satisfaction. In nursing, responsibility for career management remains relatively unexplored. A multicenter, cross-sectional questionnaire survey. Data were collected from 871 nurse employees and employers in the British National Health Service. The study was conducted in 2008, a period when policy reforms aimed at modernizing the healthcare workforce in England. In the current discussions in Europe and the USA about the future of nursing, these data reveal insights not previously reported. Exploratory analyses were undertaken using descriptive and inferential statistics. The analysis indicated a temporal dimension to career management responsibilities. Short-term responsibilities for securing funding and time for development lay more with employers. Medium-term responsibilities for assessing nurses' strengths and weakness, determining job-related knowledge and skills and identifying education and training needs appeared to be shared. Long-term responsibilities for developing individual careers and future development plans lay primarily with employees. New ways of managing nurses' career development that lead to greater independence for employees and greater flexibility for employers, while retaining a high-calibre and competent workforce, are needed. Ultimately, career management responsibilities should not tilt to either side but rather be shared to benefit both parties. Clarifying employers' and employees' responsibilities for career management may help both parties to develop a common understanding of each other's role and to meet their obligations in a constructive dialogue. © 2014 John Wiley & Sons Ltd.

Presenteeism in nursing: An evolutionary concept analysis.

PubMed

Rainbow, Jessica G; Steege, Linsey M

Presenteeism is an emerging concept in nursing that has been linked to increased health care costs, patient medication errors and falls, and negative nurse well-being. However, prior work has utilized various definitions and antecedents. Clarity on the significance, development, and consequences of presenteeism in nursing is needed. This concept analysis seeks to understand the application of presenteeism within nursing workforce literature and in the broader workforce context. Rodgers' evolutionary concept analysis method was used. The proposed definition of presenteeism as the act of being physically present at work with reduced performance can be attributed to multiple antecedents. These include nurse health, professional identity, work-life balance, and work environment. The prevalence of these antecedents with high rates of presenteeism among nurses and consequences point to the need for interventions. These findings can guide development of future interventions and policies that address the broader context of factors leading to presenteeism. Copyright © 2017 Elsevier Inc. All rights reserved.

Fast-track for fast times: catching and keeping generation Y in the nursing workforce.

PubMed

Walker, Kim

2007-04-01

There is little doubt we find ourselves in challenging times as never before has there been such generational diversity in the nursing workforce. Currently, nurses from four distinct (and now well recognised and discussed) generational groups jostle for primacy of recognition and reward. Equally significant is the acute realisation that our ageing profession must find ways to sustain itself in the wake of huge attrition as the 'baby boomer' nurses start retiring over the next ten to fifteen years. These realities impel us to become ever more strategic in our thinking about how best to manage the workforce of the future. This paper presents two exciting and original innovations currently in train at one of Australia's leading Catholic health care providers: firstly, a new fast-track bachelor of nursing program for fee-paying domestic students. This is a collaborative venture between St Vincent's and Mater Health, Sydney (SV&MHS) and the University of Tasmania (UTas); as far as we know, it is unprecedented in Australia. As well, the two private facilities of SV&MHS, St Vincent's Private (SVPH) and the Mater Hospitals, have developed and implemented a unique 'accelerated progression pathway' (APP) to enable registered nurses with talent and ambition to fast track their career through a competency and merit based system of performance management and reward. Both these initiatives are aimed squarely at the gen Y demographic and provide potential to significantly augment our capacity to recruit and retain quality people well into the future.

Pedagogy and Culture: An Educational Initiative in Supporting UAE Nursing Graduates Prepare for a High-Stakes Nurse Licensing Examination

ERIC Educational Resources Information Center

Brownie, Sharon M.; Williams, Ged; Barnewall, Kate; Bishaw, Suzanne; Cooper, Jennifer L.; Robb, Walter; Younis, Neima; Kuzemski, Dawn

2015-01-01

Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive…

An interprofessional exploration of nursing and social work roles when working jointly with families.

PubMed

Bennett, Elaine; Hauck, Yvonne; Radford, Georgina; Bindahneem, Sakina

2016-01-01

Ngala, an early parenting not-for-profit organisation in Western Australia, has provided services to families with young children since 1890. Child health nurses and mothercraft nurses were the primary workforce until the 1980s when a social worker was employed and a new era of interprofessional collaboration began. Evidence to date has focused on nursing workforce, interprofessional education, and interprofessional teams. Little is known about the roles of nursing and social work when working jointly with families. A new service commenced in 2012 for families with children with developmental delays. Social workers and child health nurses were employed for this service model. Our study aim was to explore the perceptions of how nurses and social workers work together with a family providing psychosocial support across a new service. The study was conducted alongside implementation of this new service. An exploratory case study approach was adopted to generate an in-depth understanding of the roles of nurses and social workers. In total, 22 semi-structured interviews and one focus group across the first year of implementing the new service were undertaken. Analysis of these data revealed four major themes. Findings presented in this article will inform further reflection and consideration into the future interprofessional workforce priorities and requirements for Early Parenting Services.

Healthcare reforms: implications for the education and training of acute and critical care nurses.

PubMed

Glen, S

2004-12-01

This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.

An Innovative Exchange Model for Global and Community Health Nursing Education.

PubMed

Falleiros de Mello, Débora; Larcher Caliri, Maria Helena; Villela Mamede, Fabiana; Fernandes de Aguiar Tonetto, Eliana Maria; Resop Reilly, Janet

Understanding different cultures is important in the education of nursing students who will become the health care workforce of our future interdependent and globalized societies. International practicum courses help students and nurses understand different cultures. This article describes an innovative approach to nursing education and understanding diverse cultures, in the context of a hybrid course (online course coupled with face-to-face practicum experiences), which enrolled nursing students from opposite hemispheres.

Hospital churn and casemix instability: implications for planning and educating the nursing workforce.

PubMed

Chiarella, Mary; Roydhouse, Jessica K

2011-02-01

Health workforce planning is a priority for Australian governments at both state and federal levels. Nursing shortages are a significant problem and addressing these shortages is likely to be a component of any workforce plan. This paper looks at the case of hospital nursing and argues that casemix, workforce and management instability inhibit workforce planning for hospital nursing. These issues are related and any efforts to objectively plan the hospital nursing workforce must seek to address them in order to succeed.

Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia.

PubMed

Hogan, Pamela; Moxham, Lorna; Dwyer, Trudy

2007-04-01

It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.

Evaluating an accelerated nursing program: a dashboard for diversity.

PubMed

Schmidt, Bonnie J; MacWilliams, Brent R

2015-01-01

Diversity is a topic of increasing attention in higher education and the nursing workforce. Experts have called for a nursing workforce that mirrors the population it serves. Students in nursing programs in the United States do not reflect our country's diverse population; therefore, much work is needed before that goal can be reached. Diversity cannot be successfully achieved in nursing education without inclusion and attention to quality. The Inclusive Excellence framework can be used by nurse educators to promote inclusion, diversity, and excellence. In this framework, excellence and diversity are linked in an intentional metric-driven process. Accelerated programs offer a possible venue to promote diversity, and one accelerated program is examined using a set of metrics and a dashboard approach commonly used in business settings. Several recommendations were made for future assessment, interventions, and monitoring. Nurse educators are called to examine and adopt a diversity dashboard in all nursing programs. Copyright © 2015 Elsevier Inc. All rights reserved.

The New Jersey Nursing Initiative: building sustainable collaboration.

PubMed

Bakewell-Sachs, Susan; Mertz, Lynn M; Egreczky, Dana; Ladden, Maryjoan

2011-01-01

The New Jersey Nursing Initiative was publically launched in 2009 as a 5-year, $22 million program of the Robert Wood Johnson Foundation based at the New Jersey Chamber of Commerce Foundation. It was reauthorized in 2011 through 2016 for an additional $8.5 million. The initiative includes a faculty preparation program and strategic tracks of work focusing on building education capacity, increasing current faculty capacity, making nurse faculty a preferred career, leading policy initiatives, creating sustainable funding in support of nursing education, and ultimately, building local, regional, and statewide collaborative networks. The tagline, "So a Nurse will be there for You," emphasizes both the reality of an aging nursing workforce needing replacement and the expected health care transformation that will result in the need for new knowledge and skills in the future nursing workforce. The purpose of this article was to describe the New Jersey Nursing Initiative, emphasizing the partnerships that have resulted from the project to date. Copyright © 2011 Elsevier Inc. All rights reserved.

Scaling up the global nursing health workforce: contributions of an international organization.

PubMed

Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

2009-01-01

In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.

Creativity and connections: the future of nursing education and practice: the Massachusetts Initiative.

PubMed

Sroczynski, Maureen; Gravlin, Gayle; Route, Paulette Seymour; Hoffart, Nancy; Creelman, Patricia

2011-01-01

Education and practice partnerships are key to effective academic program design and implementation in a time of decreasing supply and increasing demands on the nursing profession. An integrated education/practice competency model can positively impact patient safety, improve patient care, increase retention, and ensure a sufficient and competent nursing workforce, which is paramount to survival of the health care system. Through the contributions of nursing leaders from the broad spectrum of nursing and industry organizations within the state, the Massachusetts Nurse of the Future project developed a competency-based framework for the future design of nursing educational programs to meet current and future practice needs. The Massachusetts Nurse of the Future Nursing Core Competencies(©) expand on the Institute of Medicine's core competencies for all health care professionals and the Quality and Safety Education for Nurses competencies for quality and safety to define the expectations for all professional nurses of the future. The Massachusetts Nurse of the Future Nursing Core Competencies define the knowledge, attitude, and skills required as the minimal expectations for initial nursing practice following completion of a prelicensure professional nursing education program. These competencies are now being integrated into new models for seamless, coordinated nursing curriculum and transition into practice within the state and beyond. Copyright © 2011 Elsevier Inc. All rights reserved.

The Future of Gero-Oncology Nursing.

PubMed

Kagan, Sarah H

2016-02-01

To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

An overview of the general practice nurse workforce in Australia, 2012?15.

PubMed

Heywood, Troy; Laurence, Caroline

2018-05-08

Several surveys of the general practice nurse (GPN) workforce have been undertaken in Australia over the last decade, but they have limitations, which mean that the workforce is not well-understood. The aim of this study is to describe the profile of the GPN workforce using the dataset available through the Australia Health Practitioner Registration Agency and to explore how it differs from the non-GPN nursing workforce, and if this workforce is changing over time. Data from labour force surveys conducted from 2012 to 2015 were used. Variables examined were age group, gender, remoteness area, hours worked, nurse type (enrolled (EN) or registered (RN)), years in the workforce and also intended years of work before exiting the workforce. When compared with the broader nursing workforce, a greater proportion of GPNs in 2015 were older (60 v. 51%), worked part-time (65 v. 48%) and worked in regional areas (35 v. 26%). Additionally, the characteristics of GPNs has changed between 2012 and 2015, with an increased proportion of younger nurses, more registered nurses and fewer working in remote areas. To ensure a sustainable workforce, particularly in rural and remote areas, strategies to recruit and retain this workforce will be needed.

Models of care choices in today's nursing workplace: where does team nursing sit?

PubMed

Fairbrother, Greg; Chiarella, Mary; Braithwaite, Jeffrey

2015-11-01

This paper provides an overview of the developmental history of models of care (MOC) in nursing since Florence Nightingale introduced nurse training programs in a drive to make nursing a discipline-based career option. The four principal choices of models of nursing care delivery (primary nursing, individual patient allocation, team nursing and functional nursing) are outlined and discussed, and recent MOC literature reviewed. The paper suggests that, given the ways work is being rapidly reconfigured in healthcare services and the pressures on the nursing workforce projected into the future, team nursing seems to offer the best solutions.

The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on.

PubMed

Halcomb, Elizabeth J; Salamonson, Yenna; Davidson, Patricia M; Kaur, Rajneesh; Young, Samantha Am

2014-03-25

Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses' role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses' role in general practice was slightly decreased over time. This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce.

The Department of Veterans Affairs Nursing Academy (VANA): forging strategic alliances with schools of nursing to address nursing's workforce needs.

PubMed

Bowman, Candice C; Johnson, Linda; Cox, Malcolm; Rick, Catherine; Dougherty, Mary; Alt-White, Anna C; Wyte, Tamar; Needleman, Jack; Dobalian, Aram

2011-01-01

In 2007, the Department of Veterans Affairs (VA) established the VA Nursing Academy (VANA), a 5-year, $60-million pilot program funding 15 partnerships between schools of nursing and local VA health care facilities nationwide, to expand nursing faculty, enhance clinical faculty development, increase nursing student enrollment, and promote educational innovations. VA is an ideal setting for educating nursing students owing to a well-educated registered nurse staff, an array of traditional and nontraditional settings, a state-of-the-art computerized electronic health record system, and a unique patient population. Challenges related to the complex nature of VANA partnerships, conceptualized as strategic alliances created between disparate subunits, each embedded in a larger organization, require careful governance to ensure smooth implementation. To ensure the program's aims are met, a 6-year national evaluation has been funded to help identify which strategies best achieve VANA's goals. The speed of economic recovery and the resulting changes in the nursing workforce are important determinants of VANA's future. Published by Mosby, Inc.

Occupational health nursing in Canada: its social foundation and future.

PubMed

Olson, D K; Stovin, D

1992-01-01

Our purpose in examining the social foundation of occupational health nursing is to better determine the future direction of the profession and its impact on a diverse workforce. Part of what makes up the profession of occupational health nursing is found in its definition: a process that is determined by the interaction between the occupational health nurse, worker, work and workplace; its goal is to assist the worker to achieve his or her optimal level of functioning, primarily through health education, health promotion, prevention of disease and injury and crisis intervention. Much of occupational health nursing is also based on its history and the traditions that have been established. A true understanding, then, of what occupational health nursing's future can be comes from a solid understanding of the history of the profession. As social trends in the past affected the profession, so will they in the future.

Health workforce development planning in the Sultanate of Oman: a case study.

PubMed

Ghosh, Basu

2009-06-11

Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate). All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985-2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain self-reliance. Oman has successfully innovated workforce planning within a favorable policy environment. Its intensive and extensive workforce planning efforts, with the close involvement of policy-makers, educators and workforce managers, have ensured adequacy of suitable workforce in health institutions and its increased self-reliance in the health workforce. Oman's experience in workforce planning and development presents an illustration of a country benefiting from successful application of workforce planning concepts and tools. Instead of being complacent about its achievements so far, every country needs to improve or sustain its planning efforts in this way, in order to circumvent the current workforce deficiencies and to further increase self-reliance and improve workforce efficiency and effectiveness.

Health workforce development planning in the Sultanate of Oman: a case study

PubMed Central

Ghosh, Basu

2009-01-01

Introduction Oman's recent experience in health workforce development may be viewed against the backdrop of the situation just three or four decades ago, when it had just a few physicians and nurses (mostly expatriate). All workforce categories in Oman have grown substantially over the last two decades. Increased self-reliance was achieved despite substantial growth in workforce stocks. Stocks of physicians and nurses grew significantly during 1985–2007. This development was the outcome of well-considered national policies and plans. This case outlines how Oman is continuing to turn around its excessive dependence on expatriate workforce through strategic workforce development planning. Case description The Sultanate's early development initiatives focused on building a strong health care infrastructure by importing workforce. However, the policy-makers stressed national workforce development for a sustainable future. Beginning with the formulation of a strategic health workforce development plan in 1991, the stage was set for adopting workforce planning as an essential strategy for sustainable health development and workforce self-reliance. Oman continued to develop its educational infrastructure, and began to produce as much workforce as possible, in order to meet health care demands and achieve workforce self-reliance. Other policy initiatives with a beneficial impact on Oman's workforce development scenario were: regionalization of nursing institutes, active collaboration with universities and overseas specialty boards, qualitative improvement of the education system, development of a strong continuing professional development system, efforts to improve workforce management, planned change management and needs-based micro/macro-level studies. Strong political will and bold policy initiatives, dedicated workforce planning and educational endeavours have all contributed to help Oman to develop its health workforce stocks and gain self-reliance. Discussion and evaluation Oman has successfully innovated workforce planning within a favorable policy environment. Its intensive and extensive workforce planning efforts, with the close involvement of policy-makers, educators and workforce managers, have ensured adequacy of suitable workforce in health institutions and its increased self-reliance in the health workforce. Conclusion Oman's experience in workforce planning and development presents an illustration of a country benefiting from successful application of workforce planning concepts and tools. Instead of being complacent about its achievements so far, every country needs to improve or sustain its planning efforts in this way, in order to circumvent the current workforce deficiencies and to further increase self-reliance and improve workforce efficiency and effectiveness. PMID:19519912

Retention of Millennial Employees in the Army Acquisition Workforce

DTIC Science & Technology

2016-04-07

organizations to grow and prosper in the future. Keywords: Employee retention, Traditionalists, Baby Boomers, Generation X, Millennials x...workforce that executes the mission to “provide our Soldiers a decisive advantage in any mission by maintaining quality acquisition professionals to...of American Academy of Business, Journal of Nursing Administration, and Journal of Vocational Behavior. Scholars use a variety of theories and

Factors affecting the integration of immigrant nurses into the nursing workforce: A double hermeneutic study.

PubMed

Xiao, Lily Dongxia; Willis, Eileen; Jeffers, Lesley

2014-04-01

Variations in nursing practice and communication difficulties pose a challenge for the successful integration into the workforce of immigrant nurses. Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes and discrimination towards immigrant nurses. While the evidence shows that integrating immigrant nurses into the nursing workforce is shaped by factors that are socially constructed, studies that examine social structures affecting workforce integration are sparse. The aim of this study was to examine interplaying relationships between social structures and nurses' actions that either enabled or inhibited workforce integration in hospital settings. Giddens' Structuration Theory with double hermeneutic methodology was used to interpret 24 immigrant and 20 senior nurses' perceptions of factors affecting workforce integration. Four themes were identified from the data. These were: (1) employer-sponsored visa as a constraint on adaptation, (2) two-way learning and adaptation in multicultural teams, (3) unacknowledged experiences and expertise as barriers to integration, and (4) unquestioned sub-group norms as barriers for group cohesion. The themes presented a critical perspective that unsuitable social structures (policies and resources) constrained nurses' performance in workforce integration in the context of nurse immigration. The direction of structural changes needed to improve workforce integration is illustrated throughout the discussions of policies and resources required for workforce integration at national and organisational levels, conditions for positive group interactions and group cohesion in organisations. Our study reveals inadequate rules and resources used to recruit, classify and utilise immigrant nurses at national and healthcare organisational levels can become structural constraints on their adaptation to professional nursing practice and integration into the workforce in a host country. Learning from each other in multicultural teams and positive intergroup interaction in promoting intercultural understanding are enablers contributing to immigrant nurses' adaptation and workforce integration. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Study of Nursing Care project: back to the future for contemporary nursing research?

PubMed

Smith, Kylie M; Crookes, Patrick A

2012-11-01

  To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research.   It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required.   In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants.   The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing.  The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a national scheme.   The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century. © 2012 Blackwell Publishing Ltd.

Developing a Nursing Database System in Kenya

PubMed Central

Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

2007-01-01

Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

Australia's first transition to professional practice in primary care program for graduate registered nurses: a pilot study.

PubMed

Aggar, Christina; Bloomfield, Jacqueline; Thomas, Tamsin H; Gordon, Christopher J

2017-01-01

Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction. This study aimed to determine whether a transition to professional practice program implemented in the general practice setting led to competent practice nurses in their first year post-graduation. A longitudinal, exploratory mixed-methods design was used to assess the pilot study. Data were collected at three times points (3, 6, 12 months) with complete data sets from graduate nurses ( n =  4) and preceptors ( n =  7). We assessed perceptions of the graduates' nursing competency and confidence, satisfaction with the preceptor/graduate relationship, and experiences and satisfaction with the program. Graduate nurse competency was assessed using the National Competency Standards for Nurses in General Practice. Semi-structured interviews with participants at Time 3 sought information about barriers, enablers, and the perceived impact of the program. Graduate nurses were found to be competent within their first year of clinical practice. Program perceptions from graduate nurses and preceptors were positive and the relationship between the graduate nurse and preceptor was key to this development. With appropriate support registered nurses can transition directly into primary care and are competent in their first year post-graduation. While wider implementation and research is needed, findings from this study demonstrate the potential value of transition to professional practice programs within primary care as a nursing workforce development strategy.

Working Conditions of the Nursing Workforce Excerpts from a Policy Roundtable at AcademyHealth's 2003 Annual Research Meeting

PubMed Central

Hope, Hollis A

2004-01-01

The role of nursing in the delivery of health care has emerged as a complex and cross-cutting issue ripe for inquiry and multidisciplinary research. Indeed, problems in the nursing workforce have risen high on the agendas on many influential organizations, including the American Academy of Nursing, the Institute of Medicine, the National Quality Forum, The Robert Wood Johnson Foundation, and others. In an effort to clarify current research issues and advance an agenda for future investigations, Dr. Peter Buerhaus at Vanderbilt University organized a round table focused on the working conditions of the nursing workforce at the AcademyHealth 2003 Annual Research Meeting in Nashville, Tenn. Chaired by the University of California, Los Angeles, School of Public Health's Jack Needleman, the “Working Conditions of the Nursing Workforce” roundtable proved to be a provocative exchange of views among researchers and users of research. Participants shared background about their role in advancing the research, identified gaps in current research, and suggested specific areas for further research. What follows is an edited transcript of the Roundtable that, in addition to Dr. Needleman, included Ellen Kurtzman, National Quality Forum; Barbara Mark, University of North Carolina, Chapel Hill; Lori Melichar, The Robert Wood Johnson Foundation; and Donald Steinwachs, Johns Hopkins University. PMID:15149473

Balancing the health workforce: breaking down overall technical change into factor technical change for labour-an empirical application to the Dutch hospital industry.

PubMed

Blank, Jos L T; van Hulst, Bart L

2017-02-17

Well-trained, well-distributed and productive health workers are crucial for access to high-quality, cost-effective healthcare. Because neither a shortage nor a surplus of health workers is wanted, policymakers use workforce planning models to get information on future labour markets and adjust policies accordingly. A neglected topic of workforce planning models is productivity growth, which has an effect on future demand for labour. However, calculating productivity growth for specific types of input is not as straightforward as it seems. This study shows how to calculate factor technical change (FTC) for specific types of input. The paper first theoretically derives FTCs from technical change in a consistent manner. FTC differs from a ratio of output and input, in that it deals with the multi-input, multi-output character of the production process in the health sector. Furthermore, it takes into account substitution effects between different inputs. An application of the calculation of FTCs is given for the Dutch hospital industry for the period 2003-2011. A translog cost function is estimated and used to calculate technical change and FTC for individual inputs, especially specific labour inputs. The results show that technical change increased by 2.8% per year in Dutch hospitals during 2003-2011. FTC differs amongst the various inputs. The FTC of nursing personnel increased by 3.2% per year, implying that fewer nurses were needed to let demand meet supply on the labour market. Sensitivity analyses show consistent results for the FTC of nurses. Productivity growth, especially of individual outputs, is a neglected topic in workforce planning models. FTC is a productivity measure that is consistent with technical change and accounts for substitution effects. An application to the Dutch hospital industry shows that the FTC of nursing personnel outpaced technical change during 2003-2011. The optimal input mix changed, resulting in fewer nurses being needed to let demand meet supply on the labour market. Policymakers should consider using more detailed and specific data on the nature of technical change when forecasting the future demand for health workers.

Nursing leaders can deliver a new model of care.

PubMed

Shalala, Donna E

2014-01-01

Millions more insured Americans. Increasing numbers of older patients. Higher rates of chronic illness. Fewer providers. How can our healthcare system not only manage these challenges but also improve performance and access to care while containing costs? The answer lies with our nurses. In some parts of the United States, nurses provide the full spectrum of primary and preventive care. They have successfully improved access and quality in rural areas. In other parts, nurses' hands are tied by antiquated laws and regulations that limit their ability to expand access to care. Our system cannot increase access when we have providers who are not allowed to perform to the top of their education, training, and capability. It is time to rethink how we deliver primary and preventive care and redefine the roles of doctors and nurses. This article examines the history of the Institute of Medicine's (IOM) Future of Nursing report (chaired by the author) and the resulting Future of Nursing Campaign for Action, which is working to institute the report's recommendations in all 50 states. The IOM report's recommendations are simple: 1. Remove outdated restrictions on nursing practice. 2. Promote nurse leadership on hospital boards and in all healthcare sectors. 3. Strengthen nurse education and training, and increase the number of nurses with advanced degrees. 4. Increase diversity in the nursing workforce to better reflect the patient population. 5. Improve data reporting and compilation to predict workforce needs. New York, Kentucky, and Minnesota are three recent states to remove barriers pre venting advanced practice registered nurses from practicing at the top of their license. Similar efforts in California, Florida, and Indiana failed initially but are expected to make progress in the near future. The article makes clear how and why the Center to Champion Nursing in America (an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation) is working to advance healthcare through nursing, and it explores the progress being made to remove unnecessary restrictions on nursing practice.

Scientific Advances Shaping the Future Roles of Oncology Nurses.

PubMed

Wujcik, Debra

2016-05-01

To discuss the recent scientific advances that influence current oncology care and explore the implications of these advances for the future of oncology nursing. Current nursing, medical and basic science literature; Clinicaltrials.gov. The future of oncology care will be influenced by an aging population and increasing number of patients diagnosed with cancer. The advancements in molecular sequencing will lead to more clinical trials, targeted therapies, and treatment decisions based on the genetic makeup of both the patient and the tumor. Nurses must stay current with an ever changing array of targeted therapies and developing science. Nurses will influence cancer care quality, value, cost, and patient satisfaction. It is critical for oncology nurses and nursing organizations to engage with all oncology care stakeholders in identifying the future needs of oncology patients and the environment in which care will be delivered. Nurses themselves must identify the roles that will be needed to ensure a workforce that is adequate in number and well trained to meet the future challenges of care delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

Back to the future? Views of heads of schools of nursing about undergraduate specialization in mental health nursing.

PubMed

Happell, Brenda; McAllister, Margaret

2014-12-01

Preparation of nursing students for practice in mental health settings in Australia has been criticized since comprehensive education replaced preregistration specialist education. Current and projected workforce shortages have given rise to considering the reintroduction of specialization at preregistration level as a potential solution. Support of heads of schools of nursing would be essential for such an initiative to be considered. A qualitative exploratory study was undertaken involving in-depth telephone interviews with heads of schools of nursing in Queensland. Participants generally favoured the concept of specialization in mental health nursing at undergraduate level. Data analysis revealed the following themes: meeting workforce needs, improving quality of care, employability of graduates, an attractive option for students, and what would have to go. Participants identified many benefits to mental health service delivery and consumer outcomes. How the initiative could be developed within an already overcrowded curriculum was identified as the major barrier. This level of support is encouraging if necessary changes to the educational preparation for mental health nursing practice are to be considered. © 2014 Australian College of Mental Health Nurses Inc.

New graduate separations from New Zealand's nursing workforce in the first 5 years after registration: a retrospective cohort analysis of a national administrative data set 2005-2010.

PubMed

North, Nicola; Leung, William; Lee, Rochelle

2014-08-01

To describe workforce separation rates and its relationship with demographic and work characteristics in the 2005 new graduate cohort's first 5 years as practising RNs in NZ. Retaining new graduate RNs is critical to nursing workforce sustainability; one study showed that if an RN is still employed in a hospital setting 5 years after graduation, he/she tends to remain active in the health industry. Retrospective analysis using the Nursing Council of New Zealand's registration data set for years 2005-2010. All newly registered NZ graduates practising in NZ in 2005 (n = 1236) were tracked for 5 years. Within 5 years of graduation, 26% of the cohort had separated from the NZ nursing workforce, 18% in the first year. The under-25s (n = 517), 42% of the cohort, had the highest loss, 32%, in 5 years. Separations were significantly lower for graduates in their 30s vs. their 20s and for those who gained postgraduate tertiary qualifications post-registration (10%) vs. those who did not (29%). Hospitals were the most frequent employment setting over 5 years, the largest increase being community settings. Five-year retention rates in the four largest practice areas were surgical 26%, medical 16%, mental health 60% and continuing care 10%. After 5 years, 24% of those still practising (n = 920) worked in a different health board region. New graduate RN losses were higher than in previous research, with younger RNs at most risk, threatening future sustainability of the nursing workforce and highlighting the need for evidence-based targeted strategies to retain them. © 2013 John Wiley & Sons Ltd.

A statewide strategy for nursing workforce development through partnerships in Texas.

PubMed

Kishi, Aileen; Green, Alexia

2008-08-01

Statewide efforts and partnerships were used for nursing workforce development to address the nursing shortage in Texas. A statewide strategic action plan was developed where partnerships and collaboration were the key components. One of the most important outcomes of these statewide partnerships was the passage of the Nursing Shortage Reduction Act 2001. Through this legislation, the Texas Center for Nursing Workforce Studies and its advisory committee were established. This article describes how a statewide infrastructure for nursing workforce policy and legislative and regulatory processes were further developed. An overview is provided on the contributions made by the organizations involved with these strategic partnerships. The ingredients for establishing successful, strategic partnerships are also identified. It is hoped that nursing and health care leaders striving to address the nursing shortage could consider statewide efforts such as those used in Texas to develop nursing workforce policy and legislation.

Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road.

PubMed

Baldwin, Adele; Bentley, Karyn; Langtree, Tanya; Mills, Jane

2014-01-01

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in 'The Wizard of Oz'; brains, heart and courage and the learning process as the 'Yellow Brick Road'. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Registered nurse supply grows faster than projected amid surge in new entrants ages 23-26.

PubMed

Auerbach, David I; Buerhaus, Peter I; Staiger, Douglas O

2011-12-01

The vast preponderance of the nation's registered nurses are women. In the 1980s and 1990 s, a decline in the number of women ages 23-26 who were choosing nursing as a career led to concerns that there would be future nurse shortages unless the trend was reversed. Between 2002 and 2009, however, the number of full-time-equivalent registered nurses ages 23-26 increased by 62 percent. If these young nurses follow the same life-cycle employment patterns as those who preceded them--as they appear to be thus far--then they will be the largest cohort of registered nurses ever observed. Because of this surge in the number of young people entering nursing during the past decade, the nurse workforce is projected to grow faster during the next two decades than previously anticipated. However, it is uncertain whether interest in nursing will continue to grow in the future.

The U.S. Presidential Election and Health Care Workforce Policy

PubMed Central

McHugh, Matthew D.; Aiken, Linda H.; Cooper, Richard A.; Miller, Phillip

2009-01-01

The candidates for the 2008 presidential election have offered a range of proposals that could bring significant changes in health care. Although few are aimed directly at the nurse and physician workforce, nearly all of the proposals have the potential to affect the health care workforce. Furthermore, the success of the proposed initiatives is dependent on a robust nurse and physician workforce. The purpose of this article is to outline the current needs and challenges for the nurse and physician workforce and highlight how candidates’ proposals intersect with the adequacy of the health care workforce. Three general themes are highlighted for their implications on the physician and nurse workforce supply, including (a) expansion of health care coverage, (b) workforce investment, and (c) cost control and quality improvement. PMID:18436702

Nurses who work in rural and remote communities in Canada: a national survey.

PubMed

MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela

2017-05-23

In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

Ethnic diversity in the nurse workforce: a literature review.

PubMed

Otto, Laureen A; Gurney, Cindy

2006-01-01

In the 2000-2003 New York State Nurses Association Strategic Plan, the Board of Directors called for an assessment of the progress made toward achieving an ethnically diverse nursing workforce as reflected in the literature. In this paper the authors have responded to that request and offer a snapshot of progress as well as standstills in the journey toward diversity. Although the literature has tended to focus on cultural competency of the healthcare worker, and includes numerous calls for action to diversify the nurse workforce, very little scholarly work has been conducted that rigorously evaluates such diversification activities. The purpose of this literature review is to explore existing scholarly work in ethnic diversity at three levels: in the general workforce, the healthcare workforce, and the nursing workforce. The authors explored the literature as it addresses two aspects: academic and career factors influencing diversity; and recruitment, retention, and other strategies employed to diversify the workforce. By exploring the existing research, gaps can be identified in order to either direct further research, or target funding to recruitment strategies to effectively enhance a more ethnically diverse nurse workforce.

Educating new graduate nurses in their first year of practice: The perspective and experiences of the new graduate nurses and the director of nursing.

PubMed

Doughty, Lesley; McKillop, Ann; Dixon, Robyn; Sinnema, Claire

2018-05-01

New graduate nurses are the future of nursing and the education they receive as they transition into the workforce as a newly registered nurse is critical for building a suitably qualified nursing workforce that will adequately serve the future population. Variation exists in education programmes for new graduate nurses in their first year of practice which is known to impact on transition experience. A qualitative study using focus groups and semi-structured interviews was undertaken to explore the experiences and perceptions of New Graduate Nurses undertaking a new graduate programme and Directors of Nursing supporting them to complete the programme which may or may not have been inclusive of a postgraduate course (Masters Level). The findings of this study are in line with previous research and support the value of new graduate programmes but did reveal a lack of consensus in regards to the structure and content of such programmes. This study revealed some commonalities and challenges between the differing programmes but has identified the need for further research to establish the impact of postgraduate education in the first year of practice and how this impacts on nursing practice and patient care. There are numerous terms in the literature with reference to new graduate programmes; transition to practice programme, nurse entry to practice programme, first year of clinical practice programme, new graduate programme and early career nursing programme. For the purpose of this article the term Nurse Entry to Practice (NETP) will be used in reference to any form of new graduate programme. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of internationally educated nurses in a quality, safe workforce.

PubMed

D Sherwood, Gwen; Shaffer, Franklin A

2014-01-01

Migration and globalization of the nursing workforce affect source countries and destination countries. Policies and regulations governing the movement of nurses from one country to another safeguard the public by ensuring educational comparability and competence. The global movement of nurses and other health care workers calls for quality and safety competencies that meet standards such as those defined by the Institute of Medicine. This article examines nurse migration and employment of internationally educated nurses (IENs) in the context of supporting and maintaining safe, quality patient care environments. Migration to the United States is featured as an exemplar to consider the following key factors: the impact of nurse migration on the nursing workforce; issues in determining educational comparability of nursing programs between countries; quality and safety concerns in transitioning IENs into the workforce; and strategies for helping IENs transition as safe, qualified members of the nursing workforce in the destination country. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurses' perceptions of the challenges related to the Omanization policy.

PubMed

Al-Riyami, M; Fischer, I; Lopez, V

2015-12-01

Human resource development has become a major concern in Oman since the inception of the 'Omanization' policy in 1988. The main goal of this policy was to replace the expatriate nursing workforce with similarly qualified local nurses to develop a sustainable workforce and achieve self-reliance. The aim of this study is to explore the nurses' perceptions of Omanization policy. A qualitative research design was used and 16 Omani registered nurses and 26 student nurses were interviewed in depth. Transcribed data were analysed using content analysis. Two main themes emerged from the data: 'Challenges of sustaining the local nursing workforce' and 'Challenges of educational preparation for local nurses'. The participants agreed that Omanization benefited national development, social stability and ensuring local workforce. The challenges faced were cultural and work life balance, preparation of nurses and pace of replacement. The participants were concerned that the pace of replacement could leave behind a marked experience gap. A slow-phased approach to Omanization of the nursing workforce was recommended by the participants. Results obtained from this study reflect the perceptions and voices of student nurses and registered nurses only from the Institute of Nursing and Oman Ministry of Health. A policy of this magnitude requires gradual establishment. The upgrading of the nursing education to degree level, continuous professional development, mentoring and role modeling of expert nurses should be established to prepare local nurses for the localization of the nursing workforce. © 2015 International Council of Nurses.

Global nurse leader perspectives on health systems and workforce challenges.

PubMed

Gantz, Nancy Rollins; Sherman, Rose; Jasper, Melanie; Choo, Chua Gek; Herrin-Griffith, Donna; Harris, Kathy

2012-05-01

As part of the 2011 annual American Organization of Nurse Executives conference held in San Diego, California, a session was presented that focused on nursing workforce and health systems challenges from a global perspective. This article includes content addressed during the session representing nurse leader perspectives from the UK, Singapore and the USA. Recent events in global economic markets have highlighted the interdependence of countries. There is now a global focus on health-care costs and quality as government leaders struggle to reduce budgets and remain solvent. Finding solutions to these complex problems requires that nurse leaders adopt more of a world view and network with one another as they look for best practices and creative strategies. Nursing leadership challenges such as staffing, competency development, ageing populations, reduced health-care funding and maintaining quality are now common global problems. There is a need for innovation in nursing practice to accommodate the enormous challenges facing nursing's future. Opportunities on an international scale for nurse leaders to have dialogue and network, such as the conference presentation discussed in this article, will become increasingly more important to facilitate the development of innovative leadership strategies. © 2012 Blackwell Publishing Ltd.

Descriptive, cross-country analysis of the nurse practitioner workforce in six countries: size, growth, physician substitution potential

PubMed Central

Maier, Claudia B; Barnes, Hilary; Aiken, Linda H; Busse, Reinhard

2016-01-01

Objectives Many countries are facing provider shortages and imbalances in primary care or are projecting shortfalls for the future, triggered by the rise in chronic diseases and multimorbidity. In order to assess the potential of nurse practitioners (NPs) in expanding access, we analysed the size, annual growth (2005–2015) and the extent of advanced practice of NPs in 6 Organisation for Economic Cooperation and Development (OECD) countries. Design Cross-country data analysis of national nursing registries, regulatory bodies, statistical offices data as well as OECD health workforce and population data, plus literature scoping review. Setting/participants NP and physician workforces in 6 OECD countries (Australia, Canada, Ireland, the Netherlands, New Zealand and USA). Primary and secondary outcome measures The main outcomes were the absolute and relative number of NPs per 100 000 population compared with the nursing and physician workforces, the compound annual growth rates, annual and median percentage changes from 2005 to 2015 and a synthesis of the literature on the extent of advanced clinical practice measured by physician substitution effect. Results The USA showed the highest absolute number of NPs and rate per population (40.5 per 100 000 population), followed by the Netherlands (12.6), Canada (9.8), Australia (4.4), and Ireland and New Zealand (3.1, respectively). Annual growth rates were high in all countries, ranging from annual compound rates of 6.1% in the USA to 27.8% in the Netherlands. Growth rates were between three and nine times higher compared with physicians. Finally, the empirical studies emanating from the literature scoping review suggested that NPs are able to provide 67–93% of all primary care services, yet, based on limited evidence. Conclusions NPs are a rapidly growing workforce with high levels of advanced practice potential in primary care. Workforce monitoring based on accurate data is critical to inform educational capacity and workforce planning. PMID:27601498

Council of International Neonatal Nurses (COINN) Global Neonatal Provider Database Initiative (CGNPD): Results From an Implementation Focus Group.

PubMed

Eklund, Wakako; Kenner, Carole

2015-12-01

The neonatal nurses are the key component of the essential workforce necessary to address the healthcare needs of the infants globally. The paucity of the data regarding the availability and training of the neonatal workforce challenges the stakeholders at the regional, national, and global levels. The lack of these data makes strategic planning for initiatives especially in low-resourced countries difficult. Up-to-date data are critically needed to describe the role neonatal nurses play in global newborn health outcomes. The purpose of the COINN Global Neonatal Provider Database Initiative (CGNPD) was to develop a workforce database by developing survey questions, conducting a focus group to determine the key reasons such a database was needed and how best to implement it, and incorporating these comments into the workforce survey and launch. Pilot testing of the draft survey instrument was done. This article reports on the findings from the focus group and the development of the survey. A qualitative design using the focus group method was used. The focus group discussions were guided by semi-structured interview questions that had been developed prior to the focus group by neonatal experts. A convenience sample of 14 members from the international delegates and project advisory members who attended the COINN 2013 in Belfast, Northern Ireland, participated. These participants represented 10 countries. Thematic analysis was conducted using verbatim transcripts of the focus group data. Four main themes emerged: (1) the invisibility of neonatal nurses, (2) benchmarking needs for quality and standards, (3) need for partnership to implement the database, and (4) setting priorities for variables needed for the most salient database. The questionnaire examined participants' perceptions of the significance of and the future utilization of the workforce database and elements that should be included in the survey. The global neonatal workforce database is needed to describe who the neonatal nurses are in each country, what they do, how they are trained, and where they work. The data from the focus group aided in the development of the workforce survey that has been pilot tested and provides critical information to guide COINN's global implementation of the database project.

Strategies to address the nursing shortage in Saudi Arabia.

PubMed

Aboshaiqah, A

2016-09-01

To investigate the nursing shortage in Saudi Arabia and specifically the shortage of Saudi nurses in the healthcare workforce and to propose solutions. Literature published from 1993 to 2013 providing relevant information on the nursing shortage, cultural traditions and beliefs, and nursing education and policies in Saudi was accessed from multiple sources including Medline, CINAHL Plus and Google Scholar and from official Saudi government document and was reviewed. Saudi Arabia depends largely on an expatriate workforce, and this applies to nursing. Saudi Arabia is experiencing a nursing shortage in common with most countries in the world and a shortage of Saudi nationals, especially women, in the healthcare workforce. The world shortage of nursing is extrinsic to Saudi, but intrinsic factors include a poor image of the nursing profession in the country that is exacerbated by cultural factors. With the call for the Saudization of the workforce to replace the imported workforce by Saudi nationals, including nurses, through the 1992 Royal Decree, Saudi Arabia faces a problem in attracting and retaining Saudi nationals in the nursing workforce. Solutions are suggested that are aimed at improving the public image of nursing through education and the use of the media and improvements in the workplace by addressing working processes such as teamwork, ensuring adequate staffing levels and addressing some aspects of culture which may make working in nursing more compatible with being a Saudi national. © 2016 International Council of Nurses.

Introduction to four reviews addressing critical topics identified by the 2015 Nurse Practitioner Research Agenda Roundtable: Priorities for policy, workforce, education, and practice.

PubMed

Buchholz, Susan W; Klein, Tracy; Cooke, Cindy; Cook, Michelle L; Knestrick, Joyce; Dickins, Kirsten

2018-05-04

In 2015, an invitational think tank was convened by the Fellows of the American Association of Nurse Practitioners to update the 2010 Nurse Practitioner (NP) Research Agenda Roundtable. This effort was undertaken to provide guidance for future health care research. The purpose of this article is to introduce the process used for conducting four reviews that address critical topics related to specific research priorities emanating from the 2015 NP Research Agenda Roundtable. The four reviews are published in this issue of Journal of the American Association of Nurse Practitioners (JAANP) to address the state of current research relevant to NP policy, workforce, education, and practice. This introductory article provides an overview of the systematic process used to evaluate the four topical area. The type of review selected, the search strategy, critical appraisal, data extraction, and data synthesis will be further described in the four review articles. Four reviews that examine literature regarding specific aims important to NPs will address strengths as well as gaps in the literature. The knowledge offered by the four reviews has the potential to inform future research, which will benefit NPs and other health care stakeholders.

Recruiting and retaining men in nursing: a review of the literature.

PubMed

Villeneuve, M J

1994-01-01

A review of literature published primarily since 1980 was conducted to identify (1) historical events that have influenced the sex imbalance in the nursing workforce, (2) the existence and types of barriers affecting the recruitment of male nurses, and (3) feasible strategies that might form the basis of intervention studies in the future. Nursing continues to be undervalued as an end-point career by some, and most potential candidates lack exposure to male nurses and nursing in general. Family resistance and salary remain concerns, but they may be as important a deterrent for some women as for men. Significant barriers to men exist in nursing education and practice, and the language and history of nursing have sexualized nursing practice itself by labeling it as women's work. The latter pattern has influenced legal decisions affecting the clinical practice of male nurses and has contributed to perhaps the most significant barrier to the recruitment of male candidates: the job title and its associated images. Proactive recruitment from selected target groups, the use of role models, and the exploitation of appropriate media sources are but three feasible strategies identified from the literature review that might be considered if nurses really would value changing the sex imbalance in the nursing workforce.

Source country perceptions, experiences, and recommendations regarding health workforce migration: a case study from the Philippines.

PubMed

Marcus, Kanchan; Quimson, Gabriella; Short, Stephanie D

2014-10-31

The Philippines continues to overproduce nurses for export. Little first-hand evidence exists from leading organisations in the Philippines concerning their experiences and perceptions in relation to Filipino nurse migration. What are their views about health workforce migration? This paper addresses this research gap by providing a source country perspective on Filipino nurse migration to Australia. Focus-group interviews were conducted with key informants from nine Filipino organisations in the Philippines by an Australian-Filipino research team. The organisations were purposively selected and contacted in person, by phone, and/or email. Qualitative thematic analysis was performed using a coding framework. Health workforce migration is perceived to have both positive and negative consequences. On the one hand, emigration offers a welcome opportunity for individual Filipino nurses to migrate abroad in order to achieve economic, professional, lifestyle, and social benefits. On the other, as senior and experienced nurses are attracted overseas, this results in the maldistribution of health workers particularly affecting rural health outcomes for people in developing countries. Problems such as 'volunteerism' also emerged in our study. In the context of the WHO (2010) Code of Practice on the International Recruitment of Health Personnel it is to be hoped that, in the future, government recruiters, managers, and nursing leaders can utilise these insights in designing recruitment, orientation, and support programmes for migrant nurses that are more sensitive to the experience of the Philippines' education and health sectors and their needs.

The Effectiveness and Need for Facility Based Nurse Aide Training Competency Evaluation Programs.

PubMed

Mileski, Michael; McIlwain, Amber S; Kruse, Clemens Scott; Lieneck, Cristian; Sokan, Amanda

2016-01-01

It has become crucial for nursing facilities to rapidly train future nurse aides and remove any barriers to their matriculation into the field of care. Facilities feel the organizational burden of insufficient staffing and need to lever all effective programs to train future employees. The facility-based, Nurse Aide Training Competency Evaluation Programs (NATCEP) serve as a viable option to help fill shortages in the professional medical workforce. Data were analyzed from the National Nursing Assistant Survey to provide an overview of the benefits of using facility-trained nurse aides, versus those trained elsewhere, including their own perceptions of training and abilities. These findings also show the importance of facility based training programs for nurse aides on a global level. Providing training on site increases the efficiency and proficiency of nurse aides, making the transition to caregivers an easier for students, employers and residents.

The workforce trends of nurses in Lebanon (2009-2014): A registration database analysis.

PubMed

Alameddine, Mohamad; Chamoun, Nariman; Btaiche, Rachel; El Arnaout, Nour; Richa, Nathalie; Samaha-Nuwayhid, Helen

2017-01-01

Analysis of the nursing registration databases is a highly informative approach that provides accurate and reliable information supporting evidence based decisions relevant to the nursing workforce planning, management and development. This study presents the first systematic analysis of the nursing registration database in Lebanon. It Reports on the workforce distribution and trends using an updated version of the Order of Nurses in Lebanon (ONL) databases. This study presents a secondary data analysis of a de-identified subset of the updated ONL registration database. The workforce participation status of ONL registered nurses was categorized as active and eligible. For active nurses sectors and sub-sectors of employment were defined. Eligible nurses were categorized as unemployed, working outside nursing and working abroad. SPSS was used to conduct descriptive analysis to present workforce trends of Lebanese nurses for year 2009-2014 as frequencies, percentages and percentage changes. Increases in the size of the Active (35%) and Eligible (86%) nurses were observed over the past six years. The majority of nurses fell in the below 35 years age group (60% in 2014). The hospital sector remained the principle employer, with 87% of Lebanese nurses working in hospitals in 2014. A 173% increases was reported for nurses working abroad. Despite the growth of the Active nursing workforce, the skewed distribution of nurses in the below 35 age group and the growth in the Eligible category, especially for nurses living abroad, raise concerns on the longevity of nurses in the profession and the reasons for their attrition from the workforce. There is a need to investigate the push and pull factors that are affecting nurses and the design of policies and interventions that would encourage nurses to remain active in Lebanon. Furthermore, policies and interventions that would create employment opportunities outside hospitals, especially in the Community sector, are recommended.

The workforce trends of nurses in Lebanon (2009–2014): A registration database analysis

PubMed Central

Chamoun, Nariman; Btaiche, Rachel; El Arnaout, Nour; Richa, Nathalie; Samaha-Nuwayhid, Helen

2017-01-01

Background Analysis of the nursing registration databases is a highly informative approach that provides accurate and reliable information supporting evidence based decisions relevant to the nursing workforce planning, management and development. This study presents the first systematic analysis of the nursing registration database in Lebanon. It Reports on the workforce distribution and trends using an updated version of the Order of Nurses in Lebanon (ONL) databases. Methods This study presents a secondary data analysis of a de-identified subset of the updated ONL registration database. The workforce participation status of ONL registered nurses was categorized as active and eligible. For active nurses sectors and sub-sectors of employment were defined. Eligible nurses were categorized as unemployed, working outside nursing and working abroad. SPSS was used to conduct descriptive analysis to present workforce trends of Lebanese nurses for year 2009–2014 as frequencies, percentages and percentage changes. Results Increases in the size of the Active (35%) and Eligible (86%) nurses were observed over the past six years. The majority of nurses fell in the below 35 years age group (60% in 2014). The hospital sector remained the principle employer, with 87% of Lebanese nurses working in hospitals in 2014. A 173% increases was reported for nurses working abroad. Discussion Despite the growth of the Active nursing workforce, the skewed distribution of nurses in the below 35 age group and the growth in the Eligible category, especially for nurses living abroad, raise concerns on the longevity of nurses in the profession and the reasons for their attrition from the workforce. Conclusion There is a need to investigate the push and pull factors that are affecting nurses and the design of policies and interventions that would encourage nurses to remain active in Lebanon. Furthermore, policies and interventions that would create employment opportunities outside hospitals, especially in the Community sector, are recommended. PMID:28800618

Challenges in getting workforce research in nursing used for decision-making in policy and practice: a Canadian perspective.

PubMed

O'Brien-Pallas, Linda; Hayes, Laureen

2008-12-01

This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence-based policies and practices for nursing care and outcomes. Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses' work environments to determine factors that are amenable to policy change. Survey of literature was conducted. Electronic databases were searched using keywords. Sustained health human resource planning efforts by policy makers are difficult given changing governments and political agendas. The health human resource conceptual framework provides researchers and planners with a guide to decision-making that considers current circumstances as well as those factors that need to be accounted for in predicting future requirements. However, effective use of research depends on communication of findings between researchers and policymakers. Health care managers and other decision-makers in health care organisations often lack an understanding of the research process and do not always have easy access to current evidence. Also, managerial decisions are often constrained by organisational requirements such as resource availability and policies and procedures. Unless nursing workplace issues are addressed, the physiological and psychological stress in the work environments of nurses will continue. Effective health human resource policy and planning (at the macro level) and management strategies (at the micro level) would stabilise the nursing workforce and reduce job stress. Furthermore, the efficiency and cost-effectiveness of the health system could be enhanced through improved health outcomes of care providers and health care clients.

The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on

PubMed Central

2014-01-01

Background Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods In the nascence of the expansion of the role of nurses in Australian general practice (2003–2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009–2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Results Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses’ role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses’ role in general practice was slightly decreased over time. Conclusions This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce. PMID:24666420

Work hazards for an aging nursing workforce.

PubMed

Phillips, Jennan A; Miltner, Rebecca

2015-09-01

To discuss selected work hazards and safety concerns for aging nurses. Greater numbers of older nurses remain in the workforce. Projections suggest that one-third of the nursing workforce will be over age 50 years by 2015. Employers will struggle to find ways to protect the health and safety of their aging workforce and prevent a massive loss of intellectual and human resources when these experienced nurses exit the workforce. Review of recent relevant literature in English language journals. Repetitive motion injuries, fatigue and slips, trips and falls are three major work hazards older nurses face. We discuss several factors for each hazard, including: the normal physiological aging effects of diminished strength, hearing and vision; workplace variables of work schedules, noise and clutter; and personal characteristics of sleep disturbances, overexertion and fatigue. Inconclusive evidence exists to guide best practices for designing safe workplace environments and shift patterns for nursing work. There are at least two areas administrators can reduce work hazards for older workers: (1) modification of the workplace, and (2) creating the infrastructure to support the aging workforce to encourage healthy behaviours. © 2014 John Wiley & Sons Ltd.

Retaining early career registered nurses: a case study.

PubMed

Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea

2016-01-01

A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs' personalities and skills; and 6) encouragement to reflect on career choices. Reducing turnover and improving retention relies on understanding the factors that influence nurses' decisions to leave or remain within an organisation and the profession. Ensuring nurses in the current workforce remain engaged and productive, rather than leave the profession, is reliant on addressing factors that cause attrition and implementing strategies that strengthen retention rates and workforce sustainability.

Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment.

PubMed

Ashley, Christine; Peters, Kath; Brown, Angela; Halcomb, Elizabeth

2018-02-12

To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Most reported positive experiences, valuing work/life balance, role diversity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care. © 2018 John Wiley & Sons Ltd.

The social context of career choice among millennial nurses: implications for interprofessional practice.

PubMed

Price, Sheri; McGillis Hall, Linda; Angus, Jan; Peter, Elizabeth

2013-11-01

Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne's theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.

Strategies for Pursuing a Master's Degree.

PubMed

Thomas, Cynthia M; McIntosh, Constance E; Mensik, Jennifer S

2016-01-01

Health care has become very complex and is in a constant state of change. As a result of the evolving change and increasing complexity, a more educated nursing workforce is needed (Dracup K. Master's nursing programs. American Association of Colleges of Nursing. 2015; Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. 2010). It is now becoming necessary for registered nurses to earn an advanced degree to work at the highest level of their practice authority (Dracup K. Master's nursing programs. American Association of Colleges of Nursing. 2015; Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. 2010.). Preparing to reenter college may be an overwhelming prospect for some registered nurses seeking an advanced degree. However, there are some simple strategies that may help sort out the many degree options, financial obligations, decisions about brick and mortar versus online learning, commitment to degree completion, and changing career paths. This article will provide the registered nurse valuable information that will assist in the exciting process of returning to college.

More care out of hospital? A qualitative exploration of the factors influencing the development of the district nursing workforce in England.

PubMed

Drennan, Vari M

2018-01-01

Objectives Many countries seek to improve care for people with chronic conditions and increase delivery of care outside of hospitals, including in the home. Despite these policy objectives in the United Kingdom, the home visiting nursing service workforce, known as district nursing, is declining. This study aimed to investigate the factors influencing the development of district nursing workforces in a metropolitan area of England. Methods A qualitative study in a metropolitan area of three million residents in diverse socio-economic communities using semi-structured interviews with a purposive sample of senior nurses in provider and commissioning organizations. Thematic analysis was framed by theories of workforce development. All participants reported that the context for the district nursing service was one of major reorganizations in the face of wider National Health Service changes and financial pressures. The analysis identified five themes that can be seen to impact the ways in which the district nursing workforce was developed. These were: the challenge of recruitment and retention, a changing case-mix of patients and the requirement for different clinical skills, the growth of specialist home visiting nursing services and its impact on generalist nursing, the capacity of the district nursing service to meet growing demand, and the influence of the short-term service commissioning process on the need for long-term workforce development. Conclusion There is an apparent paradox between health policies which promote more care within and closer to home and the reported decline in district nursing services. Using the lens of workforce development theory, an explanatory framework was offered with factors such as the nature of the nursing labour market, human resource practices, career advancement opportunities as well as the contractual context and the economic environment.

Academic-Service Partnerships in Nursing: An Integrative Review

PubMed Central

Beal, Judy A.

2012-01-01

This integrative review summarizes currently available evidence on academic-service partnerships in the profession of nursing. More than 300 articles, published primarily in refereed journals, were accessed. Articles (110) were included in this review as they presented detailed and substantive information about any aspect of a nursing academic-service partnership. The majority were anecdotal in nature. Topics clustered around the following categories: pre-requisites for successful partnerships, benefits of partnerships, types of partnerships, and workforce development with its themes of academic-practice progression and educational re-design. Many examples of partnerships between academic and service settings were thoroughly described and best practices suggested, most often, however, without formal evaluation of outcomes. Nursing leaders in both settings have a long tradition of partnering with very little replicable evidence to support their efforts. It is critical that future initiatives evaluate the effectiveness of these partnerships, not only to ensure quality of patient outcomes but also to maximize efforts at building capacity for tomorrow's workforce. PMID:22548160

Satisfaction with nursing education, job satisfaction, and work intentions of new graduate nurses.

PubMed

Kenny, Patricia; Reeve, Rebecca; Hall, Jane

2016-01-01

In the context of predictions of future shortages of nurses, retaining new graduate nurses in the nursing workforce is essential to ensure sufficient nurses in the future. This paper investigates the links between satisfaction with nursing education and job satisfaction, and job dissatisfaction and intentions to leave a nursing job. It uses survey data from a cohort study of nursing students recruited through two Australian universities and followed after graduation and workforce entry. Structural equation modeling (SEM) was used to simultaneously estimate the impact of educational satisfaction (work preparation component) on job satisfaction and the impact of job satisfaction on the expectation of leaving the current job. Two job satisfaction sub-scales were identified: 1) work environment satisfaction and 2) work hours and wages satisfaction. Work preparation satisfaction was significantly and positively associated with both job satisfaction scales but only work environment satisfaction was significantly associated with the expectation to stay in the job; a one standard deviation increase in work environment satisfaction was associated with a 13.5 percentage point reduction in the probability of expecting to leave. The estimated effect of satisfaction with education on expecting to leave, occurring indirectly through job satisfaction, was small (reducing the probability by less than 3 percentage points for a 1 point increase in work preparation satisfaction). Participating in a graduate transition program had the largest effect, reducing the probability of expecting to leave by 26 percentage points, on average. The study results suggest policies which focus on improving satisfaction with the work environment would be more effective at retaining nurses early in their career than improvements to conditions such as work hours and wages. Investment in new graduate transition programs would potentially have the largest impact on retention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Critical care staff rotation: outcomes of a survey and pilot study.

PubMed

Richardson, Annette; Douglas, Margaret; Shuttler, Rachel; Hagland, Martin R

2003-01-01

Staff rotation is defined as a reciprocal exchange of staff between two or more clinical areas for a predetermined period of time. The rationale for introducing a 'Critical Care Nurse Rotation Programme' includes important issues such as improving nurses' knowledge and skills, providing development opportunities, networking, the ability to recruit and retain nurses and the provision of a more versatile and flexible workforce. To gain the understanding of nurses' views and opinions on critical care rotation programmes, evidence was collected by means of questionnaires involving 153 critical care nurses and by undertaking semi-structured interviews with four nurses. On the basis of the responses, a pilot of three Critical Care Nurse Rotation Programmes was introduced. An evaluation of the pilot project assessed participants, supervisors and senior nurses' experience of rotation and revealed very positive experiences being reported. The benefits highlighted included improving clinical skills and experience, improving interdepartmental relationships, heightened motivation and opportunities to network. The disadvantages focused on the operational and managerial issues, such as difficulties maintaining supervision and providing an adequate supernumerary period. Evidence from the survey and pilot study suggests that in the future, providing rotational programmes for critical care nurses would be a valuable strategy for recruitment, retention and developing the workforce.

Contribution of health workforce to health outcomes: empirical evidence from Vietnam.

PubMed

Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh

2016-11-16

In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce (doctors, nurses, midwives, and pharmacists) can be an important strategy for improving health outcomes in Vietnam and other similar contexts. Future interventions will also need to consider an integrated approach, building on the link between the health and the development.

Nurse migration and health workforce planning: Ireland as illustrative of international challenges.

PubMed

Humphries, Niamh; Brugha, Ruairi; McGee, Hannah

2012-09-01

Ireland began actively recruiting nurses internationally in 2000. Between 2000 and 2010, 35% of new recruits into the health system were non-EU migrant nurses. Ireland is more heavily reliant upon international nurse recruitment than the UK, New Zealand or Australia. This paper draws on in-depth interviews (N=21) conducted in 2007 with non-EU migrant nurses working in Ireland, a quantitative survey of non-EU migrant nurses (N=337) conducted in 2009 and in-depth interviews conducted with key stakeholders (N=12) in late 2009/early 2010. Available primary and secondary data indicate a fresh challenge for health workforce planning in Ireland as immigration slows and nurses (both non-EU and Irish trained) consider emigration. Successful international nurse recruitment campaigns obviated the need for health workforce planning in the short-term, however the assumption that international nurse recruitment had 'solved' the nursing shortage was short-lived and the current presumption that nurse migration (both emigration and immigration) will always 'work' for Ireland over-plays the reliability of migration as a health workforce planning tool. This article analyses Ireland's experience of international nurse recruitment 2000-2010, providing a case study which is illustrative of health workforce planning challenges faced internationally. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Nursing Education Transformation: Promising Practices in Academic Progression.

PubMed

Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M

2015-09-01

Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.

Public School Nursing Practice in the United States

ERIC Educational Resources Information Center

Willgerodt, Mayumi A.; Brock, Douglas M.; Maughan, Erin D.

2018-01-01

School nursing practice has changed dramatically over the past 20 years, yet few nationally representative investigations describing the school nursing workforce have been conducted. The National School Nurse Workforce Study describes the demographic and school nursing practice patterns among self-reported public school nurses and the number and…

Sustaining the rural workforce: nursing perspectives on worklife challenges.

PubMed

Hunsberger, Mabel; Baumann, Andrea; Blythe, Jennifer; Crea, Mary

2009-01-01

Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique requirements of nurses in rural practice environments. To investigate whether nurses receive the resources and supports necessary to meet the challenges of rural practice. Semi-structured interviews were conducted with 21 managers and 44 staff nurses in 19 selected rural hospitals in Ontario, Canada. The interviews were taped and transcripts interpreted through a thematic analysis. Major worklife themes were identified and analyzed within a healthy work environment model based on the work of Kristensen. Three interrelated dimensions of the model were relevant to workforce sustainability: the balance between demands and the resources of the person, the level of social support, and the degree of influence. The availability of resources and supports affected whether the nurses perceived challenges as stimulating or overwhelming. Deficits interfered with practice and the well-being of the nurses and patients. The nurses felt frustrated and powerless when they lacked resources, support, and influence to manage negative situations. Strategies to achieve workforce sustainability include resources to reduce stress in the workplace, education to meet the needs of new and experienced nurses, and offering of employment preferences to the workforce. Addressing resources, support, and influence of rural nurses is essential to alleviate workplace challenges and sustain the rural nursing workforce.

Preparing nursing students for the future: Development and implementation of an Australian Bachelor of Nursing programme with a community health focus.

PubMed

Cooper, Simon; Cant, Robyn; Browning, Mark; Robinson, Eddie

2014-01-01

This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students' course experience: 'I think community health should be an elective'; 'Focus on relevance to practice'; 'Teaching by non-nursing academics' and 'Access to support during transition to university.' Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce.

Exploring the Links Between Macro-Level Contextual Factors and Their Influence on Nursing Workforce Composition

PubMed Central

Squires, Allison; Beltrán-Sánchez, Hiram

2012-01-01

Research that links macro-level socioeconomic development variables to healthcare human resources workforce composition is scarce at best. The purpose of this study was to explore the links between non-nursing factors and nursing workforce composition through a secondary, descriptive analysis of year 2000, publicly available national nursing human resources data from Mexico. Building on previous research, the authors conducted multiple robust regression analysis by federal typing of nursing human resources from 31 Mexican states against macro-level socioeconomic development variables. Average education in a state was significantly associated in predicting all types of formally educated nurses in Mexico. Other results suggest that macro level indicators have a different association with each type of nurse. Context may play a greater role in determining nursing workforce composition than previously thought. Further studies may help to explain differences both within and between countries. PMID:22513839

Racial and ethnic diversity of the U.S. national nurse workforce 1988-2013.

PubMed

Xue, Ying; Brewer, Carol

2014-01-01

The objective of this article is to examine the racial and ethnic diversity profile of the nurse workforce over time and by geographic region. We conducted survey analysis using the National Sample Survey of Registered Nurses from 1988 to 2008, and further supplemented our trend analysis using published findings from the 2013 National Workforce Survey of Registered Nurses. The gap in racial/ethnic minority representation between the RN workforce and the population has been persistent and has widened over time. This diversity gap is primarily due to underrepresentation of Hispanics and Blacks in the RN workforce, which varied across states and regions, with the largest gaps occurring for Hispanics in the South and West and for Blacks in the South. Greater levels of sustained and targeted support to increase nurse workforce diversity are needed and should be geared not only to specific underrepresented groups but also to the regions and states with the greatest needs. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Reflections on leadership talent: a void or an opportunity?

PubMed

Erickson, Jeanette Ives

2013-01-01

Nurses, the largest group of clinicians in the health care workforce, are increasingly called on to fill a number of strategic leadership roles. As nurses' roles and prominence in health care increase, the development of future generations of nurse leaders becomes ever more vital. Learning how to thrive, not simply survive, in this era of health care reform that is changing the landscape of care across the continuum requires all leaders and managers to possess new knowledge and skills. Preparing tomorrow's leaders must now begin with an organizational commitment to inspire the next generation of nurse leaders.

Nursing practice environment: a strategy for mental health nurse retention?

PubMed

Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda

2015-06-01

Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required. © 2015 Australian College of Mental Health Nurses Inc.

What interventions can improve the mental health nursing practice environment?

PubMed

Redknap, Robina; Twigg, Di; Towell, Amanda

2016-02-01

The nursing practice environment is an important factor for services to consider in the attraction and retention of a skilled workforce during future nursing shortages. Despite the significant number of international studies undertaken to understand the influence of the practice environment on nurse satisfaction and retention, few have been undertaken within the mental health setting. This paper reports on results from a survey conducted in a large Australian public mental health hospital to examine nurses' perceptions of their practice environment, and identifies interventions that could be implemented to improve the practice environment. The hospital is the only remaining, standalone public mental health hospital in Western Australia. © 2016 Australian College of Mental Health Nurses Inc.

Understanding the experience of training for overseas nurses.

PubMed

Smith, Sally

To explore the perceptions of overseas nurses during their induction programme. A pilot cohort of 20 overseas nurses. A qualitative research approach was used. The key themes were: communication issues, culture, role definition and feelings of self-worth, which are interrelated and suggest how the experience has influenced each nurse's professional development and ultimate achievement of 'competence' as a registered nurse able to practise in the UK. These findings confirm there is a need for greater understanding of the 'adjustment process' and integration into the workforce. Recommendations are made that for future projects to succeed, comprehensive support frameworks are required to fully support both the overseas nurse and the organisation as a whole.

Maldistribution or scarcity of nurses? The devil is in the detail.

PubMed

Both-Nwabuwe, Jitske M C; Dijkstra, Maria T M; Klink, Ab; Beersma, Bianca

2018-03-01

The goal of this paper was to improve our understanding of nursing shortages across the variety of health care sectors and how this may affect the agenda for addressing nursing shortages. A health care sector comprises a number of health care services for one particular type of patient care, for example, the hospital care sector. Most Western countries are shifting health care services from hospital care towards community and home care, thus increasing nursing workforce challenges in home and community care. In order to implement appropriate policy responses to nursing workforce challenges, we need to know if these challenges are caused by maldistribution of nurses and/or the scarcity of nurses in general. Focusing on the Netherlands, we reviewed articles based on data of a labour market research programme and/or data from the Dutch Employed Persons' Insurance Administration Agency. The data were analysed using a data synthesis approach. Nursing shortages are unevenly distributed across the various health care sectors. Shortages of practical nurses are caused by maldistribution, with a long-term projected surplus of practical nurses in hospitals and projected shortages in nursing/convalescent homes and home care. Shortages of first-level registered nurses are caused by general scarcity in the long term, mainly in hospitals and home care. Nursing workforce challenges are caused by a maldistribution of nurses and the scarcity of nurses in general. To implement appropriate policy responses to nursing workforce challenges, integrated health care workforce planning is necessary. Integrated workforce planning models could forecast the impact of health care transformation plans and guide national policy decisions on transitioning programmes. Effective transitioning programmes are required to address nursing shortages and to diminish maldistribution. In addition, increased recruitment and retention as well as new models of care are required to address the scarcity of nurses in general. © 2017 John Wiley & Sons Ltd.

Why older nurses leave the workforce and the implications of them staying.

PubMed

Duffield, Christine; Graham, Elizabeth; Donoghue, Judith; Griffiths, Rhonda; Bichel-Findlay, Jen; Dimitrelis, Sofia

2015-03-01

To identify factors that motivate older nurses to leave the workforce. As many older nurses are now reaching retirement age and will be eligible for government-funded pensions, governments are concerned about the impending financial burden. To prepare for this scenario, many are looking at increasing the age of retirement to 67 or 70 years. Little is known about how this will affect the continuing employment of older nurses and the consequences for employers and the nurses themselves if they remain longer in the workforce. Prospective randomised quantitative survey study. The Mature Age Workers Questionnaire, Job Descriptive Index and Job in General Scale were used to measure job satisfaction, intention to retire and factors encouraging retirement in registered nurses aged 45 years and over (n = 352) in Australia (July-August 2007). There were 319 respondents. The mean age proposed for leaving the workforce was 61·7 years. Key motivators were: financial considerations (40·1%), primarily financial security; nurse health (17·4%) and retirement age of partner (13·3%). Older nurses are leaving the workforce prior to retirement or pension age, primarily for financial, social and health reasons, taking with them significant experience and knowledge. As financial considerations are important in older nurses decisions to continue to work, increasing the age of retirement may retain them. However, consideration will need to be given to ensure that they continue to experience job satisfaction and are physically and mentally able to undertake demanding work. Increasing retirement age may retain older nurses in the workforce, however, the impact on the health of older nurses is not known, nor is the impact for employers of older nurses continuing to work known. Employers must facilitate workplace changes to accommodate older nurses. © 2014 John Wiley & Sons Ltd.

Establishing a sustainable nursing workforce.

PubMed

Knowles, Judie

2010-07-01

Occupational sustainability in healthcare services involves meeting the demands of a changing NHS without compromising the health and wellbeing of nurses. This article examines occupational sustainability in the nursing profession, focusing on issues of nursing workload, employee health and recruitment issues, and workforce diversity.

Aged over 50 years and practising: separation and changes in nursing practice among New Zealand's older Registered Nurses.

PubMed

North, Nicola; Leung, William; Lee, Rochelle

2014-12-01

To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. A cohort of all nurses aged ≥50 years on the register and practising in 2006 (n = 12,606) was tracked until 2011. After 5 years, a quarter (n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. © 2014 John Wiley & Sons Ltd.

Exploring the links between macro-level contextual factors and their influence on nursing workforce composition.

PubMed

Squires, Allison; Beltrán-Sánchez, Hiram

2011-11-01

Research that links macro-level socioeconomic development variables to health care human resources workforce composition is scarce at best. The purpose of this study was to explore the links between nonnursing factors and nursing workforce composition through a secondary, descriptive analysis of year 2000, publicly available national nursing human resources data from Mexico. Building on previous research, the authors conducted multiple robust regression analysis by federal typing of nursing human resources from 31 Mexican states against macro-level socioeconomic development variables. Average education in a state was significantly associated in predicting all types of formally educated nurses in Mexico. Other results suggest that macro-level indicators have a different association with each type of nurse. Context may play a greater role in determining nursing workforce composition than previously thought. Further studies may help to explain differences both within and between countries.

Flexible working and the contribution of nurses in mid-life to the workforce: a qualitative study.

PubMed

Harris, Ruth; Bennett, Janette; Davey, Barbara; Ross, Fiona

2010-04-01

With the changing demographic profile of the nursing workforce, retaining the skill and experience of nurses in mid-life is very important. Work-life balance is a concept that is gaining increasing prominence in today's society. However, little is known about older nurses' experience of family friendly policies and flexible working. This study explored the organisational, professional and personal factors that influence perceptions of commitment and participation in the workforce for nurses working in mid-life (aged 45 and over). A qualitative study using a range of methods including biographical methods, semi-structured face-to-face interviews, focus groups and telephone interviews. Data were analysed using constant comparative method. A large inner city acute teaching hospital and an inner city mental health and social care trust providing both community and inpatient health and social care. 34 nurses and 3 health care assistants participated in individual interviews, 10 nurses participated in two focus groups and 17 managers participated in individual telephone interviews. Four themes emerged: the nature of nursing poses a challenge to the implementation of flexible working, differences in perceptions of the availability of flexible working, ward managers have a crucial role in the implementation of flexible working policies and the implementation of flexible working may be creating an inflexible workforce. The findings suggest that there are limits to the implementation of flexible working for nurses. In some areas there is evidence that the implementation of flexible working may be producing an inflexible workforce as older nurses are required to compensate for the flexible working patterns of their colleagues. Ward managers have a key role in the implementation of family friendly policies and require support to fulfil this role. There is a need for creative solutions to address implementation of flexible working for all nurses to ensure that workforce policy addresses the need to retain nurses in the workforce in a fair and equitable way. Copyright 2009 Elsevier Ltd. All rights reserved.

Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers: A Longitudinal Analysis

PubMed Central

Uchida-Nakakoji, Mayuko; Stone, Patricia W.; Schmitt, Susan K.; Phibbs, Ciaran S.

2015-01-01

Objective To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). Data Sources A six-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). Study Design A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Principal Findings Average nursing hours per resident day was 4.59 hours (sd = 1.21). RN tenure averaged 4.7 years (sd = 1.64) and 4.2 years for both LPN (sd= 1.84) and NA (sd= 1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (IRR= 0.962 p<0.01) and 2% (IRR=0.98 p<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Conclusions Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce. PMID:25634087

A critical review of the nursing shortage in Malaysia.

PubMed

Barnett, T; Namasivayam, P; Narudin, D A A

2010-03-01

This paper describes and critically reviews steps taken to address the nursing workforce shortage in Malaysia. To address the shortage and to build health care capacity, Malaysia has more than doubled its nursing workforce over the past decade, primarily through an increase in the domestic supply of new graduates. Government reports, policy documents and ministerial statements were sourced from the Ministry of Health Malaysia website and reviewed and analysed in the context of the scholarly literature published about the health care workforce in Malaysia and more generally about the global nursing shortage. An escalation in student numbers and the unprecedented number of new graduates entering the workforce has been associated with other impacts that have been responded to symptomatically rather than through workplace reform. Whilst growing the domestic supply of nurses is a critical key strategy to address workforce shortages, steps should also be taken to address structural and other problems of the workplace to support both new graduates and the retention of more experienced staff. Nursing shortages should not be tackled by increasing the supply of new graduates alone. The creation of a safe and supportive work environment is important to the long-term success of current measures taken to grow the workforce and retain nurses within the Malaysian health care system.

Nurse workforce characteristics and infection risk in VA Community Living Centers: a longitudinal analysis.

PubMed

Uchida-Nakakoji, Mayuko; Stone, Patricia W; Schmitt, Susan K; Phibbs, Ciaran S

2015-03-01

To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). A 6-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix, and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Average nursing hours per resident day was 4.59 hours (SD=1.21). RN tenure averaged 4.7 years (SD=1.64) and 4.2 years for both LPN (SD=1.84) and NA (SD=1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (incident rate ratio [IRR]=0.962, P<0.01) and 2% (IRR=0.98, P<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce.

Casualisation of the nursing workforce in Australia: driving forces and implications.

PubMed

Creegan, Reta; Duffield, Christine; Forrester, Kim

2003-01-01

This article provides an overview of the extent of casualisation of the nursing workforce in Australia, focusing on the impact for those managing the system. The implications for nurse managers in particular are considerable in an industry where service demand is difficult to control and where individual nurses are thought to be increasingly choosing to work casually. While little is known of the reasons behind nurses exercising their preference for casual work arrangements, some reasons postulated include visa status (overseas trained nurses on holiday/working visas); permanent employees taking on additional shifts to increase their income levels; and those who elect to work under casual contracts for lifestyle reasons. Unknown is the demography of the casual nursing workforce, how these groups are distributed within the workforce, and how many contracts of employment they have across the health service--either through privately managed nursing agencies or hospital managed casual pools. A more detailed knowledge of the forces driving the decisions of this group is essential if health care organisations are to equip themselves to manage this changing workforce and maintain a standard of patient care that is acceptable to the community.

The changing nature of nursing work in rural and small community hospitals.

PubMed

Montour, Amy; Baumann, Andrea; Blythe, Jennifer; Hunsberger, Mabel

2009-01-01

The nursing literature includes descriptions of rural nursing workforces in Canada, the United States of America and Australia. However, inconsistent definitions of rural demography, diverse employment conditions and health care system reorganization make comparisons of these data difficult. In 2007, the Ministry of Health and Long-term Care in Ontario, Canada, transferred responsibility for decision-making and funding to 14 regional governing bodies known as Local Health Integration Networks (LHINs). Little is known about rural-urban variations in the nursing workforces in the LHINs because existing data repositories do not describe them. This study investigated the influence of demographic characteristics, provincial policies, organizational changes and emerging practice challenges on nursing work in a geographically unique rural region. The purpose was to describe the nature of nursing work from the perspective of rural nurse executives and frontline nurses. The study was conducted in 7 small rural and community hospitals in the Hamilton Niagara Haldimand Brant LHIN. Data collection occurred between August and November 2007. A qualitative descriptive study design was chosen to facilitate exploration of nursing in the rural setting. Study participants were identified through purposive snowball sampling. All nurses, nurse managers and nurse executives currently employed in the 7 study hospitals were eligible to participate. Data collection included the use of questionnaires and semi-structured interviews. Memos were also created to describe the relevance and applicability of concepts, categories and properties emerging from the data. Themes were compared across interviews to determine relevance and value. Twenty-one nurses from 7 different hospitals participated. The nurses reflect the aging trend in the provincial and regional workforces of Ontario. All study participants anticipate a substantial increase in retirements during the next decade, which will alter the structure and capacity of the rural workforce. Rural nursing practice is generalist in nature, requiring personal flexibility and a broad knowledge base. The nurses in the study preferred this type of practice. However, they felt that new nurses have different values and goals and are more likely to choose the specialized practice opportunities available in urban tertiary centres. Structural changes to the health system influenced relationships between hospitals and altered the internal organization of individual hospitals. Nurse executives were positive about new opportunities for cost savings, sharing best practices and continuing education. Yet they also felt that organizational changes significantly increased their administrative responsibilities and limited their opportunities for communication with frontline nurses. The nurses thought that the changing organizational structures increased opportunities to seek multiple employers to augment the lack of full-time positions in the region. Many reported that part-time and casual nurses often seek employment in other hospitals and long-term care homes to supplement their income. However, multi-site employment within and across healthcare organizations contributes to scheduling issues because casual nurses are unavailable to fill vacant shifts. Patient transports, the implementation of e-technology and emerging disease patterns in the patient population were identified as additional practice challenges. This study has implications for health human resource planning in rural and small community hospitals. The findings indicate that demographic trends pose an immediate threat to the sustainability of the nursing workforce in the rural setting. Many nurses are nearing retirement, but the lack of opportunities for full-time positions as well as specialized and expanded nursing practice are attracting younger nurses to urban centres. Government policies focussing on the retention of clinical expertise, the recruitment of new graduates and expanding the role of registered practical nurses have been more difficult to implement in the rural setting. Implications for future research include the need to address data gaps to facilitate workforce planning and to evaluate the effectiveness of provincial recruitment and retention strategies in the rural context.

Drivers for renewal and reform of contemporary nursing curricula: a blueprint for change.

PubMed

Waters, Cheryl Denise; Rochester, Suzanne Freda; McMillan, Margaret Anna

2012-06-01

The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education.

A Phenomenological Study of Nurse Administrators: Leading the Multigenerational Workforce of Registered Nurses

ERIC Educational Resources Information Center

Desir, Johanna E.

2017-01-01

Nurse shortages and nurse turnover are major issues in the health care industry. As 4 generations of nurses are working side-by-side for the first time in history in the health care industry, nurse leaders need to understand the generational differences in order to bridge the gap on retaining the nurses in the workforce. The primary focus of this…

Research lessons from implementing a national nursing workforce study.

PubMed

Brzostek, T; Brzyski, P; Kózka, M; Squires, A; Przewoźniak, L; Cisek, M; Gajda, K; Gabryś, T; Ogarek, M

2015-09-01

National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may find the insights provided by this paper useful to guide national level nursing workforce study implementation. © 2015 International Council of Nurses.

A model of succession planning for mental health nurse practitioners.

PubMed

Hampel, Sally; Procter, Nicholas; Deuter, Kate

2010-08-01

This paper reviews current literature on succession planning for mental health nurse practitioners (NPs) and discusses a model of succession planning that is underpinned by principals of leadership development, workforce participation and client engagement. The paper identifies succession planning as a means of managing a present and future workforce, while simultaneously addressing individual and organizational learning and practice development needs. A discussion of the processes attendant upon sustainable succession planning - collegial support, career planning and development, information exchange, capacity building, and mentoring is framed within the potential interrelationships between existing NP, developing NP and service directors and/or team managers. Done effectively and in partnership with wider clinical services, succession planning has the potential to build NP leadership development and leadership transition more broadly within mental health services.

Optimizing nursing human resource planning in British Columbia.

PubMed

Lavieri, Mariel S; Puterman, Martin L

2009-06-01

This paper describes a linear programming hierarchical planning model that determines the optimal number of nurses to train, promote to management and recruit over a 20 year planning horizon to achieve specified workforce levels. Age dynamics and attrition rates of the nursing workforce are key model components. The model was developed to help policy makers plan a sustainable nursing workforce for British Columbia, Canada. An easy to use interface and considerable flexibility makes it ideal for scenario and "What-If?" analyses.

Establishing Policy Foundations and Regulatory Systems to Enhance Nursing Practice in the United Arab Emirates.

PubMed

Brownie, Sharon M; Hunter, Lyndal H; Aqtash, Salah; Day, Gary E

2015-01-01

In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care-particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. © The Author(s) 2015.

Establishing Policy Foundations and Regulatory Systems to Enhance Nursing Practice in the United Arab Emirates

PubMed Central

Hunter, Lyndal H.; Aqtash, Salah; Day, Gary E.

2015-01-01

In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care—particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. PMID:25944674

Baby boomer doctors and nurses: demographic change and transitions to retirement.

PubMed

Schofield, Deborah J; Beard, John R

2005-07-18

To examine the effect of demographic change on employment patterns for general practitioners, medical specialists and nurses since 1986, and to compare their patterns of retirement. Secondary analysis of previously unpublished Australian Bureau of Statistics Census data for the years 1986, 1991, 1996 and 2001. Age distribution of GPs, specialists and nursing workforce; attrition rates as GPs, specialists and nurses left the workforce; and hours worked according to age group. The age profile of the GP, specialist and nursing workforce has aged since 1986 (P < 0.001), with the "baby boomer" generation making up more than half the workforce in 2001. A large proportion of GPs continued to work beyond the traditional retirement age of 65 years, with nurses retiring at a younger age than doctors (P < 0.001). All GP cohorts worked fewer hours in 2001 than they did in 1986 (P < 0.001), with "generation X" GPs working fewer hours than the baby boomers did at the same age (P < 0.001). Attrition of baby boomer clinicians will place unprecedented pressure on the medical workforce, and policy makers face a critical challenge to ensure workforce needs are met over the next 20 years. Policies and incentives to encourage ongoing employment among older clinicians, albeit at reduced hours, are crucial if the Australian health workforce is to be adequate to meet the growing community demand of the 21st century.

Night and day in the VA: associations between night shift staffing, nurse workforce characteristics, and length of stay.

PubMed

de Cordova, Pamela B; Phibbs, Ciaran S; Schmitt, Susan K; Stone, Patricia W

2014-04-01

In hospitals, nurses provide patient care around the clock, but the impact of night staff characteristics on patient outcomes is not well understood. The aim of this study was to examine the association between night nurse staffing and workforce characteristics and the length of stay (LOS) in 138 veterans affairs (VA) hospitals using panel data from 2002 through 2006. Staffing in hours per patient day was higher during the day than at night. The day nurse workforce had more educational preparation than the night workforce. Nurses' years of experience at the unit, facility, and VA level were greater at night. In multivariable analyses controlling for confounding variables, higher night staffing and a higher skill mix were associated with reduced LOS. © 2014 Wiley Periodicals, Inc.

Lecturers and students as stakeholders for education commissioning for learning disability nursing: focus group findings from a multiple method study.

PubMed

Gates, Bob; Statham, Mark

2013-10-01

In England, the numbers of learning disability nurses are declining; a need for urgent attention to workforce planning issues has been advocated. This paper considers views of lecturers, students and potential students as legitimate stakeholders for future education commissioning for this field of nursing. This project aimed to undertake a strategic review of learning disability nursing educational commissioning, to provide an 'evidence based' evaluation to inform future strategic commissioning of learning disability nursing for one Health Authority, UK. The project adopted a structured multiple methods approach to generate evidence from a number of data sources, this paper reports on the findings from one method [focus groups] used for two groups of stakeholders. Informants comprised 10 learning disability nursing students studying at a Higher Education Institution, 25 health and social care students studying at a Further Education College, and 6 academic staff from 5 universities; all informants were from the south of England. The method reported on in this paper is focus group methodology. Once completed, transcripts made were read in full, and subjected to content analysis. The process of content analysis led to the development of 11 theoretical categories that describe the multiplicity of views of informants, as to issues of importance for this element of the health workforce. The paper concludes by identifying key messages from these informants. It is suggested that both method and findings have national and international resonance, as stakeholder engagement is a universal issue in health care education commissioning. Copyright © 2013 Elsevier Ltd. All rights reserved.

Attracting and maintaining the Y Generation in nursing: a literature review.

PubMed

Hutchinson, Dianne; Brown, Janie; Longworth, Karen

2012-05-01

This paper explores the literature related to attracting the Y Generation (Y Gen: people born between 1980 and 2000) to the nursing profession and retaining them in our current workforce. A comprehensive review of the literature supported the need for further research. Three searches were conducted and all relevant literature was reviewed by each researcher. Literature included in the review was chosen based on specific search-term inclusion. Structured searches were conducted with no limitations on publication type, date or language. Search engines used included: Australian Family and Society, CINAHL, Expanded Academic, Google Scholar, Medline, ProQuest and PubMed. A critical review of the literature, particularly empirical work on the subject has informed decision making regarding the research questions that remain to be explored. The literature revealed that the Y Gen is currently contributing to the nursing workforce demographics. Much discussion exists surrounding the integration of the Y Gen into the workplace along with the other three generations of nurses. There is also an abundance of descriptions of the Y Gen characteristics and values. There is, however, limited reference relating to what attracted this generation to nursing or what might retain them in the nursing workforce. The Y Gen is the largest generation to enter our workforce since the Baby Boomers. Health services need to recognize the needs of the Y Gen nurses and develop strategies to move the profession forward by preparing the current workforce and environment for a generation that is already here. The focus should be on their strengths with development made to structure a workforce that will support the Y Gen in their professional nursing role. Understanding what attracts the Y Gen to nursing, what managers can do to retain the Y Gen in nursing and how the nursing profession can support the Y Gen to assume a role in nursing and nursing governance will ensure that the retiring generation has left the nursing profession in capable hands. © 2011 Blackwell Publishing Ltd.

Retaining the mental health nursing workforce: early indicators of retention and attrition.

PubMed

Robinson, Sarah; Murrells, Trevor; Smith, Elizabeth M

2005-12-01

In the UK, strategies to improve retention of the mental health workforce feature prominently in health policy. This paper reports on a longitudinal national study into the careers of mental health nurses in the UK. The findings reveal little attrition during the first 6 months after qualification. Investigation of career experiences showed that the main sources of job satisfaction were caregiving opportunities and supportive working relationships. The main sources of dissatisfaction were pay in relation to responsibility, paperwork, continuing education opportunities, and career guidance. Participants were asked whether they predicted being in nursing in the future. Gender and ethnicity were related to likelihood to remain in nursing in 5 years time. Age, having children, educational background, ethnic background, and time in first job were associated with likelihood of remaining in nursing at 10 years. Associations between elements of job satisfaction (quality of clinical supervision, ratio of qualified to unqualified staff, support from immediate line manager, and paperwork) and anticipated retention are complex and there are likely to be interaction effects because of the complexity of the issues. Sustaining positive experiences, remedying sources of dissatisfaction, and supporting diplomats from all backgrounds should be central to the development of retention strategies.

National Advisory Council on Nurse Education and Practice Report to the Secretary of the Department of Health and Human Services on the Basic Registered Nurse Workforce.

ERIC Educational Resources Information Center

National Advisory Council on Nurse Education and Practice, Rockville, MD.

The National Advisory Council on Nurse Education and Practice (NACNEP) initiated an examination of basic registered nurse workforce issues in December 1994. NACNEP took into account the environment in which registered nurses (RNs) would practice, the appropriate educational qualifications needed, and the status of the registered nurse population…

Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals.

PubMed

van Oostveen, Catharina J; Ubbink, Dirk T; Mens, Marian A; Pompe, Edwin A; Vermeulen, Hester

2016-03-01

To investigate the reliability, validity and feasibility of the RAFAELA workforce planning system (including the Oulu patient classification system - OPCq), before deciding on implementation in Dutch hospitals. The complexity of care, budgetary restraints and demand for high-quality patient care have ignited the need for transparent hospital workforce planning. Nurses from 12 wards of two university hospitals were trained to test the reliability of the OPCq by investigating the absolute agreement of nursing care intensity (NCI) measurements among nurses. Validity was tested by assessing whether optimal NCI/nurse ratio, as calculated by a regression analysis in RAFAELA, was realistic. System feasibility was investigated through a questionnaire among all nurses involved. Almost 67 000 NCI measurements were performed between December 2013 and June 2014. Agreement using the OPCq varied between 38% and 91%. For only 1 in 12 wards was the optimal NCI area calculated judged as valid. Although the majority of respondents was positive about the applicability and user-friendliness, RAFAELA was not accepted as useful workforce planning system. Nurses' performance using the RAFAELA system did not warrant its implementation. Hospital managers should first focus on enlarging the readiness of nurses regarding the implementation of a workforce planning system. © 2015 John Wiley & Sons Ltd.

Globalisation, localisation and implications of a transforming nursing workforce in New Zealand: opportunities and challenges.

PubMed

Callister, Paul; Badkar, Juthika; Didham, Robert

2011-09-01

Severe staff and skill shortages within the health systems of developed countries have contributed to increased migration by health professionals. New Zealand stands out among countries in the Organisation for Economic Co-operation and Development in terms of the high level of movements in and out of the country of skilled professionals, including nurses. In New Zealand, much attention has been given to increasing the number of Māori and Pacific nurses as one mechanism for improving Māori and Pacific health. Against a backdrop of the changing characteristics of the New Zealand nursing workforce, this study demonstrates that the globalisation of the nursing workforce is increasing at a faster rate than its localisation (as measured by the growth of the Māori and New Zealand-born Pacific workforces in New Zealand). This challenges the implementation of culturally appropriate nursing programmes based on the matching of nurse and client ethnicities. © 2011 Blackwell Publishing Ltd.

The productivity of physician assistants and nurse practitioners and health work force policy in the era of managed health care.

PubMed

Scheffler, R M; Waitzman, N J; Hillman, J M

1996-01-01

Managed care is spreading rapidly in the United States and creating incentives for physician practices to find the most efficient combination of health professionals to deliver care to an enrolled population. Given these trends, it is appropriate to reexamine the roles of physician assistants (PAs) and nurse practitioners (NPs) in the health care workforce. This paper briefly reviews the literature on PA and NP productivity, managed care plans' use of PAs and NPs, and the potential impact of PAs and NPs on the size and composition of the future physician workforce. In general, the literature supports the idea that PAs and NPs could have a major impact on the future health care workforce. Studies show significant opportunities for increased physician substitution and even conservative assumptions about physician task delegation imply a large increase in the number of PAs and NPs that can be effectively deployed. However, the current literature has certain limitations that make it difficult to quantify the future impact of PAs and NPs. Among these limitations is the fact that virtually all formal productivity studies were conducted in fee-for-service settings during the 1970s, rather than managed care settings. In addition, the vast majority of PA and NP productivity studies have viewed PAs and NPs as physician substitutes rather than as members of interdisciplinary health care teams, which may become the dominant health care delivery model over the next 10-20 years.

International nurse migration: lessons from the Philippines.

PubMed

Brush, Barbara L; Sochalski, Julie

2007-02-01

Developed countries facing nursing shortages have increasingly turned to aggressive foreign nurse recruitment, primarily from developing nations, to offset their lagging domestic nurse supplies and meet growing health care demands. Few donor nations are prepared to manage the loss of their nurse workforce to migration. The sole country with an explicit nurse export policy and the world's leading donor of nurse labor - the Philippines - is itself facing serious provider maldistribution and countrywide health disparities. Examining the historical roots of Philippines nurse migration provides lessons from which other nurse exporting countries may learn. The authors discuss factors that have predicated nurse migration and policies that have eased the way. Furthermore, the authors analyze how various stakeholders influence migratory patterns, the implications of migration for nurses and the public in their care, and the challenges that future social policy and political systems face in addressing global health issues engendered by unfettered recruitment of nurses and other health workers.

Evaluation of a community transition to professional practice program for graduate registered nurses in Australia.

PubMed

Aggar, Christina; Gordon, Christopher J; Thomas, Tamsin H T; Wadsworth, Linda; Bloomfield, Jacqueline

2018-03-26

Australia has an increasing demand for a sustainable primary health care registered nursing workforce. Targeting graduate registered nurses who typically begin their nursing career in acute-care hospital settings is a potential workforce development strategy. We evaluated a graduate registered nurse Community Transition to Professional Practice Program which was designed specifically to develop and foster skills required for primary health care. The aims of this study were to evaluate graduates' intention to remain in the primary health care nursing workforce, and graduate competency, confidence and experiences of program support; these were compared with graduates undertaking the conventional acute-care transition program. Preceptor ratings of graduate competence were also measured. All of the 25 graduates (n = 12 community, n = 13 acute-care) who completed the questionnaire at 6 and 12 months intended to remain in nursing, and 55% (n = 6) of graduates in the Community Transition Program intended to remain in the primary health care nursing workforce. There were no differences in graduate experiences, including level of competence, or preceptors' perceptions of graduate competence, between acute-care and Community Transition Programs. The Community Transition to Professional Practice program represents a substantial step towards developing the primary health care health workforce by facilitating graduate nurse employment in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

Retaining older experienced nurses in the Northern Territory of Australia: a qualitative study exploring opportunities for post-retirement contributions.

PubMed

Voit, K; Carson, D B

2012-01-01

Many countries are facing an ageing of the nursing workforce and increasing workforce shortages. This trend is due to members of the 'baby boomer' generation leaving the workforce for retirement and a declining pool of younger people entering the nursing profession. New approaches to engaging older nurses in the workforce are becoming common in nursing globally but have yet to be adapted to remote contexts such as the Northern Territory (NT) of Australia. This article reports findings from a qualitative study of 15 participants who explored perceived opportunities for and barriers to implementing flexible strategies to engage older nurses in the NT workforce after they resign from full-time work. The study used a descriptive qualitative design. Data were collected using semi-structured interviews with NT nurses approaching retirement (six nurses aged 50 years and over) and their managers (n=9). Clinicians were employed in practice settings that included hospitals, community health and 'Top End' (north of and including the town of Katherine), as well as Central Australian remote area communities. One participant who was employed as primary health centre manager in a remote community also held a clinical role. Managers were employed in both senior and line management positions in community and remote health as well as NT hospitals. Three major themes emerged from the data. First, interview participants identified potential for flexible post-retirement engagement of older nurses and a range of concrete engagement opportunities 'on and off the floor' were identified. Second, the main barriers to post-retirement engagement were an existing focus on the recruitment of younger Australian and overseas-trained nurses, and the remoteness of nursing practice settings from the residential locations of retired nurses. Third, existing informal system of post-retirement working arrangements, characterized by ad hoc agreements between individual nurses and managers, is poorly suited to scaling up. A knowledge and change-management approach is required to change employers' views of the value of older nurses. Better engagement of those nurses may assist the NT Department of Health address the severe nursing workforce shortages and prevent the loss of significant remote area nursing knowledge.

Hospital Nursing Workforce Costs, Wages, Occupational Mix,and Resource Utilization.

PubMed

Welton, John M

2015-10-01

The objective of the study was to better understand how hospitals use different types of RNs, LPNs, and nurse aides in proprietary (for-profit), nonprofit, and government-owned hospitals and to estimate the wages, cost, and intensity of nursing care using a national data set. This is a cross-sectional observational study of 3,129 acute care hospitals in all 50 states and District of Columbia using data from the 2008 Occupational Mix Survey administered by the Centers for Medicare &Medicaid Services (CMS). Nursing skill mix, hours, and labor costs were combined with other CMS hospital descriptive data, including type of hospital ownership, urban or rural location, hospital beds, and case-mix index. RN labor costs make up 25.5% of all hospital expenditures annually, and all nursing labor costs represent 30.1%, which is nearly a quarter trillion dollars ($216.7 billion) per year for inpatient nursing care. On average, proprietary hospitals employ 1.3 RNs per bed and 1.9 nursing personnel per bed in urban hospitals compared with 1.7 RNs per bed and 2.3 nursing personnel per bed for nonprofit and government-owned hospitals (P G .05). States with higher ratios of RN compared with LPN licenses used fewer LPNs in the inpatient setting. The findings from this study can be helpful in comparing nursing care across different types of hospitals, ownership, and geographic locations and used as a benchmark for future nursing workforce needs and costs.

[Application of an improved model of a job-matching platform for nurses].

PubMed

Huang, Way-Ren; Lin, Chiou-Fen

2015-04-01

The three-month attrition rate for new nurses in Taiwan remains high. Many hospitals rely on traditional recruitment methods to find new nurses, yet it appears that their efficacy is less than ideal. To effectively solve this manpower shortage, a nursing resource platform is a project worth developing in the future. This study aimed to utilize a quality-improvement model to establish communication between hospitals and nursing students and create a customized employee-employer information-matching platform to help nursing students enter the workforce. This study was structured around a quality-improvement model and used current situation analysis, literature review, focus-group discussions, and process re-engineering to formulate necessary content for a job-matching platform for nursing. The concept of an academia-industry strategic alliance helped connect supply and demand within the same supply chain. The nurse job-matching platform created in this study provided job flexibility as well as job suitability assessments and continued follow-up and services for nurses after entering the workforce to provide more accurate matching of employers and employees. The academia-industry strategic alliance, job suitability, and long-term follow-up designed in this study are all new features in Taiwan's human resource service systems. The proposed human resource process re-engineering provides nursing students facing graduation with a professionally managed human resources platform. Allowing students to find an appropriate job prior to graduation will improve willingness to work and employee retention.

Hospital nursing workforce costs, wages, occupational mix, and resource utilization.

PubMed

Welton, John M

2011-01-01

: The objective of the study was to better understand how hospitals use different types of RNs, LPNs, and nurse aides in proprietary (for-profit), nonprofit, and government-owned hospitals and to estimate the wages, cost, and intensity of nursing care using a national data set. : This is a cross-sectional observational study of 3,129 acute care hospitals in all 50 states and District of Columbia using data from the 2008 Occupational Mix Survey administered by the Centers for Medicare & Medicaid Services (CMS). Nursing skill mix, hours, and labor costs were combined with other CMS hospital descriptive data, including type of hospital ownership, urban or rural location, hospital beds, and case-mix index. : RN labor costs make up 25.5% of all hospital expenditures annually, and all nursing labor costs represent 30.1%, which is nearly a quarter trillion dollars ($216.7 billion) per year for inpatient nursing care. On average, proprietary hospitals employ 1.3 RNs per bed and 1.9 nursing personnel per bed in urban hospitals compared with 1.7 RNs per bed and 2.3 nursing personnel per bed for nonprofit and government-owned hospitals (P < .05). States with higher ratios of RN compared with LPN licenses used fewer LPNs in the inpatient setting. : The findings from this study can be helpful in comparing nursing care across different types of hospitals, ownership, and geographic locations and used as a benchmark for future nursing workforce needs and costs.

Millennials Almost Twice As Likely To Be Registered Nurses As Baby Boomers Were.

PubMed

Auerbach, David I; Buerhaus, Peter I; Staiger, Douglas O

2017-10-01

Baby-boomer registered nurses (RNs), the largest segment of the RN workforce from 1981 to 2012, are now retiring. This would have led to nurse shortages but for the surprising embrace of the profession by millennials-who are entering the nurse workforce at nearly double the rate of the boomers. Still, the boomers' retirement will reduce growth in the size of the RN workforce to 1.3 percent per year for the period 2015-30. Project HOPE—The People-to-People Health Foundation, Inc.

Generational differences of the frontline nursing workforce in relation to job satisfaction: what does the literature reveal?

PubMed

Saber, Deborah A

2013-01-01

The job satisfaction of registered nurses has been found to be associated with retention, organizational commitment, workforce safety, and cost savings to health care organizations. Satisfaction of the workforce is vital because nursing turnover can be detrimental for a labor force that is growing older. However, the summation of the most important variables that are linked to job satisfaction has been difficult to discern in part because the workforce includes 3 main generations (ie, Baby Boomers, Gen Xers, and Millennials) with unique work values that drive their job satisfiers. This article provides a review of existing literature to examine the differences in variables that are linked to job satisfaction that exist between the generational cohorts. Differences in stress sources, need for work-life balance, and compensation are discussed. The knowledge about generationally driven variables that influence job satisfaction can help managers develop strategies to maintain a diverse nursing workforce.

Diffusion of a nursing education innovation: nursing workforce development through promotion of RN/BSN education.

PubMed

Diaz Swearingen, Connie; Clarke, Pamela N; Gatua, Mary Wairimu; Sumner, Christa Cooper

2013-01-01

Despite state, national, and organizational objectives to increase the proportion of nurses with a bachelor's degree or higher, a majority of nurses hold an associate's degree in nursing. To address the need for a better-prepared nursing workforce in this rural state, an RN/BSN recruitment and retention project was implemented. The authors discuss the Leadership Education to Advance Practice project and its outcomes.

Generational diversity: what nurse managers need to know.

PubMed

Hendricks, Joyce M; Cope, Vicki C

2013-03-01

This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion. © 2012 Blackwell Publishing Ltd.

Evaluation of a support worker role, within a nurse delegation and supervision model, for provision of medicines support for older people living at home: the Workforce Innovation for Safe and Effective (WISE) Medicines Care study.

PubMed

Lee, Cik Yin; Beanland, Christine; Goeman, Dianne; Johnson, Ann; Thorn, Juliet; Koch, Susan; Elliott, Rohan A

2015-10-06

Support with managing medicines at home is a common reason for older people to receive community nursing services. With population ageing and projected nurse shortages, reliance on nurses may not be sustainable. We developed and tested a new workforce model: 'Workforce Innovation for Safe and Effective (WISE) Medicines Care', which enabled nurses to delegate medicines support home visits for low-risk clients to support workers (known as community care aides [CCAs]). Primary study aims were to assess whether the model increased the number of medicines support home visits conducted by CCAs, explore nurses', CCAs' and consumers' experiences with the CCAs' expanded role, and identify enablers and barriers to delegation of medicines support. A prospective before-after mixed-methods study was conducted within a community nursing service that employed a small number of CCAs. The CCAs' main role prior to the WISE Medicines Care model was personal care, with a very limited role in medicines support. CCAs received training in medicines support, and nurses received training in assessment, delegation and supervision. Home visit data over two three-month periods were compared. Focus groups and interviews were conducted with purposive samples of nurses (n = 27), CCAs (n = 7) and consumers (n = 28). Medicines support visits by CCAs increased from 43/16,863 (0.25 %) to 714/21,552 (3.3 %) (p < 0.001). Nurses reported mostly positive experiences, and high levels of trust and confidence in CCAs. They reported that delegating to CCAs sometimes eliminated the need for duplicate nurse and CCA visits (for people requiring personal care plus medicines support) and enabled them to visit people with more complex needs. CCAs enjoyed their expanded role and were accepted by clients and/or carers. Nurses and CCAs reported effective communication when medicine-related problems occurred. No medication incidents involving CCAs were reported. Barriers to implementation included the limited number of CCAs employed in the organisation and reluctance from some nurses to delegate medicines support to CCAs. Enablers included training and support, existing relationships between CCAs and nurses, and positive staff attitudes. Appropriately trained and supervised support workers can be used to support community nurses with providing medicines management for older people in the home care setting, particularly for those who are at low risk of adverse medication events or errors. The model was acceptable to nurses, clients and carers, and may offer a sustainable and safe and effective future workforce solution to provision of medicines support for older people in the home care setting.

General practitioner workforce planning: assessment of four policy directions.

PubMed

Teljeur, Conor; Thomas, Stephen; O'Kelly, Fergus D; O'Dowd, Tom

2010-06-02

Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations but may provide a rapid and effective response. Increased nurse substitution appears to offer the best long-term prospects of addressing GP shortages and presents the opportunity to reshape general practice to meet the demands of the future.

Five generations in the nursing workforce: implications for nursing professional development.

PubMed

Bell, Julie A

2013-01-01

Positive patient outcomes require effective teamwork, communication, and technological literacy. These skills vary among the unprecedented five generations in the nursing workforce, spanning the "Silent Generation" nurses deferring retirement to the newest "iGeneration." Nursing professional development educators must understand generational differences; address communication, information technology, and team-building competencies across generations; and promote integration of learner-centered strategies into professional development activities.

Nurse Workforce Challenges in the United States: Implications for Policy. OECD Health Working Papers, No. 35

ERIC Educational Resources Information Center

Aiken, Linda H.; Cheung, Robyn

2008-01-01

The United States has the largest professional nurse workforce in the world numbering close to 3 million but does not produce enough nurses to meet its growing demand. A shortage of close to a million professional nurses is projected to evolve by 2020. An emerging physician shortage will further exacerbate the nurse shortage as the boundaries in…

Nurses supporting nurses: creating a mentoring program for staff nurses to improve the workforce environment.

PubMed

Latham, Christine L; Hogan, Mikel; Ringl, Karen

2008-01-01

The hospital workforce environment has been recognized as an important factor for nurse retention and patient safety, yet there is ongoing evidence that inadequate communication, intraprofessional oppression, and lack of collaboration and conflict resolution continue to disempower nurses and hinder improvement of workforce conditions. A 3-year academic-hospital partnership developed and used a registered nurse (RN) mentor and advocacy program to improve the RN work environment and selected patient outcomes. The partnership initiated mentor-mentee teams and a Workforce Environment Governance Board, and obtained preliminary data on outcomes related to mentor-mentee teamwork, changes in the level of support within each unit, and the impact of improved working conditions on nurse and patient satisfaction, nurse vacancy and turnover rates, and 3 patient safety outcomes related to fall and pressure ulcer prevention and use of restraints. Dedicated mentors not only engaged in supporting fellow nurses but also assisted with enhancing the overall work environment for RNs. The partnership enhanced mutual respect between frontline RNs and managers, and allowed frontline RNs to improve the culture of support. The comprehensive approach to incorporating mentor-mentee teams changes the way fellow nurses and others perceive nurses, augments support by managers and coworkers, and improves patient care outcomes.

Implementing graduate entry registration for nursing in England: a scope review.

PubMed

DeBell, Diane; Branson, Kathy

2009-07-01

A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

Evaluation of a nurse leadership development programme.

PubMed

West, Margaret; Smithgall, Lisa; Rosler, Greta; Winn, Erin

2016-03-01

The challenge for nursing leaders responsible for workforce planning is to predict the knowledge, skills and abilities required to lead future healthcare delivery systems effectively. Succession planning requires a constant, competitive pool of qualified nursing leader candidates, and retention of those interested in career growth. Formal nursing leadership education in the United States is available through graduate education and professional nursing organisation programmes, such as the Emerging Nurse Leader Institute of the American Organization of Nurse Executives. However, there is also a need for local development programmes tailored to the needs of individual organisations. Leaders at Geisinger Health System, one of the largest rural health systems in the US, identified the need for an internal professional development scheme for nurses. In 2013 the Nurses Emerging as Leaders programme was developed to prepare nurse leaders for effective leadership and successful role transition. This article describes the programme and an evaluation of its effectiveness.

The aging nursing workforce: How to retain experienced nurses.

PubMed

Cohen, Jeremye D

2006-01-01

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.

Internationally educated nurses: profiling workforce diversity.

PubMed

Blythe, Jennifer; Baumann, Andrea

2009-06-01

Nurses with diverse educational and cultural backgrounds are likely to adapt differently to new workforces. The aim of this study was to provide a profile of nurses educated in different countries who are employed in a major settlement jurisdiction. Despite difficulties in measuring its magnitude, it is evident that nurse migration has increased as a result of globalization. Major destinations for internationally educated nurses (IENs) include the USA, Canada, the UK, Australia and the Gulf States. Chief donor countries include the Philippines, India and other South Asian countries. Half of all IENs registered in Canada work in the province of Ontario. Published literature and secondary data were used to profile cohorts of nurses educated in different countries who are employed in the Ontario workforce. Statistics available on IENs in Ontario reveal a largely urban settlement pattern. There are major differences among IEN cohorts in terms of age, gender, work status, and type and place of employment. Although IENs resident in Ontario could not be quantified, a relatively detailed description of IENs in the workforce was possible. Comparison of nurse cohorts indicated that generalizations about IENs should be made with caution. Changes in regulatory conditions have a significant effect on IEN employment. Difficulties associated with international educational and regulatory differences illustrate the need to create global nursing standards. Further investigation of differences in workforce profiles should provide insights leading to improved utilization of IENs.

How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce

PubMed Central

2014-01-01

Background Australia’s health workforce is facing significant challenges now and into the future. Health Workforce Australia (HWA) was established by the Council of Australian Governments as the national agency to progress health workforce reform to address the challenges of providing a skilled, innovative and flexible health workforce in Australia. HWA developed Australia’s first major, long-term national workforce projections for doctors, nurses and midwives over a planning horizon to 2025 (called Health Workforce 2025; HW 2025), which provided a national platform for developing policies to help ensure Australia’s health workforce meets the community’s needs. Methods A review of existing workforce planning methodologies, in concert with the project brief and an examination of data availability, identified that the best fit-for-purpose workforce planning methodology was the stock and flow model for estimating workforce supply and the utilisation method for estimating workforce demand. Scenario modelling was conducted to explore the implications of possible alternative futures, and to demonstrate the sensitivity of the model to various input parameters. Extensive consultation was conducted to test the methodology, data and assumptions used, and also influenced the scenarios selected for modelling. Additionally, a number of other key principles were adopted in developing HW 2025 to ensure the workforce projections were robust and able to be applied nationally. Results The findings from HW 2025 highlighted that a ‘business as usual’ approach to Australia’s health workforce is not sustainable over the next 10 years, with a need for co-ordinated, long-term reforms by government, professions and the higher education and training sector for a sustainable and affordable health workforce. The main policy levers identified to achieve change were innovation and reform, immigration, training capacity and efficiency and workforce distribution. Conclusion While HW 2025 has provided a national platform for health workforce policy development, it is not a one-off project. It is an ongoing process where HWA will continue to develop and improve health workforce projections incorporating data and methodology improvements to support incremental health workforce changes. PMID:24490586

How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce.

PubMed

Crettenden, Ian F; McCarty, Maureen V; Fenech, Bethany J; Heywood, Troy; Taitz, Michelle C; Tudman, Sam

2014-02-03

Australia's health workforce is facing significant challenges now and into the future. Health Workforce Australia (HWA) was established by the Council of Australian Governments as the national agency to progress health workforce reform to address the challenges of providing a skilled, innovative and flexible health workforce in Australia. HWA developed Australia's first major, long-term national workforce projections for doctors, nurses and midwives over a planning horizon to 2025 (called Health Workforce 2025; HW 2025), which provided a national platform for developing policies to help ensure Australia's health workforce meets the community's needs. A review of existing workforce planning methodologies, in concert with the project brief and an examination of data availability, identified that the best fit-for-purpose workforce planning methodology was the stock and flow model for estimating workforce supply and the utilisation method for estimating workforce demand. Scenario modelling was conducted to explore the implications of possible alternative futures, and to demonstrate the sensitivity of the model to various input parameters. Extensive consultation was conducted to test the methodology, data and assumptions used, and also influenced the scenarios selected for modelling. Additionally, a number of other key principles were adopted in developing HW 2025 to ensure the workforce projections were robust and able to be applied nationally. The findings from HW 2025 highlighted that a 'business as usual' approach to Australia's health workforce is not sustainable over the next 10 years, with a need for co-ordinated, long-term reforms by government, professions and the higher education and training sector for a sustainable and affordable health workforce. The main policy levers identified to achieve change were innovation and reform, immigration, training capacity and efficiency and workforce distribution. While HW 2025 has provided a national platform for health workforce policy development, it is not a one-off project. It is an ongoing process where HWA will continue to develop and improve health workforce projections incorporating data and methodology improvements to support incremental health workforce changes.

A nursing career lattice pilot program to promote racial/ethnic diversity in the nursing workforce.

PubMed

Sporing, Eileen; Avalon, Earlene; Brostoff, Marcie

2012-03-01

The nursing career lattice program (NCLP) at Children's Hospital Boston has provided employees with social, educational, and financial assistance as they begin or advance their nursing careers. At the conclusion of a pilot phase, 35% of employees in the NCLP were enrolled in nursing school and 15% completed nursing school. The NCLP exemplifies how a workforce diversity initiative can lead to outcomes that support and sustain a culture rich in diversity and perpetuate excellence in nursing in one organization.

Hospital nurse staffing and public health emergency preparedness: implications for policy.

PubMed

McHugh, Matthew D

2010-01-01

Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation's emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage.

Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy

PubMed Central

McHugh, Matthew D.

2010-01-01

Hospital restructuring policies and an impending nursing workforce shortage have threatened the nation’s emergency preparedness. Current emergency response plans rely on sources of nurses that are limited and overestimated. A national investment in nursing education and workforce infrastructure, as well as incentives for hospitals to efficiently maximize nurse staffing, are needed to ensure emergency preparedness in the United States. This review highlights the challenges of maintaining hospital nursing surge capacity and policy implications of a nursing shortage. PMID:20840714

International nurse migration: U-turn for safe workplace transition.

PubMed

Tregunno, Deborah; Peters, Suzanne; Campbell, Heather; Gordon, Sandra

2009-09-01

Increasing globalization of the nursing workforce and the desire for migrants to realize their full potential in their host country is an important public policy and management issue. Several studies have examined the challenges migrant nurses face as they seek licensure and access to international work. However, fewer studies examine the barriers and challenges internationally educated nurses (IEN) experience transitioning into the workforces after they achieve initial registration in their adopted country. In this article, the authors report findings from an empirically grounded study that examines the experience of IENs who entered Ontario's workforce between 2003 and 2005. We found that migrant nurses unanimously described nursing as 'different' from that in their country of origin. Specifically, IENs reported differences in the expectations of professional nursing practice and the role of patients and families in decision-making. In addition, problems with English language fluency cause work-related stress and cognitive fatigue. Finally, the experience of being the outsider is a reality for many IENs. This study provides important insights as policy and management decision-makers balance the tension between increasing the IEN workforce and the delivery of safe patient care.

Workplace practices with mental health implications impacting on recruitment and retention of overseas nurses in the context of nursing shortages.

PubMed

Omeri, Akram

2006-01-01

In response to nursing workforce shortages, health agencies in Australia and elsewhere have sought to meet the demand for nursing services by recruiting nurses internationally. While there is a major focus on recruitment, little attention is given to factors that could enhance retention of overseas qualified nurses. There are a host of factors reported in the literature that impact upon retention of overseas nurses in the workforce, including: impact of re-settlement experiences in the new country; discriminatory practices in accessing employment and negative experiences in the work place. For the benefit of long term retention of overseas nurse graduates in the workforce in Australia and globally, these experiences are major issues needing urgent attention. This discussion paper reviews the literature to explore the impact of aggression and discriminatory practices in nursing as evidence for nurses leaving the profession, and discusses the mental health implications and consequences of such practices relating to overseas nurse graduates.

Health sector reform and trends in the United Kingdom hospital workforce.

PubMed

Buchan, J; Hancock, C; Rafferty, A M

1997-10-01

The authors examine changing trends in the profile and patterns of employment of the workforce in hospitals in the National Health Service (NHS) in the United Kingdom. The effect of the implementation of the NHS reforms is considered, with particular reference to the changing composition of the nursing workforce. The authors note that there are problems with establishing trend data because of altered information requirements as a result of the NHS reforms. Analysis and review of data from secondary sources and research publications. Although hospital activity rates have grown, patient length of hospital stays decreased, and patient activity levels increased, there has not been a linked growth in the size of the nursing workforce. The main changes in the profile of the nursing workforce highlighted are a marked reduction in the numbers of nursing students and alterations in the skill mix between first- and second-level qualified nurses. The authors also note a large increase in the number of managerial and administrative staff employed and growth in medical staff numbers. Changes in working patterns and increases in contracting for support services and in the use of temporary staff also are discussed. There have been pronounced changes in the profile of the hospital workforce but little evaluation of the impact of these changes on outcomes of care.

Career transitions of inactive nurses: a registration database analysis (1993-2006).

PubMed

Alameddine, Mohamad; Baumann, Andrea; Onate, Kanecy; Deber, Raisa

2011-02-01

One important strategy to address nursing shortages is to tap into the pool of licensed nurses who are not currently working in nursing and induce them to return to the nursing labour market. However, there is a paucity of research examining their likelihood of return to the active labour market. Analyze the career transitions of nurses registered with the College of Nurses Ontario but not working in the province's nursing labour market to determine the proportion of these nurses rejoining the active nursing workforce and examine the variation by inactive sub-category and age group. Quantitative analysis of a linked longitudinal database for all those registered with the College of Nurses of Ontario for the years 1993-2006. Registration records of all 215,687 nurses registered at any time in those years were merged by their unique registration number. Each nurse was placed for each year into an employment category. Two groups of nurses were defined: active (registered, working in nursing in Ontario) and inactive (registered, not working in nursing in Ontario). Inactive nurses were then sub-categorized into five mutually exclusive sub-categories: 'not working and seeking nursing employment', 'working in non-nursing and seeking nursing employment', 'not working and not seeking nursing employment', 'working in non-nursing and not seeking nursing employment' and 'working outside Ontario'. One-year career movements of nurses were tracked by generating 13 year-to-year transition matrixes. In the short-term, inactive nurses seeking a nursing job had the highest average rate of return to the active workforce (27.3-30.8%), though they might become high risk of leaving the profession if they do not find employment in a timely manner. Inactive nurses not seeking nursing employment are a heterogeneous group, and include nurses on leave who are likely to subsequently rejoin the active workforce should appropriate opportunities arise. The proportion of nurses rejoining the active workforce decreased with age. Because 'inactive' nurses are a heterogeneous group, their optimal reintegration to the nursing workforce requires governments, professional associations and employers to work collaboratively to design targeted and timely recruitment strategies to avoid the permanent loss of skilled nursing resources. Copyright © 2010 Elsevier Ltd. All rights reserved.

The ALIVE program: developing a web-based professional development program for nursing leaders in the home healthcare sector.

PubMed

Lankshear, Sara; Huckstep, Sherri; Lefebre, Nancy; Leiterman, Janis; Simon, Deborah

2010-05-01

Home healthcare nurses often work in isolation and rarely have the opportunity to meet or congregate in one location. As a result, nurse leaders must possess unique leadership skills to supervise and manage a dispersed employee base from a distance. The nature of this dispersed workforce creates an additional challenge in the ability to identify future leaders, facilitate leadership capacity, and enhance skill development to prepare them for future leadership positions. The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery.

[Long-term care in Europe. Challenges and strategies in nursing staff management].

PubMed

Kuhlmann, E; Larsen, C

2013-08-01

Across Europe, long-term care (LTC) is one of the most challenging areas of social policy. Despite a growing awareness of the problems and improved data, current institutional reforms are an ineffective response to demographic change. This article aims to provide an overview of the challenges of future nursing and care staff in LTC in Europe, and to discuss the German case in a wider European context. We focus on the nursing workforce and on the link between current and prospective analyses on the demand and offer of LTC services and LTC professionals/nursing staff. We draw on a secondary analysis of the literature and public statistics, especially OECD data. The European comparison shows a high variation in the future demand for LTC. In Germany, a number of problematic trends create a negative scenario: the growing demand for LTC meets with a decrease in nursing staff on the supply side. We conclude by suggesting intervention strategies that may reduce this negative scenario.

Strategies to Produce New Nurses for a Changing Profession: A Policy Brief on Innovation in Nursing Education

ERIC Educational Resources Information Center

Klein-Collins, Rebecca

2011-01-01

For several years leading up to 2008, workforce data painted a picture of an imminent crisis in the healthcare workforce, with demand for registered nurses far exceeding supply. The economic recession has provided a temporary reprieve, as older nurses postponed retirement and hospitals instituted hiring freezes. However, economists believe that as…

Ageing of the baby boomer generation: how demographic change will impact on city and rural GP and nursing workforce.

PubMed

Schofield, D J; Page, S L; Lyle, D M; Walker, T J

2006-01-01

To compare the impact of ageing on the GP and nursing rural and city workforce. Cohort analysis of Australian Bureau of Statistics census data. The data was used to examine the age distribution of the city and rural GP and nursing workforce; patterns of attrition for those 50 years and over; and the impact of changes in working hours. The rural GP and nursing workforce is significantly older than their city counterparts (p<0.001) with the 'baby boomer' generation making up 52% of city GPs but 59% of rural GPs in 2001. While a large proportion of city and rural GPs continued to work past the age of 65 years, rural GPs left the workforce at a significantly younger age than city doctors (p<0.001). Rural nurses are older than their city peers (p<0.001) but retire at an older age than city nurses (p<0.001). In 1986, a significantly higher proportion of rural GPs in all age cohorts worked more than 41 hours per week compared with their city counterparts (p<0.001). By 2001, rural 'generation X' GPs were no more likely to work long hours than those in the city (p<0.001). However, significantly more rural than city 'baby boomers' continued to work long hours. Rural GPs are retiring faster than city GPs and strategies to attract rural GPs and nurses will be critical to ensure adequate rural health care and that current rural workforce shortage do not worsen.

The global summit on nurse faculty migration.

PubMed

Thompson, Patricia E; Benton, David C; Adams, Elizabeth; Morin, Karen H; Barry, Jean; Prevost, Suzanne S; Vlasich, Cynthia; Oywer, Elizabeth

2014-01-01

As global demand for health care workers burgeons, information is scant regarding the migration of faculty who will train new nurses. With dual roles as clinicians and educators, and corresponding dual sets of professional and legal obligations, nurse faculty may confront unique circumstances in migration that can impact nations' ability to secure an adequate, stable nursing workforce. In a seminal effort to address these concerns, the Honor Society of Nursing, Sigma Theta Tau International, and the International Council of Nurses invited a diverse group of international experts to a summit designed to elucidate forces that drive nurse faculty migration. The primary areas of consideration were the impact on nurse faculty migration of rapid health care workforce scale-up, international trade agreements, and workforce aging. Long-term summit goals included initiating action affecting national, regional, and global supplies of nurse educators and helping to avert catastrophic failure of health care delivery systems caused by an inadequate ability to educate next-generation nurses. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurse Migration: A Canadian Case Study

PubMed Central

Little, Lisa

2007-01-01

Objective To synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. Principal Findings Canada is both a source and a destination country for international nurse migration with an estimated net loss of nurses. The United States is the major beneficiary of Canadian nurse emigration resulting from the reduction of full-time jobs for nurses in Canada due to health system reforms. Canada faces a significant projected shortage of nurses that is too large to be ameliorated by ethical international nurse recruitment and immigration. Conclusions The current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority, and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency. PMID:17489918

The who, what, and how of evaluation within online nursing education: state of the science.

PubMed

Russell, Bedelia H

2015-01-01

The resource capacity in nursing programs has a direct impact on student admissions and number of graduates who enter the nursing workforce. Online delivery of nursing education is identified as a solution to expand nursing program capacity. As nursing programs continue to address capacity with online course delivery, it is essential that nurse educators maintain consistent evaluation practices to ensure successful and positive outcomes, compared with traditional models. Evaluation is a central component to determine program quality and mastery of learning outcomes. This article examines the state of the science around the current evaluation of educational practices, instructional strategies, and outcomes within the context of online nursing education. Thirty-six articles met the inclusion criteria. Despite substantive contributions to the state of the science, the findings reflect evaluation practices that are diffuse and superficial and serve as the basis for future recommendations and research opportunities. Copyright 2015, SLACK Incorporated.

Vacant hospitals and under-employed nurses: a qualitative study of the nursing workforce management situation in Nepal.

PubMed

Adhikari, Radha

2015-04-01

It is vital for all healthcare systems to have a sufficient number of suitably trained health professionals including nurses at all levels of health services to deliver effective healthcare. An ethnographic, qualitative method was chosen for this study, which included open-ended, in-depth interviews with a range of stakeholders including student nurses, qualified nurses, nurse managers and lecturers, and the human resource co-ordinator in the Ministry of Health and Population. Available records and policy documents were also analysed. Study findings suggest that there is a severe mal-distribution of the nursing workforce in rural and urban healthcare centres in Nepal. Although there is an oversupply of newly qualified nurses in hospitals in Kathmandu, the staffing situation outside the valley is undesirable. Additionally, the turnover of junior nursing staff remains high in major urban hospitals. Most qualified nurses aspire to work in developed countries, such as the UK, North America, Australia and New Zealand. Between 2000 and 2008, as many as 3000 nurses have left Nepal for jobs in the developed west. There is no effective management strategy in place to retain a nursing workforce, particularly in rural Nepal. This article concludes by proposing some suggestions for a nursing workforce retention policy to address this critical issue. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Understanding Value as a Key Concept in Sustaining the Perioperative Nursing Workforce.

PubMed

Kapaale, Chaluza C

2018-03-01

Perioperative nursing is faced with a staffing crisis attributed in part to minimal numbers of newly graduated nurses choosing a career in this specialty. This article analyzes and applies the concept of value to explore how to maintain an adequate perioperative nursing workforce; recruit newly graduated nurses; and encourage career professional, nurse educator, and student collaboration to generate meaningful value for perioperative nursing. This analysis revealed that value co-creation for perioperative nursing could lead to newly graduated nurses increasingly choosing perioperative nursing as a career, and enjoying satisfying perioperative nursing careers while providing high-quality patient care. © AORN, Inc, 2018.

Returning nurses to the workforce: developing a fast track back program.

PubMed

Burns, Helen K; Sakraida, Teresa J; Englert, Nadine C; Hoffmann, Rosemary L; Tuite, Patricia; Foley, Susan M

2006-01-01

Fast Track Back: Re-entry into Nursing Practice program. Describes the development, implementation, and evaluation of a state-of-the-art re-entry program facilitating the return of licensed nonpracticing RNs to the workforce through a quality education program that retools them for the workforce in the areas of pharmacology, skill development using the latest technology, practice standards, and nursing issues. The program consists of didactic content taught via classroom, Internet, skills laboratory, and high fidelity human simulated technology and a clinical component. The program is a mechanism that enables re-entry nurses to improve skills and competencies necessary to practice in today's healthcare environment.

Using operations research to plan the british columbia registered nurses' workforce.

PubMed

Lavieri, Mariel S; Regan, Sandra; Puterman, Martin L; Ratner, Pamela A

2008-11-01

The authors explore the power and flexibility of using an operations research methodology known as linear programming to support health human resources (HHR) planning. The model takes as input estimates of the future need for healthcare providers and, in contrast to simulation, compares all feasible strategies to identify a long-term plan for achieving a balance between supply and demand at the least cost to the system. The approach is illustrated by using it to plan the British Columbia registered nurse (RN) workforce over a 20-year horizon. The authors show how the model can be used for scenario analysis by investigating the impact of decreasing attrition from educational programs, changing RN-to-manager ratios in direct care and exploring how other changes might alter planning recommendations. In addition to HHR policy recommendations, their analysis also points to new research opportunities. Copyright © 2008 Longwoods Publishing.

Assessment of nurse retention challenges and strategies in Lebanese hospitals: the perspective of nursing directors.

PubMed

El-Jardali, Fadi; Merhi, Mirvat; Jamal, Diana; Dumit, Nuhad; Mouro, Gladys

2009-05-01

Assess nurse retention challenges and strategies as perceived by nursing directors in Lebanese hospitals. The Kampala Health Workforce Declaration stressed the importance of retaining an effective, responsive and equitably distributed health workforce, particularly nurses. Little is known about nurse retention challenges and strategies in Lebanon. Nursing directors of 76 hospitals participated and were sent a two-page survey on perceived retention challenges and hospital-based retention strategies. Retention challenges included unsatisfactory salary, unsuitable shifts and working hours, as well as better opportunities in other areas within or outside Lebanon. Retention strategies included implementing financial rewards and benefits, a salary scale, staff development, praise and improving work environment. Nursing directors did not address all perceived challenges in their strategies. To better manage the nursing workforce, nursing directors should regularly measure and monitor nurse turnover rates and also their causes and predictors. Nursing directors should develop, implement and evaluate retention strategies. More information is needed on the management and leadership capacities of nursing directors in addition to their span of control. Nursing directors are facing challenges in retaining their nurses. If these problems are not addressed, Lebanon will continue to lose competent and skilled nurses.

Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey.

PubMed

Bloomfield, Jacqueline G; Aggar, Christina; Thomas, Tamsin H T; Gordon, Christopher J

2018-02-01

Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. This study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. A cross-sectional survey design comprising a quantitative online survey. 14 Australian universities from all states/territories, both rural and urban. 530 final-year nursing students. Binary logistic regression identifying factors contributing to desire to work in primary health care. The desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. Collaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Creating a More Diverse Midwifery Workforce in the United States: A Historical Reflection.

PubMed

Dawley, Katy; Walsh, Linda V

2016-09-01

As nurse-midwifery practice expanded beyond areas surrounding early nurse-midwifery education programs, leaders in the profession wanted to establish a strong diverse, inclusive professional organization, a necessary step in creating a diverse workforce (defined here as open to nurse-midwives of all colors, ethnicities, and national origins) that would maintain standards, provide continuing education, and facilitate communication among nurse-midwives. This research presents historical context and organizational factors supporting and limiting development of a workforce reflective of communities served by nurse-midwives. Searches in the National Library of Medicine Historical Collection, American College of Nurse-Midwives (ACNM) Collections, and the Rockefeller Archives Center, as well as recorded interview data, provided primary sources for analysis. Secondary sources include research and opinions in scholarly publications including journals and books released from 1930 to the present. Nurse-midwifery leaders developed relationships with well-respected philanthropists, as well as maternal and child health administrators in state departments of health and the US Children's Bureau, to implement initiatives to recruit and retain midwives of color. Continued interest in the goal of inclusion, work of midwives of color, and commitment to creating a diverse workforce led to the creation of the standing ACNM Midwives of Color Committee in 1990 and the Diversity and Inclusion Task Force, which released its report, "Shifting the Frame: A Report on Diversity and Inclusion in the American College of Nurse-Midwives," 1 in June 2015. Over the past 60 years, ACNM leadership and midwives of color have continued to explore new and effective means to create a workforce that reflects the communities in which nurse-midwives practice. © 2016 by the American College of Nurse-Midwives.

Analysis of a government policy to address nursing shortage and nursing education quality.

PubMed

Abhicharttibutra, K; Kunaviktikul, W; Turale, S; Wichaikhum, O-A; Srisuphan, W

2017-03-01

A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. A qualitative study employing Longest's model to examine policy-making processes. Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand. Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments. © 2016 International Council of Nurses.

Strategy development to sustain and strengthen the Navy Nurse Corps.

PubMed

Raimondo, Lisa H; Pierce, Kathleen M; Bruzek-Kohler, Christine M

2008-01-01

This article demonstrates how the strategic planning process was utilized to determine organizational priorities for the Navy Nurse Corps amidst a time of ongoing conflicts in Iraq and professional duress resulting from the national nursing shortage. The authors denote how overarching organizational goals of the US Navy and Navy medicine are woven into the priorities that were established for Navy Nursing. The emerging 6 priorities are relevant and vital to the sustainment of Navy Nursing today and in the future. They reflect the challenges associated with the development of clinical proficiency, educational policies, force structure/recruitment and retention, mid-grade and senior leadership roles, productivity measurement, and organizational communication. Similarly, these priorities mirror those that confront and warrant the attention of chief nursing officers in the civilian sector as they lead and develop their workforce.

Education evolution: a historical perspective of associate degree nursing.

PubMed

Orsolini-Hain, Liana; Waters, Verle

2009-05-01

Exploring the inception and growth of associate degree nursing education informs our understanding of what led to such explosive growth so that most of the nursing workforce is currently educated at the associate degree level. The success of associate degree nursing programs led to many divisive years in nursing education of differentiation of practice debates that were hardly productive. Work world practices and patient needs are creating pressures on community colleges to join forces with universities to increase the percentage of baccalaureate-educated nurses. Associate degree nursing education continues to evolve to meet the demands of a higher educated nursing workforce.

Should I stay or should I go? Career change and labor force separation among registered nurses in the U.S.

PubMed

Nooney, Jennifer G; Unruh, Lynn; Yore, Michelle M

2010-06-01

Efforts to retain nurses within the profession are critical for resolving the global nursing shortage, but very little research explores the phenomenon of nursing workforce attrition in the U.S. This study is the first to simultaneously investigate the timing of attrition through survival analysis, the exit path taken (career change vs. labor force separation), and the major socioeconomic, family structure, and demographic variables predicting attrition in this country. Using nationally representative U.S. data from the 2004 National Sample Survey of Registered Nurses (N=29,472), we find that the rate of labor force separation is highest after the age of 60, a typical pattern for retirement. However, a non-trivial proportion of career change also occurs at older ages (50+ years old), and the rate of labor force separation begins to climb at relatively young ages (30-40 years old). Particularly strong predictors of early labor force separation include being married and providing care to dependents in the home (young children or elderly parents). Career change is predicted strongly by higher levels of education, male gender, and current enrollment in a non-nursing degree program. Having an Advanced Practice credential reduced the hazards of attrition for both exit paths. The results suggest a fruitful path for future research and a number of policy approaches to curbing nurse workforce attrition. Copyright 2010 Elsevier Ltd. All rights reserved.

Strategic Workforce Planning for Health Human Resources: A Nursing Case Analysis.

PubMed

Baumann, Andrea; Crea-Arsenio, Mary; Akhtar-Danesh, Noori; Fleming-Carroll, Bonnie; Hunsberger, Mabel; Keatings, Margaret; Elfassy, Michael David; Kratina, Sarah

2016-01-01

Background Health-care organizations provide services in a challenging environment, making the introduction of health human resources initiatives especially critical for safe patient care. Purpose To demonstrate how one specialty hospital in Ontario, Canada, leveraged an employment policy to stabilize its nursing workforce over a six-year period (2007 to 2012). Methods An observational cross-sectional study was conducted in which administrative data were analyzed to compare full-time status and retention of new nurses prepolicy and during the policy. The Professionalism and Environmental Factors in the Workplace Questionnaire® was used to compare new nurses hired into the study hospital with new nurses hired in other health-care settings. Results There was a significant increase in full-time employment and a decrease in part-time employment in the study hospital nursing workforce. On average, 26% of prepolicy new hires left the study hospital within one year of employment compared to 5% of new hires during policy implementation. The hospital nurses scored significantly higher than nurses employed in other health-care settings on 5 out of 13 subscales of professionalism. Conclusions Decision makers can use these findings to develop comprehensive health human resources guidelines and mechanisms that support strategic workforce planning to sustain and strengthen the health-care system.

Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

PubMed

Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

2014-01-01

It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

PubMed Central

Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

2014-01-01

It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

Development and psychometric testing of the Nurse Practitioner Primary Care Organizational Climate Questionnaire.

PubMed

Poghosyan, Lusine; Nannini, Angela; Finkelstein, Stacey R; Mason, Emanuel; Shaffer, Jonathan A

2013-01-01

Policy makers and healthcare organizations are calling for expansion of the nurse practitioner (NP) workforce in primary care settings to assure timely access and high-quality care for the American public. However, many barriers, including those at the organizational level, exist that may undermine NP workforce expansion and their optimal utilization in primary care. This study developed a new NP-specific survey instrument, Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), to measure organizational climate in primary care settings and conducted its psychometric testing. Using instrument development design, the organizational climate domain pertinent for primary care NPs was identified. Items were generated from the evidence and qualitative data. Face and content validity were established through two expert meetings. Content validity index was computed. The 86-item pool was reduced to 55 items, which was pilot tested with 81 NPs using mailed surveys and then field-tested with 278 NPs in New York State. SPSS 18 and Mplus software were used for item analysis, reliability testing, and maximum likelihood exploratory factor analysis. Nurse Practitioner Primary Care Organizational Climate Questionnaire had face and content validity. The content validity index was .90. Twenty-nine items loaded on four subscale factors: professional visibility, NP-administration relations, NP-physician relations, and independent practice and support. The subscales had high internal consistency reliability. Cronbach's alphas ranged from.87 to .95. Having a strong instrument is important to promote future research. Also, administrators can use it to assess organizational climate in their clinics and propose interventions to improve it, thus promoting NP practice and the expansion of NP workforce.

Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Northern Territory of Australia.

PubMed

Zhao, Yuejen; Russell, Deborah J; Guthridge, Steven; Ramjan, Mark; Jones, Michael P; Humphreys, John S; Carey, Timothy A; Wakerman, John

2017-12-19

International evidence suggests that a key to improving health and attaining more equitable health outcomes for disadvantaged populations is a health system with a strong primary care sector. Longstanding problems with health workforce supply and turnover in remote Aboriginal communities in the Northern Territory (NT), Australia, jeopardise primary care delivery and the effort to overcome the substantial gaps in health outcomes for this population. This research describes temporal changes in workforce supply in government-operated clinics in remote NT communities through a period in which there has been a substantial increase in health funding. Descriptive and Markov-switching dynamic regression analysis of NT Government Department of Health payroll and financial data for the resident health workforce in 54 remote clinics, 2004-2015. The workforce included registered Remote Area Nurses and Midwives (nurses), Aboriginal Health Practitioners (AHPs) and staff in administrative and logistic roles. total number of unique employees per year; average annual headcounts; average full-time equivalent (FTE) positions; agency employed nurse FTE estimates; high and low supply state estimates. Overall increases in workforce supply occurred between 2004 and 2015, especially for administrative and logistic positions. Supply of nurses and AHPs increased from an average 2.6 to 3.2 FTE per clinic, although supply of AHPs has declined since 2010. Each year almost twice as many individual NT government-employed nurses or AHPs are required for each FTE position. Following funding increases, some clinics doubled their nursing and AHP workforce and achieved relative stability in supply. However, most clinics increased staffing to a much smaller extent or not at all, typically experiencing a "fading" of supply following an initial increase associated with greater funding, and frequently cycling periods of higher and lower staffing levels. Overall increases in workforce supply in remote NT communities between 2004 and 2015 have been affected by continuing very high turnover of nurses and AHPs, and compounded by recent declines in AHP supply. Despite substantial increases in resourcing, an imperative remains to implement more robust health service models which better support the supply and retention of resident health staff.

The public sector nursing workforce in Kenya: a county-level analysis

PubMed Central

2014-01-01

Background Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. Methods National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Results Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). Conclusions An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved. PMID:24467776

The public sector nursing workforce in Kenya: a county-level analysis.

PubMed

Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan; Rakuom, Chris; Rogers, Martha; English, Mike

2014-01-27

Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.

New Zealand rural primary health care workforce in 2005: more than just a doctor shortage.

PubMed

Goodyear-Smith, Felicity; Janes, Ron

2008-02-01

To obtain a 2005 snapshot of New Zealand (NZ) rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. Postal questionnaires, November 2005. NZ-wide rural general practices and community pharmacies. Rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists. Self-reported data: demographics, country of training, years in practice, business ownership, hours worked including on-call, intention to leave rural practice. General practices: response rate 95% (206/217); 70% GP-owned, practice size ranged from one GP/one nurse to 12 GPs/nine nurses. PHARMACIES: Response rate 90% (147/163). Majority had one (33%) or two (32%) pharmacists; <10% had more than three pharmacists. GPs: response rate 64% (358/559), 71% male, 73% aged >40, 61% full-time, 79% provide on-call, 57% overseas-trained, 78% male and 57% female GPs aged >40; more full-time male GPs (76%) than female (37%) . Nurses: response rate 65% (445/685), 97% female, 72% aged >40, 31% full-time, 28% provide on-call, 84% NZ-trained, 45% consulted independently in 'nurse-clinics' within practice setting. Pharmacists: response rate 96% (248/258), 52% male, 66% aged >40, 71% full-time, 33% provide on-call, 92% NZ-trained, 55% sole/partner pharmacy owners. Many intend to leave NZ rural practice within 5 years: GPs (34%), nurses (25%) and pharmacists (47%). This is the first NZ-wide rural workforce survey to include a range of rural primary health care providers (GPs, nurses and pharmacists). Ageing rural primary health care workforce and intentions to leave herald worsening workforce shortages.

Work satisfaction, intent to stay, desires of nurses, and financial knowledge among bedside and advanced practice nurses.

PubMed

Hill, Karen S

2011-05-01

To better understand factors that may contribute to retention of experienced nurses, a study examined differences and relationships among work satisfaction, intent to stay in the nursing profession, and financial knowledge of retirement consequences related to income between clinical bedside nurses (CBNs) and advanced practice nurses (APNs) and described the importance of 7 workforce desires of nurses. Overall, nurses are not informed regarding the financial implications of transitioning from the workforce into retirement. In addition, little is known about the workforce desires and intent to stay among experienced nurses. A cross-sectional, descriptive, comparative design was used. Data were collected from a convenience sample (n = 176) of CBNs employed by a 371-bed, acute care, Magnet-designated hospital, who worked in telemetry and medical-surgical care, and APNs employed by the hospital or employed by a credentialed physicians within the facility in a variety of care settings and roles. Findings from the Work Satisfaction and Intent to Stay scales suggest that relationships in the workplace are important. Data related to the 7 workforce desire questions show that nurses in this organization support the characteristics of caring in the work environment as identified by Watson. The financial knowledge of the consequences of retirement related to income was low among both groups but slightly higher for the APNs. Implications of this study for nurse leaders include the importance of strengthening relationships among nursing colleagues and between the nurse and the supervisor particularly in the constructs of caring. Data support a need for increased education about finances and retirement for RNs in the workplace.

Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany.

PubMed

Kuhlmann, Ellen; Larsen, Christa

2015-12-01

Health workforce needs have moved up on the reform agendas, but policymaking often remains 'piece-meal work' and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions.

PubMed

Jansen, Christel; Codjia, Laurence; Cometto, Giorgio; Yansané, Mohamed Lamine; Dieleman, Marjolein

2014-01-01

Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. A needs-based approach was used to project human resources for health (HRH) requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural) informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a "policy rich" scenario B which allowed for analysis of their potential impact. In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary nurses who are currently employed pose an opportunity for improving the availability, accessibility, and performance of the health workforce for maternal and neonatal health in Guinea, especially in rural areas. Guinea will need to scale up its recruitment efforts in order to improve health workforce availability. Targeted labor market interventions need to be planned and executed over several decades to correct entrenched distortions and mismatches between workforce need, supply, and demand. The case of Guinea illustrates how to design and operationalize HRH interventions based on workforce projections to accompany and facilitate universal health coverage reforms.

Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions

PubMed Central

Jansen, Christel; Codjia, Laurence; Cometto, Giorgio; Yansané, Mohamed Lamine; Dieleman, Marjolein

2014-01-01

Background Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods A needs-based approach was used to project human resources for health (HRH) requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural) informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary nurses who are currently employed pose an opportunity for improving the availability, accessibility, and performance of the health workforce for maternal and neonatal health in Guinea, especially in rural areas. Conclusion Guinea will need to scale up its recruitment efforts in order to improve health workforce availability. Targeted labor market interventions need to be planned and executed over several decades to correct entrenched distortions and mismatches between workforce need, supply, and demand. The case of Guinea illustrates how to design and operationalize HRH interventions based on workforce projections to accompany and facilitate universal health coverage reforms. PMID:25429245

Chief Nursing Officer Survey: BSN and Higher Degree Initiatives in North Carolina.

PubMed

Schuler, Mary E; Polly Johnson, Mary P; Stallings, Karen D; Li, Yin

The purpose of this study was to determine gap areas where North Carolina should implement strategies to promote the Institute of Medicine's recommendation of an 80 percent bachelor of science workforce. The North Carolina Action Coalition sought information about the nursing BSN and higher degree workforce and about human resource policies/strategies that promote BSN and higher degree education. An electronic survey was used to query 120 acute care hospital chief nursing officers over a four-year period and 100 public health chief nursing officers over a two-year period. A majority of acute care and a minority of public health institutions had policies promoting BSN education. Barriers included lack of tuition reimbursement, scheduling/staffing issues, lack of local universities, and a perceived lack of value for nurses. A minority of respondents reported an 80 percent BSN workforce. Strategies are needed statewide to support nursing academic progression.

Who's talking? Communication and the casual/part-time nurse: a literature review.

PubMed

Batch, Mary; Barnard, Alan; Windsor, Carol

2009-08-01

The rapidly evolving nursing working environment has seen the increased use of flexible non standard employment, including part-time, casual and itinerate workers. Evidence suggests that the nursing workforce has been at the forefront of the flexibility push which has seen the appearance of a dual workforce and marginalization of part-time and casual workers by their full-time peers and managers. The resulting fragmentation has meant that effective communication management has become difficult. Additionally, it is likely that poor organisational communication exacerbated by the increased use of non standard staff, is a factor underlying current discontent in the nursing industry and may impact on both recruitment and retention problems as well as patient outcomes. This literature review explores the relationship between the increasing casualisation of the nursing workforce and, among other things, the communication practices of nurses within healthcare organisations.

A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning

PubMed Central

2012-01-01

Economic downturns and recession lead to budget cuts and service reductions in the healthcare sector which often precipitate layoffs and hiring freezes. Nurses, being the largest professional group in healthcare, are strongly affected by cost reductions. Economic downturns destabilize the nursing labour market with potential negative outcomes, including serious shortages, extending beyond the recessionary period. The objectives of this manuscript are to provide an overview of the potential short- and long-run impact of economic downturns on the supply and demand of nurses, and present healthcare decision makers with a framework to enhance their ability to strategically manage their human resources through economic cycles. A narrative review of the literature on the effects of economic downturns on the nursing labour market in developed countries was carried out with a special focus on studies offering a longitudinal examination of labour force trends. Analysis indicates that economic downturns limit the ability of public payers and institutions to finance their existing health workforce. As salaried healthcare workers, nurses are especially susceptible to institutional budget cuts. In the short run, economic downturns may temporarily reduce the demand for and increase the supply of nurses, thereby influencing nursing wages and turnover rates. These effects may destabilise the nursing labour market in the long run. After economic downturns, the market would quickly display the pre-recessionary trends and there may be serious demand–supply imbalances resulting in severe shortages. Potential long-term effects of recession on the nursing labour market may include a downsized active workforce, difficulty in retaining younger nurses, a decreased supply of nurses and workforce casualisation. Lack of understanding of labour market dynamics and trends might mislead policy makers into making misinformed workforce downsizing decisions that are often difficult and expensive to reverse. In the aftermath of an economic downturn, the costs of attracting nurses back often outweigh the short term cost savings. Effective management should support the nursing workforce by creating attractive and stable work environments to retain nurses at a manageable cost. PMID:22905739

A narrative review on the effect of economic downturns on the nursing labour market: implications for policy and planning.

PubMed

Alameddine, Mohamad; Baumann, Andrea; Laporte, Audrey; Deber, Raisa

2012-08-20

Economic downturns and recession lead to budget cuts and service reductions in the healthcare sector which often precipitate layoffs and hiring freezes. Nurses, being the largest professional group in healthcare, are strongly affected by cost reductions. Economic downturns destabilize the nursing labour market with potential negative outcomes, including serious shortages, extending beyond the recessionary period. The objectives of this manuscript are to provide an overview of the potential short- and long-run impact of economic downturns on the supply and demand of nurses, and present healthcare decision makers with a framework to enhance their ability to strategically manage their human resources through economic cycles.A narrative review of the literature on the effects of economic downturns on the nursing labour market in developed countries was carried out with a special focus on studies offering a longitudinal examination of labour force trends. Analysis indicates that economic downturns limit the ability of public payers and institutions to finance their existing health workforce. As salaried healthcare workers, nurses are especially susceptible to institutional budget cuts. In the short run, economic downturns may temporarily reduce the demand for and increase the supply of nurses, thereby influencing nursing wages and turnover rates. These effects may destabilise the nursing labour market in the long run. After economic downturns, the market would quickly display the pre-recessionary trends and there may be serious demand-supply imbalances resulting in severe shortages. Potential long-term effects of recession on the nursing labour market may include a downsized active workforce, difficulty in retaining younger nurses, a decreased supply of nurses and workforce casualisation.Lack of understanding of labour market dynamics and trends might mislead policy makers into making misinformed workforce downsizing decisions that are often difficult and expensive to reverse. In the aftermath of an economic downturn, the costs of attracting nurses back often outweigh the short term cost savings. Effective management should support the nursing workforce by creating attractive and stable work environments to retain nurses at a manageable cost.

[Assessing the trend in the aging of the nursing staff at two hospitals of the Friuli Venezia Giulia region: application of a deterministic mathematical model].

PubMed

Guardini, Ilario; Deroma, Laura; Salmaso, Daniele; Palese, Alvisa

2011-01-01

The aging of the nursing workforce is a phenomenon that several industrialized countries has been facing for at least a decade. In Italy, for the period between 2011 and 2021, the issue associated with the nursing workforce will not be one of shortage but rather one of aging. The main objective of this study was to estimate the employed nurse population aging trends for the period 2009-2035 in two Teaching Hospitals (TH1 and TH2) located in the North of Italy. A deterministic mathematical model has been developed in order to obtain aging projections for the nursing workforce from 2009 until 2035. Within the next six years, the aging trend of nurse populations, with respect to 2008, at the TH 1 and 2 will show a steady increase of nurses aged over 45; specifically, a 29.4% vs. 34.1% increase and a 21.6% vs. 41.4% respectively. It is hypothesized that the TH 1 will have the highest proportion of nurses aged over 45 in 2014, whereas it is estimated that for the TH 2 this trend will continue until 2021 when the proportion of nurses aged over 45 will make up 48.8% out of the nurse population. The trend may lead to an increase in the number of experienced nurses; however, such a trend should be looked at with concern, with respect to the physical unsuitability. Nurses aged over 45 represent 20% of the workforce at both TH. Conclusions/implications for management and research. If the trend predicted by the model were to occur in the coming years, the problem of nursing workforce ageing will have to be addressed because it involves different expectations but also the perception of different work skills. The nursing direction is called to test new strategies for managing the staff and the career of nurses will also need to be redesigned, because contract law looks primarily at the initial stage of working life (specializations, university education, career opportunities) neglecting the final one (from the 50th year of age to retirement).

The (mis)management of migrant nurses in the UK: a sociological study.

PubMed

Adhikari, Radha; Melia, Kath M

2015-04-01

To examine Nepali migrant nurses' professional life in the UK. In the late 1990 s the UK experienced an acute nursing shortage. Within a decade over 1000 Nepali nurses migrated to the UK. A multi-sited ethnographic approach was chosen for this study. Between 2006 and 2009, 21 in-depth interviews with Nepali nurses were conducted in the UK using snowballing sampling. Nepali migrant nurses are highly qualified and experienced in specialised areas such as critical care, management and education. However, these nurses end up working in the long-term care sector, providing personal care for elderly people - an area commonly described by migrant nurses as British Bottom Care (BBC). This means that migrant nurses lack career choices and professional development opportunities, causing them frustration and lack of job satisfaction. International nurse migration is an inevitable part of globalisation in health. Nurse managers and policy makers need to explore ways to make better use of the talents of the migrant workforce. We offer a management strategy to bring policies for the migrant workforce into line with the wider workforce plans by supporting nurses in finding jobs relevant to their expertise and providing career pathways. © 2013 John Wiley & Sons Ltd.

Thriving in chaos: Educating the nurse leaders of the future.

PubMed

Garrison, Deborah R; Morgan, Debra A; Johnson, Jewett G

2004-01-01

Nurse educators are challenged to prepare students to become effective leaders in a time of chaos. The last two decades have heralded many changes that have an impact on health care delivery, including changes in health care financing, the information explosion, the recognition of quality chasms, and the composition of the workforce. Nurses continue to be at the forefront of health care delivery and they must orchestrate care for their patients in an increasingly complex health care system. Our goal is to provide nurse educators with strategies to help students blend leadership and management techniques to lead the new generation of knowledge workers. Educators have the opportunity and the challenge to empower their students to master an eclectic set of management and leadership tools, including the best from historical management strategies and embracing the latest theories of leadership. This article presents thoughts and ideas to ponder as well as strategies to consider and implement as we create the curriculum and the learning environment for our students and the future leaders of our profession.

Evaluation of an academic service partnership using a strategic alliance framework.

PubMed

Murray, Teri A; James, Dorothy C

2012-01-01

Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model. Copyright © 2012 Elsevier Inc. All rights reserved.

Nursing practice and work environment issues in the 21st century: a leadership challenge.

PubMed

Manojlovich, Milisa; Barnsteiner, Jane; Bolton, Linda Burnes; Disch, Joanne; Saint, Sanjay

2008-01-01

A leadership conference titled "Have Patient Safety and the Workforce Shortage Created the Perfect Storm?" was held in honor of Dr. Ada Sue Hinshaw, who was ending her tenure as dean of the University of Michigan School of Nursing. A morning panel on the preferred future for practice featured plenary speaker Dr. Linda Burnes Bolton and participating panelists Dr. Sanjay Saint, Dr. Jane Barnsteiner, and Dr. Joanne Disch. Each speaker presented a unique yet complementary perspective, with several common themes permeating the morning's presentations. For example, all of the speakers mentioned how important interprofessional collaboration is to promoting patient safety. The themes can be categorized broadly as nursing practice and work environment issues, with subthemes of interprofessional communication and collaboration, systems solutions to patient safety problems, and future directions in nursing education. A synopsis of comments made during the morning practice panel and empirical support for the themes and subthemes identified by panelists are provided in this article.

Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review.

PubMed

Cummings, Greta G; MacGregor, Tara; Davey, Mandy; Lee, How; Wong, Carol A; Lo, Eliza; Muise, Melanie; Stafford, Erin

2010-03-01

Numerous policy and research reports call for leadership to build quality work environments, implement new models of care, and bring health and wellbeing to an exhausted and stretched nursing workforce. Rarely do they indicate how leadership should be enacted, or examine whether some forms of leadership may lead to negative outcomes. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. The search strategy of this multidisciplinary systematic review included 10 electronic databases. Published, quantitative studies that examined leadership behaviours and outcomes for nurses and organizations were included. Quality assessments, data extractions and analysis were completed on all included studies. 34,664 titles and abstracts were screened resulting in 53 included studies. Using content analysis, 64 outcomes were grouped into five categories: staffsatisfaction with work, role and pay, staff relationships with work, staff health and wellbeing, work environment factors, and productivity and effectiveness. Distinctive patterns between relational and task focused leadership styles and their outcomes for nurses and their work environments emerged from our analysis. For example, 24 studies reported that leadership styles focused on people and relationships (transformational, resonant, supportive, and consideration) were associated with higher nurse job satisfaction, whereas 10 studies found that leadership styles focused on tasks (dissonant, instrumental and management by exception) were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. Our results document evidence of various forms of leadership and their differential effects on the nursing workforce and work environments. Leadership focused on task completion alone is not sufficient to achieve optimum outcomes for the nursing workforce. Efforts by organizations and individuals to encourage and develop transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current and worsening nursing shortage. Copyright 2009 Elsevier Ltd. All rights reserved.

Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review.

PubMed

Cummings, Greta G; Tate, Kaitlyn; Lee, Sarah; Wong, Carol A; Paananen, Tanya; Micaroni, Simone P M; Chatterjee, Gargi E

2018-05-03

Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Nursing workforce policy and the economic crisis: a global overview.

PubMed

Buchan, James; O'May, Fiona; Dussault, Gilles

2013-09-01

To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses. This article draws from international data sources (Organisation for Economic Co-operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns. A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed. The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries. This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries. © 2013 Sigma Theta Tau International.

Is graduate entry education a solution to increasing numbers of men in nursing?

PubMed

McKenna, Lisa; Vanderheide, Rebecca; Brooks, Ingrid

2016-03-01

Males have traditionally constituted a very small proportion of the nursing workforce in many countries, including Australia. Together with a need to address the gender imbalance, nursing workforce shortages require strategies for recruiting new nurses, including males. This study examined characteristics of males entering one accelerated graduate entry masters pre-registration nursing program in Victoria, Australia. A quantitative survey gathered a variety of demographic data and factors relating to participants' decisions to undertake nursing. Data were analysed using descriptive statistics including frequencies and distributions. Forty-three male nursing students from four cohorts of the Master of Nursing Practice (MNP) course from 2009 to 2011 completed the survey. The proportion of males (30%) was considerably greater than traditional nursing courses and the profession generally. Participants demonstrated wide distributions in age ranges, professional backgrounds and previous years in the workforce. Graduate entry appears attractive to males of varying ages, personal and professional backgrounds. More research is needed to examine this phenomenon on a larger scale. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Motivations to nurse: an exploration of what motivates students in Pacific Island countries to enter nursing.

PubMed

Usher, Kim; West, Caryn; Macmanus, Mary; Waqa, Silina; Stewart, Lee; Henry, Renee; Lindsay, David; Conaglen, Jo; Hall, Julianne; McAuliffe, Marie; Redman-MacLaren, Michelle

2013-10-01

The aim of this study was to explore the motivations of student nurses enrolled in nursing courses across a variety of Pacific Island countries. The image of nursing, the desire to help others, family and friends in the profession, personal experience, security, travel opportunities and flexibility have all been identified as motivators for people to enter nursing. To date, what motivates students in Pacific Island countries to enrol in a nursing course has not been investigated. An exploratory qualitative approach using focus group interviews with 152 nursing students was undertaken. Data were analysed using thematic content analysis, revealing four themes: (i) helping others; (ii) 'making a difference for my people'; (iii) following in the footsteps of others; and (iv) financial and professional gain. In a time of health and nursing workforce shortages, developing a deeper understanding of what drives people can be used to improve recruitment strategies in the future. © 2013 Wiley Publishing Asia Pty Ltd.

Doing more with less in nursing work: a review of the literature.

PubMed

Bradley, C

1999-09-01

The paper explores the literature on changes in nursing work. It examines the suggestion that changes in work practices are management responses to cost cutting imperatives. Nursing labour force issues such as staffing roles and staffing mix, the push for flexibility in the workforce and casualisation are discussed. The paper concludes that given the rise of casual work in the general Australian workforce, research needs to be conducted on the extent of casualisation of nursing, and the implications this may have for nursing practice, professional development and on the nursing labour market.

Trend in distribution of primary health care professionals in Jiangsu province of eastern China.

PubMed

Xu, Kang; Zhang, Kaijin; Wang, Dan; Zhou, Ling

2014-11-28

Since the late 1990 s, the Chinese government has carried out several reforms on the primary health care, which is greatly improved but still left much to be desired, especially for the health workforces. The aim of this study was to analyze the number of health workforces and the trends in distribution of health workforces in Jiangsu province of eastern China from 2008 to 2012. The time trends in number and distribution of health professionals were compared in study period. Lorenz curves were plotted and Gini coefficient, Atkinson index and Theil index were calculated for inequalities in the distribution of health workforces to population and area. The number of health workforces increased every year and the inequality in the distribution of health workforces showed a decline trend from 2008 to 2012. After 2009, these trends changed more rapidly. There was the disproportionality between physicians and nurses. The values of three inequality indicators based on area were larger than those based on population. The health reform in 2009 might play an important role in increasing the number of health workforces and improving the distribution of health workforces in primary health care facilities. The disproportionality between physicians and nurses was related to the shortage of number of nurses.

Potential of China in global nurse migration.

PubMed

Fang, Zhiwu Zack

2007-06-01

The purpose of this paper is to examine what is known about the nurse workforce and nursing education in China in order to assess the likely potential for nurse migration from China in the future. There is a severe shortage of nurses in China (only one nurse per thousand in population), but at the same time there is a very high level of unemployment and underemployment of nurses. China's nursing education system is huge in size (about 500,000 nursing students in 2005), but weak in quality and career development. As a result of lack of limited job opportunities, low salary, and low job satisfaction, many talented Chinese nurses intend to switch occupation or work outside China. Commercial recruiters have expressed a strong interest in recruitment of nurses in China, but to date there are few examples of successful ventures. Even if the Chinese government were to implement health care financing reforms that led to an increase in nursing jobs and improved work conditions, some level of surplus will remain. As such, it is likely that China will become an important source of nurses for developed nations in the coming years.

Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review.

PubMed

Husebø, Anne Marie Lunde; Storm, Marianne; Våga, Bodil Bø; Rosenberg, Adriana; Akerjordet, Kristin

2018-04-01

To give an overview of empirical studies investigating nursing homes as a learning environment during nursing students' clinical practice. A supportive clinical learning environment is crucial to students' learning and for their development into reflective and capable practitioners. Nursing students' experience with clinical practice can be decisive in future workplace choices. A competent workforce is needed for the future care of older people. Opportunities for maximum learning among nursing students during clinical practice studies in nursing homes should therefore be explored. Mixed-method systematic review using PRISMA guidelines, on learning environments in nursing homes, published in English between 2005-2015. Search of CINAHL with Full Text, Academic Search Premier, MEDLINE and SocINDEX with Full Text, in combination with journal hand searches. Three hundred and thirty-six titles were identified. Twenty studies met the review inclusion criteria. Assessment of methodological quality was based on the Mixed Methods Appraisal Tool. Data were extracted and synthesised using a data analysis method for integrative reviews. Twenty articles were included. The majority of the studies showed moderately high methodological quality. Four main themes emerged from data synthesis: "Student characteristic and earlier experience"; "Nursing home ward environment"; "Quality of mentoring relationship and learning methods"; and "Students' achieved nursing competencies." Nursing home learning environments may be optimised by a well-prepared academic-clinical partnership, supervision by encouraging mentors and high-quality nursing care of older people. Positive learning experiences may increase students' professional development through achievement of basic nursing skills and competencies and motivate them to choose the nursing home as their future workplace. An optimal learning environment can be ensured by thorough preplacement preparations in academia and in nursing home wards, continuous supervision and facilitation of team learning. © 2018 John Wiley & Sons Ltd.

The characteristics of registered nurses whose licenses expire: why they leave nursing and implications for retention and re-entry.

PubMed

Skillman, Susan M; Palazzo, Lorella; Hart, L Gary; Keepnews, David

2010-01-01

Little is known about RNs who drop their licenses and their potential re-entry into the nursing workforce. The results of this study provide insight into reasons nurses leave their careers and the barriers to re-entry, all important indicators of the current professional climate for nursing. While representing only one state, these findings suggest that RNs who allow their licenses to expire do so because they have reached retirement age or, among those who do not cite age as a factor, because many are unable or unwilling to work in the field. Inactive nurses who might otherwise appear to be likely candidates for re-entry into the profession may not be easily encouraged to practice nursing again without significant changes in their personal circumstances or the health care work environment. Effective ways to address current and pending RN workforce shortages include expanding RN education capacity to produce more RNs who can contribute to the workforce across the coming decades, and promote work environments in which RNs want to, and are able to, practice across a long nursing career.

Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013-2015.

PubMed

Russell, Deborah J; Zhao, Yuejen; Guthridge, Steven; Ramjan, Mark; Jones, Michael P; Humphreys, John S; Wakerman, John

2017-08-15

The geographical maldistribution of the health workforce is a persisting global issue linked to inequitable access to health services and poorer health outcomes for rural and remote populations. In the Northern Territory (NT), anecdotal reports suggest that the primary care workforce in remote Aboriginal communities is characterised by high turnover, low stability and high use of temporary staffing; however, there is a lack of reliable information to guide workforce policy improvements. This study quantifies current turnover and retention in remote NT communities and investigates correlations between turnover and retention metrics and health service/community characteristics. This study used the NT Department of Health 2013-2015 payroll and financial datasets for resident health workforce in 53 remote primary care clinics. Main outcome measures include annual turnover rates, annual stability rates, 12-month survival probabilities and median survival. At any time point, the clinics had a median of 2.0 nurses, 0.6 Aboriginal health practitioners (AHPs), 2.2 other employees and 0.4 additional agency-employed nurses. Mean annual turnover rates for nurses and AHPs combined were extremely high, irrespective of whether turnover was defined as no longer working in any remote clinic (66%) or no longer working at a specific remote clinic (128%). Stability rates were low, and only 20% of nurses and AHPs remain working at a specific remote clinic 12 months after commencing. Half left within 4 months. Nurse and AHP turnover correlated with other workforce measures. However, there was little correlation between most workforce metrics and health service characteristics. NT Government-funded remote clinics are small, experience very high staff turnover and make considerable use of agency nurses. These staffing patterns, also found in remote settings elsewhere in Australia and globally, not only incur higher direct costs for service provision-and therefore may compromise long-term sustainability-but also are almost certainly contributing to sub-optimal continuity of care, compromised health outcomes and poorer levels of staff safety. To address these deficiencies, it is imperative that investments in implementing, adequately resourcing and evaluating staffing models which stabilise the remote primary care workforce occur as a matter of priority.

Workforce characteristics of privately practicing nurse practitioners in Australia: Results from a national survey.

PubMed

Currie, Jane; Chiarella, Mary; Buckley, Thomas

2016-10-01

Australian private practice nurse practitioner (PPNP) services have grown since legislative changes in 2010 enabled eligible nurse practitioners (NPs) to access reimbursement for care delivered through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). This article provides data from a national survey on the workforce characteristics of PPNPs in Australia. PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. There were 73 completed surveys. One of the intentions of expanding access to MBS and PBS for patients treated by NPs was to increase patients' access to health care through greater flexibility in the healthcare workforce. The results of this survey confirm that the workforce characteristics of PPNPs provide a potentially untapped resource to meet current primary healthcare demand. The findings of this study allow us to understand the characteristics of PPNP services, which are significant for workforce planning. The focus of PPNP practice is toward primary health care with PPNPs working predominantly in general practice settings. The largest age group of PPNPs is over 50 years and means a proportion will be retiring in the next 15 years. ©2016 American Association of Nurse Practitioners.

Developing a smartphone app to support the nursing community.

PubMed

Colton, Scott; Hunt, Louise

2016-02-01

Healthcare professionals are turning increasingly to the digital sector to access information they need for their work. Mobile technology, such as smartphones and tablets, provides a unique opportunity to place high-quality information directly into users' hands. This article describes the ongoing development of a smartphone app, Preparing for Caring, designed to prepare the future workforce by enabling mentors and nursing students to access supportive material during practice-based learning episodes. The article explores the rationale for designing the app and discusses the challenges and benefits of developing this resource from the perspectives of student, mentor and healthcare manager.

The Maternity Care Nurse Workforce in Rural U.S. Hospitals.

PubMed

Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B

To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (<300 annual births) and 49% were high volume (≥300 annual births). Among low-volume hospitals, 78% used a shared nurse staff model. In contrast, 31% of high-volume hospitals used a shared nurse staff model. Respondents praised the teamwork, dedication, and skill of their maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Casualisation of the teaching workforce: implications for nursing education.

PubMed

Halcomb, Elizabeth J; Andrew, Sharon; Peters, Kath; Salamonson, Yenna; Jackson, Debra

2010-08-01

Internationally, nursing faculty shortages have been reported and there is a potential for them to worsen into the next decade as existing faculty age. To, in part, address this issue, across disciplines there is clearly an international trend towards the increasing casualisation of the higher education workforce. Despite the potential impact of this two-tiered workforce structure, there has been limited examination of the discipline specific issues related to the employment of a growing number of sessional nursing staff. This paper provides a critical review of the literature related to the employment of sessional teachers in higher education. The paper advances the discourse around the role and implications of employing sessional teachers in undergraduate nursing schools. Recommendations for supporting sessional staff and further research are presented. Copyright 2009 Elsevier Ltd. All rights reserved.

[The Role of Nursing Education in the Advancement of the Nursing Profession].

PubMed

Chang Yeh, Mei

2017-02-01

The present article discusses the role of nursing education in the advancement of the nursing profession in the context of the three facets of knowledge: generation, dissemination, and application. Nursing is an applied science and the application of knowledge in practice is the ultimate goal of the nursing profession. The reform of the healthcare delivery model requires that nurses acquire and utilize evidence-based clinical knowledge, critical thinking, effective communication, and team collaboration skills in order to ensure the quality of patient care and safety. Therefore, baccalaureate education has become the minimal requirement for pre-licensure nursing education. Schools of nursing are responsible to cultivate competent nurses to respond to the demands on the nursing workforce from the healthcare system. Attaining a master's education in nursing helps cultivate Advanced Practice Registered Nurses (APRNs) to further expand the roles and functions of the nursing profession in order to promote the quality of care in clinical practice. Nursing faculty and scholars of higher education institutions generate nursing knowledge and develop professional scholarship through research. Attaining a doctoral education in nursing cultivates faculties and scholars who will continually generate and disseminate nursing knowledge into the future.

Does State Legislation Improve Nursing Workforce Diversity?

PubMed

Travers, Jasmine; Smaldone, Arlene; Cohn, Elizabeth Gross

2015-08-01

A health-care workforce representative of our nation's diversity is a health and research priority. Although racial and ethnic minorities represent 37% of Americans, they comprise only 16% of the nursing workforce. The purpose of this study was to examine the effect of state legislation on minority recruitment to nursing. Using data from the National Conference of State Legislatures, American Association of Colleges of Nursing, and U.S. census, we compared minority enrollment in baccalaureate nursing programs of states (Texas, Virginia, Michigan, California, Florida, Connecticut, and Arkansas) before and 3 years after enacting legislation with geographically adjacent states without legislation. Data were analyzed using descriptive and chi-square statistics. Following legislation, Arkansas (13.8%-24.5%), California (3.3%-5.4%), and Michigan (8.0%-10.0%) significantly increased enrollment of Blacks, and Florida (11.8%-15.4%) and Texas (11.2%-13.9%) significantly increased enrollment of Hispanic baccalaureate nursing students. States that tied legislation to funding, encouragement, and reimbursement had larger enrollment gains and greater minority representation. © The Author(s) 2015.

Recent Developments in Public Health Nursing in the Americas

PubMed Central

Nigenda, Gustavo; Magaña-Valladares, Laura; Cooper, Kelly; Ruiz-Larios, Jose Arturo

2010-01-01

This study presents an assessment of the participation and training of nurses in public health areas in the Americas. Information was gathered through a literature review and interviews with key informants from Mexico, Colombia, and Paraguay. Results demonstrate that there is significant variation in definitions of public health nursing across the region and current systematized data about the workforce profile of public health nursing personnel is not available for many countries in the Americas. There are significant regional differences in the levels and types of training of nurses working in public health areas and an increasing number of nurses are pursuing training in public health at the master’s and doctoral levels. Many nurses carry out some or all of the essential functions of public health, but are not considered to be public health nurses. Generally, auxiliary and technical nurses have a broader presence in public health areas than professional nurses. In the future, regional health systems reforms should support increased recruitment and training of public health nurses, as well as stronger roles in public health research and health care at the individual, community, and population levels. PMID:20617000

Uncovering degrees of workplace bullying: A comparison of baccalaureate nursing students' experiences during clinical placement in Australia and the UK.

PubMed

Birks, Melanie; Cant, Robyn P; Budden, Lea M; Russell-Westhead, Michele; Sinem Üzar Özçetin, Yeter; Tee, Stephen

2017-07-01

Bullying in health workplaces has a negative impact on nurses, their families, multidisciplinary teams, patient care and the profession. This paper compares the experiences of Australian and UK baccalaureate nursing students in relation to bullying and harassment during clinical placement. A secondary analysis was conducted on two primary cross-sectional studies of bullying experiences of Australian and UK nursing students. Data were collected using the Student Experience of Bullying during Clinical Placement (SEBDCP) questionnaire and analysed using descriptive and inferential statistics. The total sample was 833 Australian and 561 UK students. Australian nursing students experienced a higher rate of bullying (50.1%) than UK students (35.5%). Students identified other nurses as the main perpetrators (Aust 53%, UK 68%), although patients were the main source of physical acts of bullying. Few bullied students chose to report the episode/s. The main reason for non-reporting was fear of being victimised. Sadly, some students felt bullying and harassment was 'part of the job'. A culture of bullying in nursing persists internationally. Nursing students are vulnerable and can question their future in the 'caring' profession of nursing after experiencing and/or witnessing bullying during clinical placement. Bullying requires a zero tolerance approach. Education providers must develop clearer policies and implement procedures to protect students - the future nursing workforce. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nurses aged over 50 and their perceptions of flexible working.

PubMed

Clendon, Jill; Walker, Léonie

2016-04-01

To explore the experiences and needs of older nurses in relation to flexible working and the barriers and facilitators to implementation within workplaces. An ageing nursing workforce and anticipated nursing workforce shortages require effective approaches to workforce retention. A mixed method approach (focus group and individual interviews) with nurses aged over 50 (n = 46) combined with analysis of district health board (DHB) flexible working policies. Participants had a good understanding of flexible working and recognised the importance of balancing their own needs with those of their organisation. Participants had legitimate reasons for making requests and became frustrated when turned down. They recommended job sharing, shorter shifts, no night shift and greater recognition of their work to improve retention. There was discrepancy between organisational policy (where this existed) and implementation. Organisations should review flexible working policies, ensuring these are understood and implemented at the unit level. Training of nurse managers is recommended. Nurse managers must recognise the individual needs of nurses, be cognisant of workplace policies regarding flexible working, ensure these are implemented consistently and make the effort to recognise the work of older nurses. © 2015 John Wiley & Sons Ltd.

The development of the Older Person's Nurse Fellowship: Education concept to delivery.

PubMed

Naughton, Corina; Hayes, Nicky; Zahran, Zainab; Norton, Christine; Lee, Geraldine; Fitzpatrick, Joanne M; Crawford, Mary; Tee, Stephen

2016-09-01

Preparing the nursing workforce to meet the challenges of an ageing population is a priority for many countries. The development of an Older Person's Nurse Fellowship (OPNF) programme for senior clinical nurses is an important innovation. This article describes the philosophical development, delivery and early evaluation of the OPNF. In 2014, Health Education England funded 24 senior clinical nurses to participate in the OPNF. The Fellowship was designed to build clinical leadership and innovation capability and develop a network of nurses to influence local and national strategy for older people's care. The Fellows selected were drawn from mental health (n=4), community/primary care (n=9) and acute care (n=11). The twelve month programme consisted of two Masters-level modules, delivered through study days and e-learning. The first cohort (n=12) commenced the course in November 2014 with a module designed to enhance clinical knowledge and skills. Evaluation data were collected from the first cohort using anonymous surveys (n=11) and focus group interviews (n=9). Descriptive statistics are presented for the quantitative data and common themes are described in the qualitative data. The overall satisfaction with the clinical module was high with a median score of 18/20 (range 17-20). Topics such as comprehensive geriatric assessment, frailty, pharmacology and cognitive assessment were regarded as highly relevant and most likely to result in a change to clinical practice. In the focus group interviews students discussed their learning experience in terms of: module specificity, peer-to-peer learning and using the OPNF as leverage for change. The OPNF is a timely innovation and a positive commitment to developing an academic pathway for senior nurses. It marks an important step in the future development of the older person's nursing workforce. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sustaining the Rural Workforce: Nursing Perspectives on Worklife Challenges

ERIC Educational Resources Information Center

Hunsberger, Mabel; Baumann, Andrea; Blythe, Jennifer; Crea, Mary

2009-01-01

Context: Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique…

Nursing and Allied Health Shortages: TBR Responds.

ERIC Educational Resources Information Center

Berryman, Treva

Staff members of the Tennessee Board of Regents (TBR) and the Tennessee Higher Education Commission worked jointly to establish a task force to investigate and develop recommendations for addressing the workforce shortages in nursing and allied health in Tennessee. The investigation established that Tennessee already has a workforce shortage of…

Expanding the capacity of nursing education.

PubMed

Cleary, Brenda L; McBride, Angela Barron; McClure, Margaret L; Reinhard, Susan C

2009-01-01

Assuring a nurse workforce that is large enough and possesses the right competencies for the changing demographic and health reform scenarios of the early twenty-first century is nothing short of an imperative. Getting there will involve continual recruitment of a talented and diverse group of people and increasing nurses' progression to a more highly educated workforce, no matter where they enter the profession. These actions will enable the United States to fill vacant nursing faculty positions as we simultaneously re-create how nursing education is delivered in this country. The nation's health is dependent on the actions we now take.

Is there a crisis in nursing retention in New South Wales?

PubMed Central

Doiron, Denise; Hall, Jane; Jones, Glenn

2008-01-01

Background There is a severe shortage of nurses in Australia. Policy makers and researchers are especially concerned that retention levels of nurses in the health workforce have worsened over the last decade. There are also concerns that rapidly growing private sector hospitals are attracting qualified nurses away from the public sector. To date no systematic analysis of trends in nursing retention rates over time has been conducted due to the lack of consistent panel data. Results A 1.4 percentage point improvement in retention has led to a 10% increase in the overall supply of nurses in NSW. There has also been a substantial aging of the workforce, due to greater retention and an increase in mature age entrants. The improvement in retention is found in all types of premises and is largest in nursing homes. There is a substantial amount of year to year movement in and out of the workforce and across premises. The shortage of nurses in public hospitals is due to a slowdown in entry rather than competition from the rapidly growing private sector hospitals. Policy Implications The finding of an improvement (rather than a worsening) in retention suggests that additional improvements may be difficult to achieve as further retention must involve individuals more and more dissatisfied with nursing relative to other opportunities. Hence policies targeting entry such as increased places in nursing programs and additional subsidies for training costs may be more effective in dealing with the workforce shortage. This is also the case for shortages in public sector hospitals as retention in nursing is found to be relatively high in this sector. However, the large amount of year to year movements across nursing jobs, especially among the younger nurses, also suggests that policies aimed at reducing job switches and increasing the number who return to nursing should also be pursued. More research is needed in understanding the relative importance of detailed working conditions and the problems associated with combining family responsibilities and nursing jobs. PMID:18681970

Mentoring the minority nurse leader of tomorrow.

PubMed

Washington, Deborah; Erickson, Jeanette Ives; Ditomassi, Marianne

2004-01-01

Diversity is crucial to the future of nursing. And fortunately, a shift in the composition of the nursing workforce so that it more accurately mirrors the composition of America's patient population is already taking place. However, this emerging multiculturalism brings an important issue to the forefront-the leadership tier in healthcare organizations must also reflect the ethnic and cultural changes taking place. Movement in this direction makes prominent the importance of the mentor role in the life of the minority nurse seeking a leadership career path. Acknowledging the present demographics of the profession, it is most unlikely that the mentor and mentee will be a cultural or ethnic match. The good news is that this should not be viewed as an automatic barrier. This article describes the 5 Cs of mentoring a minority nurse professional, that is, candor, compromise, confidence, complexity, and champion-the specific competencies that promote a mentor-mentee relationship focused on career success.

Thirteen years and counting: Outcomes of a concurrent ASN/BSN enrollment program.

PubMed

Heglund, Stephen; Simmons, Jessica; Wink, Diane; D'Meza Leuner, Jean

In their 2011 report, The Future of Nursing, the Institute of Medicine called for 80% of the nursing workforce to be comprised of baccalaureate prepared Registered Nurses by the year 2020. One suggested approach to achieve this goal is the creation of programs that allow students to progress through associate and baccalaureate nursing preparation simultaneously. This paper describes the University of Central Florida's 13-year experience after implementing a Concurrent Enrollment Program. Development and structure of the program, advisement and curriculum details, facilitators and barriers are described. Data on National Council Licensure Examination for Registered Nurses pass rates, completion rates, comparison with traditional RN-BSN students, and progression to graduate school are also included. The Concurrent Program model described here between a specific university and state college partners, demonstrated positive outcomes that support achievement of the Institute of Medicine's goals. Copyright © 2017 Elsevier Inc. All rights reserved.

The production economics of nursing: a discussion paper.

PubMed

Newbold, David

2008-01-01

Nursing is numerically the largest health profession providing direct care, and this, plus the imperative for effective cost control, makes their costs and impact a legitimate study focus and policy target. Production theory techniques can help nurse executives maximize outcome and minimize costs, yet little of such evidence currently exists in mainstream nursing workforce research. The balance of available evidence supports an inverse association between nurse staffing levels and adverse outcomes. However, 'adequate' staffing levels may be perceived as expensive and some providers may try to reduce them. The response, in some US and Australian states, is legislation to force hospitals to implement mandatory minimum patient-to-nurse (P/N) ratios. In this paper, existing data from Aiken et al. [2003. Education levels of hospital nurses and patient mortality. Journal of the American Medical Association 290, 1617-1623] is re-interpreted using production theory, to illustrate the possible relationship between two key workforce variables "Staff Level" and "Staff Mix", and clinical outcome, and show how this informs decision making. Consistent with other studies, this suggests that diminishing returns to each variable exist. This preliminary analysis suggests that increasing the number of graduate RNs in the workforce might be the most cost-effective way to expand the nursing workforce. However, more detailed and rigorous research is needed to estimate speciality specific cost and production functions and compute the optimal solution. This can predict the most cost-effective staff combination for a set outcome, or the set of inputs yielding best outcome for a given budget. With this, nurse executives can systematically maintain service quality or safety in the most economical way.

Beliefs and perceptions of mentorship among nursing faculty and traditional and accelerated undergraduate nursing students.

PubMed

Navarra, Ann-Margaret; Stimpfel, Amy Witkoski; Rodriguez, Karla; Lim, Fidelindo; Nelson, Noreen; Slater, Larry Z

2018-02-01

In order to meet the demands of a dynamic and complex health care landscape, nursing education must develop and implement programming to produce a highly educated nursing workforce. Interprofessional honors education in nursing with targeted mentorship is one such model. To describe undergraduate nursing student and faculty perceptions and beliefs of mentorship in the context of interprofessional honors education, and compare and contrast the perceptions and beliefs about mentorship in interprofessional honors education between undergraduate nursing students and faculty. The study used a cross-sectional, descriptive design. Data were collected at an urban university in the northeast US, using a researcher-developed electronic survey. The sample included 24 full-time nursing faculty, and 142 undergraduate nursing students. Perceptions and beliefs regarding mentorship in the context of interprofessional honors education were similar for faculty and students, with both ranking mentorship among the most important components of a successful honors program. Honors education with a dedicated mentorship component may be implemented to improve the undergraduate education experience, facilitate advanced degree attainment, and develop future nursing leaders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Future-proofing nursing education.

PubMed

Keighley, Tom

2014-12-01

The origin of future-proofing seems lost in the mists of recent history. Dictionaries date its use from about 1991, referring to the prevention of obsolescence in information technology manufacturing and occasionally in organizational systems. However, closer analysis in healthcare demonstrates it can be traced back to the Rand Corporation and the studies commissioned there in the 1960s. These aimed at identifying the predictive factors in planning healthcare, including development of the workforce. It is a managerial concept that helps to project a vision of change that is not simply reactive or short-term. It permits a focus on leadership and the maximising of learning opportunities and includes analysis of the policy horizon. It held within it an assumption about the importance of establishing the cognitive frameworks that would influence long-term behaviours and not focus simply on short-term gains. This paper utilises this approach to explore options for future-proofing of nurse education.

Nursing in the United Arab Emirates: an historical background.

PubMed

El-Haddad, M

2006-12-01

To gain a better understanding of some of the factors that may be contributing to the shortage of national nurses in the United Arab Emirates (UAE). Approximately 3% of the UAE nursing workforce are currently nationals, which explains the UAE dependency on transient expatriate nurses. Even though Emirati women have been recently empowered to join the national workforce, not many have joined the nursing profession. Several factors may be contributing, in varying degrees, to this predicament. The socio-economic factors as well as the cultural and religious customs that have shaped the country and its people are examined. Hence, the historical background to the establishment of the UAE, women in Islam, the first nurse in Islam, the development of nursing in the UAE and the Emirates Nursing Association are considered. Factors contributing to the limited number of UAE nationals in the nursing profession include, but are not limited to: the low status of nursing in the UAE; the variations in basic nursing programmes in the country; the lack of Arabic educational resources; the affluent life style of UAE nationals as well as the strict cultural norms and religious values by which they live. As the need to nationalize the nursing workforce in the UAE is paramount, these issues and other perceived barriers from the perspective of Emirati nurses need to be explored and addressed.

The Workforce Task Force report: clinical implications for neurology.

PubMed

Freeman, William D; Vatz, Kenneth A; Griggs, Robert C; Pedley, Timothy

2013-07-30

The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care.

The Workforce Task Force Report

PubMed Central

Vatz, Kenneth A.; Griggs, Robert C.; Pedley, Timothy

2013-01-01

The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care. PMID:23783750

The importance of marketing in nurse education.

PubMed

Webster, R

There can be little doubt that changes in the National Health Service (NHS) heralded by the 1989 Government White Paper, Working for Patients, have significant implications for nurse education. Not least will be the need for Colleges and Schools of Nursing to present a high profile in terms of the services they offer. This paper explores the concept of marketing and its increasing importance to nurse education. It examines Giles' three propositions in relation to marketing, and suggests that these may be applied successfully to organisations providing a service, as well as those producing material goods. It looks at how and why marketing is necessary to nurse education, and suggests that marketing is an essential tool in assisting the School to achieve its objectives. Marketing strategies are discussed in detail, looking first at methods of research, then at the processes used to sell the courses being offered. These include the techniques of developing the offering, marketing the offering, facilitation, valuation and finally, promotional communication. The paper concludes by summarising the reasons why marketing techniques will be essential to the future success of nurse education, at a time when it is so vital to ensure that a well qualified nursing workforce is prepared to meet the challenges of the future.

Creating a successful transcultural on-boarding program.

PubMed

Nease, Beth

2009-01-01

A diverse workforce enables an organization to reflect and respond to community diversity. With an increase in the number of nurses educated outside of the United States seeking licensure and employment within U.S. hospitals, the development of an approach to assimilate these international nurses is essential. A thorough and holistic approach will ensure an ethical and safe introduction into the U.S. nursing workforce. This article describes a program based on the hospital's nursing professional practice model that was developed to address the challenges of skill transfer, role definition, and communication.

The migration of nurses: trends and policies.

PubMed Central

Buchan, James; Sochalski, Julie

2004-01-01

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States. We also examine the policy challenges for workforce planning and the design of health systems infrastructure. Data are derived from registries of professional nurses, censuses, interviews with key informants, case studies in source and destination countries, focus groups, and empirical modelling to examine the patterns and implications of the movement of nurses across borders. The flow of nurses to these destination countries has risen, in some cases quite substantially. Recruitment from lower-middle income countries and low-income countries, as defined by The World Bank, dominate trends in nurse migration to the United Kingdom, Ireland, and the United States, while Norway and Australia, primarily register nurses from other high-income countries. Inadequate data systems in many countries prevent effective monitoring of these workforce flows. Policy options to manage nurse migration include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Recommendations for enhancements to workforce data systems are provided. PMID:15375448

Nurses aged over 50 years and their experiences of shift work.

PubMed

Clendon, Jill; Walker, Leonie

2013-10-01

The Late Career Nurse project examined views and characteristics of nurses working in New Zealand who were born before 1960. This paper focuses on the experiences of such nurses who undertake shift work. The mean age of registered nurses in New Zealand has been rising steadily, and 40% are now aged 50 years or over. While there is substantial literature on the phenomenon and consequences of the ageing nursing workforce, little is known of the particular experiences of nurses aged over 50 years who work shifts. An anonymous online survey was emailed to eligible nurse New Zealand Nurses Organisation members aged over 50 years in February 2012. Quantitative and qualitative analyses of the 3273 responses received were undertaken. Over 45% of respondents worked shifts or flexible hours. While shift work suited many, others noted deleterious effects on family and social relationships, physical and mental health (notably sleep patterns and fatigue), and decreasing tolerance for shift work as they age. Poor scheduling practices were particularly detrimental. Worldwide, workforce ageing means strategies are required to retain older nurses in the workforce. Improved scheduling practices including increasing access to flexible and part time work hours, and development of resources on coping with shift work are recommended. © 2013 John Wiley & Sons Ltd.

2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030.

PubMed

Battafarano, Daniel F; Ditmyer, Marcia; Bolster, Marcy B; Fitzgerald, John D; Deal, Chad; Bass, Ann R; Molina, Rodolfo; Erickson, Alan R; Hausmann, Jonathan S; Klein-Gitelman, Marisa; Imundo, Lisa F; Smith, Benjamin J; Jones, Karla; Greene, Kamilah; Monrad, Seetha U

2018-04-01

To describe the character and composition of the 2015 US adult rheumatology workforce, evaluate workforce trends, and project supply and demand for clinical rheumatology care for 2015-2030. The 2015 Workforce Study of Rheumatology Specialists in the US used primary and secondary data sources to estimate the baseline adult rheumatology workforce and determine demographic and geographic factors relevant to workforce modeling. Supply and demand was projected through 2030, utilizing data-driven estimations regarding the proportion and clinical full-time equivalent (FTE) of academic versus nonacademic practitioners. The 2015 adult workforce (physicians, nurse practitioners, and physician assistants) was estimated to be 6,013 providers (5,415 clinical FTE). At baseline, the estimated demand exceeded the supply of clinical FTE by 700 (12.9%). By 2030, the supply of rheumatology clinical providers is projected to fall to 4,882 providers, or 4,051 clinical FTE (a 25.2% decrease in supply from 2015 baseline levels). Demand in 2030 is projected to exceed supply by 4,133 clinical FTE (102%). The adult rheumatology workforce projections reflect a major demographic and geographic shift that will significantly impact the supply of the future workforce by 2030. These shifts include baby-boomer retirements, a millennial predominance, and an increase of female and part-time providers, in parallel with an increased demand for adult rheumatology care due to the growing and aging US population. Regional and innovative strategies will be necessary to manage access to care and reduce barriers to care for rheumatology patients. © 2018, American College of Rheumatology.

Managing equality and cultural diversity in the health workforce.

PubMed

Hunt, Beverley

2007-12-01

This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re-negotiate and overcome such discriminatory practices. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty-five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include cultural sensitivity, equality and human rights; performance management; and transparent human resource management processes. Managing a racially and culturally diverse workforce is complex and challenging for managers. There are no ready-made tools to show them how to do so. Achieving effective management of a culturally diverse workforce comes from an intrinsic motivation to develop the cultural competence to engage with them. This article, together with others in this special issue, provides a springboard for moving this agenda on. It offers managers a framework of themes, which they can draw on to develop their own best practice for managing racial equality and cultural diversity in the health workforce.

Recent Changes in the Number of Nurses Graduating from Undergraduate and Graduate Programs.

PubMed

Buerhaus, Peter I; Auerbach, David I; Staiger, Douglas O

2016-01-01

Since the 1970s, a number of initiatives have attempted to increase the proportion of nursing graduates with a baccalaureate degree, but with little national effect. Now market forces, health reforms, and an Institute of Medicine report (2011) have combined to transform the educational composition of the nursing workforce. Today, there are considerably more graduates of baccalaureate nursing programs than associate degree programs. The educational transformation of the nursing workforce is not limited to baccalaureate education but includes the rapidly increasing numbers of registered nurses who have earned graduate degrees. These changes in nursing education are increasing the readiness of nursing professionals to capitalize on new opportunities, overcome challenges, and take on new roles and responsibilities as the nation's health care delivery and payments systems evolve in coming years.

The rate and cost of nurse turnover in Australia.

PubMed

Roche, Michael A; Duffield, Christine M; Homer, Caroline; Buchan, James; Dimitrelis, Sofia

2015-01-01

Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia.

The challenges of undergraduate mental health nursing education from the perspectives of heads of schools of nursing in Queensland, Australia.

PubMed

Happell, Brenda; McAllister, Margaret

2015-01-01

The shortage of a skilled mental health nursing workforce is persistent and worsening. Research consistently demonstrates the inability of the comprehensive model of nursing education to meet nursing workforce needs in mental health. Introducing specialisation in mental health at undergraduate level has been suggested as a strategy to address this problem. Exploration of barriers to this educational approach is essential. The aim of this research is to examine with Queensland Heads of Schools of Nursing, the perceived barriers to a specialist mental health nursing stream within an undergraduate nursing programme. Qualitative exploratory methods, involving in-depth telephone interviews with Heads of Schools of Nursing in Queensland, Australia. Data were analysed thematically. Participants encountered a number of barriers revealed in five main themes: academic staffing; staff attitudes; funding and resource implications; industry support; entry points and articulation pathways. Barriers to the implementation of mental health nursing specialisation in undergraduate programmes are evident. While these barriers pose real threats, potential solutions are also evident. Most notably is the need for Schools of Nursing to become more co-operative in mounting mental health nursing specialisations in a smaller number of universities, where specialist expertise is identified. Quality mental health services rely on a sufficiently skilled and knowledgeable nursing workforce. To achieve this it is important to identify and implement the educational approach best suited to prepare nurses for practice in this field.

Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation.

PubMed

Perry, Lin; Nicholls, Rachel; Duffield, Christine; Gallagher, Robyn

2017-11-01

To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. The study used a modified Delphi design conducted between September and November 2015. Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health. © 2017 John Wiley & Sons Ltd.

Navajo nation public health nurses inspire thoughts on health care reform.

PubMed

Douglas, Kathy S

2012-01-01

The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.

Building emotional intelligence: a strategy for emerging nurse leaders to reduce workplace bullying.

PubMed

Bennett, Karen; Sawatzky, Jo-Ann V

2013-01-01

Bullying is one of the most concerning forms of aggression in health care organizations. Conceptualized as an emotion-based response, bullying is often triggered by today's workplace challenges. Unfortunately, workplace bullying is an escalating problem in nursing. Bullying contributes to unhealthy and toxic environments, which in turn contribute to ineffective patient care, increased stress, and decreased job satisfaction among health care providers. These equate to a poor workforce environment, which in turn increases hospital costs when nurses choose to leave. Nurse managers are in positions of power to recognize and address negative workplace behaviors, such as bullying. However, emerging leaders in particular may not be equipped with the tools to deal with bullying and consequently may choose to overlook it. Substantive evidence from other disciplines supports the contention that individuals with greater emotional intelligence are better equipped to recognize early signs of negative behavior, such as bullying. Therefore, fostering emotional intelligence in emerging nurse leaders may lead to less bullying and more positive workplace environments for nurses in the future.

Geriatric Oncology Program Development and Gero-Oncology Nursing.

PubMed

Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

2016-02-01

To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Intention to stay of nurses in current posts in difficult-to-staff areas of Yemen, Jordan, Lebanon and Qatar: a cross-sectional study.

PubMed

El-Jardali, Fadi; Murray, Susan F; Dimassi, Hani; Jamal, Diana; Abualrub, Raeda; Al-Surimi, Khaled; Clinton, Michael; Dumit, Nuhad Y

2013-11-01

The nursing workforce shortages in difficult-to-staff areas have implications not only for quality of care but also for population health outcomes. An understanding of attrition and of retention is important to inform policies on the nursing workforce. This paper draws on questionnaire survey data from nurses working in difficult-to-staff areas in four countries in the Eastern Mediterranean Region (Yemen, Jordan, Lebanon and Qatar). It aims to identify the specific and common factors associated with nurses' intention to stay in their current post for the coming 1-3 years in three countries with an internally trained nursing workforce and in a fourth where the workforce is externally recruited. Nurses working in 'difficult to staff' areas in Yemen, Jordan, Lebanon and Qatar were surveyed. A conceptual model composed of 6 dimensions based on that of the World Health Organization was constructed with 'intent to stay' (Career Decisions) as the main outcome. Regression models were constructed for each of the dimensions in the conceptual model with 'intent to stay' as the dependent variable for each of the study countries. Subsequently, a collective model that combined Lebanon, Jordan and Yemen was constructed to identify common factors that are associated with intent to stay. Factors associated with intent to stay differed for study countries. Marriage was positively associated with intent to stay in Lebanon and Jordan whereas years of experience were positively significant for Lebanon and Yemen. Shorter commuting time was significantly associated with intent to stay in Jordan whereas a preference for village life was significant for Lebanon. Job satisfaction was significantly associated with intent to stay in all study countries. Nurses in Lebanon, Jordan and Qatar who indicated that they would choose nursing if they had the opportunity to choose a career all over again were significantly more likely to intend to stay in their current post. Studies of nurses working in these areas can help national policymakers and local nursing directors better manage the sparse nursing workforce in these localities and to provide them with appropriate incentives and support to encourage them to stay. Copyright © 2013 Elsevier Ltd. All rights reserved.

Addressing the primary care workforce: a study of nurse practitioner students' plans after graduation.

PubMed

Budd, Geraldine M; Wolf, Andrea; Haas, Richard Eric

2015-03-01

Primary care is a growing area, and nurse practitioners (NPs) hold promise for meeting the need for additional providers. This article reports on the future plans of more than 300 primary care NP students in family, adult, and adult gerontology programs. The sample was obtained through NP faculty, and data were collected via an online survey. Results indicated that although these students chose primary care, only 48% anticipated working in primary care; 26% planned to practice in rural areas, and 16% planned to work in an inner city. Reasons cited as important for pursuing a primary care position included the long-term patient relationship, faculty and preceptor mentors from the NP program, and clinical experiences as a student. Implications include providing more intensive faculty mentoring to increase the number of individuals seeking primary care positions after graduation and help with future career planning to meet personal career and nursing profession needs. Copyright 2015, SLACK Incorporated.

Australian primary health care nurses most and least satisfying aspects of work.

PubMed

Halcomb, Elizabeth; Ashley, Christine

2017-02-01

To identify the aspects of working in Australian primary health care that nurses rate as the most and least satisfying. The nursing workforce in Australian primary health care has grown exponentially to meet the growing demand for health care. To maintain and further growth requires the recruitment and retention of nurses to this setting. Understanding the factors that nurses' rate as the most and least satisfying about their job will inform strategies to enhance nurse retention. A cross-sectional online survey. Nurses employed in primary health care settings across Australia were recruited (n = 1166) to participate in a survey which combined items related to the respondent, their job, type of work, clinical activities, job satisfaction and future intention, with two open-ended items about the most and least satisfying aspects of their work. Patient interactions, respect, teamwork, collegiality and autonomy were identified as the most satisfying professional aspects of their role. Personal considerations such as family friendly work arrangements and a satisfactory work-life balance were also important, overriding negative components of the role. The least satisfying aspects were poor financial support and remuneration, lack of a career path, physical work environment and time constraints. National restructuring of the primary health care environment was seen as a barrier to role stability and ability to work to a full scope of practice. This study has identified a range of positive and negative professional and personal aspects of the primary health care nursing role, which may impact on staff recruitment and retention. Findings from the study should be considered by employers seeking to retain and maximise the skills of their primary health care workforce. Understanding the factors that nurses perceive as being the most and least satisfying aspects of the work is can open up dialogue about how to improve the working experience of nurses in primary health care. © 2016 John Wiley & Sons Ltd.

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey.

PubMed

Delaney, Kathleen R; Drew, Barbara L; Rushton, Amy

2018-06-01

Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.

United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit.

PubMed

Zhang, Xiaoming; Tai, Daniel; Pforsich, Hugh; Lin, Vernon W

This is a reevaluation of registered nurse (RN) supply and demand from 2016 to 2030 using a previously published work forecast model and grading methodology with more recent workforce data. There will be a shortage of 154 018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions. This reflects a nearly 50% overall improvement when compared with the authors' prior study, and the low-performing states have improved from 18 "D" and 12 "F" grades as published earlier to 13 "D" and 1 "F" in this study. Although progress has been made, efforts to foster the pipelines for improving the nursing workforce need to be continued.

Rural nursing education: a photovoice perspective.

PubMed

Leipert, Beverly; Anderson, Emma

2012-01-01

For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status. Exemplar photos and reflections are provided. The photovoice research approach used in this rural education endeavour proved to be very useful in fostering students' exposure to, interest in, and understanding of rural settings and their influence on rural nursing practice. Photovoice is also recommended for use in rural courses other than nursing. Suggested strategies include group photovoice experience and the expansion of reflection to enhance rural health research.

District nursing workforce planning: a review of the methods.

PubMed

Reid, Bernie; Kane, Kay; Curran, Carol

2008-11-01

District nursing services in Northern Ireland face increasing demands and challenges which may be responded to by effective and efficient workforce planning and development. The aim of this paper is to critically analyse district nursing workforce planning and development methods, in an attempt to find a suitable method for Northern Ireland. A systematic analysis of the literature reveals four methods: professional judgement; population-based health needs; caseload analysis and dependency-acuity. Each method has strengths and weaknesses. Professional judgement offers a 'belt and braces' approach but lacks sensitivity to fluctuating patient numbers. Population-based health needs methods develop staffing algorithms that reflect deprivation and geographical spread, but are poorly understood by district nurses. Caseload analysis promotes equitable workloads but poorly performing district nursing localities may continue if benchmarking processes only consider local data. Dependency-acuity methods provide a means of equalizing and prioritizing workload but are prone to district nurses overstating factors in patient dependency or understating carers' capability. In summary a mixed method approach is advocated to evaluate and adjust the size and mix of district nursing teams using empirically determined patient dependency and activity-based variables based on the population's health needs.

Perceptions from the front line: professional identity in mental health nursing.

PubMed

Hercelinskyj, Gylo; Cruickshank, Mary; Brown, Peter; Phillips, Brian

2014-02-01

In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses (MHN) in Victoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of MHN: (i) the ambiguity of the MHN role; (ii) the weak definition and lack of understanding of the scope of the MHN role by nursing students; and (iii) a lack of communication about MHN as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of MHN; and (iii) more accurately defining the role of the MHN. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Workforce planning. Catching the drift.

PubMed

Jinks, C; Ong, B N; Paton, C

1998-09-17

NHS workforce planning has traditionally ignored the role of doctors and nurses trained in continental Europe and Scandinavia. At present doctors trained in the European Economic Area make up 10 per cent of senior house officers in England and Wales. But the numbers coming to the UK are falling. Falling medical unemployment in Europe will mean these doctors have less incentive to come to the UK, leaving a considerable gap in the NHS workforce. More local research is needed into working patterns and career plans of European-trained nurses and doctors.

Starting Out: qualitative perspectives of new graduate nurses and nurse leaders on transition to practice.

PubMed

Regan, Sandra; Wong, Carol; Laschinger, Heather K; Cummings, Greta; Leiter, Michael; MacPhee, Maura; Rhéaume, Ann; Ritchie, Judith A; Wolff, Angela C; Jeffs, Lianne; Young-Ritchie, Carol; Grinspun, Doris; Gurnham, Mary Ellen; Foster, Barbara; Huckstep, Sherri; Ruffolo, Maurio; Shamian, Judith; Burkoski, Vanessa; Wood, Kevin; Read, Emily

2017-05-01

To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles. Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services. A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces. New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads. The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face organisational constraints in being able to support new graduate nurses. Organisations should ensure that nurse leaders have the resources they need to support the positive transition of new graduate nurses including adequate staffing and realistic workloads for both experienced and new nurses. Nurse leaders should work to create unit cultures that foster learning by encouraging new graduate nurses to ask questions and seek feedback without fear of criticism or incivility. © 2017 John Wiley & Sons Ltd.

Can nurse practitioners and physicians beat parochialism into plowshares?

PubMed

Phillips, Robert L; Harper, Doreen C; Wakefield, Mary; Green, Larry A; Fryer, George E

2002-01-01

Nurse practitioners have evolved into a large and flexible workforce. Far too often, nurse practitioner and physician professional organizations do not work together but rather expend considerable effort jousting in policy arenas. Turf battles interfere with joint advocacy for needed health system change and delay development of interdisciplinary teams that could help patients. A combined, consistent effort is urgently needed for studying, training, and deploying a collaborative, integrated workforce aimed at improving the health care system of tomorrow. The country can ill afford doctors and nurses who ignore one another's capabilities and fail to maximize each other's contributions cost-effectively.

The nursing shortage: part way down the slippery slope.

PubMed

Cowin, Leanne; Jacobsson, Denise

2003-07-01

The shortage of nurses has reached a crisis point for health care services. A number of issues including the effects of economic rationalism, generational differences, working conditions and nurse education are revisited in a discussion that aims to refuel the debate on workplace reform for nurses. Economic rationalism has altered the healthcare service landscape. Attempts to balance service delivery with workforce resources have led to possibly unforeseen changes. Highly skilled nurses are required in acute services, however resource allocation may prevent this. The nursing workforce is aging although the current nursing workforce consists of three generations: baby boomers, generation X and generation Y. There are significant ideological and work organisational differences between these generations leading to possible conflict between nurses. The pool of available nurses to fill employment vacancies is finite. Attracting overseas nurses to fill nurse vacancies will leave vacancies elsewhere and is not a long-term solution to the nursing shortage. Moreover, if the workplace has not addressed the reasons why nurses have left the health care workplace then there is a real danger of losing those recently attracted back into the workplace. Working conditions are a critical element within the retention puzzle. Job satisfaction dimensions such as autonomy and professional relationships are key components for improving working conditions. The final issue explored is the question of whether the tertiary education system is the most appropriate place in which to develop and educate nurses. It is suggested that workplace reforms should be the target of retention strategies rather than changes in the educational process of nursing.

The 'greying' of the United Kingdom nursing workforce: implications for employment policy and practice.

PubMed

Buchan, J

1999-10-01

One in five nurses on the United Kingdom (UK) professional register is aged 50 years or older. Over the next few years, the profession will lose, through retirement, many of its most experienced practitioners. The significance for policy makers and for employers of this age-shift is two-fold. Firstly it is clear that greater numbers of nurses and midwives are reaching, or soon will reach, potential retirement age. Secondly many more nurses are now reaching their middle years and they are likely to have different requirements and attitudes to nursing work. This paper examines the employment policy and practice of the ageing of the UK nursing population. The paper examines data from official sources, and information from attitudinal surveys and case studies with employing organizations to assess the major effects of the ageing of the nursing workforce. Key findings are that the age profile of those nurses working in the National Health Service appears to be 'younger' than that of the total population, with the age profile of nurses working in nursing homes and as practice nurses being older than that of the NHS nursing workforce. However, the overall age profile of NHS nurses masks considerable variation between specialties and trusts, and the 'pool' of potential nurse returners from which the NHS and other employers attempts to recruit, is declining in numbers, as it too ages. Other major issues requiring policy attention are the provision of appropriate flexible hours to older nurses who have caring responsibilities, improving access to continuing professional development, and reducing pension provision inflexibility.

Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique.

PubMed

Adhikari, Radha; Grigulis, Astrida

2014-03-01

The UK National Health Service has a long history of recruiting overseas nurses to meet nursing shortages in the UK. However, recruitment patterns regularly fluctuate in response to political and economic changes. Typically, the UK government gives little consideration of how these unstable recruitment practices affect overseas nurses. In this article, we present findings from two independent research studies from Malawi and Nepal, which aimed to examine how overseas nurses encountered and overcame the challenges linked to recent recruitment and migration restrictions. We show how current UK immigration policy has had a negative impact on overseas nurses' lives. It has led them to explore alternative entry routes into the UK, affecting both the quality of their working lives and their future decisions about whether to stay or return to their home country. We conclude that the shifting forces of nursing workforce demand and supply, leading to abrupt policy changes, have significant implications on overseas nurses' lives, and can leave nurses 'trapped' in the UK. We make recommendations for UK policy-makers to work with key stakeholders in nurse-sending countries to minimize the negative consequences of unstable nurse recruitment, and we highlight the benefits of promoting circular migration.

The current state of nursing performance measurement, public reporting, and value-based purchasing.

PubMed

Kurtzman, Ellen T; Dawson, Ellen M; Johnson, Jean E

2008-08-01

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.

Nurse practitioners, certified nurse midwives, and physician assistants in physician offices.

PubMed

Park, Melissa; Cherry, Donald; Decker, Sandra L

2011-08-01

The expansion of health insurance coverage through health care reform, along with the aging of the population, are expected to strain the capacity for providing health care. Projections of the future physician workforce predict declines in the supply of physicians and decreasing physician work hours for primary care. An expansion of care delivered by nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) is often cited as a solution to the predicted surge in demand for health care services and calls for an examination of current reliance on these providers. Using a nationally based physician survey, we have described the employment of NPs, CNMs, and PAs among office-based physicians by selected physician and practice characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Achieving effective staffing through a shared decision-making approach to open-shift management.

PubMed

Valentine, Nancy M; Nash, Jan; Hughes, Douglas; Douglas, Kathy

2008-01-01

Managing costs while retaining qualified nurses and finding workforce solutions that ensure the delivery of high-quality patient care is of primary importance to nurse leaders and executive management. Leading healthcare organizations are using open-shift management technology as a strategy to improve staffing effectiveness and the work environment. In many hospitals, open-shift management technology has become an essential workforce management tool, nursing benefit, and recruitment and retention incentive. In this article, the authors discuss how a successful nursing initiative to apply automation to open-shift scheduling and fulfillment across a 3-hospital system had a broad enterprise-wide impact resulting in dramatic improvements in nurse satisfaction, retention, recruitment, and the bottom line.

The case for renewed investment in the district nursing specialist practitioner qualification.

PubMed

Longstaff, Fiona

2013-09-01

District nursing as a profession has been under significant threat over the last few years due to a lack of foresight and funding, resulting in an undervalued and underinvested workforce. The once-heralded specialist practitioner programme was slowly decommissioned in all but a handful of universities, leaving no alternative but for community trusts to employ staff nurses in team leader roles without the development the added qualification gave them. In light of the renewed focus on the fundamental advancement of district nurses and recent Government publications clearly reinforcing the district nurse's role, this article argues for the need for educational commissioners and workforce planners to commit to continued investment in this vital profession.

A missing piece of the workforce puzzle. The experiences of internationally qualified nurses in New Zealand: a literature review.

PubMed

Jenkins, Brittany Lauren; Huntington, Annette

2015-01-01

To analyse the literature regarding the context and experiences of internationally qualified registered nurses, particularly Filipino and Indian nurses, who have transitioned to New Zealand. Internationally qualified nurses are a significant proportion of the nursing workforce in many developed countries including New Zealand. This is increasingly important as populations age, escalating demand for nurses. Understanding the internationally qualified nurse experience is required as this could influence migration in a competitive labour market. Examination of peer-reviewed research, policy and discussion documents, and technical reports. A systematic literature search sought articles published between 2001 and 2014 using Google Scholar, CINAHL, and Medline. Articles were critically appraised for relevance, transferability, and methodological rigour. Fifty-one articles met inclusion criteria and demonstrate internationally qualified nurses face significant challenges transitioning into New Zealand. The internationally qualified nurse experience of transitioning into a new country is little researched and requires further investigation.

Fatigue in hospital nurses - 'Supernurse' culture is a barrier to addressing problems: A qualitative interview study.

PubMed

Steege, Linsey M; Rainbow, Jessica G

2017-02-01

Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. The purpose of this paper is to describe emergent themes that offer new insight describing the relationships among nurse perceptions of fatigue, nursing professional culture, and implications for the nursing workforce. A qualitative exploratory study was used to explore nurse identified sources, barriers to addressing, and consequences of fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center in the United States participated in the interviews. Interviews with the participants followed a semi-structured interview guide that included questions eliciting participants' views on nurse fatigue levels, consequences of fatigue, and barriers to addressing fatigue. The interview transcripts were analyzed using directed content analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Additional themes that did not directly align with the SEIPS model were also identified. All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges. A new construct related to nursing professional culture was identified and defined as "Supernurse". Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego. These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs and achieving safety culture in hospital organizations. Nurse fatigue and attributes of nurse professional culture also have implications for nurse satisfaction and retention. Findings from this study further support the role of nursing professional culture as an important barrier to effectively addressing fatigue in nursing work systems. Future work is needed to identify and evaluate innovative culture change models and strategies to target these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nurses' motivators to work part-time.

PubMed

Jamieson, Lynn N; Williams, Leonie Mosel; Lauder, William; Dwyer, Trudy

2007-04-01

There has been a trend of growth in part-time employment within the Australian nursing workforce and currently half of the profession work part-time. While the literature across disciplines has postulated reasons behind preferences for part-time employment, little is known about nurses' motivators to work part-time. In an era of nursing shortages that form considerable barriers to meeting healthcare service demands, a clear understanding of these motivators is critical for the effective planning and management of the nursing workforce. A grounded theory study that explored the phenomenon of part-time nursing found that nurses' motivators to work part-time were complex and identifiable with nursing, establishing that nurses' working time decisions are made in contexts that may be unique to the profession. This paper provides an exhaustive description and explanation of one cohort of part-time nurses that accounts for variations between nurses and provides an understanding of the complexity of factors that contribute to nurses' decisions to work part-time.

Nurses and global health: 'at the table' or 'on the menu'?

PubMed

Scammell, Janet

2018-01-11

Janet Scammell, Associate Professor (Nursing), Bournemouth University, looks at the role of the nursing workforce in shaping wider global health care, and the part nurse educators play in promoting international involvement.

National nursing strategies in seven countries of the Region of the Americas: issues and impact.

PubMed

Shasanmi, Rebecca O; Kim, Esther M; Cassiani, Silvia Helena De Bortoli

2015-07-01

To identify and examine the current national nursing strategies and policy impact of workforce development regarding human resources for health in seven selected countries in the Region of the Americas: Argentina, Canada, Costa Rica, Jamaica, Mexico, Peru, and the United States. A review of available literature was conducted to identify publicly-available documents that describe the general backdrop of nursing human resources in these seven countries. A keyword search of PubMed was supplemented by searches of websites maintained by Ministries of Health and nursing organizations. Inclusion criteria limited documents to those published in 2008-2013 that discussed or assessed situational issues and/or progress surrounding the nursing workforce. Nursing human resources for health is progressing. Canada, Mexico, and the United States have stronger nursing leadership in place and multisectoral policies in workforce development. Jamaica shows efforts among the Caribbean countries to promote collaborative practices in research. The three selected countries in Central and South America championed networks to revive nursing education. Yet, overall challenges limit the opportunities to impact public health. The national nursing strategies prioritized multisectoral collaboration, professional competencies, and standardized educational systems, with some countries underscoring the need to align policies with efforts to promote nursing leadership, and others, focusing on expanding the scope of practice to improve health care delivery. While each country wrestles with its specific context, all require proper leadership, multisectoral collaboration, and appropriate resources to educate, train, and empower nurses to be at the forefront.

Evidence-based practice: how nurse leaders can facilitate innovation.

PubMed

Shirey, Maria R

2006-01-01

Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.

Pay or conditions? The role of workplace characteristics in nurses' labor supply.

PubMed

Eberth, Barbara; Elliott, Robert F; Skåtun, Diane

2016-07-01

Empirically rigorous studies of nursing labor supply have to date relied on extant secondary data and focused almost exclusively on the role of pay. Yet the conditions under which nurses work and the timing and convenience of the hours they work are also important determinants of labor supply. Where there are national pay structures and pay structures are relatively inflexible, as in nursing in European countries, these factors become more important. One of the principal ways in which employers can improve the relative attractiveness of nursing jobs is by changing these other conditions of employment. This study uses new primary data to estimate an extended model of nursing labor supply. It is the first to explore whether and how measures of non-pecuniary workplace characteristics and observed individual (worker) heterogeneity over non-pecuniary job aspects impact estimates of the elasticity of hours with respect to wages. Our results have implications for the future sustainability of an adequately sized nurse workforce and patient care especially at a time when European healthcare systems are confronted with severe financial pressures that have resulted in squeezes in levels of healthcare funding.

Factor analysis and Mokken scaling of the Organizational Commitment Questionnaire in nurses.

PubMed

Al-Yami, M; Galdas, P; Watson, R

2018-03-22

To generate an Arabic version of the Organizational Commitment Questionnaire that would be easily understood by Arabic speakers and would be sensitive to Arabic culture. The nursing workforce in Saudi Arabia is undergoing a process of Saudization but there is a need to understand the factors that will help to retain this workforce. No organizational commitment tools exist in Arabic that are specifically designed for health organizations. An Arabic version of the organizational commitment tool could aid Arabic speaking employers to understand their employees' perceptions of their organizations. Translation and back-translation followed by factor analysis (principal components analysis and confirmatory factor analysis) to test the factorial validity and item response theory (Mokken scaling). A two-factor structure was obtained for the Organizational Commitment Questionnaire comprising Factor 1: Value commitment; and Factor 2: Commitment to stay with acceptable reliability measured by internal consistency. A Mokken scale was obtained including items from both factors showing a hierarchy of items running from commitment to the organization and commitment to self. This study shows that the Arabic version of the OCQ retained the established two-factor structure of the original English-language version. Although the two factors - 'value commitment' and 'commitment to stay' - repudiate the original developers' single factor claim. A useful insight into the structure of the Organizational Commitment Questionnaire has been obtained with the novel addition of a hierarchical scale. The Organizational Commitment Questionnaire is now ready to be used with nurses in the Arab speaking world and could be used a tool to measure the contemporary commitment of nursing employees and in future interventions aimed at increasing commitment and retention of valuable nursing staff. © 2018 International Council of Nurses.

Nursing Workforce in Hubei China: Implications for the Development of Traditional Chinese Medicine Education.

PubMed

Cai, Yi; Mao, Zongfu; Corazzini, Kirsten; Petrini, Marcia A; Wu, Bei

2015-01-01

Research evidence suggests that educating nurses about traditional Chinese medicine (TCM) significantly improves their nursing care practice and the health care outcomes of community residents. The purpose of this study was to describe the current use of TCM by China's nursing workforce, as well as the typical nurse to physician ratio and types of TCM education that nurses receive in health care facilities. A large retrospective survey was conducted in Hubei Province, China, in 2010. The sample included 620 non-TCM hospitals, 120 TCM hospitals, and 1254 community health centers (CHCs). Descriptive analysis and 1-way analysis of variance were used to test statistical differences. There were 79 447 nurses employed, of which 1527 had a TCM degree and 5689 had on-the-job TCM education. Non-TCM hospitals employed more nurses than TCM hospitals and CHCs, and TCM hospitals employed more TCM nurses than non-TCM hospitals and CHCs. The median nurse to physician ratio varied by level of urbanization and type of health care facility, from 0.6 in rural CHCs to 1.3 in rural non-TCM hospitals. Differences in TCM education preparation of nurses were significantly different in the urban and rural settings and by type of health care facility. The study suggested a shortage of nurses educated in TCM in Hubei Province China, as well as uneven TCM workforce distribution. More opportunities for TCM education are needed for nurses, especially in CHCs where health promotion and chronic disease management are the most important and mandated functions.

A flexible nursing workforce: realities and fallouts.

PubMed

Grinspun, Doris

2002-01-01

While policy-makers are increasingly concerned about a looming nursing shortage, almost half of Canada's nursing workforce is currently employed on a part-time or casual basis. Why are so many nurses not working full-time and providing the nursing care that would help to alleviate such shortages in our healthcare organizations? Do nurses want to work part-time, or are they driven into this by labour market forces, life demands, poor working conditions and policy decisions external to them? The answers to these questions are critical to ensure that care will be there for all of us. This article presents a brief analysis of flexible employment arrangements in nursing, particularly part-time and casual work, and the impact on nurses, patients and the healthcare system as a whole. Given the sharp increases in these work arrangements in Canada during the last decade, the limited discussion of these trends in the literature is both surprising and troublesome.

Health Workforce and International Migration: Can New Zealand Compete? OECD Health Working Papers No. 33

ERIC Educational Resources Information Center

Zurn, Pascal; Dumont, Jean-Christophe

2008-01-01

This paper examines health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses. The health workforce in New Zealand, as in all OECD countries, plays a central role in the health system. Nonetheless, maybe more than for any other OECD country, the health workforce in New…

Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study.

PubMed

Perry, Lin; Xu, Xiaoyue; Gallagher, Robyn; Nicholls, Rachel; Sibbritt, David; Duffield, Christine

2018-05-09

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014⁻2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25⁻34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

Internationally educated nurses in Canada: predictors of workforce integration.

PubMed

Covell, Christine L; Primeau, Marie-Douce; Kilpatrick, Kelley; St-Pierre, Isabelle

2017-04-04

Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs' workforce integration. A cross-sectional, descriptive, correlational survey design was used. Eligible IENs were immigrants, registered and employed as regulated nurses in Canada. Data were collected in 2014 via online and paper questionnaires. Descriptive statistics were used to examine the data by year of immigration. Logistic regression modeling was employed to identify predictors of IENs' workforce integration measured as passing the licensure exam to acquire professional recertification and securing employment. The sample consisted of 2280 IENs, representative of all Canadian provincial jurisdictions. Since changes to the immigrant selection process in 2002, the IEN population in Canada has become more racially diverse with greater numbers emigrating from developing countries. Recent arrivals (after 2002) had high levels of human capital (knowledge, professional experience, language proficiency). Some, but not all, benefited from the formal and informal assistance available to facilitate their workforce integration. Professional experience and help studying significantly predicted if IENs passed the licensure exam on their first attempt. Bridging program participation and assistance from social networks in Canada were significant predictors if IENs had difficulty securing employment. Nurses will continue to migrate from a wide variety of countries throughout the world that have dissimilar nursing education and health systems. Thus, IENs are not a homogenous group, and a "one size fits all" model may not be effective for facilitating their professional recertification and employment in the destination country. Canada, as well as other countries, could consider using a case management approach to develop and tailor education and forms of assistance to meet the individual needs of IENs. Using technology to reach IENs who have not yet immigrated or have settled outside of urban centers are other potential strategies that may facilitate their timely entrance into the destination countries' nursing workforce.

Tracking and monitoring the health workforce: a new human resources information system (HRIS) in Uganda

PubMed Central

2011-01-01

Background Health workforce planning is important in ensuring that the recruitment, training and deployment of health workers are conducted in the most efficient way possible. However, in many developing countries, human resources for health data are limited, inconsistent, out-dated, or unavailable. Consequently, policy-makers are unable to use reliable data to make informed decisions about the health workforce. Computerized human resources information systems (HRIS) enable countries to collect, maintain, and analyze health workforce data. Methods The purpose of this article is twofold. First, we describe Uganda's transition from a paper filing system to an electronic HRIS capable of providing information about country-specific health workforce questions. We examine the ongoing five-step HRIS strengthening process used to implement an HRIS that tracks health worker data at the Uganda Nurses and Midwives Council (UNMC). Secondly, we describe how HRIS data can be used to address workforce planning questions via an initial analysis of the UNMC training, licensure and registration records from 1970 through May 2009. Results The data indicate that, for the 25 482 nurses and midwives who entered training before 2006, 72% graduated, 66% obtained a council registration, and 28% obtained a license to practice. Of the 17 405 nurses and midwives who obtained a council registration as of May 2009, 96% are of Ugandan nationality and just 3% received their training outside of the country. Thirteen per cent obtained a registration for more than one type of training. Most (34%) trainings with a council registration are for the enrolled nurse training, followed by enrolled midwife (25%), registered (more advanced) nurse (21%), registered midwife (11%), and more specialized trainings (9%). Conclusion The UNMC database is valuable in monitoring and reviewing information about nurses and midwives. However, information obtained from this system is also important in improving strategic planning for the greater health care system in Uganda. We hope that the use of a real-world example of HRIS strengthening provides guidance for the implementation of similar projects in other countries or contexts. PMID:21329516

Contemporary challenges for specialist nursing in interstitial lung disease

PubMed Central

Russell, Anne Marie; Olive, Sandra; Lines, Sarah; Murphy, Anna; Hocking, Julie; Newell, Karen; Morris, Helen; Harris, Emma; Dixon, Catherine; Agnew, Sarah; Burge, Geraldine

2018-01-01

The role of clinical nurse specialists (CNSs) in interstitial lung disease (ILD) is evolving in response to clinical guidelines and the growth of clinical research. The role is well established in the UK, although more ILD posts are needed to ensure supply meets clinical demand. This phenomenon is also happening across Europe. An appreciation of the similarities and differences between CNS and advanced nurse practitioners is important given the challenges in defining, developing and supporting this nursing specialisation. Globally, different models exist. In some countries charitable organisations take a leading role in supporting patients. Many European centres look to the National Institute for Health and Care Excellence guidelines and quality standards as a template to develop and evaluate the role of the ILD CNS. We present a UK perspective in the context of a government subsidised healthcare system to promote professional discussion and debate regarding the future of nursing practice in the ILD specialty. Key points ILDs are often complex and associated with significant mortality, morbidity and co-morbid conditions that require a technical healthcare skill set There is worldwide shortage of nurses, low retention rates and retirement of many skilled nurses Collaboration across the ILD interdisciplinary community is needed to safeguard the future of our professions and high-quality patient care The ILD interdisciplinary and nurse network has identified key priorities to help secure the future of the ILD clinical and academic nurse specialism Educational aims To explain the similarities and differences between clinical nurse specialists (CNSs) and advanced nurse practitioners (ANPs) in the context of ILD specialism To review contemporary nursing specialism in the UK’s government subsidised healthcare system To stimulate discussion and debate across the European/international respiratory community regarding the clinical and academic development of the ILD CNS To identify key priorities that will support collaboration across the ILD interdisciplinary workforce in clinical practice and research PMID:29515666

Contemporary challenges for specialist nursing in interstitial lung disease.

PubMed

Russell, Anne Marie; Olive, Sandra; Lines, Sarah; Murphy, Anna; Hocking, Julie; Newell, Karen; Morris, Helen; Harris, Emma; Dixon, Catherine; Agnew, Sarah; Burge, Geraldine

2018-03-01

The role of clinical nurse specialists (CNSs) in interstitial lung disease (ILD) is evolving in response to clinical guidelines and the growth of clinical research. The role is well established in the UK, although more ILD posts are needed to ensure supply meets clinical demand. This phenomenon is also happening across Europe. An appreciation of the similarities and differences between CNS and advanced nurse practitioners is important given the challenges in defining, developing and supporting this nursing specialisation. Globally, different models exist. In some countries charitable organisations take a leading role in supporting patients. Many European centres look to the National Institute for Health and Care Excellence guidelines and quality standards as a template to develop and evaluate the role of the ILD CNS. We present a UK perspective in the context of a government subsidised healthcare system to promote professional discussion and debate regarding the future of nursing practice in the ILD specialty. ILDs are often complex and associated with significant mortality, morbidity and co-morbid conditions that require a technical healthcare skill setThere is worldwide shortage of nurses, low retention rates and retirement of many skilled nursesCollaboration across the ILD interdisciplinary community is needed to safeguard the future of our professions and high-quality patient careThe ILD interdisciplinary and nurse network has identified key priorities to help secure the future of the ILD clinical and academic nurse specialism. To explain the similarities and differences between clinical nurse specialists (CNSs) and advanced nurse practitioners (ANPs) in the context of ILD specialismTo review contemporary nursing specialism in the UK's government subsidised healthcare systemTo stimulate discussion and debate across the European/international respiratory community regarding the clinical and academic development of the ILD CNSTo identify key priorities that will support collaboration across the ILD interdisciplinary workforce in clinical practice and research.

Creating innovative programs for the future.

PubMed

Allen, Patricia E; Keough, Vicki A; Armstrong, Myrna L

2013-09-01

Although several major national mandates advocate for a better educated workforce, this push comes at a time when the competition for faculty, financial resources, advanced technology, and students remains strong. If nurse educators are seriously considering creating a new nurse program at their school, some key points are essential during the development stage. Using the innovation frameworks from the Institute of Healthcare Improvement, from the global design firm IDEO, and from Gladwell's The Tipping Point: How Little Things Can Make a Big Difference, this article examines the informal, formal, internal, and external work needed during program conceptualization, initial program exploration, resource infrastructure, support, and evaluation for an effective and innovative plan. Copyright 2013, SLACK Incorporated.

Future directions for career choice research in nursing: a discussion paper.

PubMed

Price, Sheri

2009-02-01

The last few decades have seen considerable changes in the characteristics of the healthcare workplace and workforce. There is a significant emphasis on recruitment and retention of healthcare providers internationally especially within the profession of Nursing, where there is a critical and growing shortage of nurses. Career choice is a critical component of recruitment and retention strategies and has significant organizational implications in regards to person-environment fit, career satisfaction and commitment. Many extant career choice theories fail to capture the challenges, complexities and uncertainties of the 21st century. Moreover, some early theories do not recognize the unique characteristics of upcoming generational cohorts and the multivariate influences on their career decisions. An extensive review and synthesis of the related literature provide the basis for a critical discussion on the adoption of new methodological approaches to exploring career choice in Nursing. The use of qualitative and mixed method approaches, a focus on generational differences and an exploration of adaptive and adjustment processes to career change provide a foundation for future career choice research and theoretical development which are reflective of the characteristics of the contemporary employee and the reality of modern healthcare organizations.

Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers

ERIC Educational Resources Information Center

Wise, Vanessa

2013-01-01

As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…

Is anybody listening? A qualitative study of nurses' reflections on practice.

PubMed

Huntington, Annette; Gilmour, Jean; Tuckett, Anthony; Neville, Stephen; Wilson, Denise; Turner, Catherine

2011-05-01

To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct. Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care. © 2011 Blackwell Publishing Ltd.

U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency

PubMed Central

Aiken, Linda H

2007-01-01

Objectives To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Principal Findings Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Conclusions Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and implementing evidence-based initiatives to improve nurse retention and productivity could prevent future nurse shortages. PMID:17489916

US nurse labor market dynamics are key to global nurse sufficiency.

PubMed

Aiken, Linda H

2007-06-01

To review estimates of U.S. nurse supply and demand, document trends in nurse immigration to the United States and their impact on nursing shortage, and consider strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. Production capacity of nursing schools is lagging current and estimated future needs, suggesting a worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S. registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from lower-income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the same time that American nursing schools are turning away large numbers of native applicants because of capacity limitations. Increased reliance on immigration may adversely affect health care in lower-income countries without solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding nursing school capacity to accommodate qualified native applicants and implementing evidence-based initiatives to improve nurse retention and productivity could prevent future nurse shortages.

The future of the New Zealand plastic surgery workforce.

PubMed

Adams, Brandon M; Klaassen, Michael F; Tan, Swee T

2013-04-05

The New Zealand (NZ) plastic and reconstructive surgery (PRS) workforce provides reconstructive plastic surgery (RPS) public services from six centres. There has been little analysis on whether the workforce is adequate to meet the needs of the NZ population currently or in the future. This study analysed the current workforce, its distribution and future requirements. PRS manpower data, workforce activities, population statistics, and population modelling were analysed to determine current needs and predict future needs for the PRS workforce. The NZ PRS workforce is compared with international benchmarks. Regional variation of the workforce was analysed with respect to the population's access to PRS services. Future supply of specialist plastic surgeons is analysed. NZ has a lower number of plastic surgeons per capita than comparable countries. The current NZ PRS workforce is mal-distributed. Areas of current and emerging future need are identified. The current workforce mal-distribution will worsen with future population growth and distribution. Up to 60% of the NZ population will be at risk of inadequate access to PRS services by 2027. Development of PRS services must be coordinated to ensure that equitable and sustainable services are available throughout NZ. Strategies for ensuring satisfactory future workforce are discussed.

Nursing practice. Report of a WHO expert committee.

PubMed

1996-01-01

Nursing is remarkable for the scope of activities that it includes. Nursing practice involves so many things in so many places that finding a definition that includes everything and applies everywhere is no easy task. This report by the WHO Expert Committee on Nursing Practice describes the basic functions of nursing practice and how they are manifested in different socioeconomic situations. Whatever the environment, the report concludes, there are certain core elements that are the responsibility of nurses the world over. The influence that social attitudes and political and economic policies have on nursing practice is examined. The report is honest in its admission that the situation in many places is far from ideal and that in most there is clear room for improvement. Policy-makers, legislators, managers, educators, researchers, other professionals and nurses themselves have important roles to play in a comprehensive approach to the development of nursing practice proposed by the Expert Committee. The report emphasizes the importance of a well educated and highly skilled nursing workforce that is consistent in maintaining quality of care but is also responsive to change. It points the way to international standards in nursing practice and lays the foundation for new strategies to ensure that nurses will be fully equipped to meet future challenges in the delivery of health care.

The development and issues of nursing education in China: a national data analysis.

PubMed

You, Li-ming; Ke, Ying-ying; Zheng, Jing; Wan, Li-hong

2015-02-01

The development of and the issues arising in the nursing educational sector as the provider for nursing workforce have drawn increasing attention. To describe the development of nursing education in mainland China and to analyze related issues. A retrospective, descriptive study with secondary data analysis. The scale and composition of nursing education programs from 2006 to 2012 in mainland China were analyzed, and changes in the scale of the nursing workforce from 2002 to 2013 were compared to facilitate an interpretation of nursing education. The scale of initial nursing education was large and expanded rapidly. In 2012, the total recruitment was 515,710, including 39,747 (7.71%) students training for a baccalaureate degree, 143,726 (27.87%) students training for an advanced diploma, and 332,237 (64.42%) students training in secondary diploma programs. The nursing workforce in China grew dramatically, with an increase of 120,000 to 286,000 nurses each year since 2006, but the nurse shortage remained existed (there were only 2.05 nurses per 1000 population, and the nurse to doctor ratio was 1:1 in 2013). The recruitment of nursing students per 1000 population was greater in the west (0.51) and middle (0.40) regions than in the east region (0.28), while the number of nurses per 1000 population had the opposite pattern (1.71, 1.75, and 2.02 nurses per 1000 population in the west, middle, and east regions, respectively) in 2012. Nursing education in China has developed rapidly, and some issues require attention. We suggest that initial nursing education be improved by increasing the recruitment to advanced diploma and baccalaureate programs and decreasing the recruitment to secondary diploma programs and by ensuring the quality of education. Multiple strategies should be taken to effectively raise the social status and prestige of the nursing profession and to ease the nurse shortage. Copyright © 2014 Elsevier Ltd. All rights reserved.

Healthcare context and nursing workforce in a main city of Angola.

PubMed

Costa Mendes, I A; Marchi-Alves, L M; Mazzo, A; Nogueira, M S; Trevizan, M A; de Godoy, S; Bistafa Pereira, M J; Leonardo de Oliveira Gaioli, C C; Arena Ventura, C A

2013-03-01

Angola is one of the largest African countries with continuing levels of insecurity, considerable weakness in terms of respect for human rights, destroyed infrastructure and low transparency and social accountability levels. The health system displays gaps and nursing represents the main contingent among human resources in health. This research aims to understand the healthcare context in Angola from the perspective of Brazilian nurses who were involved in helping their Angolan colleagues. This general view of health services is followed by a description of nursing workforce particularities at a tertiary health service in the province of Luanda. Data were extracted from the database of the Global Network of World Health Organization Collaborating Centres for Nursing and Midwifery Development, constructed based on technical visits to Angola in 2009. Information related to health service characteristics was used, focusing on nursing human resource activities at two tertiary, one secondary and one primary health institutions located in the province of Luanda. The study data were analysed through descriptive statistics. Among the problems the nursing workforce faces, the lack of human, material and financial resources stands out, as well as insufficient professional qualification, excessive work journeys, low remunerations, non-valuation of professionals, leading to unsatisfactory work environments and discouraged human resources. Nursing in Angola is conquering its professional space. Therefore, regulatory policies are fundamental, defining the rights and obligations of all categories involved, with a view to determining nurses' function in the health team, including respect for and acknowledgement of their role in the community. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Baccalaureate Minority Nursing Students Perceived Barriers and Facilitators to Clinical Education Practices: An Integrative Review.

PubMed

Graham, Crystal L; Phillips, Shannon M; Newman, Susan D; Atz, Teresa W

2016-01-01

This integrative review synthesized baccalaureate minority nursing students' perceptions of their clinical experiences. The diversity of the nursing workforce does not mirror the United States population. Attrition rates of minority nursing students remain higher than rates for White students. Literature examining facilitators and barriers to minority student success predominantly focuses on academic factors, excluding those relevant to clinical education. An integrative review using literature from nursing and education. Three common perceived barriers were identified: discrimination from faculty, peers, nursing staff, and patients; bias in faculty grading practices; and isolation. Although little is known about the relationship between clinical failures and overall attrition, this review provides evidence that minority students encounter significant barriers in clinical education. To increase the diversity of the nursing workforce, faculty must address these issues and make modifications to ensure an equal opportunity at a quality education for all students.

The changing roles of registered nurses in Pioneer Accountable Care Organizations.

PubMed

Pittman, Patricia; Forrest, Emily

2015-01-01

This study focuses on whether and how Pioneer Accountable Care Organization (ACO) leaders believe the deployment of the registered nurse workforce is changing in response to the shared savings incentives. Semistructured phone interviews with leaders from 18 of the original 32 Pioneer ACOs were conducted. Narrative analysis suggests that all of the organizations are developing new and enhanced roles for registered nurses across the continuum of care. Overall, eight types of changes were reported: enhancement of roles, substitution, delegation, increased numbers of nurses, relocation of services, transfer of nurses from one setting to another, the use of liaison nurses across settings, and partnerships between nurses coordinating care in primary and acute care settings. This exploratory study suggests that Pioneer ACO leaders believe that payment models are affecting the deployment of the health workforce and that these changes are, in turn, driving outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

The nursing informatics workforce: who are they and what do they do?

PubMed

Murphy, Judy

2011-01-01

Nursing informatics has evolved into an integral part of health care delivery and a differentiating factor in the selection, implementation, and evaluation of health IT that supports safe, high-quality, patient-centric care. New nursing informatics workforce data reveal changing dynamics in clinical experience, job responsibilities, applications, barriers to success, information, and compensation and benefits. In addition to the more traditional informatics nurse role, a new position has begun to emerge in the health care C-suite with the introduction of the chief nursing informatics officer (CNIO). The CNIO is the senior informatics nurse guiding the implementation and optimization of HIT systems for an organization. With their fused clinical and informatics background, informatics nurses and CNIOs are uniquely positioned to help with "meaningful use" initiatives which are so important to changing the face of health care in the United States.

Informing the scale-up of Kenya’s nursing workforce: a mixed methods study of factors affecting pre-service training capacity and production

PubMed Central

2014-01-01

Background Given the global nursing shortage and investments to scale-up the workforce, this study evaluated trends in annual student nurse enrolment, pre-service attrition between enrolment and registration, and factors that influence nurse production in Kenya. Methods This study used a mixed methods approach with data from the Regulatory Human Resources Information System (tracks initial student enrolment through registration) and the Kenya Health Workforce Information System (tracks deployment and demographic information on licensed nurses) for the quantitative analyses and qualitative data from key informant interviews with nurse training institution educators and/or administrators. Trends in annual student nurse enrolment from 1999 to 2010 were analyzed using regulatory and demographic data. To assess pre-service attrition between training enrolment and registration with the nursing council, data for a cohort that enrolled in training from 1999 to 2004 and completed training by 2010 was analyzed. Multivariate logistic regression was used to test for factors that significantly affected attrition. To assess the capacity of nurse training institutions for scale-up, qualitative data was obtained through key informant interviews. Results From 1999 to 2010, 23,350 students enrolled in nurse training in Kenya. While annual new student enrolment doubled between 1999 (1,493) and 2010 (3,030), training institutions reported challenges in their capacity to accommodate the increased numbers. Key factors identified by the nursing faculty included congestion at clinical placement sites, limited clinical mentorship by qualified nurses, challenges with faculty recruitment and retention, and inadequate student housing, transportation and classroom space. Pre-service attrition among the cohort that enrolled between 1999 and 2004 and completed training by 2010 was found to be low (6%). Conclusion To scale-up the nursing workforce in Kenya, concurrent investments in expanding the number of student nurse clinical placement sites, utilizing alternate forms of skills training, hiring more faculty and clinical instructors, and expanding the dormitory and classroom space to accommodate new students are needed to ensure that increases in student enrolment are not at the cost of quality nursing education. Student attrition does not appear to be a concern in Kenya compared to other African countries (10 to 40%). PMID:25142037

Belief in the "free choice" model of homosexuality: a correlate of homophobia in registered nurses.

PubMed

Blackwell, Christopher W

2007-01-01

A great amount of social science research has supported the positive correlation between heterosexuals' belief in the free choice model of homosexuality and homophobia. Heterosexuals who believe gay, lesbian, bisexual, and transgender (GLBT) persons consciously choose their sexual orientation and practice a lifestyle conducive to that choice are much more likely to possess discriminatory, homophobic, homonegative, and heterosexist beliefs. In addition, these individuals are less likely to support gay rights initiatives such as nondiscrimination policies or same-sex partner benefits in the workplace or hate crime enhancement legislation inclusive of GLBT persons. Although researchers have demonstrated this phenomenon in the general population, none have specifically assessed it in the nursing workforce. The purpose of this study was to examine registered nurses' overall levels of homophobia and attitudes toward a workplace policy protective of gays and lesbians. These variables were then correlated with belief in the free choice model of homosexuality. Results indicated that belief in the free choice model of homosexuality was the strongest predictor of homophobia in nurses. Implications for nursing leadership and management, nursing education, and future research are discussed.

"I won't be staying here for long": a qualitative study on the retention of migrant nurses in Ireland

PubMed Central

2009-01-01

Background Although international nurse recruitment campaigns have succeeded in attracting large numbers of migrant nurses to countries such as Ireland, where domestic supply has not kept pace with demand, the long-term success of such initiatives from a workforce planning perspective will depend on the extent to which these nurses can be retained in destination countries. Methods This paper draws on qualitative, in-depth interviews undertaken with 21 migrant nurses in Ireland, focusing specifically on their future migration intentions. Results Our findings indicate that more than half of the respondents are considering migration onwards, for the most part because the destination country has failed to provide them with sufficient stability, particularly in terms of citizenship and family reunification. In considering onward migration, factors outside the health system were of most concern to those interviewed. Conclusion This demonstrates the need for destination countries to take a broader and more long-term approach to international nurse recruitment, rather than regarding it as an inexpensive way to fill gaps within the health care system. PMID:19660106

Transitioning into new clinical areas of practice: An integrative review of the literature.

PubMed

Kinghorn, Grant R; Halcomb, Elizabeth J; Froggatt, Terry; Thomas, Stuart Dm

2017-12-01

To critically synthesise research related to the transition of registered nurses into new areas of clinical practice. Global workforce shortages and rising healthcare demands have encouraged registered nurses to move into new clinical settings. While a body of literature reports on the transition of newly qualified nurses, evidence surrounding the transition of more experienced registered nurses to new clinical areas remains poorly explored. An integrative review was conducted, guided by Whittemore and Knafl (Journal of Advanced Nursing, 52, 2005, 546) framework. An electronic database search was conducted for papers published between 1996-2016. Papers were then subjected to a methodological quality appraisal, with findings synthesised using thematic analysis into core themes. Ten articles met the inclusion criteria. Three themes emerged, namely Support, Professional Development and Emotional Impact. These themes suggest that transitioning nurses experience challenges in adapting to new clinical areas and developing necessary skills. Such challenges prompted various emotional and physical responses. While formal and informal support systems were regarded as valuable by transitioning nurses, they were inconsistent across the new clinical areas. There is some evidence to highlight the initial shock and emotional stress experienced by registered nurses during transition to a new clinical area. However, the influence of formal and informal support systems for such registered nurses is far from conclusive. Further research is needed, to examine registered nurse transition into a variety of clinical areas to inform workforce support, policy and practices. The demand of health care is growing while global shortages of nursing workforce remain. To ensure retention and enhance the transition experience of registered nurses, it is important for nurse leaders, managers and policymakers to understand the transition experience and factors that impact this experience. © 2017 John Wiley & Sons Ltd.

Immigration policy and internationally educated nurses in the United States: A brief history

PubMed Central

Masselink, Leah E.; Jones, Cheryl B.

2015-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. PMID:24345614

New Careers in Nursing: An Effective Model for Increasing Nursing Workforce Diversity.

PubMed

Craft-Blacksheare, Melva

2018-03-01

The Robert Wood Johnson Foundation and the American Association of Colleges of Nursing developed the New Careers in Nursing (NCIN) program to address the nursing shortage, increase workforce diversity, and raise the profession's educational level. The program provided scholarships to second-degree underrepresented or economically disadvantaged (UED) students attending an accelerated nursing program to earn a Bachelor of Science in Nursing degree. A midwestern university received three academic-year cycles of NCIN funding. The program's model, resources, and functioning are described. The NCIN provided exceptional financial and program support that received high marks from participants. During the three award cycles, 20 UED scholars graduated with a Bachelor of Science in Nursing degree. Nineteen of the 20 scholars passed the NCLEX-RN on the first attempt. While the NCIN program has ended, nursing school administrators and faculty wishing to promote UED student success should consider using the program's model and resources as the basis for their own program. [J Nurs Educ. 2018;57(3):178-183.]. Copyright 2018, SLACK Incorporated.

Views of Student Nurses on Caring and Technology in Nursing

ERIC Educational Resources Information Center

Brodell, Elizabeth Becky

2009-01-01

Nurses entering the workforce are faced with many challenges, but today the multiple demands of patient care are complicated by a nurse's need to keep abreast of fast-changing technology. This research is universally relevant to nursing practice in educational settings and practice areas because nursing education needs to develop strategies to…

Succession planning: a call to action for nurse executives.

PubMed

Trepanier, Sylvain; Crenshaw, Jeannette T

2013-10-01

To discuss the organisational benefits of strategic succession planning in acute care hospital settings as a responsibility of chief nurse executives. A formal succession planning process is crucial to the financial and operational viability and sustainability of acute care hospitals. A succession plan is an essential business strategy that promotes effective leadership transition and continuity while maintaining productivity. Nursing and business literature were reviewed; reports contrasting institutions with and without succession plans were examined; and, operational implications were considered. It is imperative that chief nurse executives respond to the business benefits of an effective succession planning programme, identify common barriers and solutions, and implement best practices for a successful strategic succession planning programme. A strategic succession planning programme may offer many benefits to an acute care hospital, including improved retention rates, increased staff engagement and enhanced financial performance. Considering the ageing nursing workforce and the potential increase in demand for nursing services in the near future, nurse executives and other nurse leaders must actively engage in a formal succession planning process. A formal succession planning programme will help to provide strategic leadership continuity, operational effectiveness and improved quality of care. © 2013 John Wiley & Sons Ltd.

Service user involvement in preregistration child nursing programmes.

PubMed

Barnley, Rebecca

2017-12-05

Service user involvement is a fundamental part of preregistration nursing education programmes, however achieving this for child nursing students is challenging. Service user involvement can be achieved through online forums but this method can lack the emotional interaction and opportunity for deep reflection. This article reviews the background and challenges of service user involvement in preregistration child nursing programmes, further exploring the evaluation of a group of final year child nursing students' experience of appreciating the journey of two service users. The input from service users provided the opportunity for reflection, empathy and improved student self-awareness in nursing practice. Students gained perspective of the holistic needs of the service user, which empowered them to have confidence in their communication skills to ensure the voice of the child is heard and their rights are upheld. This article concludes that service user involvement is crucial in preregistration nursing programmes for the development of child nursing students, not only affecting their training but also the future workforce. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

"iM Ready to Learn": Undergraduate Nursing Students Knowledge, Preferences, and Practice of Mobile Technology and Social Media.

PubMed

Hay, Benjamin; Carr, Peter J; Dawe, Lydia; Clark-Burg, Karen

2017-01-01

The purpose of this study was to identify in what way social media and mobile technology assist with learning and education of the undergraduate nurse. The study involved undergraduate nursing students across three campuses from the University of Notre Dame Australia. Participants were invited to complete an online questionnaire that related to their current knowledge, preferences, and practice with mobile technology and social media within their undergraduate nursing degree. A quantitative descriptive survey design was adapted from an initial pilot survey by the authors. A total of 386 nursing students (23.47% of the total enrolment) completed the online survey. Overall, results suggested that students are more supportive of social media and mobile technology in principle than in practice. Students who frequently use mobile technologies prefer to print out, highlight, and annotate the lecture material. Findings suggest that nursing students currently use mobile technology and social media and are keen to engage in ongoing learning and collaboration using these resources. Therefore, nursing academia should encourage the appropriate use of mobile technology and social media within the undergraduate curriculum so that responsible use of such technologies positively affects the future nursing workforce.

Nurses as family caregivers - barriers and enablers facing nurses caring for children, parents or both.

PubMed

Clendon, Jill; Walker, Léonie

2017-03-01

To examine the dual caregiving and nursing responsibilities of nurses in New Zealand with a view to identifying potential strategies, policies and employment practices that may help to retain nurses with caregiving responsibilities in the workplace. As the nursing workforce ages, child-bearing is delayed and older family members are living longer, family caregiving responsibilities are impacting more on the working life of nurses. This may complicate accurate workforce planning assumptions. An explorative, descriptive design using interviews and focus groups with 28 registered nurses with family caregiving responsibilities. A depth of (largely hidden) experience was exposed revealing considerable guilt, physical, emotional and financial hardship. Regardless of whether the nurse chose to work or had to for financial reasons, family always came first. Demographic and societal changes related to caregiving may have profound implications for nursing. Workplace support is essential to ensure that nurses are able to continue to work. Increased awareness, support, flexibility and specific planning are required to retain nurses with family caregiving responsibilities. © 2016 John Wiley & Sons Ltd.

Exploring Student Perceptions of Retention Issues in a 3-Year Baccalaureate-Level Nursing Program

ERIC Educational Resources Information Center

Taulbee, Rebecca

2017-01-01

The nursing shortage, a major concern for the United States, has a multitude of causative factors. Nursing education has been tasked with helping to decrease the shortage of qualified registered nurses. Poor retention of nursing students in higher education is impacting the number of qualified nurses entering the workforce. Nursing education has…

The impact of hospital structure and restructuring on the nursing workforce.

PubMed

Duffield, Christine; Kearin, Mark; Johnston, Judy; Leonard, Joanna

2007-01-01

Health systems throughout much of the world have been subject to 'reform' in recent years as countries have attempted to contain the rapidly rising costs of health care. Changes to hospital structures (restructuring) have been an important part of these reforms. A significant impact of current approaches to restructuring is the loss of, or changes to, nursing management roles and functions. Australian hospitals Little evaluation has been undertaken to determine the impact of hospital structure and organisational restructuring on the nursing workforce. There is some indication that nurses have experienced a loss of key management positions, which may impact on their capacity to ensure that adequate and safe care is provided at the ward level.

Treading the clinical pathway: a qualitative study of advanced practice nurses in a local health district in Australia.

PubMed

Luck, Lauretta; Wilkes, Lesley; O'Baugh, Jennifer

2015-01-01

Career planning in nursing is often haphazard, with many studies showing that nurses need personal motivation, education, and the support of workplaces, which are often dominated by political and fiscal agendas. Nurses often need institutional and personal support to plan their careers and make decisions regarding their career aspirations. A descriptive qualitative design was used. Data were gathered using semi-structured digitally recorded interviews and analysed for common categories. Twenty seven (n = 27) participants were interviewed. There were four categories revealed by the participants who described their career progression experiences: moving up the ladder, changing jobs for career progression, self-driven and the effects of institutional environments. Many of the participants' careers had been shaped serendipitously. Similar to other studies, these nurses felt political, institutional and financial factors impacted on their career opportunities. There are implications for nursing managers with more support required for nurses to plan their career trajectories. In addition to an organisation centred approach to career planning, nurse leaders and managers must take into account the personal and professional requirements of their nurses. Nurses themselves also need to take personal responsibility for career development. Greater support for nurses' career planning and personal drive will help organisations to plan their future workforce needs.

Career in mental health still an unlikely career choice for nursing graduates: a replicated longitudinal study.

PubMed

Stevens, John; Browne, Graeme; Graham, Iain

2013-06-01

The lack of qualified mental health nurses is at critical level with the problem likely to worsen as the aging mental health nursing workforce retires. This study investigates the career preferences of undergraduate nursing students by comparing preferences at the start, middle, and end of the Bachelor of Nursing program. The comparison of the cohorts gave an indication of the change in preferences over the intervening years. It replicates research completed in 1992, 1997, and 2001, and develops a profile of nursing career preferences and the rationale underpinning those preferences in a cohort of students (n = 150) who began their Bachelor of Nursing studies in 2007 and completed in 2009. The main findings included that, like the previous studies, mental health nursing is one of the least desirable career choices for most nurses at the start of their course and remains so as they approach graduation. The reasons change but the outcome remains the same. The current system of using the Bachelor of Nursing award to produce mental health nurses in Australia does not encourage nurses to consider a career in mental health nursing. Which begs the question: where will mental health nurses in the future come from? © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Use of video-feedback, reflection, and interactive analysis to improve nurse leadership practices.

PubMed

Crenshaw, Jeannette T

2012-01-01

The chronic shortage of registered nurses (RNs) affects patient safety and health care quality. Many factors affect the RN shortage in the workforce, including negative work environments, exacerbated by ineffective leadership approaches. Improvements in the use of relationship-based leadership approaches lead to healthier work environments that foster RN satisfaction and reduce RN turnover and vacancy rates in acute care settings. In this article, an innovative approach to reduce nurse turnover and decrease vacancy rates in acute care settings is described. Video feedback with reflection and interactive analysis is an untapped resource for nurse leaders and aspiring nurse leaders in their development of effective leadership skills. This unique method may be an effective leadership strategy for addressing recruitment and retention issues in a diverse workforce.

Nurse management of hypertension in rural western Kenya: implementation research to optimize delivery.

PubMed

Vedanthan, Rajesh; Kamano, Jemima H; Horowitz, Carol R; Ascheim, Deborah; Velazquez, Eric J; Kimaiyo, Sylvester; Fuster, Valentin

2014-01-01

Hypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and insufficient human resource capacity is among the contributing factors. Thus, a critical component of hypertension management is to develop novel and effective solutions to the human resources challenge. One potential solution is task redistribution and nurse management of hypertension in these settings. The aim of this study is to investigate whether nurses can effectively reduce blood pressure in hypertensive patients in rural western Kenya and, by extension, throughout sub-Saharan Africa. An initial phase of qualitative inquiry will assess facilitators and barriers of nurse management of hypertension. In addition, we will perform usability and feasibility testing of a novel, electronic tablet-based integrated decision-support and record-keeping tool for the nurses. An impact evaluation of a pilot program for nurse-based management of hypertension will be performed. Finally, a needs-based workforce estimation model will be used to estimate the nurse workforce requirements for stable, long-term treatment of hypertension throughout western Kenya. The primary outcome measure of the impact evaluation will be the change in systolic blood pressure of hypertensive individuals assigned to nurse-based management after 1 year of follow-up. The workforce estimation modeling output will be the full-time equivalents of nurses. This study will provide evidence regarding the effectiveness of strategies to optimize task redistribution and nurse-based management of hypertension that can be applicable to noncommunicable disease management in low- and middle-income countries. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.

PubMed

Schober, Madrean M; Gerrish, Kate; McDonnell, Ann

2016-06-01

To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.

The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: a qualitative snapshot.

PubMed

Tuckett, Anthony; Hegney, Desley; Parker, Deborah; Eley, Robert M; Dickie, Robyn

2011-10-01

The attainment of a work-life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work-life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care. © 2011 Blackwell Publishing Asia Pty Ltd.

Diversity and education of the nursing workforce 2006-2016.

PubMed

Kovner, Christine T; Djukic, Maja; Jun, Jin; Fletcher, Jason; Fatehi, Farida K; Brewer, Carol S

The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. The purpose of this paper is to report the progress toward achievement of these recommendations. We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations. Copyright © 2017. Published by Elsevier Inc.

Information literacy: using LISTEN project strategies to equip nurses worldwide.

PubMed

Patterson, Ramona; Carter-Templeton, Heather; Russell, Cynthia

2009-01-01

The 21st century presents a major challenge in the form of information overload. In a profession where new knowledge is ever expanding, nurse educators must equip nurses to find the information they need to provide safe evidence-based care. Information literacy and information technology competencies have become a priority in nursing education, but inconsistencies in definitions, frameworks, content, and design, combined with ill-equipped faculty have hindered the development of a transferable model geared toward improving nurses' information literacy. Challenges are compounded for nurses in developing nations, where access to information and training for information literacy are both problematic. This paper describes experiences from the LISTEN project, during the 1st year of a 3-year funded Nurse Education Practice and Retention grant. Designed to improve information literacy competencies of student and workforce nurses, using individualized learning via interactive web-based modules, LISTEN provides on its' website a Did You Know video dramatizing the importance of information literacy to nurses, and offers resources for information literacy, information technology, and evidence-based nursing practice. Preliminary findings from beta testing reveal the module content is realistic, complete, and logical. The website and video have generated worldwide interest. Future possibilities include nationwide implementation and adaptation for the international arena.

Capturing district nursing through a knowledge-based electronic caseload analysis tool (eCAT).

PubMed

Kane, Kay

2014-03-01

The Electronic Caseload Analysis Tool (eCAT) is a knowledge-based software tool to assist the caseload analysis process. The tool provides a wide range of graphical reports, along with an integrated clinical advisor, to assist district nurses, team leaders, operational and strategic managers with caseload analysis by describing, comparing and benchmarking district nursing practice in the context of population need, staff resources, and service structure. District nurses and clinical lead nurses in Northern Ireland developed the tool, along with academic colleagues from the University of Ulster, working in partnership with a leading software company. The aim was to use the eCAT tool to identify the nursing need of local populations, along with the variances in district nursing practice, and match the workforce accordingly. This article reviews the literature, describes the eCAT solution and discusses the impact of eCAT on nursing practice, staff allocation, service delivery and workforce planning, using fictitious exemplars and a post-implementation evaluation from the trusts.

Novice nurse practitioner workforce transition and turnover intention in primary care.

PubMed

Faraz, Asefeh

2017-01-01

Little is known about the workforce transition and turnover intention of novice nurse practitioners (NPs) in primary care (PC). This research aimed to describe the individual characteristics, role acquisition and job satisfaction of novice NPs, and identify factors associated with their successful transition and turnover intention in the first year of PC practice. A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a PC setting for 3-12 months. This study demonstrated that greater professional autonomy in the workplace is a critical factor in turnover intention in novice NPs in the PC setting. Further research is needed regarding the novice NP workforce transition to provide adequate professional autonomy and support during this critical period. ©2016 American Association of Nurse Practitioners.

Nurse occupational burnout and patient-rated quality of care: The boundary conditions of emotional intelligence and demographic profiles.

PubMed

Chao, Minston; Shih, Chih-Ting; Hsu, Shu-Fen

2016-01-01

Most previous studies on the relationship between occupational burnout and the quality of care among nurses have used self-reported data on the quality of care from nurses, thus rendering evaluating the relationship between burnout and the quality of care difficult. Hospitals increasingly hire contract nurses and high turnover rates remain a concern. Little is known about whether nurses' emotional intelligence and demographic factors such as contract status, tenure, and marital status affect the quality of care when burnout occurs. This study investigated the relationship between burnout and patient-rated quality of care and investigated the moderating role of emotional intelligence and demographic variables. Hierarchical moderated regression was used to analyze 98 sets of paired data obtained from nurses and their patients at a teaching hospital in northern Taiwan. The results suggest that occupational burnout has a less unfavorable effect on the quality of care from permanent, married, and senior nurses. Nursing management should pay particular attention to retaining permanent, married, and senior nurses. To ensure a sustainable nursing workforce in the future, newly graduated registered nurses should have access to permanent positions and opportunities for long-term professional development. In addition, married nurses should be provided with flexible work-family arrangements to ensure their satisfaction in the nursing profession. © 2015 Japan Academy of Nursing Science.

Nursing: Supply and Demand through 2020

ERIC Educational Resources Information Center

Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem

2015-01-01

This report analyzes the growing need for qualified nurses. The study projects that the economy will create 1.6 million job openings for nurses through 2020. Yet, there will not be enough nurses to fill those openings. this report projects that the nursing workforce will be facing a shortfall of roughly 200,000 nursing professionals by 2020. One…

Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.

PubMed

Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne

2016-01-01

Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs.

Increasing Racial/Ethnic Diversity in Nursing to Reduce Health Disparities and Achieve Health Equity

PubMed Central

Malone, Beverly

2014-01-01

As nursing continues to advance health care in the 21st century, the current shift in demographics, coupled with the ongoing disparities in health care and health outcomes, will warrant our ongoing attention and action. As within all health professions, concerted efforts are needed to diversify the nation's health-care workforce. The nursing profession in particular will be challenged to recruit and retain a culturally diverse workforce that mirrors the nation's change in demographics. This increased need to enhance diversity in nursing is not new to the profession; however, the need to successfully address this issue has never been greater. This article discusses increasing the diversity in nursing and its importance in reducing health disparities. We highlight characteristics of successful recruitment and retention efforts targeting racial/ethnic minority nurses and conclude with recommendations to strengthen the development and evaluation of their contributions to eliminating health disparities. PMID:24385664

New Nurses' Perspectives of Horizontal Violence in Nursing

ERIC Educational Resources Information Center

Owens, Michael R.

2017-01-01

The purpose of this basic qualitative study was to better understand the perspectives of horizontal violence through the described experiences of new nurses during the transition from novice to professional nurse within the workforce. The focus of this study was on the new nurses' ability to recognize, report, and reduce the effects of horizontal…

Mentoring in Associate Degree Nursing: A Mixed-Methods Study for Student Success

ERIC Educational Resources Information Center

Fishman, Darlene C.

2013-01-01

For over a decade, the nursing profession has increased enrollments and established new education programs in response to the national nursing shortage. The profession has focused on increasing the numbers of new graduate nurses prepared to replace the nation's aging nursing workforce. Considering the expense of this educational process with close…

Examination of Academic Self-Regulation Variances in Nursing Students

ERIC Educational Resources Information Center

Schutt, Michelle A.

2009-01-01

Multiple workforce demands in healthcare have placed a tremendous amount of pressure on academic nurse educators to increase the number of professional nursing graduates to provide nursing care both in both acute and non-acute healthcare settings. Increased enrollment in nursing programs throughout the United States is occurring; however, due to…

The 'gender gap' in authorship in nursing literature.

PubMed

Shields, Linda; Hall, Jenny; Mamun, Abdulla A

2011-11-01

Gender bias has been found in medical literature, with more men than women as first or senior authors of papers, despite about half of doctors being women. Nursing is about 90% female, so we aimed to determine if similar biases exist in nursing literature. Taking the eight non-specialist nursing journals with the highest impact factors for that profession, we counted the numbers of men and women first authors over 30 years. We used nursing journals from around the world which attract the highest impact factors for nursing publication. Eight journals qualified for entry, three from the United Kingdom, four from the United States of America, and one from Australia. MAIN OUTCOME MEASURES Using Chi-square and Fisher exact tests, we determined differences between the numbers of men and women across all the journals, between countries (USA, UK and Australia), changes over the 30 years, and changes within journals over time. RESULTS Despite the small proportion of men in the nursing workforce, up to 30% of first authors were men. UK journals were more likely to have male authors than USA journals, and this increased over time. USA journals had proportions of male first authors consistent with the male proportion of its nursing workforce. CONCLUSIONS In the UK (though not in the USA) gender bias in nursing publishing exists, even though the nursing workforce is strongly feminized. This warrants further research, but is likely to be due to the same reasons for the gender gap in medical publishing; that is, female nurses take time out to have families, and social and family responsibilities prevent them taking opportunities for career progression, whereas men's careers often are not affected in such ways.

The ‘gender gap’ in authorship in nursing literature

PubMed Central

Shields, Linda; Hall, Jenny; Mamun, Abdulla A

2011-01-01

Objectives Gender bias has been found in medical literature, with more men than women as first or senior authors of papers, despite about half of doctors being women. Nursing is about 90% female, so we aimed to determine if similar biases exist in nursing literature. Design Taking the eight non-specialist nursing journals with the highest impact factors for that profession, we counted the numbers of men and women first authors over 30 years. Setting We used nursing journals from around the world which attract the highest impact factors for nursing publication. Participants Eight journals qualified for entry, three from the United Kingdom, four from the United States of America, and one from Australia. Main outcome measures Using Chi-square and Fisher exact tests, we determined differences between the numbers of men and women across all the journals, between countries (USA, UK and Australia), changes over the 30 years, and changes within journals over time. Results Despite the small proportion of men in the nursing workforce, up to 30% of first authors were men. UK journals were more likely to have male authors than USA journals, and this increased over time. USA journals had proportions of male first authors consistent with the male proportion of its nursing workforce. Conclusions In the UK (though not in the USA) gender bias in nursing publishing exists, even though the nursing workforce is strongly feminized. This warrants further research, but is likely to be due to the same reasons for the gender gap in medical publishing; that is, female nurses take time out to have families, and social and family responsibilities prevent them taking opportunities for career progression, whereas men's careers often are not affected in such ways. PMID:22048677

Nurse manager succession planning: A cost-benefit analysis.

PubMed

Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

2018-03-01

This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

Hawai'i Island Health Workforce Assessment 2008.

PubMed

Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

2009-12-01

Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued surveillance of the health workforce is vital to tracking the impact of interventions. This could be accomplished through community informants and data collected at the time of professional relicensure to include practice location and practice intensions for future planning estimates.

The Quality of Nurses' Work Environment and Workforce Outcomes From the Perspective of Swiss Allied Healthcare Assistants and Registered Nurses: A Cross-Sectional Survey.

PubMed

Lacher, Stefanie; De Geest, Sabina; Denhaerynck, Kris; Trede, Ines; Ausserhofer, Dietmar

2015-09-01

Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear. (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes. A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals. We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes. AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction. This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals. Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses. © 2015 Sigma Theta Tau International.

Envisioning an oral healthcare workforce for the future.

PubMed

Nash, David A

2012-10-01

Health is critical to human well-being. Oral health is an integral component of health. One is not healthy without oral health. As health is essential to human flourishing, it is important that an oral healthcare delivery system and workforce be developed and deployed which can help ensure all citizens have the potential to access oral health care. As such access does not generally exist today, it is imperative to advance the realization of this goal and to develop a vision of an oral healthcare workforce to functionally support access. Public funding of basic oral health care is an important element to improving access. However, funding is only economically feasible if a workforce exists that is structured in a manner such that duties are assigned to individuals who have been uniquely trained to fulfill specific clinical responsibilities. An essential element of any cost-effective organizational system must be the shared responsibility of duties. Delegation must occur in the oral health workforce if competent, cost-effective care is to be provided. Desirable members of the oral health team in an efficient and effective system are as follows: generalist dentists who are educated as physicians of the stomatognathic system (oral physicians), specialist dentists, dental therapists, dental hygienists, dually trained hygienists/therapists (oral health therapists), oral prosthetists (denturists), and expanded function dental assistants (dental nurses). © 2012 John Wiley & Sons A/S.

Considerations for increasing the competences and capacities of the public health workforce: assessing the training needs of public health workers in Texas

PubMed Central

Borders, Stephen; Blakely, Craig; Quiram, Barbara; McLeroy, Kenneth

2006-01-01

Background Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them. Methods A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services. Results and conclusion Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public. PMID:16872494

Pandemic (H1N1) 2009 Influenza in Australia: Absenteeism and redeployment of emergency medicine and nursing staff.

PubMed

Considine, Julie; Shaban, Ramon Z; Patrick, Jennifer; Holzhauser, Kerri; Aitken, Peter; Clark, Michele; Fielding, Elaine; FitzGerald, Gerry

2011-10-01

The aim of the present study was to examine the impact of Pandemic (H(1)N(1)) 2009 Influenza on the Australian emergency nursing and medicine workforce, specifically absenteeism and deployment. Data were collected using an online survey of 618 members of the three professional emergency medicine or emergency nursing colleges. Despite significant increases in emergency demand during the Pandemic (H(1)N(1)) 2009 Influenza, 56.6% of emergency nursing and medicine staff reported absenteeism of at least 1 day and only 8.5% of staff were redeployed. Staff illness with influenza-like illness was reported by 37% of respondents, and 87% of respondents who became ill were not tested for the Pandemic (H(1)N(1)) 2009 Influenza. Of the respondents who became ill, 43% (n= 79) reported missing no days of work and only 8% of respondents (n= 14) reported being absent for more than 5 days. The mean number of days away from work was 3.73 (standard deviation = 3.63). Factors anecdotally associated with staff absenteeism (caregiver responsibilities, concern about personal illness, concern about exposing family members to illness, school closures, risk of quarantine, stress and increased workload) appeared to be of little or no relevance. Redeployment was reported by 8% of respondents and the majority of redeployment was for operational reasons. Future research related to absenteeism, redeployment during actual pandemic events is urgently needed. Workforce data collection should be an integral part of organizational pandemic planning. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

LPN perspectives of factors that affect nurse mobility in Canada.

PubMed

Harris, Alexandra; Hall, Linda McGillis; Price, Sheri; Lalonde, Michelle; Andrews, Gavin; MacDonald-Rencz, Sandra

2013-01-01

Although the licensed practical nurse (LPN) workforce represents an ever-growing and valuable human resource, very little is known about reasons for practical nurse mobility. The purpose of this study was to describe LPN perspectives regarding motives for inter-provincial/territorial (P/T) movement in Canada. Participants included 200 LPNs from nine P/T, and data were analyzed using a qualitative descriptive approach. Three primary themes were identified regarding motivators for LPN migration, including (a) scope of practice, (b) education and advancement opportunities and (c) professional respect and recognition. Although current economic forces have a strong influence on nurse mobility, these findings emphasize that there are other equally important factors influencing LPNs to move between jurisdictions. As such, policy makers, administrators and researchers should further explore and address these themes in order to strengthen Canada's nursing workforce.

A study examining senior nursing students' expectations of work and the workforce.

PubMed

Saber, Deborah A; Anglade, Debbie; Schirle, Lori M

2016-03-01

This study explored traditional and accelerated Bachelor of Science nursing students' expectations of nursing work and the workforce. Role transition difficulty is blamed for much of the 15-60% newly licensed registered nurse turnover in their first 3 years of employment. This qualitative study consisted of 14 focus groups (n = 98) to determine Bachelor of Science nursing students' expectations of work as newly licensed registered nurses. Two overriding themes for accelerated and traditional students emerged: stressors and coping strategies. Students believe four stressors will affect their progression into the newly licensed registered nurse role and have developed coping strategies. This study suggests that students have experienced stressors in the clinical environment and anticipate them in the newly licensed registered nurse role. During transition, strategies such as 'fitting in' and 'staying safe' will be employed to ensure work success. Younger generations value a healthy work-life balance and a positive working environment. These nurses will not tolerate positions that do not align with their values. With the aging of citizens in the USA and the predicted nursing shortage, nursing management needs to employ strategies to retain newly licensed registered nurses. © 2015 John Wiley & Sons Ltd.

Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers.

PubMed

Drennan, Vari M; Halter, Mary; Gale, Julia; Harris, Ruth

2016-11-01

To investigate the views of senior nurse and human resource managers of strategies to retain hospital nurses in a metropolitan area. Against a global shortage, retaining nurses is a management imperative for the quality of hospital services. Semi-structured interviews, thematically analysed. Metropolitan areas have many health organisations in geographical proximity, offering nurses choices in employer and employment. Senior nurse and human resource managers recognised the complexity of factors influencing nurse turnover, including those that 'pulled' nurses out of their jobs to other posts and factors that 'pushed' nurses to leave. Four themes emerged in retaining nurses: strategy and leadership, including analysis of workforce and leavers' data, remuneration, the type of nursing work and career development and the immediate work environment. In contexts where multiple organisations compete for nurses, addressing retention through strategic leadership is likely to be important in paying due attention and apportioning resources to effective strategies. Aside from good human resource management practices for all, strategies tailored to different segments of the nursing workforce are likely to be important. This metropolitan study suggests attention should be paid to strategies that address remuneration, progressing nursing careers and the immediate work environment. © 2016 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.

The global nursing shortage: an overview of issues and actions.

PubMed

Oulton, Judith A

2006-08-01

Today's global nursing shortage is having an adverse impact on health systems around the world. A major initiative by the International Council of Nurses (ICN) yielded important information regarding the shortage and solutions to it. These are organized into five priority areas: policy intervention; macroeconomics and health sector funding; workforce planning and policy, including regulation; positive practice environments; and retention and recruitment (includes migration); and nursing leadership. Internationally momentum is building, providing the opportunity to bring attention to these issues and to take action. This article presents an overview of the global nursing shortage (which, since 2002, has been termed a global crisis), provides the perspectives of the ICN, and discusses the ICN's initiatives regarding that crisis. Founded in 1899, the ICN is the world's first and largest organization for health professionals. As a federation of national nurses' associations in 129 countries, ICN represents the more than 13 million nurses working worldwide. It works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected, competent professional workforce.

Immigration policy and internationally educated nurses in the United States: A brief history.

PubMed

Masselink, Leah E; Jones, Cheryl B

2014-01-01

Since the 1980s, U.S. policy makers have used immigration policy to influence the supply of nurses by allowing or restricting the entry of internationally educated nurses (IENs) into the U.S. workforce. The methods pursued have shifted over time from temporary visa categories in the 1980s and 1990s to permanent immigrant visas in the 2000s. The impact of policy measures adopted during nursing shortages has often been blunted by political and economic events, but the number and representation of IENs in the U.S. nursing workforce has increased substantially since the 1980s. Even as the United States seeks to increase domestic production of nurses, it remains a desirable destination for IENs and a target market for nurse-producing source countries. Hiring organizations and nurse leaders play a critical role in ensuring that the hiring and integration of IENs into U.S. health care organizations is constructive for nurses, source countries, and the U.S. health care system. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluation of a Clinical Cancer Trial Research Training Workshop: Helping Nurses Build Capacity in Southwest Virginia.

PubMed

Burnett, Camille; Bullock, Linda; Collins, Cathleen A; Hauser, Lindsay

2016-11-01

Residents of Southwest Virginia (SWVA) face significant barriers in accessing the most advanced forms of cancer care, cancer risk reduction, and clinical trials involvement. A collaboration between the University of Virginia (UVA) Cancer Center and UVA School of Nursing was forged with oncology caregivers in this region to build community capacity to support Cancer Clinical trials (CCT) by strengthening the workforce, and thus improving health outcomes for this underserved region of Appalachia. The UVA School of Nursing designed an educational workshop focusing on the basics of CCT to facilitate the development of a skilled nursing workforce in the SWVA region that could provide care to patients on protocol and/or to encourage residents to participate in trials. The goal of the workshop was to offer a CCT training session for oncology nurses that fostered the knowledge and skills necessary to facilitate and support CCT infrastructure across this high-risk region. This evaluation reports the learning outcomes of the CCT training on 32 nurse participants from SWVA. Evaluations of the training program showed high rates of satisfaction, increased comfort level with CCTs, and increased knowledge and attitude toward CCTs. These findings provide information about a curriculum that could be useful in educating other oncology nurses and student nurses how to care for patients who may be enrolled in a clinical trial. Nurses can also be advocates for participation in clinical trials once they have the knowledge and are comfortable in their own understanding of a trial's usefulness. Educating the nursing workforce is an essential component of building capacity and infrastructure to support clinical trials research. © 2016 Wiley Periodicals, Inc.

Recent graduate nurse views of nursing, work and leadership.

PubMed

Cleary, Michelle; Horsfall, Jan; Jackson, Debra; Muthulakshmi, Paulpandi; Hunt, Glenn E

2013-10-01

To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention. Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world. Qualitative interviews with recent nursing graduates. Seventeen face-to-face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes. Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention-related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service. Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work. Quality health care is dependent on a well-educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce. © 2013 John Wiley & Sons Ltd.

Exploring the value of dignity in the work-life of nurses.

PubMed

Lawless, Jane; Moss, Cheryle

2007-04-01

In this paper the authors draw attention to the value of nurse dignity in the work-life of nurses. How does the profession currently understand this as a concept and construct? How might the valuing of worker dignity in the workplace affect the wellbeing of the workforce? A review of nursing literature and a theoretical lens on worker dignity derived from recent work by Hodson (2001) was used to explore these questions. In the context of current and international workforce issues associated with recruitment and retention, analysis of the construct of worker dignity within the profession takes on a strong imperative. The large existing body of research into nursing workplace environments highlights concern that nurses have in understanding and improving work-life quality. Findings of this inquiry reveal that while there is a degree of coherence between the nursing research and elements of Hodson's (2001) research on worker dignity, the dignity of nurses, as a specific construct and as an intrinsic human and worker right has received little explicit attention. Reasons for this may lie partly in approaches that privilege patient dignity over nurse dignity and which rely on the altruism and self-sacrifice of nurses to sustain patient care in environments dominated by cost-control agendas. The value of dignity in the work-life of nurses has been under-explored and there is a critical need for further theoretical work and research. This agenda goes beyond acceptance of dignity in the workplace as a human right towards the recognition that worker dignity may be a critical factor in sustaining development of healthy workplaces and healthy workforces. Directing explicit attention to nurse dignity may benefit the attainment of both nurse and organisational goals. Hodson's (2001) framework offers a new perspective on dignity in the workplace and leads to new insights and a slightly different view of a 'road well travelled' in nursing literature.

Health workforce metrics pre- and post-2015: a stimulus to public policy and planning.

PubMed

Pozo-Martin, Francisco; Nove, Andrea; Lopes, Sofia Castro; Campbell, James; Buchan, James; Dussault, Gilles; Kunjumen, Teena; Cometto, Giorgio; Siyam, Amani

2017-02-15

Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning.

Workforce Characteristics, Perceptions, Stress, and Satisfaction among Staff in Green House and Other Nursing Homes.

PubMed

Brown, Patrick B; Hudak, Sandra L; Horn, Susan D; Cohen, Lauren W; Reed, David Allen; Zimmerman, Sheryl

2016-02-01

To compare workforce characteristics and staff perceptions of safety, satisfaction, and stress between Green House (GH) and comparison nursing homes (CNHs). Primary data on staff perceptions of safety, stress, and satisfaction from 13 GHs and 8 comparison NHs in 11 states; secondary data from human resources records on workforce characteristics, turnover, and staffing from 01/01/2011-06/30/2012. Observational study. Workforce data were from human resources offices; staff perceptions were from surveys. Few significant differences were found between GH and CNHs. Exceptions were GH direct caregivers were older, provided twice the normalized hours per week budgeted per resident than CNAs in CNHs or Legacy NHs, and trended toward lower turnover. GH environment may promote staff longevity and does not negatively affect worker's stress, safety perceptions, or satisfaction. Larger studies are needed to confirm findings. © Health Research and Educational Trust.

Perspectives on Age and Continuing Professional Development for Nurses: A Literature Review

ERIC Educational Resources Information Center

Pool, Inge A.; Poell, Rob F.; ten Cate, Th. J.

2013-01-01

The need for nurses to participate in continuing professional development (CPD) is growing to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Ageing leads to changes in biological, psychological, and social functioning. Little is known about the effects of age-related changes on nurses'…

Characteristics and Recruitment Paths of Certified Nursing Assistants in Rural and Urban Nursing Homes

ERIC Educational Resources Information Center

Probst, Janice C.; Baek, Jong-Deuk; Laditka, Sarah B.

2009-01-01

Context: Most nursing home care is provided by certified nursing assistants (CNAs), but little is known about rural CNAs. Purpose: To develop a representative geographic profile of the CNA workforce, focusing on paths leading to present job. Methods: Cross-sectional analysis of data from the 2004 National Nursing Assistant Survey (NNAS), a…

Cultural Characteristics of a Nursing Education Center of Excellence: A Naturalistic Inquiry Case Study

ERIC Educational Resources Information Center

Leiker, Tona L.

2011-01-01

Nursing education is at a crossroad today. Stressors in nursing programs include expanding enrollments to meet growing workforce demands for more registered nurses, demanding workloads with low average nursing faculty salaries compared to practice peers, and growing numbers of faculty retirements. The purpose of this study was to identify the…

Rebuilding human resources for health: a case study from Liberia

PubMed Central

2011-01-01

Introduction Following twenty years of economic and social growth, Liberia's fourteen-year civil war destroyed its health system, with most of the health workforce leaving the country. Following the inauguration of the Sirleaf administration in 2006, the Ministry of Health & Social Welfare (MOHSW) has focused on rebuilding, with an emphasis on increasing the size and capacity of its human resources for health (HRH). Given resource constraints and the high maternal and neonatal mortality rates, MOHSW concentrated on its largest cadre of health workers: nurses. Case description Based on results from a post-war rapid assessment of health workers, facilities and community access, MOHSW developed the Emergency Human Resources (HR) Plan for 2007-2011. MOHSW established a central HR Unit and county-level HR officers and prioritized nursing cadres in order to quickly increase workforce numbers, improve equitable distribution of workers and enhance performance. Strategies included increasing and standardizing salaries to attract workers and prevent outflow to the private sector; mobilizing donor funds to improve management capacity and fund incentive packages in order to retain staff in hard to reach areas; reopening training institutions and providing scholarships to increase the pool of available workers. Discussion and evaluation MOHSW has increased the total number of clinical health workers from 1396 in 1998 to 4653 in 2010, 3394 of which are nurses and midwives. From 2006 to 2010, the number of nurses has more than doubled. Certified midwives and nurse aides also increased by 28% and 31% respectively. In 2010, the percentage of the clinical workforce made up by nurses and nurse aides increased to 73%. While the nursing cadre numbers are strong and demonstrate significant improvement since the creation of the Emergency HR Plan, equitable distribution, retention and performance management continue to be challenges. Conclusion This paper illustrates the process, successes, ongoing challenges and current strategies Liberia has used to increase and improve HRH since 2006, particularly the nursing workforce. The methods used here and lessons learned might be applied in other similar settings. PMID:21569435

Front-line ordering clinicians: matching workforce to workload.

PubMed

Fieldston, Evan S; Zaoutis, Lisa B; Hicks, Patricia J; Kolb, Susan; Sladek, Erin; Geiger, Debra; Agosto, Paula M; Boswinkel, Jan P; Bell, Louis M

2014-07-01

Matching workforce to workload is particularly important in healthcare delivery, where an excess of workload for the available workforce may negatively impact processes and outcomes of patient care and resident learning. Hospitals currently lack a means to measure and match dynamic workload and workforce factors. This article describes our work to develop and obtain consensus for use of an objective tool to dynamically match the front-line ordering clinician (FLOC) workforce to clinical workload in a variety of inpatient settings. We undertook development of a tool to represent hospital workload and workforce based on literature reviews, discussions with clinical leadership, and repeated validation sessions. We met with physicians and nurses from every clinical care area of our large, urban children's hospital at least twice. We successfully created a tool in a matrix format that is objective and flexible and can be applied to a variety of settings. We presented the tool in 14 hospital divisions and received widespread acceptance among physician, nursing, and administrative leadership. The hospital uses the tool to identify gaps in FLOC coverage and guide staffing decisions. Hospitals can better match workload to workforce if they can define and measure these elements. The Care Model Matrix is a flexible, objective tool that quantifies the multidimensional aspects of workload and workforce. The tool, which uses multiple variables that are easily modifiable, can be adapted to a variety of settings. © 2014 Society of Hospital Medicine.

Composition and distribution of the health workforce in India: estimates based on data from the National Sample Survey.

PubMed

Rao, Krishna D; Shahrawat, Renu; Bhatnagar, Aarushi

2016-09-01

The availability of reliable and comprehensive information on the health workforce is crucial for workforce planning. In India, routine information sources on the health workforce are incomplete and unreliable. This paper addresses this issue and provides a comprehensive picture of India's health workforce. Data from the 68th round (July 2011 to June 2012) of the National Sample Survey on the Employment and unemployment situation in India were analysed to produce estimates of the health workforce in India. The estimates were based on self-reported occupations, categorized using a combination of both National Classification of Occupations (2004) and National Industrial Classification (2008) codes. Findings suggest that in 2011-2012, there were 2.5 million health workers (density of 20.9 workers per 10 000 population) in India. However, 56.4% of all health workers were unqualified, including 42.3% of allopathic doctors, 27.5% of dentists, 56.1% of Ayurveda, yoga and naturopathy, Unani, Siddha and homoeopathy (AYUSH) practitioners, 58.4% of nurses and midwives and 69.2% of health associates. By cadre, there were 3.3 qualified allopathic doctors and 3.1 nurses and midwives per 10 000 population; this is around one quarter of the World Health Organization benchmark of 22.8 doctors, nurses and midwives per 10 000 population. Out of all qualified workers, 77.4% were located in urban areas, even though the urban population is only 31% of the total population of the country. This urban-rural difference was higher for allopathic doctors (density 11.4 times higher in urban areas) compared to nurses and midwives (5.5 times higher in urban areas). The study highlights several areas of concern: overall low numbers of qualified health workers; a large presence of unqualified health workers, particularly in rural areas; and large urban-rural differences in the distribution of qualified health workers.

The costs of training a nurse practitioner in primary care: the importance of allowing for the cost of education and training when making decisions about changing the professional-mix.

PubMed

Curtis, Lesley; Netten, Ann

2007-05-01

What is already known on this topic * Cost containment through the most effective mix of staff achievable within available resources and organisational priorities is of increasing importance in most health systems. However, there is a dearth of information about the full economic implications of changing skill mix. * In the UK a major shift in the primary care workforce is likely in response to the rapidly developing role of nurse practitioners and policies aimed to encourage GP practices to transfer some of their responsibilities to other, less costly, professionals. * Previous research has developed an approach to incorporating the costs of qualifications, and thus the investment required to develop a skilled workforce, for a variety of health service professionals including GPs. What this study adds * This paper describes a methodology of costing nurse practitioners that incorporates the human capital cost implications of developing a skilled nurse practitioner workforce. With appropriate sources of data the method could be adapted for use internationally. * Including the full cost of qualifications results in nearly a 24 per cent increase in the unit cost of a Nurse Practitioner. * Allowing for all investment costs and adjusting for length of consultation, the cost of a GP consultation was nearly 60 per cent higher than that of a Nurse Practitioner.

Diabetes educator role boundaries in Australia: a documentary analysis.

PubMed

King, Olivia; Nancarrow, Susan; Grace, Sandra; Borthwick, Alan

2017-01-01

Diabetes educators provide self-management education for people living with diabetes to promote optimal health and wellbeing. Their national association is the Australian Diabetes Educators Association (ADEA), established in 1981. In Australia the diabetes educator workforce is a diverse, interdisciplinary entity, with nurses, podiatrists, dietitians and several other health professional groups recognised by ADEA as providers of diabetes education. Historically nurses have filled the diabetes educator role and anecdotally, nurses are perceived to have wider scope of practice when undertaking the diabetes educator role than the other professions eligible to practise diabetes education. The nature of the interprofessional role boundaries and differing scopes of practice of diabetes educators of various primary disciplines are poorly understood. Informed by a documentary analysis, this historical review explores the interprofessional evolution of the diabetes educator workforce in Australia and describes the major drivers shaping the role boundaries of diabetes educators from 1981 until 2017. This documentary analysis was undertaken in the form of a literature review. STARLITE framework guided the searches for grey and peer reviewed literature. A timeline featuring the key events and changes in the diabetes educator workforce was developed. The timeline was analysed and emerging themes were identified as the major drivers of change within this faction of the health workforce. This historical review illustrates that there have been drivers at the macro, meso and micro levels which reflect and are reflected by the interprofessional role boundaries in the diabetes educator workforce. The most influential drivers of the interprofessional evolution of the diabetes educator workforce occurred at the macro level and can be broadly categorised according to three major influences: the advent of non-medical prescribing; the expansion of the Medicare Benefits Schedule to include rebates for allied health services; and the competency movement. This analysis illustrates the gradual movement of the diabetes educator workforce from a nursing dominant entity, with an emphasis on interprofessional role boundaries, to an interdisciplinary body, in which role flexibility is encouraged. There is however, recent evidence of role boundary delineation at the meso and micro levels.

Race as a predictor of job satisfaction and turnover in US nurses.

PubMed

Doede, Megan

2017-04-01

The purpose of this analysis is to determine US minority nurses' job satisfaction and turnover using three outcome variables: job dissatisfaction; change of jobs; and intent to quit. A balanced nursing workforce is essential for supporting a racially diverse nation. Understanding minority nurses' job satisfaction is the first step in achieving this balance. A secondary data analysis was conducted using the 2008 National Sample Survey of Registered Nurses. The association between race and job satisfaction was examined using logistic regression. Black nurses were more likely to intend to quit than white ones (OR = 1.46, 95% CI = 1.31-1.64), as were Hispanics (OR = 1.35, 95% CI = 1.18-1.55). Asians were less dissatisfied (OR = 0.69, 95% CI = 0.57-0.84), and less likely to have changed jobs (OR = 0.71, 95% CI = 0.60-85) or intend to quit (OR = 0.84, 95% CI = 0.75-0.95) than white nurses. This analysis demonstrated that black and Hispanic nurses are more likely to intend to quit, even while controlling for dissatisfaction. The reasons for this, and the increased job satisfaction demonstrated by Asian nurses, are directions for future research. Nurse managers should endeavour to create a workplace free of discrimination. Efforts to increase the job satisfaction of all nurses are of equal importance. © 2017 John Wiley & Sons Ltd.

Educational pipelines of nurses in Texas: promoting academic mobility through partnerships.

PubMed

Darnall, Emily D; Kishi, Aileen; Wiebusch, Pamela

2011-01-01

Texas, like many states across the nation, is struggling to position itself to achieve the Institute of Medicine (IOM) recommendations on the future of nursing. This article provides insights into the hurdles faced by Texas in achieving some of the IOM goals, particularly those related to a better educated nursing workforce. Only 9% of actively licensed nurses have pursued higher degrees, putting Texas below the national average. Currently, there is a gap between actual academic mobility and national recommendations to increase the numbers of baccalaureate- and doctorate-prepared nurses by 2020. The purpose of this study was to evaluate the educational pipeline in the state of Texas while suggesting partnerships as a solution to promote academic mobility. This cross-sectional study evaluated the academic mobility of four selected cohorts of nurses who have been in practice for 5 to 20 years. The findings revealed limited academic mobility compared with national benchmarks among all cohorts, regardless of basic degree and length in the profession. Educational pipelines for nurses need to be more dynamic in Texas than current trends reflect. Collaboration and partnerships between academics, clinicians, administrators, employers, and policy makers should be developed to address barriers that are deterring nurses from continuing their education. Copyright © 2011 Elsevier Inc. All rights reserved.

The impact of recent physiotherapy graduates in the workforce: a study of Curtin University entry-level physiotherapists 2000-2004.

PubMed

Mulcahy, Amanda J; Jones, Sue; Strauss, Geoff; Cooper, Ian

2010-05-01

Physiotherapy is the largest healthcare contributor after nursing and medicine and it is important to understand its employment characteristics. This study aimed to explore workforce trends for recent physiotherapy graduates, including satisfaction and motivating factors, and future career intentions. A self-administered questionnaire was provided to contactable entry-level physiotherapy graduates (2000-2004) from Curtin University. Of 256 respondents (62.9%), 76.5% were employed full-time. A total of 45% of physiotherapists worked in the public health system; 79.3% worked in cities; 92.2% were clinicians. Top salaries were earned by those completing more continuing professional development hours, working privately, in rural locations and males. A total of 65% (n = 118) of respondents believed they would leave physiotherapy within 10 years. The best aspects of working in physiotherapy were 'helping people', 'flexibility' and 'working in a healthcare team'. Major areas for improvement were 'remuneration', 'skill recognition' and 'marketing'. This study suggests serious implications for the future of the health; planning to avert shortages is essential.

Saudi Arabian ICU safety culture and nurses' attitudes.

PubMed

Alayed, Abdulrahman S; Lööf, Helena; Johansson, Unn-Britt

2014-01-01

The purpose of this paper is to examine nurses' attitudes towards safety culture in six Saudi Arabian intensive care units (ICUs). The study is descriptive with a cross-sectional design. The Safety Attitude Questionnaire (SAQ)-ICU version was distributed and 216 completed questionnaires were returned. The findings provide a basis for further research on Saudi Arabian ICU safety culture. This study showed that the SAQ-ICU can be used to measure safety climate to identify areas for improvement according to nurse attitudes and perceptions. Findings indicate that ICU safety culture is an important issue that hospital managers should prioritise. The SAQ-ICU questionnaire, used to measure safety climate in Saudi Arabian ICUs, identifies service strengths and improvement areas according to attitudes and perceptions. To the knowledge, this is the first study to use SAQ to examine nurses' safety culture attitudes in Saudi Arabian ICUs. The present findings provide a baseline and further details about Saudi Arabian ICU safety. Study participants represented nine nationalities, indicating the nursing workforce's diversity, which is expected to continue in the future. Such a nursing cultural heterogeneity calls for further studies to examine and evaluate attitudes and values to improve ICU safety culture.

Pediatric nurse practitioners: influences on career choice.

PubMed

Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura

2014-01-01

The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Workforce Development in Nursing: Priming the Pipeline.

ERIC Educational Resources Information Center

Heller, Barbara R.; Nichols, Mary A.

2001-01-01

The University of Maryland School of Nursing is addressing the nursing shortage through public-private partnerships and alliances with the health care industry. Strategies include increasing public awareness through marketing, supporting legislation, expanding articulation agreements, and working with secondary schools to recruit students. (SK)

A spatial analysis of the expanding roles of nurses in general practice.

PubMed

Pearce, Christopher; Hall, Sally; Phillips, Christine; Dwan, Kathryn; Yates, Rachael; Sibbald, Bonnie

2012-08-07

Changes to the workforce and organisation of general practice are occurring rapidly in response to the Australian health care reform agenda, and the changing nature of the medical profession. In particular, the last five years has seen the rapid introduction and expansion of a nursing workforce in Australian general practices. This potentially creates pressures on current infrastructure in general practice. This study used a mixed methods, 'rapid appraisal' approach involving observation, photographs, and interviews. Nurses utilise space differently to GPs, and this is part of the diversity they bring to the general practice environment. At the same time their roles are partly shaped by the ways space is constructed in general practices. The fluidity of nursing roles in general practice suggests that nurses require a versatile space in which to maximize their role and contribution to the general practice team.

Factors Related to School Nurse Workload

ERIC Educational Resources Information Center

Jameson, Beth E.; Engelke, Martha Keehner; Anderson, Lori S.; Endsley, Patricia; Maughan, Erin D.

2018-01-01

Recognizing the need for a school nurse workload model based on more than the number of students in a caseload, the National Association of School Nurses issued recommendations related to measuring school nurse workload. Next, a workforce acuity task force (WATF) was charged with identifying the steps needed to further the recommendations. As a…

Valuable yet Vulnerable-A review of the challenges encountered by older nurses in the workplace.

PubMed

Ryan, C; Bergin, M; Wells, J S

2017-07-01

As the global nursing workforce ages, developing a comprehensive understanding of the experiences, needs and values specific to older nurses is increasingly significant. This paper reviews the evidence with regard to the specific challenges encountered by older nurses in the workplace. A scoping review of the published literature was conducted using the electronic databases Medline, CINAHL, PsycINFO, Science Direct and Google Scholar. A total of 20 papers were included in this review, most of which were qualitative (n=14). Three quantitative studies were identified (including one study which combined a physical exam with survey methods) as well as three mixed method studies. The challenges faced by older nurses in their practice are synthesised across three primary domains: Nursing and the ageing body; Recognition and support of the older nurse and Demands associated with middle-age. As older nurses form a substantial proportion of the healthcare workforce in many countries, the development and implementation of strategies to address these challenges is of utmost importance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Work/life balance and health: the Nurses and Midwives e-cohort Study.

PubMed

Schluter, P J; Turner, C; Huntington, A D; Bain, C J; McClure, R J

2011-03-01

Nursing and midwifery are demanding professions. Efforts to understand the health consequences and workforce needs of these professions are urgently needed. Using a novel electronic approach, the Nurses and Midwives e-cohort Study (NMeS) aims to investigate longitudinally Australian and New Zealand nurses' and midwives' work/life balance and health. This paper describes NMeS participation; provides key baseline demographic, workforce and health indicators; compares these baseline descriptions with external norms; and assesses the feasibility of the electronic approach. From 1 April 2006 to 31 March 2008, nurses in Australia and New Zealand, and midwives in Australia were invited to participate. Potential participants were directed to a purpose-built NMeS Internet site, where study information was provided and consent sought. Once obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited. Overall, 7633 (2.3%) eligible nurses and midwives participated (6308 from Australia and 1325 from New Zealand) from a total pool of 334,400. Age, gender, occupational and health profiles were similar between countries and to national figures. However, some differences were noted; for instance, Queensland participants were over-represented, while Victorian and South Australian participants were under-represented, and 28.2% of Australians were in high strain positions compared with 18.8% of New Zealanders. Using an internationally novel web-based approach, a large cohort, which appears generally similar to population norms, has been established. Provided participant retention is adequate, the NMeS will provide insight into understanding the drivers of nurses' and midwives' workforce retention and work-related factors associated with their health. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

World-Class Care: Boston Welcome Back Center Puts Internationally Educated Nurses Back to Work

ERIC Educational Resources Information Center

Fifield, Mary L.

2008-01-01

Massachusetts alone needs an estimated 5,000 nurses, and the shortage is deepening. Nurses are retiring and quitting faster than new nurses can be trained. In this article, the author describes Bunker Hill Community College's Welcome Back Center, a workforce development program that has thus far helped 47 internationally educated nurses from 29…

Illuminating the Experiences of African-American Nursing Faculty Seeking Employment in Higher Education in Nursing

ERIC Educational Resources Information Center

Loyd, Vanessa

2015-01-01

This study explored and described the experience of female African-American nursing faculty seeking employment in higher education in nursing. The lack of diversity in the nursing workforce has been attributed as a major underlying cause of disparity in healthcare in the United States. The importance of increasing the number of minority nursing…

Employment goals, expectations, and migration intentions of nursing graduates in a Canadian border city: a mixed methods study.

PubMed

Freeman, Michelle; Baumann, Andrea; Akhtar-Danesh, Noori; Blythe, Jennifer; Fisher, Anita

2012-12-01

Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work environment before entering the workforce. The graduates doubted that their future work environment would meet many of their job expectations, a troubling finding requiring further investigation. Expectations influenced their migration intentions and may be relevant to their integration and retention in the workforce. Copyright © 2012 Elsevier Ltd. All rights reserved.

Heterogeneity in the background and earnings of nurses in India: evidence from a cross-sectional study in Gujarat.

PubMed

Seth, Katyayni

2017-11-01

It is important to understand the service conditions of nurses because these influence nurses' motivations and ability to provide care. Although nurses are estimated to constitute 30% of India's health workforce, limited empirical information is available about them. This paper attempts to address this gap in research. A cross-sectional survey of 266 nurses in the state of Gujarat was conducted to understand the demographic characteristics, qualifications and employment features of nurses working in India's private and public health sectors. Descriptive and univariate analyses were performed using the collected information. A multivariate regression model was also estimated with monthly earnings as the dependent variable, and workplace, type of employment contract, caste background and years in the nursing workforce as independent variables. The three main findings presented in this article highlight considerable heterogeneity in the background and employment of nurses in India. First, 49% of nurses working in private hospitals and as temporary employees in public facilities belonged to historically disadvantaged social groups (deemed Scheduled Castes and Scheduled Tribes) and were estimated to earn 9% less than similarly qualified and practiced nurses from general caste categories (P = 0.02). Second, 18% of nurses working in private hospitals did not have formal nursing qualifications. Third, nurses working in private hospitals and as temporary employees in public facilities earned less than the minimum wage stipulated by the Government of India. Permanent public sector nurses were estimated to earn 105% more than private sector nurses with the same qualifications, years of work and caste background (P <  0.001). This study finds that the disproportionate presence of women and socially discriminated caste groups in the nursing workforce, coupled with the failure of governmental agencies to regulate the health sector, might help explain the low wages and lack of job security that most nurses in India contend with. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessment of the nursing skill mix in Mozambique using a task analysis methodology

PubMed Central

2014-01-01

Background The density of the nursing and maternal child health nursing workforce in Mozambique (0.32/1000) is well below the WHO minimum standard of 1 nurse per 1000. Two levels of education were being offered for both nurses and maternal child health nurses, in programmes ranging from 18 to 30 months in length. The health care workforce in Mozambique also includes Medical Technicians and Medical Agents, who are also educated at either basic or mid-level. The Ministry of Health determined the need to document the tasks that each of the six cadres was performing within various health facilities to identify gaps, and duplications, in order to identify strategies for streamlining workforce production, while retaining highest educational and competency standards. The methodology of task analysis (TA) was used to achieve this objective. This article provides information about the TA methodology, and selected outcomes of the very broad study. Methods A cross-sectional descriptive task analysis survey was conducted over a 15 month period (2008–2009). A stratified sample of 1295 individuals was recruited from every type of health facility in all of Mozambique’s 10 provinces and in Maputo City. Respondents indicated how frequently they performed any of 233 patient care tasks. Data analysis focused on identifying areas where identical tasks were performed by the various cadres. Analyses addressed frequency of performance, grouped by level of educational preparation, within various types of health facilities. Results Task sharing ranged from 74% to 88% between basic and general nurse cadres and from 54% to 88% between maternal and child health nurse cadres, within various health facility types. Conversely, there was distinction between scope of practice for nursing and maternal/child health nursing cadres. Conclusion The educational pathways to general nursing and maternal/child health nursing careers were consolidated into one 24 month programme for each career. The scopes of practice were affirmed based on task analysis survey data. PMID:24460789

When nursing takes ownership of financial outcomes: achieving exceptional financial performance through leadership, strategy, and execution.

PubMed

Goetz, Kristopher; Janney, Michelle; Ramsey, Kristin

2011-01-01

With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.

Health and safety of older nurses.

PubMed

Letvak, Susan

2005-01-01

The nursing workforce is aging at an unprecedented rate yet little is known about the health and safety of older registered nurses (RNs). The survey reported here examined the relationships between demographic variables, job attributes (job satisfaction, control over practice, and job demands) and the physical and mental health and job-related injuries and health disorders of 308 nurses over the age of 50. Findings indicate that nurses with higher job satisfaction, higher control over practice, and lower job demands experienced increased physical health. Increasing age was positively correlated with mental health. Almost a quarter of older RNs experienced a job-related injury within the past 5 years, and over a third experienced job-related health problems. Nurses with higher job demands and those employed in hospital settings were more likely to have an injury. Overall, older RNs reported higher levels of physical and mental health than the national norm. Efforts must be made to keep older RNs healthy so we can retain them in the workforce.

A Summer Prematriculation Program: Bridging the Gap for Disadvantaged Underrepresented Minority Students Interested in a Nursing Career.

PubMed

Norris, Tommie L; Wicks, Mona N; Cowan, Patricia A; Davison, Erwin Story

2016-08-01

The nursing and health care workforce needs diverse clinicians who can provide culturally competent and high-quality care to an increasingly diverse U.S. Achieving this goal requires creating learning environments that foster the success of disadvantaged underrepresented minority (URM) students seeking nursing careers. This 4-week summer prematriculation program introduced 33 URM individuals from disadvantaged backgrounds to nursing as a career through financial support, academic enrichment, and social support to enhance nursing program admission success. Federal guidelines were used to establish URM and economically disadvantaged status. To date, one third of program participants have been admitted to nursing programs. Fundamental reforms in pre-college education systems, such as the evidence-based strategies implemented in our summer prematriculation program, may be needed to achieve a diverse, culturally competent workforce that can help eliminate persistent health and health care disparities. [J Nurs Educ. 2016;55(8):471-475.]. Copyright 2016, SLACK Incorporated.

Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles. OECD Health Working Papers, No. 17

ERIC Educational Resources Information Center

Buchan, James; Calman, Lynn

2005-01-01

An important potential contribution to the efficient use of the health workforce, is the possibility of "skill mix" changes. "Skill mix" is a relatively broad term which can refer to the mix of staff in the workforce or the demarcation of roles and activities among different categories of staff. Most of the policy attention on…

The Internet as a research site: establishment of a web-based longitudinal study of the nursing and midwifery workforce in three countries.

PubMed

Huntington, Annette; Gilmour, Jean; Schluter, Philip; Tuckett, Anthony; Bogossian, Fiona; Turner, Catherine

2009-06-01

The aim of this paper is to describe the development of a web-based longitudinal research project, The Nurses and Midwives e-cohort Study. The Internet has only recently been used for health research. However, web-based methodologies are increasingly discussed as significant and inevitable developments in research as Internet access and use rapidly increases worldwide. In 2006, a longitudinal web-based study of nurses and midwives workforce participation patterns, health and wellbeing, and lifestyle choices was established. Participating countries are Australia, New Zealand and the United Kingdom. Data collection is handled through a dedicated website using a range of standardized tools combined into one comprehensive questionnaire. Internet-specific data collection and a range of recruitment and retention strategies have been developed for this study. Internet-based technology can support the maintenance of cohorts across multiple countries and jurisdictions to explore factors influencing workforce participation. However, barriers to widespread adoption of web-based approaches include website development costs, the need for fast broadband connection for large data collection instruments, and varying degrees of Internet and computer literacy in the nursing and midwifery workforce. Many of the issues reported in this paper are transitional in nature at a time of rapid technological development. The development of on-line methods and tools is a major and exciting development in the world of research. Research via the world-wide web can support international collaborations across borders and cultures.

Global Government Health Partners' Forum 2006: eighteen months later.

PubMed

Foster, J; Guisinger, V; Graham, A; Hutchcraft, L; Salmon, M

2010-06-01

The challenge of global health worker shortages, particularly among nurses, has been the topic of numerous forums over the last several years. Nevertheless, there has been little attention given to the roles of government chief nursing and medical officers as key partners in addressing health worker shortages. This partnership and its potential impact on the adequacy of the global health workforce was the focus of the most recent Global Government Health Partners (GGHP) Forum held in November 2006 in Atlanta, Georgia, USA. This forum was uniquely designed to create a context for government chief nursing officers and chief medical officers to engage in a joint learning and planning experience focused on positioning their leadership to impact health workforce issues. This article describes an 18-month follow-up evaluation of the outcomes of the GGHP. The purpose of the evaluation was to assess the impact of the forum experience on the actions of participants based on the country-level plans they produced at the forum. This important feedback is intended to inform the design of future partnered global forums and gain insights into the utility of forum-based action plans. The evaluation process itself has served as an opportunity for the engagement of university faculty, students and staff in a global service learning experience. The outcomes of this evaluation indicate that important progress has been made by countries whose leadership was involved in the forum, and was also an important learning activity for those participating in the conduct of the study.

State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes.

PubMed

Yang, Y Tony; Attanasio, Laura B; Kozhimannil, Katy B

2016-01-01

Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care, midwifery plays a more important role in some U.S. states than in others. However, this variability is not well-understood. This study estimates the association between state scope of practice laws related to the autonomy of midwifery practice with the certified nurse-midwifery (CNM) workforce, access to midwife-attended births, and childbirth-related procedures and outcomes. Using multivariate regression models, we analyzed Natality Detail File data from births occurring from 2009 to 2011. Each state was classified regarding autonomous midwifery practice (not requiring supervision or contractual agreements) based on Lexis legal search. States with autonomous practice laws had an average of 4.85 CNMs per 1,000 births, compared with 2.17 in states where CNM practice is subject to collaborative agreement. In states with autonomous CNM practice, women had higher odds of having a CNM-attended birth (adjusted odds ratio [AOR], 1.59; p = .004), compared with women in states where midwifery is subject to collaborative agreement. In addition, women in states with autonomous practice had lower odds of cesarean delivery (AOR, 0.87; p = .016), preterm birth (AOR, 0.87; p < .001), and low birth weight (AOR, 0.89; p = .001), compared with women in states without such practice. States with regulations that support autonomous midwifery practice have a larger nurse-midwifery workforce, and a greater proportion of CNM-attended births. Correlations between autonomous practice laws and better birth outcomes suggest future policy efforts to enhance access to midwifery services may be beneficial to pregnancy outcomes and infant health. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Social responsibility of nursing: a global perspective.

PubMed

Tyer-Viola, Lynda; Nicholas, Patrice K; Corless, Inge B; Barry, Donna M; Hoyt, Pamela; Fitzpatrick, Joyce J; Davis, Sheila M

2009-05-01

This study addresses social responsibility in the discipline of nursing and implications for global health. The concept of social responsibility is explicated and its relevance for nursing is examined, grounded in the American Nurses Association Code of Ethics and the International Council of Nurses Code of Ethics. Social justice, human rights, nurse migration, and approaches to nursing education are discussed within the framework of nursing's social responsibility. Strategies for addressing nursing workforce issues and education within a framework of social responsibility are explored.

Inequality of Paediatric Workforce Distribution in China.

PubMed

Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin

2016-07-12

Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the paediatric workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation.

Inequality of Paediatric Workforce Distribution in China

PubMed Central

Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin

2016-01-01

Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the paediatric workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083

Effectiveness of a Simulated Hospital Day with Undergraduate Student Nurses: A Comparative Descriptive Design

ERIC Educational Resources Information Center

Wholeben, Melissa A.

2013-01-01

Currently, outside forces create blocks that affect the quality and quantity of clinical experiences for pre-licensure nursing students. These limitations create an environment in which entry-level nursing students enter the workforce without a solid foundation in nursing concepts or in exposure to situations that they might encounter. To counter…

75 FR 12554 - National Advisory Council on Nurse Education and Practice; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

... Advisory Council on Nurse Education and Practice; Notice of Meeting In accordance with section 10(a)(2) of... meetings: Name: National Advisory Council on Nurse Education and Practice (NACNEP). Dates and Times: April... workforce. The objectives of the meeting are to: (1) Delineate the variety of roles nurses play in primary...

Employment and Wage Disparities for Nurses With Activity Limitations.

PubMed

Wilson, Barbara L; Butler, Richard J; Butler, Matthew J

2016-11-01

No studies quantify the labor market disparities between nurses with and without activity difficulties (physical impairment or disability). We explore disparate treatment of nurses with activity difficulties at three margins of the labor market: the ability to get a job, the relative wage rate offered once a nurse has a job, and the annual hours of work given that wage rate. Key variables from the American Community Survey (ACS) were analyzed, including basic demographic information, wages, hours of work, and employment status of registered nurses from 2006 to 2014. Although there is relatively little disparity in hourly wages, there is enormous disparity in the disabled's employment and hours of work opportunities, and hence a moderate amount of disparity in annual wages. This has significant implications for the nursing labor force, particularly as the nursing workforce continues to age and physical limitations or disabilities increase by 15-fold from 25 to 65 years of age.  Physical or psychological difficulties increase sharply over the course of a nurse's career, and employers must heighten efforts to facilitate an aging workforce and provide appropriate job accommodations for nurses with activity limitations. © 2016 Sigma Theta Tau International.

So many, yet few: Human resources for health in India.

PubMed

Rao, Krishna D; Bhatnagar, Aarushi; Berman, Peter

2012-08-13

In many developing countries, such as India, information on human resources in the health sector is incomplete and unreliable. This prevents effective workforce planning and management. This paper aims to address this deficit by producing a more complete picture of India's health workforce. Both the Census of India and nationally representative household surveys collect data on self-reported occupations. A representative sample drawn from the 2001 census was used to estimate key workforce indicators. Nationally representative household survey data and official estimates were used to compare and supplement census results. India faces a substantial overall deficit of health workers; the density of doctors, nurses and midwifes is a quarter of the 2.3/1000 population World Health Organization benchmark. Importantly, a substantial portion of the doctors (37%), particularly in rural areas (63%) appears to be unqualified. The workforce is composed of at least as many doctors as nurses making for an inefficient skill-mix. Women comprise only one-third of the workforce. Most workers are located in urban areas and in the private sector. States with poorer health and service use outcomes have a lower health worker density. Among the important human resources challenges that India faces is increasing the presence of qualified health workers in underserved areas and a more efficient skill mix. An important first step is to ensure the availability of reliable and comprehensive workforce information through live workforce registers.

Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.

ERIC Educational Resources Information Center

Heinrich, Janet

Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. Total employment of registered nurses (RNs) per capita and the national unemployment rate for RNs have declined, and providers from around the country report growing difficulty recruiting and…

New Careers in Nursing: Optimizing Diversity and Student Success for the Future of Nursing.

PubMed

DeWitty, Vernell P; Huerta, Carolina G; Downing, Christine A

2016-01-01

In 2008, the Robert Wood Johnson Foundation collaborated with the American Association of Colleges of Nursing to create the New Careers in Nursing (NCIN) scholarship program. Two goals of the program were to alleviate the nursing shortage and to increase diversity of the workforce. During this 7-year program (i.e., seven funding cycles), 130 schools of nursing in 41 states and the District of Columbia were selected as grantees, and they awarded 3,517 scholarships to second-degree accelerated nursing students who were members of groups underrepresented in nursing or who were economically disadvantaged. This article describes the demographic characteristics of the NCIN students, degree of satisfaction with their learning environment, perceptions of their mentoring experiences, and self-identified facilitators and barriers to program completion. Data sources for this article resulted from three surveys completed by scholars during their academic programs: the beginning, the midpoint, and within 6 months postgraduate. Results of analysis indicated that NCIN scholars are significantly more diverse compared with the national nurse population, and they reported high levels of satisfaction with their learning environments. Student relationships with peers and faculty improved during the period of program enrollment. Faculty support was the greatest facilitator for program completion, and competing priorities of finances and family responsibilities were the greatest challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

Earnings of the internationally educated nurses in the U.S. labor market.

PubMed

Walani, Salimah R

2013-01-01

Internationally educated registered nurses comprise 5.4% of the U.S. nursing workforce. These nurses perceive unequal treatment in the workplace. However, studies comparing their wages to U.S.-educated registered nurses are limited and inconclusive. It is unclear whether there is a wage differential in the U.S. labor market. The aims of this study were to determine if there is a difference in the wages of internationally and U.S.-educated nurses and to determine the extent to which the wage gap relates to differences in the human capital, employment, and demographic characteristics of the two groups. The 2008 National Sample Survey of Registered Nurses data were used for this secondary data analysis study. The sample included 988 internationally educated nurses and 21,715 U.S.-educated nurses. Multiple regression and Oaxaca decomposition were used to find predictors of log hourly wages. Internationally educated nurses earned 5% higher log hourly wages, controlling for human capital, employment, and demographic characteristics. Male gender, working in a metropolitan area, hospital job, union representation, higher nursing experience, and higher education exerted significant positive effects on hourly wages. Oaxaca decomposition showed that 67% of the wage differential was because of the differences in the characteristics of two groups. If there is any form of discrimination against internationally educated nurses in the United States, it does not translate into wage inequality. Predictors of economic success should be explored in future research.

The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

PubMed

Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

2014-04-01

Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

What are Chinese nurses' experiences whilst working overseas? A narrative scoping review.

PubMed

Zhong, Yaping; McKenna, Lisa; Copnell, Beverley

2017-09-01

Transnational nurse migration has become an apparent attribute of the global nurse shortage and it is foreseeable that China will play an increasingly significant role in nurse exports. These nurses have unique cultural and professional needs throughout their journey of migration and in-depth analysis of Chinese migrant nurses' experiences is urgently required to manage and empower an ethnically diverse workforce. To synthesise Chinese migrant nurses' experiences by examining the findings of existing studies. Scoping review methods incorporating narrative synthesis were conducted. Arksey and O'Malley's five-stage scoping review framework was utilised to identify Chinese migrant nurses' experiences. 13 databases were searched, and 5009 articles were retrieved. After screening the titles and abstracts, 169 articles were assessed in full text for eligibility, and finally 22 articles plus 2 manually included ones, representing 19 discrete studies, were further analysed and synthesised with a three-step narrative synthesis. 13 qualitative studies, 5 quantitative studies and 1 mixed- methods study met inclusion criteria. Two main themes were identified. "Contexts and migration" comprised three subthemes: perceptions of nursing, original culture and nursing differences. "The self and migration" included four subthemes: initiating, transition, reality and future. This scoping review revealed the literature on Chinese migrant nurses and provided insight into their stories and circumstances. There were external factors which affected Chinese nurses' interpretations and choices. Throughout their migration journeys, they encountered various challenges and also successes. They responded with positive or negative behavioural and psychosocial changes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nursing competency standards in primary health care: an integrative review.

PubMed

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2016-05-01

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce. © 2016 John Wiley & Sons Ltd.

The effects of organizational flexibility on nurse utilization and vacancy statistics in Ontario hospitals.

PubMed

Fisher, Anita; Baumann, Andrea; Blythe, Jennifer

2007-01-01

Social and economic changes in industrial societies during the past quarter-century encouraged organizations to develop greater flexibility in their employment systems in order to adapt to organizational restructuring and labour market shifts (Kallenberg 2003). During the 1990s this trend became evident in healthcare organizations. Before healthcare restructuring, employment in the acute hospital sector was more stable, with higher levels of full-time staff. However, in the downsizing era, employers favoured more flexible, contingent workforces (Zeytinoglu 1999). As healthcare systems evolved, staffing patterns became more chaotic and predicting staffing requirements more complex. Increased use of casual and part-time staff, overtime and agency nurses, as well as alterations in skills mix, masked vacancy counts and thus rendered this measurement of nursing demand increasingly difficult. This study explores flexible nurse staffing practices and demonstrates how data such as nurse vacancy statistics, considered in isolation from nurse utilization information, are inaccurate indicators of nursing demand and nurse shortage. It develops an algorithm that provides a standard methodology for improved monitoring and management of nurse utilization data and better quantification of vacancy statistics. Use of standard methodology promotes more accurate measurement of nurse utilization and shortage. Furthermore, it provides a solid base for improved nursing workforce planning, production and management.

Supply and distribution of primary healthcare registered nurses in british columbia.

PubMed

Wong, Sabrina T; Watson, Diane E; Young, Ella; Mooney, Dawn

2009-11-01

WHAT DID WE DO?: This study uses an existing data source to (a) describe the population and geographic distribution of registered nurses (RNs) working in primary healthcare (PHC) in British Columbia, (b) compare this workforce to PHC physicians and (c) assess the distribution of PHC-RNs relative to population health status. WHAT DID WE LEARN?: Of the 27,570 practising RNs in British Columbia in 2000, there were 3,179 (12%) in the PHC workforce. This translates into 147 people per practising RN and 1,277 people per PHC-RN. In 2000, there were 990 people per PHC physician. PHC-RNs represented 43% of the combined PHC workforce of physicians and RNs. A large proportion (47%) of PHC-RNs worked in community health centres, whereas less than 2% worked in physicians' offices. Geographic distribution of PHC-RNs is similar to the distribution of PHC physicians and is not associated with population health status. WHAT ARE THE IMPLICATIONS?: There seem to be sufficient PHC-RNs to implement policy objectives in support of interdisciplinary PHC teams, but physicians and nurses will increasingly need to practice in the same location or have access to electronic information systems to support coordination, continuity and comprehensiveness of PHC. The PHC workforce could be better deployed to align with population health status.

Recognition and assessment of resident' deterioration in the nursing home setting: A critical ethnography.

PubMed

Laging, Bridget; Kenny, Amanda; Bauer, Michael; Nay, Rhonda

2018-04-01

To explore the recognition and assessment of resident deterioration in the nursing home setting. There is a dearth of research exploring how nurses and personal-care-assistants manage a deteriorating nursing home resident. Critical ethnography. Observation and semi-structured interviews with 66 participants (general medical practitioners, nurses, personal-care-assistants, residents and family members) in two Australian nursing homes. The study has been reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. The value of nursing assessment is poorly recognised in the nursing home setting. A lack of clarity regarding the importance of nursing assessments associated with resident care has contributed to a decreasing presence of registered nurses and an increasing reliance on personal-care-assistants who had inadequate skills and knowledge to recognise signs of deterioration. Registered nurses experienced limited organisational support for autonomous decision-making and were often expected to undertake protocol-driven decisions that contributed to potentially avoidable hospital transfers. Nurses need to demonstrate the importance of assessment, in association with day-to-day resident care and demand standardised, regulated, educational preparation of an appropriate workforce who are competent in undertaking this role. Workforce structures that enhance familiarity between nursing home staff and residents could result in improved resident outcomes. The value of nursing assessment, in guiding decisions at the point of resident deterioration, warrants further consideration. © 2018 John Wiley & Sons Ltd.

Moving to understanding and change.

PubMed

Washington, Deborah

2010-05-01

Creating an environment of inclusion for a culturally diverse nursing workforce is complex. The demographic shift in the country forecasted for over a decade has arrived. Today programs set up to recruit and retain multicultural and multilingual nursing staff are important organizational priorities. Employers want to build responsive and welcoming workplaces in which all feel engaged. This requires several things. Leaders must oversee system changes stimulated by a workforce similar to newly emerging cultural groups in their areas of service. The need exists for managers to possess non-ethnocentric management skills and are competent to take charge of teams motivated by a broad range of culture based values and beliefs. Diversity training, mentoring of staff and leadership development are benchmarks of an organization at the "tipping point" of change related to employing a diverse workforce.

Partnering to Increase Capacity in a Nursing Program

ERIC Educational Resources Information Center

Gallagher, Peg; Gukenberger, Vickie

2012-01-01

The effectiveness of an Associate Degree Nursing (ADN) program designed to allow incumbent employees in healthcare agencies to pursue nursing licensure was evaluated. The program offering drew upon resources from a partnership comprised of personnel from a college, two participating health care agencies, and the local workforce board. This…

The needs and expectations of generation Y nurses in the workplace.

PubMed

Lavoie-Tremblay, Melanie; Leclerc, Edith; Marchionni, Caroline; Drevniok, Ulrika

2010-01-01

Generation Y nurses represent the new nursing workforce. This article describes a study examining the needs, motivations, and expectations of generation Y nurses at the start of their careers. New nurses, on average 24.1 years old in 2007, were interviewed. The generation Y nurses reported that recognition was a key motivator. Their needs are stability, flexible work schedules and shifts, recognition, opportunities for professional development, and adequate supervision.

Nursing Workforce: Recruitment and Retention of Nurses and Nurse Aides Is a Growing Concern. Testimony before the Committee on Health, Education, Labor and Pensions, U.S. Senate.

ERIC Educational Resources Information Center

Scanlon, William J.

The General Accounting Office examined existing and anticipated concerns related to the recruitment and retention of nurse and nurses aides. Special attention was paid to the following aspects of the problem: (1) factors contributing to the current and anticipated shortage among nurses; (2) what is known about the current and projected supply of…

The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.

PubMed

Smith, David Barton; Aaronson, William

2003-01-01

In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment. Confounding these predictions was the fact that hospital and healthcare employment actually grew. By the end of 2001, hospitals in the region were experiencing problems in recruiting sufficient numbers of nurses, pharmacists, and technicians. The forecast failed to anticipate the impact of a strong regional economy on supply and underestimated the resilience of underlying forces that have driven the long-term growth in healthcare workforce demand. More effective ongoing monitoring can help moderate the fluctuation of workforce shortages and surpluses.

A survey of the current neonatal nurse practitioner workforce.

PubMed

Cusson, R M; Buus-Frank, M E; Flanagan, V A; Miller, S; Zukowsky, K; Rasmussen, L

2008-12-01

To assess the adequacy and characteristics of the US neonatal nurse practitioner (NNP) workforce. Internet-based survey of 271 NNP conference participants. Data were analyzed using SPSS (version 14; Chicago, IL, USA); descriptive statistics, including chi(2)-tests of independence, were performed (alpha=0.05). Respondents were primarily masters-prepared females, working in level III newborn intensive care units. Unfilled NNP positions were common; time estimated to fill positions averaged 6-18 months. One-third of the respondents' practice settings had substituted other providers. The mean NNP salary was $86,700. Motivators for becoming an NNP included autonomy and increased knowledge; challenges identified were overload of responsibilities and the NNP shortage. This study provides the first data about NNP education and workforce characteristics in the United States. The use of an internet-based data collection process facilitated the rapid response of a large sample of NNPs and demonstrated the effectiveness of this method of data collection. The results of this survey suggest a mismatch between the need for NNPs the available NNP workforce supply.

Addressing the midwifery workforce crisis: evaluating an employment model for undergraduate midwifery students at a tertiary maternity hospital in Melbourne, Australia.

PubMed

McLachlan, Helen L; Forster, Della A; Ford, Rachael L; Farrell, Tanya

2011-12-01

In Victoria, maternity services are under significant strain due to increased numbers of women giving birth and critical workforce shortages. Hospitals have experienced challenges in adequately staffing maternity units, particularly on postnatal wards. In 2008, a tertiary maternity hospital in Melbourne introduced a model where undergraduate midwifery students were employed as Division 2 nurses (SMW_Div2) (enrolled nurses), to work in the postnatal area only. This study explored the pilot employment model from the perspective of the SMW_Div2 and hospital midwives. A web-based survey was administered to hospital midwives and the SMW_Div2s in the employment model in January 2010. The survey explored the views of midwives and SMW_Div2s regarding the perceived impact of the model on workforce readiness, recruitment and retention, and clinical competence and confidence. Forty-seven of 158 midwives (30%) and five of nine SMW_Div2s employed in the model responded to the survey. Both groups considered the model to have benefits for the organisation, including increased: student workforce readiness; clinical confidence and competence; and organisational loyalty. Both groups also considered that the model would facilitate: workforce recruitment; a teaching and learning culture within the organisation; and enhanced partnerships between students, hospitals and universities. Caution was expressed regarding workload and the need for ongoing support for SMW_Div2s working in the model. SMW_Div2s and midwives were positive about the introduction of the paid employment model at the Women's. The findings are consistent with evaluations of similar programs in the nursing setting. The employment model has potential short and long term individual and organisational advantages, which is important in the context of increasing births and workforce shortages. Progression of such models will be contingent on the collaboration and cooperation of the various stakeholders involved in maternity workforce and education. Copyright © 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

An integrative review of the literature on registered nurses' medication competence.

PubMed

Sulosaari, Virpi; Suhonen, Riitta; Leino-Kilpi, Helena

2011-02-01

The aim of this integrative literature review was to describe registered nurses' medication competence. The objectives of the literature review were to chart the need for future studies and use the results for instrument development. Nurses play a vital role in different phases of a patient's medication process and thus need adequate competence to fulfil their role. Research on nurses' level of medication competence in different competency areas has been published. However, previous studies have lacked a comprehensive or integrated definition or description of medication competence in nursing. Integrative literature review. The integrative literature review followed five stages: (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Eligible articles were identified via systematic literature search of research and evidence-based--databases. Twenty-one studies met the selection criteria. Eleven competency areas that constitute nurses' medication competence were identified: (1) anatomy and physiology, (2) pharmacology, (3) communication, (4) interdisciplinary collaboration, (5) information seeking, (6) mathematical and medication calculation, (7) medication administration, (8) medication education, (9) assessment and evaluation, (10) documentation and (11) promoting medication safety as part of patient safety. The analysis revealed three major categories which integrate these competency areas: (1) decision making competence, (2) theoretical competence and (3) practical competence. Medication competence requires a solid knowledge base and the ability to apply that knowledge in real-life situations during often complex and dynamic patient medication processes. Decision making competence was found to be an important and integral part of a nurses' theoretical and practical competence. These main competence categories integrated all of the 11 competency areas identified in this review. It is important to determine registered nurses' medication competence in the context of developing nursing education and migration of the nursing workforce. This literature review contributes an integrated perspective on nurses' medication competence and in doing so has clinical relevance for curriculum development and to future research in this area. © 2010 Blackwell Publishing Ltd.

Nurses on the move: a global overview.

PubMed

Kingma, Mireille

2007-06-01

To look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. The number of international migrants has doubled since 1970 and nurses are increasingly part of the migratory stream. Critical nursing shortages in industrialized countries are generating a demand that is fueling energetic international recruitment campaigns. Structural adjustments in the developing countries have created severe workforce imbalances and shortfalls often coexist with large numbers of unemployed health professionals. A nurse's motivation to migrate is multifactorial, not limited to financial incentives, and barriers exist that discourage or slow the migration process. The migration flows vary in direction and magnitude over time, responding to socioeconomic factors present in source and destination countries. The dearth of data on which to develop international health human resource policy remains. There is growing recognition, however, that migration will continue and that temporary migration will be a focus of attention in the years to come. Today's search for labor is a highly organized global hunt for talent that includes nurses. International migration is a symptom of the larger systemic problems that make nurses leave their jobs. Nurse mobility becomes a major issue only in a context of migrant exploitation or nursing shortage. Injecting migrant nurses into dysfunctional health systems-ones that are not capable of attracting and retaining staff domestically-will not solve the nursing shortage.

The underrepresentation of Hispanics/Latinos in nursing education: a deafening silence.

PubMed

Taxis, J Carole

2002-01-01

While our national population is growing more ethnically and racially diverse, the nursing workforce and faculty remains predominantly White (non-Hispanic). Ethnic/racial minorities are seriously underrepresented in nursing and, as such, are a factor in the nursing workforce shortage. The nursing literature has addressed the need for ethnic/racial diversity for several decades, most often citing diversification as a means of providing culturally competent care. However the fact remains that the nursing population continues to be underrepresented by people of color. The diversification of the nursing profession will require culturally sensitive research and theory development regarding the recruitment and education of ethnic/racial minorities. While there is a growing body of knowledge regarding the educational needs and experiences of minorities in nursing education, much of this data generalize minorities as if they were a homogeneous group. There is a striking paucity of research regarding the underepresentation of Hispanics in nursing and the unique issues of recruitment and retention of this group in nursing education. This paper provides a review of the mostly anecdotal literature regarding the experiences of Hispanics in nursing education. It explores the underrepresentation and paucity of culturally specific knowledge regarding the recruitment, retention, and graduation of Hispanics/Latinos in nursing. The homogeneity of nursing and its consequences specifically in relation to Hispanics is discussed. The research implications are highlighted throughout.

Enhancing Nursing Staffing Forecasting With Safety Stock Over Lead Time Modeling.

PubMed

McNair, Douglas S

2015-01-01

In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.

A case study exploring the current issues faced by diploma-prepared nurses.

PubMed

Droskinis, Amy

2013-01-01

Nursing is a dynamic and rapidly progressing field. As the profession changes over time, it is vital to study how these transformations influence the workforce. In this study, the aim was to explore how diploma-prepared nurses are functioning in the acute care setting and how modifications in educational requirements and technological advancement have affected their nursing practice.

Introducing contemporary shift patterns in a hospice setting.

PubMed

Greene, Kay

For many nurses, quality of life is dependent on the balance of work and home life. Registered, skilled and experienced nurses are necessary to ensure that a high-quality service is provided. The hospice recognised that its main asset in providing such a service is its nursing workforce. This article describes how the hospice introduced new working patterns for nursing staff.

The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce

ERIC Educational Resources Information Center

Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth

2009-01-01

Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

Factors Affecting Graduate Degree Pursuit for BSN-Prepared Filipino and Filipino American Nurses Working in the United States

ERIC Educational Resources Information Center

Nagtalon-Ramos, Jamille Kristine

2017-01-01

Although Filipino and Filipino American nurses represent an impressive share of the nursing workforce, they are not well represented in advanced practice, faculty, and executive leadership positions. Obtaining a graduate degree in nursing has the potential to open a wider range of opportunities to meet the healthcare demands of a population that…

RE-ENGINEERING PRIMARY HEALTHCARE NURSING AS A FIRST CAREER CHOICE.

PubMed

Wheeler, Emily; Govan, Linda

2016-08-01

In line with international models and critical to the primary healthcare nursing workforce, the Australian Primary Health Care Nursing Association (APNA) has been funded by the Commonwealth Department of Health to develop an Education and Career Framework and Toolkit for primary healthcare nurses. The aim of the project is to improve the recruitment and retention of nurses and to re-engineer primary healthcare as a first choice career option.

Government officials' representation of nurses and migration in the Philippines.

PubMed

Masselink, Leah E; Daniel Lee, Shoou-Yih

2013-01-01

During the past few decades, the nursing workforce has been in crisis in the United States and around the world. Many health care organizations in developed countries recruit nurses from other countries to maintain acceptable staffing levels. The Philippines is the centre of a large, mostly private nursing education sector and an important supplier of nurses worldwide, despite its weak domestic health system and uneven distribution of health workers. This situation suggests a dilemma faced by developing countries that train health professionals for overseas markets: how do government officials balance competing interests in overseas health professionals' remittances and the need for well-qualified health professional workforces in domestic health systems? This study uses case studies of two recent controversies in nursing education and migration to examine how Philippine government officials represent nurses when nurse migration is the subject of debate. The study finds that Philippine government officials cast nurses as global rather than domestic providers of health care, implicating them in development more as sources of remittance income than for their potential contributions to the country's health care system. This orientation is motivated not simply by the desire for remittance revenues, but also as a way to cope with overproduction and lack of domestic opportunities for nurses in the Philippines.

Occupational stressors, stress perception levels, and coping styles of medical surgical RNs: a generational perspective.

PubMed

Wakim, Nada

2014-12-01

The purpose of this study was to compare the occupational stressors, the perceived stress levels, and coping styles of 3 generations of medical-surgical (MS) nurses. The literature supports that the nurse's role is stressful based on a variety of factors including physical labor, human suffering, work hours, staffing, and interpersonal relationships. Data indicate that there are generational differences in the response to stress. The 3 predominant nursing generations coexisting in the nursing workforce add to the complexity of the recognition and coping skills to address stress. A correlational design was used. A convenience sample of MS nurses participated in this study by completing 4 questionnaires. Occupational stressors were found to be significant predictors for perceived stress among all generations of nurses in this sample. Also, the higher the level of stress perception among nurses, the higher the use of coping behaviors. Generation Y reported a higher level of perceived stress and higher use of escape avoidance coping behaviors, while baby boomers reported higher use of self-controlling coping behaviors. By identifying the needs of each of the generational cohorts, nurse leaders, nurse educators, and policy makers can better assist the nursing workforce to remain at the bedside, improve patient outcomes, and maintain a positive work environment.

Leadership for learning: a literature study of leadership for learning in clinical practice.

PubMed

Allan, Helen T; Smith, Pamela A; Lorentzon, Maria

2008-07-01

To report a literature study of leadership for learning in clinical practice in the United Kingdom. Background Previous research in the United Kingdom showed that the ward sister was central to creating a positive learning environment for student nurses. Since the 1990s, the ward mentor has emerged as the key to student nurses' learning in the United Kingdom. A literature study of new leadership roles and their influence on student nurse learning (restricted to the United Kingdom) which includes an analysis of ten qualitative interviews with stakeholders in higher education in the United Kingdom undertaken as part of the literature study. Learning in clinical placements is led by practice teaching roles such as mentors, clinical practice facilitators and practice educators rather than new leadership roles. However, workforce changes in clinical placements has restricted the opportunities for trained nurses to role model caring activities for student nurses and university based lecturers are increasingly distant from clinical practice. Leadership for learning in clinical practice poses three unresolved questions for nurse managers, practitioners and educators - what is nursing, what should student nurses learn and from whom? Leadership for student nurse learning has passed to new learning and teaching roles with Trusts and away from nursing managers. This has implications for workforce planning and role modelling within the profession.

Undergraduate student nurses' perspectives of an integrated clinical learning model in the mental health environment.

PubMed

Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg

2018-06-13

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning. © 2018 Australian College of Mental Health Nurses Inc.

Culture and Climate: Factors That Influence the Academic Success of African American Students in Prelicensure Nursing Education.

PubMed

Murray, Teri A

2015-12-01

Despite numerous calls to diversify the nursing workforce, little progress has been made in increasing the numbers of African American graduates from prelicensure nursing programs, thus widening the diversity gap in the number of African Americans who enter the RN workforce. An integrative literature review was conducted to determine whether, from the students' perspective, the institutional climate and culture influenced their academic success. Themes of Alienation and Isolation, Persistent Determination, and Difficulty Seeking Help emerged as having an influence on students' academic success. On the basis of this review, professional development programs on topics such as implicit bias, microaggressions, and other unintentional and unconscious behaviors are recommended. Copyright 2015, SLACK Incorporated.

Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.

PubMed

Heath, Janie; Swartz, Colleen

2017-09-01

Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.

Intersection of migration and turnover theories-What can we learn?

PubMed

Brewer, Carol S; Kovner, Christine T

2014-01-01

The international migration of nurses has become a major issue in the international health and workforce policy circles, but analyses are not based on a comprehensive theory. The purpose of this article was to compare the concepts of an integrated nursing turnover theory with the concepts of one international migration framework. An integrated turnover theory is compared with a frequently used migration framework using examples of each. Migration concepts relate well to turnover concepts, but the relative importance and strength of various concepts may differ. For example, identification, development, and measurement of the concept of national commitment, if it exists, is parallel to organizational commitment and may be fruitful in understanding the processes that lead to nurse migration. The turnover theory provides a framework for examining migration concepts and considering how these concepts could relate to each other in a future theory of migration. Ultimately, a better understanding of the relationships and strengths of these concepts could lead to more effective policy. Copyright © 2014 Elsevier Inc. All rights reserved.

Can We Predict Burnout among Student Nurses? An Exploration of the ICWR-1 Model of Individual Psychological Resilience

PubMed Central

Rees, Clare S.; Heritage, Brody; Osseiran-Moisson, Rebecca; Chamberlain, Diane; Cusack, Lynette; Anderson, Judith; Terry, Victoria; Rogers, Cath; Hemsworth, David; Cross, Wendy; Hegney, Desley G.

2016-01-01

The nature of nursing work is demanding and can be stressful. Previous studies have shown a high rate of burnout among employed nurses. Recently, efforts have been made to understand the role of resilience in determining the psychological adjustment of employed nurses. A theoretical model of resilience was proposed recently that includes several constructs identified in the literature related to resilience and to psychological functioning. As nursing students are the future of the nursing workforce it is important to advance our understanding of the determinants of resilience in this population. Student nurses who had completed their final practicum were invited to participate in an online survey measuring the key constructs of the ICWR-1 model. 422 students from across Australia and Canada completed the survey between July 2014 and July 2015. As well as several key demographics, trait negative affect, mindfulness, self-efficacy, coping, resilience, and burnout were measured. We used structural equation modeling and found support for the major pathways of the model; namely that resilience had a significant influence on the relationship between mindfulness, self-efficacy and coping, and psychological adjustment (burnout scores). Furthermore, as predicted, Neuroticism moderated the relationship between coping and burnout. Results are discussed in terms of potential approaches to supporting nursing students who may be at risk of burnout. PMID:27486419

Can We Predict Burnout among Student Nurses? An Exploration of the ICWR-1 Model of Individual Psychological Resilience.

PubMed

Rees, Clare S; Heritage, Brody; Osseiran-Moisson, Rebecca; Chamberlain, Diane; Cusack, Lynette; Anderson, Judith; Terry, Victoria; Rogers, Cath; Hemsworth, David; Cross, Wendy; Hegney, Desley G

2016-01-01

The nature of nursing work is demanding and can be stressful. Previous studies have shown a high rate of burnout among employed nurses. Recently, efforts have been made to understand the role of resilience in determining the psychological adjustment of employed nurses. A theoretical model of resilience was proposed recently that includes several constructs identified in the literature related to resilience and to psychological functioning. As nursing students are the future of the nursing workforce it is important to advance our understanding of the determinants of resilience in this population. Student nurses who had completed their final practicum were invited to participate in an online survey measuring the key constructs of the ICWR-1 model. 422 students from across Australia and Canada completed the survey between July 2014 and July 2015. As well as several key demographics, trait negative affect, mindfulness, self-efficacy, coping, resilience, and burnout were measured. We used structural equation modeling and found support for the major pathways of the model; namely that resilience had a significant influence on the relationship between mindfulness, self-efficacy and coping, and psychological adjustment (burnout scores). Furthermore, as predicted, Neuroticism moderated the relationship between coping and burnout. Results are discussed in terms of potential approaches to supporting nursing students who may be at risk of burnout.

Nursing Workforce: Multiple Factors Create Nurse Recruitment and Retention Problems. Testimony before the Subcommittee on Oversight of Government Management, Restructuring and the District of Columbia, Committee on Governmental Affairs, U.S. Senate.

ERIC Educational Resources Information Center

Heinrich, Janet

Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. The nationwide unemployment rate for registered nurses (RNs), which has been low for many years, has declined to 1.0 percent, the lowest level in more than a decade. Nurses report job dissatisfaction…

Why nurses chose to remain in the workforce: Portraits of resilience.

PubMed

Cope, Vicki; Jones, Bronwyn; Hendricks, Joyce

2016-01-01

This study explored why nurses chose to remain in the Western Australian workforce and to develop insights into the role of resilience of nurses and to identify the key characteristics of resilience displayed by these nurses. Nursing is a stressful profession. Prolific quantitative research which measures job stress and resilience has been implemented; however, there is a dearth of qualitative studies which hear the personal narratives as to why nurses remain and thrive in a stressful workplace. Vignettes of nursing resilience reveal underlying themes of resilience where personal stories and events are presented as narrative. Portraiture recognises the inherent value of the nurses' stories giving attention to the nature of their resilience. Interpretation illuminates the portraits or verbal canvasses of the told experience, reflecting success and positivity despite disarray in healthcare settings. Eight themes were identified. The portraits highlight a sometimes imperceptible theme of resilience within nursing. Nurses are resilient; they rely on the social support of colleagues, family and friends to continue to bear their mantle of responsibility. They take pride in their work and accomplishments and give to others altruistically. They laugh, they love nursing and they keep the needs of their patients, clients, residents or students foremost. This paper describes the hallmarks of resilience demonstrated by nurses. Resilience and its relationship to coping in times of adversity are captured within the portraits presented.

Early nurse attrition in New Zealand and associated policy implications.

PubMed

Walker, L; Clendon, J

2018-03-01

To examine the factors contributing to nurses choosing to exit the nursing profession before retirement age. Population growth, ageing and growing demand for health services mean increased demand for nurses. Better retention could help meet this demand, yet little work has been done in New Zealand to understand early attrition. An online survey of registered and enrolled nurses and nurse practitioners who had left nursing was used. This study reports analysis of responses from 285 ex-nurses aged under 55. The primary reasons nurses left the profession were as follows: workplace concerns; personal challenges; career factors; family reasons; lack of confidence; leaving for overseas; unwillingness to complete educational requirements; poor work-life balance; and inability to find suitable nursing work. Most nurses discussed their intentions to leave with a family member or manager and most reported gaining transferrable skills through nursing. Nurses leave for many reasons. Implementing positive practice environments and individualized approaches to retaining staff may help reduce this attrition. Generational changes in the nature of work and careers mean that nurses may continue to leave the profession sooner than anticipated by policymakers. If the nursing workforce is to be able to meet projected need, education, recruitment and retention policies must urgently address issues leading to early attrition. In particular, policies improving the wider environmental context of nursing practice and ensuring that working environments are safe and nurses are well supported must be developed and implemented. Equally, national nursing workforce planning must take into account that nursing is no longer viewed as a career for life. © 2017 International Council of Nurses.

Western Australia facing critical losses in its midwifery workforce: a survey of midwives' intentions.

PubMed

Pugh, Judith D; Twigg, Diane E; Martin, Tracy L; Rai, Tapan

2013-05-01

the ongoing attrition of the midwifery workforce frustrates future workforce planning and the provision of maternity services in Western Australia. This project determined factors contributing to the intention of the midwives to move jobs and/or leave the profession. a cross-sectional survey approach was taken for this descriptive research utilising a self-administered questionnaire developed by the Nursing and Midwifery Office, Department of Health, Western Australia. public and private health sectors in Western Australia, April-May 2010. 1,600 midwives employed in the public and private health sectors throughout Western Australia were invited to participate: 712 responded (44.5%), one-fifth of the state's registered midwives. most midwives worked part-time in a clinical role in public hospitals. Almost half intended moving jobs within 5 years and/or leaving midwifery. Excluding midwives of retirement age, the most common reasons for intending to move jobs were family commitments, working conditions and role dissatisfaction. Those intending to leave midwifery cited work-life balance, career change and family commitments. Midwives thought addressing the following issues would improve midwifery retention: flexible work arrangements, remuneration, staffing and caseload, workplace culture, professional development and models of care. retaining the midwifery workforce requires attention to workforce practices particularly flexible work arrangements and workloads; models of care to strengthen midwives' relationships with clients and colleagues; and accessible professional development. a review of workplace practices at unit and institution levels is urgently required in Western Australia so that midwives can achieve work-life balance and practice to the full extent of their professional role. These changes are necessary to forestall premature retirement of skilled and experienced midwives from the profession and workforce churn. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Nurses for Wisconsin: A Collaborative Initiative to Enhance the Nurse Educator Workforce.

PubMed

Young, Linda K; Adams, Jan L; Lundeen, Sally; May, Katharyn A; Smith, Rosemary; Wendt, L Elaine

2016-01-01

Wisconsin, like much of the nation, is currently suffering from a growing nursing shortage. The University of Wisconsin-Eau Claire College of Nursing and Health Sciences, in partnership with the University of Wisconsin-Madison, University of Wisconsin-Milwaukee, and University of Wisconsin Oshkosh nursing programs, took advantage of a University of Wisconsin System Incentive Grant for economic and workforce development to address this problem. With a $3.2 million award, the Nurses for Wisconsin goal is to increase the number of baccalaureate registered nurses by expanding the nursing education capacity within the University of Wisconsin System. Nurses for Wisconsin is accelerating the preparation of nursing faculty by supporting nurses to enroll in doctor of nursing practice or nursing doctor of philosophy programs with pre- and postdoctoral fellowship awards ranging from $21,500 to $90,000 and the recruitment of faculty with a loan repayment program of up to $50,000. In exchange for the financial support, fellows and faculty must make a 3-year commitment to teach in a UW System nursing program. Two conferences for program participants are also funded through the award. The first conference was held in October 2014. The second conference is scheduled for summer 2015. With the first year of the 2-year project completed, this article describes Nurses for Wisconsin from inception to implementation and midterm assessment with a focus on lessons learned. A follow-up article addressing final outcomes and next steps is planned. Copyright © 2016 Elsevier Inc. All rights reserved.

Faculty support for ESL nursing students: action plan for success.

PubMed

Hansen, Eileen; Beaver, Shirley

2012-01-01

Nursing students whose first language is not English have lower retention and NCLEX-RN pass rates. This review identifies four areas of difficulty and recommends strategies that can be employed by supportive faculty to assist these students and help ensure a more diverse nursing workforce to care for our increasingly diverse patient population.

Rethinking Teaching Nursing Homes: Potential for Improving Long-Term Care

ERIC Educational Resources Information Center

Mezey, Mathy D.; Mitty, Ethel L.; Burger, Sarah Green

2008-01-01

To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

Experiences of Underrepresented Minorities in Doctoral Nursing Programs at Predominantly White Universities

ERIC Educational Resources Information Center

Gregory, Linda D.

2017-01-01

The representation of racial and ethnic minorities in the nursing workforce is disproportionately low in comparison with their representation in the general population in the United States. Despite diversity initiatives, the slight increase in enrollment of under-represented minority (URM) students in graduate schools of nursing at predominantly…

Self-perception of readiness for clinical practice: A survey of accelerated Masters program graduate registered nurses.

PubMed

Cantlay, Andrew; Salamanca, Jennifer; Golaw, Cherie; Wolf, Daniel; Maas, Carly; Nicholson, Patricia

2017-05-01

Accelerated nursing programs are gaining momentum as a means of career transition into the nursing profession for mature age learners in an attempt to meet future healthcare workforce demands in Australia. With a gap in the literature on readiness for practice of graduates from accelerated nursing programs at the Masters level the purpose of this study was to evaluate the effectiveness of the program based on graduates' preparedness for practice and graduate outcomes. Using a descriptive, exploratory design an online survey was used to explore the perception of graduate nurses' readiness for clinical practice. Forty-nine graduates from a nursing Masters program at an Australian university completed the survey defining readiness for practice as knowledge of self-limitations and seeking help, autonomy in basic clinical procedures, exhibiting confidence, possessing theoretical knowledge and practicing safe care. Graduates perceived themselves as adequately prepared to work as a beginner practitioner with their perception of readiness for clinical practice largely positive. The majority of participants agreed that the program had prepared them for work as a beginner practitioner with respondents stating that they felt adequately prepared in most areas relating to clinical practice. This would suggest that educational preparation was adequate and effective in achieving program objectives. Copyright © 2017 Elsevier Ltd. All rights reserved.

A critical exploration of "Working Together, Learning Together"--does it meet the learning needs of nurses?

PubMed

Walshe, Amanda

2003-10-01

Recent government educational initiatives have emphasised the need for lifelong learning to facilitate and equip nurses with the appropriate knowledge and skills to operate in a dynamic healthcare delivery system. In this paper I will critically explore a recent educational framework from an educational ideology and curriculum design perspective. It is recognised that any educational program cannot be devised or constructed in a socio-political vacuum and any developments must acknowledge this influence on the context in which nurse education operates. The framework is debated from an ideological perspective and I surmise that an ideological change from Romanticism to Revisionism will facilitate change in curriculum design that is in keeping with the realties of healthcare needs. The educational initiative is explored from a curriculum design perspective utilising Beattie's Fourfold Model. I further surmise that the educational initiative fails to acknowledge the uniqueness of nursing knowledge and the integral learning processes such as reflection thus marginalising nursing as a profession. In this paper I suggest that any educational initiative must recognise the evolving role of nursing, the profession and the realties of healthcare systems to ensure the present and future workforce is skilled and empowered to aspire to these multifaceted demands.

Career choice, pathways and continuing professional development of dental nurses at one institution.

PubMed

Durkan, C; Belsi, A; Johnson, R; Gallagher, J

2012-07-27

To explore the career pathways and continuing professional development of dental nurses employed at one institution relative to the scope of practice. A questionnaire exploring career pathways and continuing professional development of dental nurses was compiled and delivered to clinical departments. Responses were entered onto SPSS v17 for analysis. Ninety-eight percent (n = 64) of available nurses responded to the questionnaire survey. Eighty percent (n = 51) of the dental nurses were aged between 25 and 44 years, and 95% (n = 61) were female. The ethnicity of the workforce varied; 58% (n = 37) were White and this consequently constituted the largest ethnic group in the workforce. The dental nurses reported that they chose their profession for a wide variety of reasons, the most common one being the opportunity to progress in the dental sector. Before commencing training 38% (n = 24) were aware of their options for progression; this increased subsequent to training with between 55% (n = 35) and 66% (n = 42), depending on the option, stating that they were aware of their options for progression. Eighty-three percent (n = 53) were trained in an additional skill and all of those who were not (n = 11) stated that they would like this training. Conscious sedation was the most frequently possessed additional skill and radiography was the additional skill in which the highest proportion would like to be trained. Personal satisfaction was the most significant factor affecting the willingness of the workforce to pursue career progression. The findings suggest that amongst dental nurses employed in one institution there is evidence that the majority benefit from continuing professional development opportunities, possess additional skills and are motivated to further their skills and progress in their careers.

Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review

PubMed Central

Lucas, Grace; Wiseman, Theresa; Griffiths, Peter

2017-01-01

Objectives To provide an overview of the evidence base on the effectiveness of workforce interventions for improving the outcomes for older people with cancer, as well as analysing key features of the workforce associated with those improvements. Design Systematic review. Methods Relevant databases were searched for primary research, published in English, reporting on older people and cancer and the outcomes of interventions to improve workforce knowledge, attitudes or skills; involving a change in workforce composition and/or skill mix; and/or requiring significant workforce reconfiguration or new roles. Studies were also sought on associations between the composition and characteristics of the cancer care workforce and older people's outcomes. A narrative synthesis was conducted and supported by tabulation of key study data. Results Studies (n=24) included 4555 patients aged 60+ from targeted cancer screening to end of life care. Interventions were diverse and two-thirds of the studies were assessed as low quality. Only two studies directly targeted workforce knowledge and skills and only two studies addressed the nature of workforce features related to improved outcomes. Interventions focused on discrete groups of older people with specific needs offering guidance or psychological support were more effective than those broadly targeting survival outcomes. Advanced Practice Nursing roles, voluntary support roles and the involvement of geriatric teams provided some evidence of effectiveness. Conclusions An array of workforce interventions focus on improving outcomes for older people with cancer but these are diverse and thinly spread across the cancer journey. Higher quality and larger scale research that focuses on workforce features is now needed to guide developments in this field, and review findings indicate that interventions targeted at specific subgroups of older people with complex needs, and that involve input from advanced practice nurses, geriatric teams and trained volunteers appear most promising. PMID:28760795

Call to Action: The Case for Advancing Disaster Nursing Education in the United States.

PubMed

Veenema, Tener Goodwin; Lavin, Roberta Proffitt; Griffin, Anne; Gable, Alicia R; Couig, Mary Pat; Dobalian, Aram

2017-11-01

Climate change, human conflict, and emerging infectious diseases are inexorable actors in our rapidly evolving healthcare landscape that are triggering an ever-increasing number of disaster events. A global nursing workforce is needed that possesses the knowledge, skills, and abilities to respond to any disaster or large-scale public health emergency in a timely and appropriate manner. The purpose of this article is to articulate a compelling mandate for the advancement of disaster nursing education within the United States with clear action steps in order to contribute to the achievement of this vision. A national panel of invited disaster nursing experts was convened through a series of monthly semistructured conference calls to work collectively towards the achievement of a national agenda for the future of disaster nursing education. National nursing education experts have developed consensus recommendations for the advancement of disaster nursing education in the United States. This article proposes next steps and action items to achieve the desired vision of national nurse readiness. Novel action steps for expanding disaster educational opportunities across the continuum of nursing are proposed in response to the current compelling need to prepare for, respond to, and mitigate the impact of disasters on human health. U.S. educational institutions and health and human service organizations that employ nurses must commit to increasing access to a variety of quality disaster-related educational programs for nurses and nurse leaders. Opportunities exist to strengthen disaster readiness and enhance national health security by expanding educational programming and training for nurses. © 2017 Sigma Theta Tau International.

Building the Workforce of the Future

ERIC Educational Resources Information Center

González-Rivera, Christian

2016-01-01

"Building the Workforce of the Future" is an in-depth, independent report on the first eighteen months of Career Pathways, New York City's sweeping new strategy for workforce development. In November 2014, Mayor de Blasio launched a sweeping new approach to workforce development in New York City. Unlike the previous model, which…

[Nursing manpower and solutions in Taiwan].

PubMed

Teng, Su-Wen

2014-04-01

The shortage of nursing manpower is a long-term problem worldwide that affects Taiwan despite this country's internationally admired achievements in terms of its healthcare and national health insurance systems. This article reviews discussions related to the nursing shortage issue published by the World Health Organization, International Council of Nurses, and Taiwan Ministry of Health and Welfare. Next, an overview is given of the nursing workforce profile, causal factors behind the nursing shortage, and demand for and supply of nursing manpower. Finally, problems, resolutions, and expected outcomes for the nursing shortage in Taiwan are analyzed.

Clinical Research Nursing: Development of a Residency Program
.

PubMed

Showalter, Brandi L; Cline, Debbie; Yungclas, Jan; Frentz, Kelly; Stafford, Susan R; Maresh, Kelly J

2017-10-01

Clinical research nurses are essential in the coordination of clinical trials and the management of research participants. Without a stable, knowledgeable research nurse workforce, the conduct of research is affected. A research nurse residency is a novel approach to preparing new graduate nurses for the oncology research nurse role. This article will describe the development and content of the research nurse residency and how this approach is being used to address a need for clinical research nurses to support burgeoning clinical trials at a National Cancer Institute-designated comprehensive cancer center.
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Leading change to create a healthy and satisfying work environment.

PubMed

Sanders, Carolyn L; Krugman, Mary; Schloffman, Danielle H

2013-01-01

Nurse executives must take a leadership role in creating a healthy work environment for nurses and all disciplines. Engaging in partnerships and empowering clinical nurses to construct the solutions to barriers that may stand in the way of the goal of a satisfied and healthy workforce are important strategies toward success. This publication outlines many projects a 3-time Magnet-designated academic hospital has implemented, working with our shared leadership councils, to meet the standards for a healthy work environment. These initiatives, from the unit to the hospital level, included standardizing a culture change of uninterrupted meal breaks, the creation of intensive care unit Zen rooms, strategies to better manage increased patient volumes, best practices for facility design, enhancing physician-nurse relations, and a hospital wellness program. Data were benchmarked against national nurse and employee surveys to compare progress and report outcomes. Two important nursing organization structures that have contributed to the success of a healthy and satisfied nursing work environment include UEXCEL, a longstanding clinical nurse professional practice program, and the hospital's 11-year participation in the University HealthSystem Consortium/American Association of Colleges of Nursing National Post-Baccalaureate Nurse Residency Program. A highly engaged, well-educated, and committed nursing workforce, nurtured by a strong leadership team, has created a positive work environment characterized by low turnover and high retention.

Generation Y New Zealand Registered Nurses' views about nursing work: a survey of motivation and maintenance factors.

PubMed

Jamieson, Isabel; Kirk, Ray; Wright, Sarah; Andrew, Cathy

2015-07-01

The aim of this article was to report on the analysis of qualitative, open text data, received from a national on-line survey of what factors Generation Y New Zealand Registered Nurses wish to change about nursing and consideration of the potential policy and practice impacts of these requests on their retention. Prior to the economic recession of 2007-2010, the growing shortage of nurses in New Zealand presented a serious concern for the healthcare workforce. Given the ageing New Zealand nursing workforce, an ageing population and the increasing demands for health care, it is imperative that issues of retention of Generation Y nurses are resolved prior to the imminent retirement of more experienced nurses. A descriptive exploratory approach using a national wide, on-line survey, eliciting both quantitative and qualitative data was used. The survey, conducted from August 2009-January 2010, collected data from Generation Y New Zealand Registered Nurses ( n  =   358) about their views about nursing, work and career. Herzberg's Motivation-Hygiene theory was used as the framework for the analysis of the open text data. The factors that nurses wanted changed were skewed towards Herzberg's hygiene-maintenance factors rather than motivating factors. This is of concern because hygiene-maintenance factors are considered to be dissatisfiers that are likely to push workers to another employment option.

Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process.

PubMed

Isobel, Sophie; Edwards, Clair

2017-02-01

Without agreeing on an explicit approach to care, mental health nurses may resort to problem focused, task oriented practice. Defining a model of care is important but there is also a need to consider the philosophical basis of any model. The use of Trauma Informed Care as a guiding philosophy provides a robust framework from which to review nursing practice. This paper describes a nursing workforce practice development process to implement Trauma Informed Care as an inpatient model of mental health nursing care. Trauma Informed Care is an evidence-based approach to care delivery that is applicable to mental health inpatient units; while there are differing strategies for implementation, there is scope for mental health nurses to take on Trauma Informed Care as a guiding philosophy, a model of care or a practice development project within all of their roles and settings in order to ensure that it has considered, relevant and meaningful implementation. The principles of Trauma Informed Care may also offer guidance for managing workforce stress and distress associated with practice change. © 2016 Australian College of Mental Health Nurses Inc.

Job and industry turnover for registered and licensed vocational nurses.

PubMed

Spetz, Joanne; Rickles, Jordan; Chapman, Susan; Ong, Paul M

2008-09-01

Most studies of nurse turnover focus on job turnover, which could reflect nurse advancement and thus not be detrimental to the workforce. The authors discuss findings from a study that involved 2 cohorts of graduates from registered nursing and licensed vocational nursing community college programs in California. The duration of employment in the healthcare industry, as well as with specific employers, is tracked, lending a more thorough analysis of nursing job and industry turnover than found in other studies.

A scoping review of the nurse practitioner workforce in oncology.

PubMed

Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

2016-08-01

The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Investigating the adequacy of the Competence-Turnover Intention Model: how does nursing competence affect nurses' turnover intention?

PubMed

Takase, Miyuki; Teraoka, Sachiko; Kousuke, Yabase

2015-03-01

The aim of this study was to test the adequacy of the Competence-Turnover Intention Model, which was developed to identify how nursing competence could affect nurses' turnover intention (nurses' intention to voluntarily leave an organisation). Recent studies have suggested that the level of nursing competence is negatively related to nurses' intention to leave their jobs, suggesting that a lack of competence threatens both the quality and quantity of the nursing workforce. However, the mechanism of how nursing competence affects nurses' turnover intention has not been explored previously. A cross-sectional survey design was used. Surveys were distributed to 1337 Japanese registered nurses/midwives in October, 2013. The adequacy of the model was analysed using structural equation modelling. In total, 766 questionnaires were returned, with a return rate of 57%. The model fitted well with the data. The results showed that the level of nursing competence was related positively to the quantity of organisational rewards they felt they had received, and negatively related to the level of exhaustion they experienced. Moreover, the perceived organisational rewards and exhaustion were correlated with nurses' turnover intention through affective commitment. The Competence-Turnover Intention Model is useful for explaining how nursing competence impacts on their turnover intention. Clinical implications derived from the findings are that: promoting nursing competence is key to improving not only the quality of care provided by nurses, but also to retaining the nursing workforce, and the model can be used to develop strategies that would mitigate their turnover intention. © 2014 John Wiley & Sons Ltd.

Staff satisfaction and retention and the role of the nursing unit manager.

PubMed

Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine; King, Madeleine

2009-01-01

Despite recent increases in nursing recruitment in Australia, participation in the workforce is still below the numbers predicted to meet future needs. This paper discusses factors impacting on nurses' job satisfaction, satisfaction with nursing and intention to leave in public sector hospitals in New South Wales (NSW), Australia. Staffing and patient data were collected on 80 medical and surgical units during 2004/5. This included a wide range of individual nurse data from a Nurse Survey; detailed and comprehensive staffing data including skill mix variables; patient characteristics; workload data; a profile of the ward's characteristics; and adverse event patient data. Nurses who were intending to remain in their job were more likely to be satisfied, be older, and have dependents. They were also likely to be experiencing good leadership and to have allied health support on the ward. Most nurses reported being satisfied with their profession, while a lower proportion reported satisfaction with their current position. Work environment factors such as nurses' autonomy, control over their practice and nursing leadership on the ward were statistically significant predictors of job satisfaction. This study will inform decision-making and policy for managers in both the public and private hospital sectors. This is the first large study which explored the work environment at the ward/unit level in public hospitals in NSW (Australia). It illustrates that there are no typical wards; each ward functions differently. The importance of nursing leadership at the ward level to job satisfaction, satisfaction with nursing and intention to leave, cannot be overstated.

The importance of a servant leader orientation.

PubMed

Jenkins, Marjorie; Stewart, Alice C

2010-01-01

Ensuring a quality nursing workforce for the future in a time of increasing labor shortage and declining nurse satisfaction is a key challenge to the health care industry. Understanding what impacts job satisfaction is vital to solving the problem of nurse attrition. We suggest that the approach to supporting staff in the care giving role requires additional expectations of managers who supervise inpatient nursing staff. This study empirically tested the impact of nurse managers' servant leadership orientation on nurse job satisfaction. Nurses providing direct bedside patient care within inpatient departments of a five-hospital system were asked to respond to four questionnaires. Seventeen departments participated. There were 346 available nurses across the departments. The average response rate was 73% across all of the units surveyed. Hypotheses were tested using multivariate regression analysis of the nurse-nurse manager dyad. Statistical findings of this study provided evidence that behaviors and attitudes of the nurse manager do impact employee job satisfaction. Departments where staff perceived that managers had higher servant leadership orientation demonstrated significant positive impact on individual employee job satisfaction. Nursing is a unique occupation in that it requires both competence in professional service and compassion in patient caregiving. Hospitals are not factories dealing with inanimate objects or data. The results of this research suggested that the management approach in a health care environment might be enhanced by a more servant-oriented management approach. Specific policy changes that may be implied on the basis of findings of this research include key areas of management selection, management development, and management reward/evaluation.

Nurses on the Move: A Global Overview

PubMed Central

Kingma, Mireille

2007-01-01

Objective To look at nurse migration flows in the light of national nursing workforce imbalances, examine factors that encourage or inhibit nurse mobility, and explore the potential benefits of circular migration. Principal Findings The number of international migrants has doubled since 1970 and nurses are increasingly part of the migratory stream. Critical nursing shortages in industrialized countries are generating a demand that is fueling energetic international recruitment campaigns. Structural adjustments in the developing countries have created severe workforce imbalances and shortfalls often coexist with large numbers of unemployed health professionals. A nurse's motivation to migrate is multifactorial, not limited to financial incentives, and barriers exist that discourage or slow the migration process. The migration flows vary in direction and magnitude over time, responding to socioeconomic factors present in source and destination countries. The dearth of data on which to develop international health human resource policy remains. There is growing recognition, however, that migration will continue and that temporary migration will be a focus of attention in the years to come. Conclusions Today's search for labor is a highly organized global hunt for talent that includes nurses. International migration is a symptom of the larger systemic problems that make nurses leave their jobs. Nurse mobility becomes a major issue only in a context of migrant exploitation or nursing shortage. Injecting migrant nurses into dysfunctional health systems—ones that are not capable of attracting and retaining staff domestically—will not solve the nursing shortage. PMID:17489915

Theory of Constraints: What Can We Learn to Support the Nursing Workforce?

PubMed

Pawlak, Roberta

2016-11-01

Demand for nurses is influenced by many factors. Labor statistics and health services literature reveal current and predicted supply gaps in meeting this demand. One strategy in response can be drawn from manufacturing industries. This column suggests the application of the Theory of Constraints in efforts to relieve bottlenecks in producing and retaining nurse labor.

A Study of Personality, Emotional Intelligence, Social Maturity, and Job Performance among Nurses in Rural East Texas

ERIC Educational Resources Information Center

Cox, Shannon J.

2012-01-01

Nursing professionals are held to a variety of roles and responsibilities specific to their field. The success of nursing professionals in their specified roles is essential for quality of care and the success of the healthcare workforce. The current study explored the relationships between personality type, emotional intelligence, social…

Accountability among Baccalaureate Nursing Students: Definitions, Perceptions, and Engagement Practices of Accountability

ERIC Educational Resources Information Center

Ort, Jennifer Ann

2016-01-01

To ensure optimal patient care an especially high level of accountability is required when entering the workforce. The purpose of this qualitative study was to explore, describe, and define perceptions of accountability as described by sophomore and senior nursing students in two baccalaureate nursing programs. The research questions aimed to (a)…

A comparison of the education and work experiences of immigrant and the United States of America-trained nurses.

PubMed

Mazurenko, O; Gupte, G; Shan, G

2014-12-01

This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group. © 2014 International Council of Nurses.

Longitudinal Outcomes of an Institutionally Developed Nurse Residency Program

PubMed Central

Cline, Debbie; La Frentz, Kelly; Fellman, Bryan; Summers, Barbara; Brassil, Kelly

2017-01-01

Nurse residency programs are widely implemented to enhance integration of new graduate nurses entering the workforce. This article presents a retrospective analysis of 10 years of residency data from an internally developed residency program that utilized the Casey-Fink Graduate Nurse Experience Survey. Outcomes of this program were similar to those from studies using commercially available products, suggesting an internally developed residency curricula may be equally beneficial to the development of new graduate nurses. PMID:28727624

Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact.

PubMed

Burton, Christopher; Rycroft-Malone, Jo; Williams, Lynne; Davies, Siân; McBride, Anne; Hall, Beth; Rowlands, Anne-M; Jones, Adrian

2016-08-26

Nursing staffing levels in hospitals appear to be associated with improved patient outcomes. National guidance indicates that the triangulation of information from workforce planning and deployment technologies (WPTs; eg, the Safer Nursing Care Tool) and 'local knowledge' is important for managers to achieve appropriate staffing levels for better patient outcomes. Although WPTs provide managers with predictive information about future staffing requirements, ensuring patient safety and quality care also requires the consideration of information from other sources in real time. Yet little attention has been given to how to support managers to implement WPTs in practice. Given this lack of understanding, this evidence synthesis is designed to address the research question: managers' use of WPTs and their impacts on nurse staffing and patient care: what works, for whom, how and in what circumstances? To explain how WPTs may work and in what contexts, we will conduct a realist evidence synthesis through sourcing relevant evidence, and consulting with stakeholders about the impacts of WPTs on health and relevant public service fields. The review will be in 4 phases over 18 months. Phase 1: we will construct an initial theoretical framework that provides plausible explanations of what works about WPTs. Phase 2: evidence retrieval, review and synthesis guided by the theoretical framework; phase 3: testing and refining of programme theories, to determine their relevance; phase 4: formulating actionable recommendations about how WPTs should be implemented in clinical practice. Ethical approval has been gained from the study's institutional sponsors. Ethical review from the National Health Service (NHS) is not required; however research and development permissions will be obtained. Findings will be disseminated through stakeholder engagement and knowledge mobilisation activities. The synthesis will develop an explanatory programme theory of the implementation and impact of nursing WPTs, and practical guidance for nurse managers. CRD42016038132. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Nursing as a Career Choice by Hispanic/Latino College Students

ERIC Educational Resources Information Center

Stroup, Linda M.

2013-01-01

A culturally competent healthcare workforce is essential to meet the needs of an increasingly diverse society. Greater diversity in the healthcare workforce is expected have many benefits, including improved access to care for the medically underserved and the promotion of research in areas of societal need (Cohen, Gabriel, & Terrell, 2002).…

Utilizing the Intercultural Development Inventory® to develop intercultural competence.

PubMed

Kruse, Julie A; Didion, Judy; Perzynski, Kathy

2014-01-01

Health care professional education programs in the United States have been charged to devise strategies to increase the racial and ethnic diversity of the workforce (Health Resources and Services Administration, Nursing Workforce Diversity (NWD) http://bhpr.hrsa.gov/nursing/grants/nwd.html, 2014). The purpose of this charge is to develop a healthcare workforce that can better provide culturally relevant care to meet the needs of diverse communities. The purpose of this study was to assess the cultural competency of students, faculty, and staff from a small Midwest-university college of nursing. This study was part of a larger interventional study to enhance the cultural development of the College of Nursing faculty, staff, and students. The sample for this study included 314 participants (students, faculty, and staff) in phase one of the parent study. Phase one included the initial administration of the Intercultural Development Inventory (IDI®) over a two year period with analysis of the pre-test results. Phase two includes the implementation of cultural development interventions with a post-test IDI® survey and is currently in process. IDI® aggregate results were similar for students and faculty/staff in that most participants scored at the Minimization level according to the IDI®. Ninety-eight percent of student participants overestimated their level of cultural competency. Minority students had higher cultural competency scores in terms of developmental orientation (M = 98.85, SD = 14.21) compared to non-minority students (M = 94.46, SD = 14.96). Overall, the IDI® was a valuable self-reflection tool to assess cultural development. At the individual level, it has allowed for self-reflection and awareness to the reality of cultural development, attitudes, and values. At an institutional level, the aggregate results provided a framework for the examination of department policies, procedures, and curriculum design with the ultimate goal of graduating a more culturally competent nursing workforce to serve the greater community.

A Strategy to Enhance Student Experiences in Public Health Emergency Preparedness and Response: Medical Reserve Corps Nursing Student Summer Externship.

PubMed

Stein, Loren Nell Melton

Development of the public health nursing workforce is crucial to advancing our nation's health. Many organizations, including the American Association of Colleges of Nursing, Centers for Disease Control and Prevention, and the US Department of Health and Human Services, have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The Medical Reserve Corps is a national organization with more than 200 000 volunteers dedicated to strengthening public health, improving emergency response capabilities, and building community resiliency. In the summer of 2015, the OKMRC offered a 10-week public health emergency preparedness and response externship pilot program to 8 nursing students. In the summer of 2016, the program expanded to include 3 Oklahoma baccalaureate nursing programs. Students completed trainings and participated in activities designed to provide a broad base of knowledge, an awareness of the local disaster plans, and leadership skills to assist their communities with preparedness and disaster response.

Madagascar nursing needs assessment: education and development of the profession.

PubMed

Plager, K A; Razaonandrianina, J O

2009-03-01

To address how Madagascar is improving nursing education and the profession to strengthen their nursing workforce. The sub-Saharan Africa nursing workforce shortage is more than 600,000. Madagascar measures among affected countries. Nursing in Madagascar with reference to the Malagasy Lutheran Church Health Department (SALFA) is examined in this paper. The Malagasy Lutheran Nursing School (SEFAM) was established in 1956 to prepare nurses and midwives. The school recently relocated to better meet SALFA goals to increase nurses in the system and improve nursing education. A US nursing faculty and the SEFAM director proposed to conduct programme assessment to ensure that nursing and midwifery education meet health, social and community needs in Madagascar. DATA SOURCE/METHODS: An in-depth needs assessment of the school programme, facilities and resources occurred. Site visits and informal interviews were held. Field study visits to nursing schools and health-care facilities in Kenya and Tanzania assisted the authors in learning how nursing developed in those countries. Data analysis included comparison of the authors' comprehensive notes for congruity and accuracy. Strategies are needed to support and maintain quality education, improve quality and quantity of nursing care services in hospitals and dispensaries, and improve conditions for nurses and other health-care workers. Compared with Madagascar, Kenya and Tanzania have more well-developed systems of nursing education and professional development. There were limited written sources for some information but methods, such as verbal accounts, compensated for this limitation. Implications include advantages, disadvantages, facilitators and barriers to nursing educational and professional development in Madagascar. Development of nursing education, regulation and the profession will continue with support from key stakeholders. Kenya and Tanzania can serve as role models for Madagascar nurses. Countries with similar nursing education and professional development issues can be informed by lessons learned in this project.

[Migration. Opportunities for recruitment of skilled employees in the care sector].

PubMed

Braeseke, G; Merda, M; Bauer, T K; Otten, S; Stroka, M A; Talmann, A E

2013-08-01

A central objective of this study was to estimate the potential workforce for the elderly care sector in Germany and to compare it with the predicted demand for nurses in 2030. The authors describe the opportunities and obstacles in recruiting skilled professionals from EU member states and from countries outside the EU. Different scenarios of how to raise labor input are discussed so as to determine the domestic potential until 2030 in Germany. The results show that only by assuming unrealistic conditions, e. g., expectations of a high full-time working quota or far more working women, can the domestic potential meet the predicted future demands. Therefore, Germany's chances of attracting skilled foreign workers were assessed by analyzing wage differentials, unemployment probabilities, demographic developments, and professional and cultural aspects between the countries. A major finding study is that the German labor market cannot provide enough nursing care professionals for the elderly care sector by 2030. Secondly, most of the other EU member states are facing similar challenges, at least in the long run. Therefore, it is recommendable to intensify collaboration with populous Asian countries in the future.

Measuring success: Results from a national survey of recruitment and retention initiatives in the nursing workforce

PubMed Central

Carthon, J. Margo Brooks; Nguyen, Thai-Huy; Chittams, Jesse; Park, Elizabeth; Guevara, James

2015-01-01

Objectives The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. Design Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). Participants Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. Methods Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities’ graduation and enrollment between nursing schools with and without diversity pipeline programs Results Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%–10.4%, p = .001), but they decreased among Black (6.8%–5.0%, p = .004) and Native American/Pacific Islander students (2.1 %–0.3%, p ≥ .001). Conclusions Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students. PMID:24880900

Measuring success: results from a national survey of recruitment and retention initiatives in the nursing workforce.

PubMed

Brooks Carthon, J Margo; Nguyen, Thai-Huy; Chittams, Jesse; Park, Elizabeth; Guevara, James

2014-01-01

The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities' graduation and enrollment between nursing schools with and without diversity pipeline programs Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%-10.4%, p = .001), but they decreased among Black (6.8%-5.0%, p = .004) and Native American/Pacific Islander students (2.1 %-0.3%, p ≥ .001). Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students. Copyright © 2014 Elsevier Inc. All rights reserved.

Interdisciplinary transportation education and workforce development modules (ITEWDM).

DOT National Transportation Integrated Search

2014-01-01

The transportation industry will face a shortage of skilled workforce to manage future advanced transportation systems as the current workforce begins to retire. Education and training of future transportation professionals is critical in view of the...

Cultural similarity, cultural competence, and nurse workforce diversity.

PubMed

McGinnis, Sandra L; Brush, Barbara L; Moore, Jean

2010-11-01

Proponents of health workforce diversity argue that increasing the number of minority health care providers will enhance cultural similarity between patients and providers as well as the health system's capacity to provide culturally competent care. Measuring cultural similarity has been difficult, however, given that current benchmarks of workforce diversity categorize health workers by major racial/ethnic classifications rather than by cultural measures. This study examined the use of national racial/ethnic categories in both patient and registered nurse (RN) populations and found them to be a poor indicator of cultural similarity. Rather, we found that cultural similarity between RN and patient populations needs to be established at the level of local labor markets and broadened to include other cultural parameters such as country of origin, primary language, and self-identified ancestry. Only then can the relationship between cultural similarity and cultural competence be accurately determined and its outcomes measured.

Kenya's health workforce information system: a model of impact on strategic human resources policy, planning and management.

PubMed

Waters, Keith P; Zuber, Alexandra; Willy, Rankesh M; Kiriinya, Rose N; Waudo, Agnes N; Oluoch, Tom; Kimani, Francis M; Riley, Patricia L

2013-09-01

Countries worldwide are challenged by health worker shortages, skill mix imbalances, and maldistribution. Human resources information systems (HRIS) are used to monitor and address these health workforce issues, but global understanding of such systems is minimal and baseline information regarding their scope and capability is practically non-existent. The Kenya Health Workforce Information System (KHWIS) has been identified as a promising example of a functioning HRIS. The objective of this paper is to document the impact of KHWIS data on human resources policy, planning and management. Sources for this study included semi-structured interviews with senior officials at Kenya's Ministry of Medical Services (MOMS), Ministry of Public Health and Sanitation (MOPHS), the Department of Nursing within MOMS, the Nursing Council of Kenya, Kenya Medical Practitioners and Dentists Board, Kenya's Clinical Officers Council, and Kenya Medical Laboratory Technicians and Technologists Board. Additionally, quantitative data were extracted from KHWIS databases to supplement the interviews. Health sector policy documents were retrieved from MOMS and MOPHS websites, and reviewed to assess whether they documented any changes to policy and practice as having been impacted by KHWIS data. Interviews with Kenyan government and regulatory officials cited health workforce data provided by KHWIS influenced policy, regulation, and management. Policy changes include extension of Kenya's age of mandatory civil service retirement from 55 to 60 years. Data retrieved from KHWIS document increased relicensing of professional nurses, midwives, medical practitioners and dentists, and interviewees reported this improved compliance raised professional regulatory body revenues. The review of Government records revealed few references to KHWIS; however, documentation specifically cited the KHWIS as having improved the availability of human resources for health information regarding workforce planning, management, and development. KHWIS data have impacted a range of improvements in health worker regulation, human resources management, and workforce policy and planning at Kenya's ministries of health. Published by Elsevier Ireland Ltd.

'Ready to hit the ground running': Alumni and employer accounts of a unique part-time distance learning pre-registration nurse education programme.

PubMed

Draper, Jan; Beretta, Ruth; Kenward, Linda; McDonagh, Lin; Messenger, Julie; Rounce, Jill

2014-10-01

This study explored the impact of The Open University's (OU) preregistration nursing programme on students' employability, career progression and its contribution to developing the nursing workforce across the United Kingdom. Designed for healthcare support workers who are sponsored by their employers, the programme is the only part-time supported open/distance learning programme in the UK leading to registration as a nurse. The international literature reveals that relatively little is known about the impact of previous experience as a healthcare support worker on the experience of transition, employability skills and career progression. To identify alumni and employer views of the perceived impact of the programme on employability, career progression and workforce development. A qualitative design using telephone interviews which were digitally recorded, and transcribed verbatim prior to content analysis to identify recurrent themes. Three geographical areas across the UK. Alumni (n=17) and employers (n=7). Inclusion criterion for alumni was a minimum of two years' post-qualifying experience. Inclusion criteria for employers were those that had responsibility for sponsoring students on the programme and employing them as newly qualified nurses. Four overarching themes were identified: transition, expectations, learning for and in practice, and flexibility. Alumni and employers were of the view that the programme equipped them well to meet the competencies and expectations of being a newly qualified nurse. It provided employers with a flexible route to growing their own workforce and alumni the opportunity to achieve their ambition of becoming a qualified nurse when other more conventional routes would not have been open to them. Some of them had already demonstrated career progression. Generalising results requires caution due to the small, self-selecting sample but findings suggest that a widening participation model of pre-registration nurse education for employed healthcare support workers more than adequately prepares them for the realities of professional practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

International survey of occupational health nurses' roles in multidisciplinary teamwork in occupational health services.

PubMed

Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie

2014-07-01

Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. Copyright 2014, SLACK Incorporated.

Achieving workforce growth in UK nursing: policy options and implications.

PubMed

Buchan, James

2009-01-01

This paper examines how the National Health Service (NHS) in the UK achieved significant nursing workforce growth during the period between 2000 and 2006 and discusses the policy implications of the methods used to achieve this staffing growth. Data analysis, literature review and policy analysis. NHS nurse staffing growth was approximately 25% over the period 1997-2007, with most growth occurring in the years between 1999 and 2005. Whilst increases in intakes to home-based pre-registration education was a factor in achieving growth, the pace and level of growth which occurred was only possible by using active international recruitment, which was adopted as a deliberate national policy. The numbers of nurses and midwives entering the UK from other countries increased rapidly from 1999 onwards, to a peak in 2002, and then reduced markedly in the period from 2005 onwards. The policy of supporting international recruitment shifted rapidly in late 2005/2006 when financial difficulties hit the NHS and staffing growth was curtailed. Active international recruitment can contribute to health sector staffing growth, assuming the recruiting country has the resources to recruit and can tap into international markets, but it may not be effective in addressing all types of skills shortages. If it is not well linked to other components of workforce planning it may cause difficulties of over expansion, as well as raising broader issues of the ethics and impact.

Creating walking tracks to success: A narrative analysis of AustralianAboriginal and Torres Strait Islander nursing students’ stories ofsuccess.

PubMed

West, Roianne; Foster, Kim; Usher, Kim

2016-01-01

Australian Aboriginal and Torres Strait Islander people have higher rates of morbidity and mortality thanother Australians. One proposed strategy to improve this situation is to increase the participation ofAboriginal and Torres Strait Islander people, including Aboriginal and Torres Strait Islander nurses, inthe health workforce. Although the numbers of Aboriginal and Torres Strait Islander students under-taking tertiary nursing courses have increased, completion rates have not kept pace. The study aimedto describe Aboriginal and Torres Strait Islander nursing students’ experiences of enablers for successfulcourse completion and to develop a narrative of student experience. A qualitative study using a strengths-based approach with a narrative analysis of semi-structured interview data was conducted across fourschools of Nursing in Queensland, Australia. Eight final-year Aboriginal and Torres Strait Islander nursingstudents volunteered to participate in the study. A collective story with the overarching plotline Creatingwalking tracks to success was developed. Six threads of experience emerged: Making a difference, Valu-ing Indigeneity, Healing strength of connections, Resisting racism, Embracing support, and perseveringtowards completion. Key success factors included resilient attributes, building supportive connectionsand having positive expectations of the future, along with sustained institutional support from Aboriginaland Torres Strait Islander nurse academics and clinicians. Development of tailored resilience-buildingtraining for Aboriginal and Torres Strait Islander nursing students and appointment of Aboriginal andTorres Strait Islander academics in Schools of Nursing that include such students may facilitate futuresuccessful completions in other programs.

Empirical evolution of a framework that supports the development of nursing competence.

PubMed

Lima, Sally; Jordan, Helen L; Kinney, Sharon; Hamilton, Bridget; Newall, Fiona

2016-04-01

The aim of this study was to refine a framework for developing competence, for graduate nurses new to paediatric nursing in a transition programme. A competent healthcare workforce is essential to ensuring quality care. There are strong professional and societal expectations that nurses will be competent. Despite the importance of the topic, the most effective means through which competence develops remains elusive. A qualitative explanatory method was applied as part of a mixed methods design. Twenty-one graduate nurses taking part in a 12-month transition programme participated in semi-structured interviews between October and November 2013. Interviews were informed by data analysed during a preceding quantitative phase. Participants were provided with their quantitative results and a preliminary model for development of competence and asked to explain why their competence had developed as it had. The findings from the interviews, considered in combination with the preliminary model and quantitative results, enabled conceptualization of a Framework for Developing Competence. Key elements include: the individual in the team, identification and interpretation of standards, asking questions, guidance and engaging in endeavours, all taking place in a particular context. Much time and resources are directed at supporting the development of nursing competence, with little evidence as to the most effective means. This study led to conceptualization of a theory thought to underpin the development of nursing competence, particularly in a paediatric setting for graduate nurses. Future research should be directed at investigating the framework in other settings. © 2015 John Wiley & Sons Ltd.

Nursing casualization and communication: a critical ethnography.

PubMed

Batch, Mary; Windsor, Carol

2015-04-01

The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Critical ethnography. Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009. The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management. © 2014 John Wiley & Sons Ltd.

Local Workforce Rx: Training Students to Meet the Needs of a Changing Health Care Job Market

ERIC Educational Resources Information Center

Murray, Corey; Ullman, Ellen

2011-01-01

Those following recent employment trends have heard about the nursing shortage. A combination of increased demand and impending retirements means 1 million nurses will be needed in hospitals, homes, and medical facilities by 2018. That's good news for job seekers. But it is not just shortages in nursing. Allied health careers, including…

What nurses and midwives want: Findings from the national survey on workplace climate and well-being.

PubMed

Holland, Peter J; Tham, Tse Leng; Gill, Fenella J

2018-06-01

A discussion of the findings from a nationwide study of workplace and well-being issues of Australian nurses and midwives. Current discourse only provides a fragmented understanding of a multifaceted nature of working conditions and well-being, necessitating a more holistic investigation to identify critical workplace issues within these professions. Discussion paper. A national survey conducted in July 2016 involving Australian Nursing and Midwifery Federation members. The literature supporting this paper focuses on the nursing and midwifery workforce and studies on attraction and retention issues. Workplace policies and practices in place in health care organizations that are within the control of management are key factors in the negative issues associated with the profession from the survey. Proactive and targeted interventions particularly aimed at salient issues of work intensification, declining engagement, and effective voice mechanisms are needed to address these crucial issues if the attrition of individuals from nursing and midwifery occupations is going to be ameliorated. To alleviate workforce issues pushing nurses and midwives to the tipping point of exiting the professions, health care organizations need to take a proactive stance in addressing issues under the control of management. © 2018 John Wiley & Sons Australia, Ltd.

The relationship between nursing leadership and patient outcomes: a systematic review update.

PubMed

Wong, Carol A; Cummings, Greta G; Ducharme, Lisa

2013-07-01

Our aim was to describe the findings of a systematic review of studies that examine the relationship between nursing leadership practices and patient outcomes. As healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are paramount. However, a gap still exists in what is known about the association between nursing leadership and patient outcomes. Published English-only research articles that examined leadership practices of nurses in formal leadership positions and patient outcomes were selected from eight online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies. A total of 20 studies satisfied our inclusion criteria and were retained. Current evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, restraint use and hospital-acquired infections. The findings document evidence of a positive relationship between relational leadership and a variety of patient outcomes, although future testing of leadership models that examine the mechanisms of influence on outcomes is warranted. Efforts by organisations and individuals to develop transformational and relational leadership reinforces organisational strategies to improve patient outcomes. © 2013 John Wiley & Sons Ltd.

Men in nursing.

PubMed

MacWilliams, Brent Robert; Schmidt, Bonnie; Bleich, Michael R

2013-01-01

This literature review examines the ability of the nursing profession to recruit and retain men in nursing schools and in the nursing workforce. The authors consider such educational barriers as role stress, discrimination, and stereotyping, and explore questions of male touch and the capacity of men to care. In identifying challenges faced by men entering or working in a profession in which women predominate, the authors hope to promote actions on the part of nurse leaders, educators, and researchers that may address issues of sex bias and promote greater sexual diversity within nursing.

Developing from within: ensuring the ambulatory emergency care workforce is fit for purpose.

PubMed

Thurgate, Claire; Holmes, Sue

2015-11-01

Emergency healthcare provision is changing, and services need to respond to evolving health economies while providing safe, effective, patient-centred care. Ambulatory care is developing to meet these needs, but workforce planners need to ensure that staff are fit for purpose. To address this, one trust, in partnership with a local university, designed a bespoke in-house, work-based learning package on ambulatory care, which was delivered to registered nurses by practice experts. This article describes the project and discusses the evaluation, which highlighted the benefits of this way of learning for the nurses, the trust and the university, and identified some areas that require development.

Guidelines for successful self-scheduling on nursing units.

PubMed

Russell, Elizabeth; Hawkins, Jenna; Arnold, Kara A

2012-09-01

Self-scheduling programs are an increasingly popular strategy utilized by employers to address the individual and organizational challenges resulting from employee work-life imbalance among the nursing workforce. Certain key components will ensure buy-in and support from staff when self-scheduling programs are developed.

Advancing Health Equity Through Student Empowerment and Professional Success: A Statewide Approach.

PubMed

Noone, Joanne; Wros, Peggy; Cortez, David; Najjar, Rana; Magdaleno, Leela

2016-06-01

A lack of diversity in the nursing workforce nationally has been identified by Oregon state leaders as a factor contributing to health inequity. The goal of Advancing Health Equity Through Student Empowerment and Professional Success (HealthE STEPS) is to graduate nursing students from disadvantaged backgrounds to improve health equity within their communities. A comprehensive plan of evidence-based strategies was developed based on social determinants of health and addresses academic socialization, learning support, financial resources, networking, curriculum development, and campus culture. Ninety undergraduate nursing students participated in the program during a 2-year period. Retention of participants was 97% with graduation rates of 94%. First-time licensure pass rates were 82% and 96% of participating graduates employed in a medically underserved community. This comprehensive innovative program of evidence-based strategies addresses health equity by developing a diverse nursing workforce to practice in medically underserved communities. [J Nurs Educ. 2016;55(6):316-322.]. Copyright 2016, SLACK Incorporated.

Estimating the market for nursing personnel in North Carolina.

PubMed

Cleary, B L; Lacey, L M; Beck-Warden, M

1998-01-01

To facilitate nurse workforce planning in the United States at the state level, the North Carolina Center for Nursing conducted a statewide survey of nurse employers to describe the current market for nurses; identify the types of nursing personnel in short supply; estimate the effect of organizational changes on nursing demand; examine preferences for RNs with varying levels of education; and identify the specific skills or competencies desired by employers. Descriptive. A geographically stratified random sample of 909 nurse-employing organizations in North Carolina was surveyed in 1996 by telephone. A total of 667 interviews were completed for a response rate of 78%. Descriptive statistics and correlation analyses are reported. A nursing labor market was found characterized by uncertainty in hospitals, particularly those undergoing reorganization, but of definite growth outside of hospitals. Demand is increasing for unlicensed assistive personnel, RNs with baccalaureate degrees, some advanced practice RNs, and in hospitals, for RNs with master's degrees in management. Recruitment continues to be a major challenge to hospitals in specialty areas, particularly critical care and surgery. In the community sector, demand is strong for all types of nursing personnel. Tests for substitution of specific types of nursing personnel revealed no systematic substitution by employers. Critical thinking and management skills were competencies most valued by hospital employers while specific clinical competencies, including assessment skills and technical skills, received priority emphasis by community-based employers. Although change is occurring in the health system of North Carolina, there remains a strong demand for nursing personnel. The findings pose a challenge to produce a nursing workforce sufficient in numbers and education.

'I love nursing, but..'- qualitative findings from Australian aged-care nurses about their intrinsic, extrinsic and social work values.

PubMed

Tuckett, Anthony; Parker, Deborah; Eley, Robert M; Hegney, Desley

2009-12-01

Aim.  The aim of this qualitative analysis - a component of a larger survey study, was to provide insights and understandings about intrinsic and extrinsic work values for nurses in aged-care. Background.  Intrinsic and extrinsic work values impact on nurses' job satisfaction and ultimately nursing retention. This study contributes further to knowledge development in this area by building on a previous work values study in aged-care nursing. Methods.  This paper presents the qualitative research findings from the final open-ended question from a survey of nurses employed in the aged-care sector in the State of Queensland, Australia in 2007. Data from a cohort of 105 aged care sector nurses was analysed relying on deductive content analysis. Findings.  Two intrinsic work values emerged - low morale and images of nursing and two extrinsic work values emerged - remuneration and working conditions. The work value 'working conditions' comprised four aspects of aged-care work, specifically staff turnover, workplace violence, care team membership specifically the Assistants-in-Nursing and paperwork. A single social workplace value 'support by management' is discussed as identified as important to these nurses. Conclusion.  Qualitative insights into aged-care nurses' intrinsic and extrinsic work values suggest that work satisfaction is low. Workforce policy makers and employers of nurses in aged-care need to comprehend the relationship between job satisfaction, retention and work values. Relevance to clinical practice.  These findings have implications for recruitment, retention and workforce planning within the aged-care environment. © 2009 Blackwell Publishing Ltd.

An exploration of the role and scope of the clinical nurse consultant (CNC) in a metropolitan health service.

PubMed

Bloomer, Melissa J; Cross, Wendy M

2011-01-01

Clinical nurse consultants have been a part of the nursing workforce for some time however a lack of clarity regarding this role has led to significant variations in health service expectations, workloads and scope for the Clinical nurse consultants working within this metropolitan health service. The aim of this study was to explore the role of the CNC as it is perceived by them, in the context of this health service. A qualitative approach was used for this study. Following ethics approval a single audio-taped focus group was undertaken to gather data. Guiding questions were used to elicit responses from the group, moderated by the co-investigators. The focus group was transcribed verbatim. Each researcher independently analysed the narrative data, using coding and clustering the data to develop primary and sub-themes. Whilst each participant experiences their role individually, there were four themes derived from comments expressed by the participants: 'Diversity and conflict', 'Leaders but powerless', 'Support systems' and 'The portfolio holder role'. The role of the Clinical nurse consultant is complex and diverse. The variability in the role suggests that organisational consensus of the role, scope and purpose of the CNC position has not been actualised, resulting in a lack of support systems, and an underutilisation of the Clinical nurse consultants as leaders, where they can challenge existing practice and guide future directions in care delivery.

Authentic leaders creating healthy work environments for nursing practice.

PubMed

Shirey, Maria R

2006-05-01

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

Blood work. Canadian nursing and blood transfusion, 1942-1990.

PubMed

Toman, C

2001-01-01

The extension of blood transfusion to civilian populations was contingent on the availability of a nursing workforce capable of taking on increasingly responsible roles. Nurses assumed a variety of roles as they incorporated blood work into patient care and, in the process, enabled, embodied, and engendered it as nurses' and women's work. Initially, the student workforce facilitated transfusion through roles that were congruent with nursing's domestic roots. Later, it constrained the expansion of blood work because of its perpetually novice nature. Delegation constituted one strategy by which a limited number of persons could become experienced and autonomous in a particular role. As long as the skill remained limited, nurses shared its associated power and status, which differentiated them within the work culture. A few women were able to shape blood work to their advantage, using their expertise either as job security or as a bargaining point to negotiate better working conditions. However, when the skill was routinized and dispersed among many nurses, it became dirty work. The examination of one specific technology that shifted from medicine into nursing contributes insights to current issues of expanded roles and delegated skills. Nurses need to question seriously what is gained and lost as they take on and let go of technologies. They need to consider what kinds of knowledge will be needed and how best to develop it. Finally, they need to reflect how changes might complicate care giving and nurses' work.

Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

PubMed

De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

2008-11-01

An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

Workforce Education: Issues for the New Century.

ERIC Educational Resources Information Center

Pautler, Albert J., Jr., Ed.

This book contains 22 papers on workforce education issues for the new century: "Introduction" (Alfred J. Pautler, Jr.); "Vocational Education: Past, Present, and Future" (Cheryl L. Hogg); "A Philosophic View for Seeing the Past of Vocational Education and Envisioning the Future of Workforce Education: Pragmatism…

Facilitating the quality of care in a specialist Pacific ophthalmic nursing workforce.

PubMed

du Toit, R; Hughes, F; Mason, I; Tousignant, B

2011-03-01

Sufficient, appropriately trained health personnel need to be retained in the workforce, and their performance maintained, to achieve quality care. Mid-level ophthalmic personnel in Western Pacific Island Countries and Territories (WPICT) are no exception. The study aims to assess influences on the quality of care provided by specialist mid-level ophthalmic personnel in WPICT and devise strategies to train, retain and maintain performance of these personnel. A situational assessment employed a checklist and semi-structured interviews with specialist mid-level ophthalmic personnel, nursing bodies and Ministry of Health representatives from seven WPICT. A selective literature review guided strategies to address the issues identified. Appropriate training allows nurses to fulfill a mid-level role in WPICT as specialist ophthalmic nurses. Resources generally do not restrict practice. Nursing structures have generally failed to support professionalism: scope and conditions of service, clinical supervision, career structures, professional recognition and opportunities for continuing professional development are rudimentary. Ophthalmic nurses were dissatisfied with the lack of specialty recognition, career progression and salary increase. Regional and local strategies tailored to each country have been devised to establish sustainable processes for support. Salary was a major cause of dissatisfaction. It should be addressed along with professional recognition and related processes. Without professional support, specialist and advanced cadres within nursing may cease to exist, nurses' performance may be affected or they may leave. Specialist ophthalmic nursing, recognized, situated within and properly supported by nursing structures can provide a model for specialist clinical care for other specialties and in other countries. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

Post-retirement intentions of nurses and midwives living and working in the Northern Territory of Australia.

PubMed

Voit, Katharina; Carson, D B

2014-01-01

Previous research undertaken in the Northern Territory of Australia has identified interest among nurses in engaging in the active workforce post-retirement. Relatively little is known about which nurses are interested in such engagement, and the types of work arrangements that might be of interest. This study aims to provide an enhanced understanding of the retirement plans and post-retirement employment intentions of nurses and midwives living and working in the Northern Territory (NT) of Australia. An online survey was developed to examine retirement intentions, and investigate the types and facilitators significant for post-retirement engagement. The results indicated a strong interest among nurses and midwives in engaging in post-retirement work, with 73.2% of respondents (n=207) having considered continuing in the active workforce. The most preferred types of engagement included the gradual reduction of hours in current workplaces, part-year or seasonal employment, short-term placements, job-sharing or job-rotation, mentoring, research and policy development or acting as 'Northern Territory representatives' promoting jobs to prospective nurses and midwives elsewhere in Australia. A range of facilitators for post-retirement engagement was found, including for nurses who had not currently considered such engagement. The data collected from this research also identified barriers to post-retirement employment. The most favoured facilitators were financial incentives (90.0% of respondents identified it as a facilitator for post-retirement engagement), followed by support from line management (82.0%). Regardless of whether they had considered engaging post-retirement, the largest proportion of respondents intended to leave the NT for the time of their retirement (33.7%). The most prominent barrier to post-retirement engagement was that only a smaller proportion intended to retire in the NT (24.1%). Importantly, many nurses who had not currently considered post-retirement engagement were interested in some of the opportunities listed in the survey, and may therefore be tempted to consider continued engagement in the future. This study has provided an enhanced understanding of the retirement intentions of nurses and midwives living and working in the NT, and the significant types and facilitators of post-retirement engagement. The barriers arising from the inability of workplaces to cater to the needs of older workers potentially continuing their employment post-retirement are consistent with previous research. The types and facilitators of engagement presented in this study might assist in overcoming these barriers.

Relationships between nurse- and physician-to-population ratios and state health rankings.

PubMed

Bigbee, Jeri L

2008-01-01

To evaluate the relationship between nurse-to-population ratios and population health, as indicated by state health ranking, and to compare the findings with physician-to-population ratios. Secondary analysis correlational design. The sample consisted of all 50 states in the United States. Data sources included the United Health Foundation's 2006 state health rankings, the 2004 National Sample Survey for Registered Nurses, and the U.S. Health Workforce Profile from the New York Center for Health Workforce Studies. Significant relationships between nurse-to-population ratio and overall state health ranking (rho=-.446, p tf?>=.001) and 11 of the 18 components of that ranking were found. Significant components included motor vehicle death rate, high school graduation rate, violent crime rate, infectious disease rate, percentage of children in poverty, percentage of uninsured residents, immunization rate, adequacy of prenatal care, number of poor mental health days, number of poor physical health days, and premature death rate, with higher nurse-to-population ratios associated with higher health rankings. Specialty (public health and school) nurse-to-population ratios were not as strongly related to state health ranking. Physician-to-population ratios were also significantly related to state health ranking, but were associated with different components than nurses. These findings suggest that greater nurses per capita may be uniquely associated with healthier communities; however, further multivariate research is needed.

Educating a Diverse Workforce: The Student of Color Experience in a Research University's Accelerated Undergraduate Nursing Program

ERIC Educational Resources Information Center

Johnson-Campbell, Tanisha

2018-01-01

This study is an investigation into a 15-month accelerated undergraduate nursing program and the minority student experience. Using a mixed methods approach, this research addressed the following questions: 1. What was the retention rate for students enrolled in the accelerated nursing bachelor's program and how did that differ by race? 2. What…

Impact of primary care nursing workforce characteristics on the control of high-blood pressure: a multilevel analysis

PubMed Central

Parro-Moreno, Ana; Serrano-Gallardo, Pilar; Díaz-Holgado, Antonio; Aréjula-Torres, Jose L; Abraira, Victor; Santiago-Pérez, Isolina M; Morales-Asencio, Jose M

2015-01-01

Objective To determine the impact of Primary Health Care (PHC) nursing workforce characteristics and of the clinical practice environment (CPE) perceived by nurses on the control of high-blood pressure (HBP). Design Cross-sectional analytical study. Setting Administrative and clinical registries of hypertensive patients from PHC information systems and questionnaire from PHC nurses. Participants 76 797 hypertensive patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with a higher socioeconomic situation and South-West Zone (SWZ) with a lower socioeconomic situation, and 442 reference nurses. Segmented analyses by area were made due to their different socioeconomic characteristics. Primary outcome measure: Poor HBP control (adequate figures below the value 140/90 mm Hg) associated with the characteristics of the nursing workforce and self-perceived CPE. Results The prevalence of poor HBP control, estimated by an empty multilevel model, was 33.5% (95% CI 31.5% to 35.6%). In the multilevel multivariate regression models, the perception of a more favourable CPE was associated with a reduction in poor control in NWZ men and SWZ women (OR=0.99 (95% CI 0.98 to 0.99)); the economic immigration conditions increased poor control in NWZ women (OR=1.53 (95% CI 1.24 to 1.89)) and in SWZ, both men (OR=1.89 (95% CI 1.43 to 2.51)) and women (OR=1.39 (95% CI 1.09 to 1.76)). In all four models, increasing the annual number of patient consultations was associated with a reduction in poor control (NWZ women: OR=0.98 (95% CI0.98 to 0.99); NWZ men: OR=0.98 (95% CI 0.97 to 0.99); SWZ women: OR=0.98 (95% CI 0.97 to 0.99); SWZ men: OR=0.99 (95% CI 0.97 to 0.99). Conclusions A CPE, perceived by PHC nurses as more favourable, and more patient–nurse consultations, contribute to better HBP control. Economic immigration condition is a risk factor for poor HBP control. Health policies oriented towards promoting positive environments for nursing practice are needed. PMID:26644122

Where do all the undergraduate and new graduate nurses go and why? A search for empirical research evidence.

PubMed

Gaynor, Lynda; Gallasch, Tamara; Yorkston, Emily; Stewart, Simon; Turner, Catherine

To review the published scientific literature for studies quantifying or examining factors associated with the attrition of undergraduate nursing students in pre-registration programs and the retention of graduate nurses in the workforce. The following selection criteria were used to systematically search the literature: target populations were either students in pre-registration nursing programs or registered nurses in their graduate year; the studies were to be primary observational or analytical (cross-sectional, case-control or prospective cohort studies) in design; and outcome measures were attrition in undergraduate programs and/or retention of graduates within the workforce. Three authors guided by a standardised procedure performed data extraction and quality assessment independently. Synthesis of the data appears in text and tabular format. Due to the heterogenic nature of the study methods, meta-analysis was not possible. This review found only four studies that met all inclusion criteria. All four studies examined undergraduate attrition as an outcome with two studies reporting a range of 25-27% attrition within the first year. No studies were found that quantified or examined retention of new graduates as an outcome measure. Only two of the four studies followed cohorts of students prospectively and were able to provide a high level of evidence, although each of these studies was designed to assess specific exposures as potential predictors of attrition, rather than assess actual factors associated with students leaving their program. There is a paucity of research studies in the literature from which evidence quantifying attrition and retention and the reasons why students leave undergraduate nursing programs or new graduates leave the profession can be obtained. Clearly there is a need to systematically track undergraduates and new graduates to quantify and understand attrition, retention and workforce choices within the nursing profession and begin to build this evidence-base.

Recruitment and retention strategies for expert nurses in abortion care provision.

PubMed

McLemore, Monica R; Levi, Amy; James, E Angel

2015-06-01

The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. Thematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units. Several themes emerged from the broad categories that contribute to successful nurse recruitment, retention, and career development in abortion care provision. All areas were significantly influenced by engagement in leadership activities and professional society membership. The most notable theme specific to recruitment was exposure to abortion through education as a student, or through an employer. Retention is most influenced by flexibility in practice, including: advocating for patients, translating one's skill set, believing that nursing is shared work, and juggling multiple roles. Lastly, providing on the job training opportunities for knowledge and skill advancement best enables career development. Clear mechanisms exist to develop expert nurses in abortion care provision. The findings from our study should encourage employers to provide exposure opportunities, develop activities to recruit and retain nurses, and to support career development in abortion care provision. Additionally, future workforce development efforts should include and engage nursing education institutions and employers to design structured support for this trajectory. Copyright © 2015 Elsevier Inc. All rights reserved.

Saudi Arabian nurses' experiences of studying Masters degrees in Australia.

PubMed

Clerehan, R; McCall, L; McKenna, L; Alshahrani, K

2012-06-01

This paper presents findings from a study which explored a group of Saudi Arabian nurses' experiences of studying for a Masters degree in Australia. Arab states in the Middle East, Saudi Arabia in particular, have high expatriate nursing populations, and governments in the region have allocated considerable funding to up-skilling their health workforce, often at Western universities. However, there has been little research into the learning experiences of nursing students from Middle East nations. A descriptive qualitative study design was used. Middle Eastern students undertaking Masters courses in a School of Nursing and Midwifery at one Australian university were invited to participate in a semi-structured interview. Ten Saudi students participated and data were analysed using content analysis. Students experienced challenges related to the transition to very different forms of study; to managing relationships and family. They were resourceful, employing strategies to manage multiple demands, including differences in culture, and stressed the significance of strong personal relationships with staff. Students acknowledged being changed, even transformed, by their experience, and saw themselves as future change agents. Highly skilled local nursing professionals are being sought in many Middle Eastern countries and may undertake post-graduate studies in Western contexts quite different from their own. Students reported that, in spite of difficulties, their experience prompted transformational change: intellectually, psychologically and developmentally. It is necessary for staff to understand expectations and learning preferences of these students to ensure fruitful learning outcomes and benefits to nursing in their home countries. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Motivational pathways of occupational and organizational turnover intention among newly registered nurses in Canada.

PubMed

Fernet, Claude; Trépanier, Sarah-Geneviève; Demers, Mireille; Austin, Stéphanie

Staff turnover is a major issue for health care systems. In a time of labor shortage, it is critical to understand the motivational factors that underlie turnover intention in newly licensed nurses. To examine whether different forms of motivation (the reasons for which nurses engage in their work) predict intention to quit the occupation and organization through distinct forms (affective and continuance) and targets (occupation and organization) of commitment. Cross-sectional data were collected from a sample of 572 French-Canadian newly registered nurses working in public health care in the province of Quebec, Canada. The hypothesized model was tested by structural equation modeling. Autonomous motivation (nurses accomplish their work primarily out of a sense of pleasure and satisfaction or because they personally endorse the importance or value of their work) negatively predicts intention to quit the profession and organization through target-specific affective commitment. However, although controlled motivation (nurses accomplish their work mainly because of internal or external pressure) is positively associated with continuance commitment to the occupation and organization, it directly predicts, positively so, intention to quit the occupation and organization. These results highlight the complexity of the motivational processes at play in the turnover intention of novice nurses, revealing distinct forms of commitment that explain how motivation quality is related simultaneously to intention to quit the occupation and organization. Health care organizations are advised to promote autonomous over controlled motivation to retain newly recruited nurses and sustain the future of the nursing workforce. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Health Care Evolution Is Driving Staffing Industry Transformation.

PubMed

Faller, Marcia; Gogek, Jim

2016-01-01

The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry.

Is the US Workforce Prepared to Thrive in the Past or in the Future?

ERIC Educational Resources Information Center

Burrus, Daniel

2014-01-01

Past education focused on the three Rs (reading, 'riting and 'rithmetic), but these no longer give humans an edge over advanced computers and automation systems. This is why we need to understand where the future is heading and better prepare both our current workforce as well as the future workforce for tomorrow's job market. Of…

The Medical Physics Workforce.

PubMed

Newhauser, Wayne D

2017-02-01

The medical physics workforce comprises approximately 24,000 workers worldwide and approximately 8,200 in the United States. The occupation is a recognized, established, and mature profession that is undergoing considerable growth and change, with many of these changes being driven by scientific, technical, and medical advances. Presently, the medical physics workforce is adequate to meet societal needs. However, data are emerging that suggest potential risks of shortages and other problems that could develop within a few years. Some of the governing factors are well established, such as the increasing number of incident cancers thereby increasing workload, while others, such as the future use of radiation treatments and changes in healthcare economic policies, are uncertain and make the future status of the workforce difficult to forecast beyond the next several years. This review examines some of the major factors that govern supply and demand for medical physicists, discusses published projections and their uncertainties, and presents other information that may help to inform short- and long-term planning of various aspects of the future workforce. It includes a description of the general characteristics of the workforce, including information on its size, educational attainment, certification, age distribution, etc. Because the supply of new workers is governed by educational and training pathways, graduate education, post-doctoral training, and residency training are reviewed, along with trends in state and federal support for research and education. Selected professional aspects of the field also are considered, including professional certification and compensation. We speculate on the future outlook of the workforce and provide recommendations regarding future actions pertaining to the future medical physics workforce.

Pan-London tuberculosis services: a service evaluation

PubMed Central

2012-01-01

Background London has the largest proportion of tuberculosis (TB) cases of any western European capital, with almost half of new cases drug-resistant. Prevalence varies considerably between and within boroughs with research suggesting inadequate control of TB transmission in London. Economic pressures may exacerbate the already considerable challenges for service organisation and delivery within this context. This paper presents selected findings from an evaluation of London’s TB services’ organisation, delivery, professional workforce and skill mix, intended to support development of a strategic framework for a pan-London TB service. These may also interest health service professionals and managers in TB services in the UK, other European cities and countries and in services currently delivered by multiple providers operating independently. Methods Objectives were: 1) To establish how London’s TB services are structured and delivered in relation to leadership, management, organisation and delivery, coordination, staffing and support; 2) To identify tools/models for calculating skill mix as a basis for identifying skill mix requirements in delivering TB services across London; 3) To inform a strategic framework for the delivery of a pan-London TB service, which may be applicable to other European cities. The multi-method service audit evaluation comprised documentary analysis, semi-structured interviews with TB service users (n = 10), lead TB health professionals and managers (n = 13) representing London’s five sectors and focus groups with TB nurses (n = 8) and non-London network professionals (n = 2). Results Findings showed TB services to be mainly hospital-based, with fewer community-based services. Documentary analysis and professionals’ interviews suggested difficulties with early access to services, low suspicion index amongst some GPs and restricted referral routes. Interviews indicated lack of managed accommodation for difficult to treat patients, professional workforce shortages, a need for strategic leadership, nurse-led clinics and structured career paths for TB nurses and few social care/outreach workers to support patients with complex needs. Conclusions This paper has identified key issues relating to London’s TB services’ organisation, delivery, professional workforce and skill mix. The majority of these present challenges which need to be addressed as part of the future development of a strategic framework for a pan-London TB service. More consistent strategic planning/co-ordination and sharing of best practice is needed, together with a review of pan-London TB workforce development strategy, encompassing changing professional roles, skills development needs and patient pathways. These findings may be relevant with the development of TB services in other European cities. PMID:22805234

Nurses' attitudes towards older people care: An integrative review.

PubMed

Rush, Kathy L; Hickey, Stormee; Epp, Sheila; Janke, Robert

2017-12-01

To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes. © 2017 John Wiley & Sons Ltd.

Assessing new graduate nurse performance.

PubMed

Berkow, Steven; Virkstis, Katherine; Stewart, Jennifer; Conway, Lindsay

2008-11-01

New graduate nurses now comprise more than 10% of a typical hospital's nursing staff, with this number certain to grow given the increasing numbers of entrants into the nurse workforce. Concomitantly, only 10% of hospital and health system nurse executives believe their new graduate nurses are fully prepared to provide safe and effective care. As part of a multipronged research initiative on bridging the preparation-practice gap, the Nursing Executive Center administered a national survey to a cross section of frontline nurse leaders on new graduate nurse proficiency across 36 nursing competencies deemed essential to safe and effective nursing practice. Based on survey data analysis, the authors discuss the most pressing and promising opportunities for improving the practice readiness of new graduate nurses.

Comprehensive Review of Nutritional Components for Occupational Health Nurses-Part 1.

PubMed

Toothaker, Rebecca; Chikotas, Noreen

2018-05-01

This article, the first in a two-part series, reviews and examines the components of clinical nutrition. In Part 1, the authors introduce the concept of nutrition and the role it plays in supporting healthy employees, current guidelines, and recommendations for determining healthy eating and the nutritional component of carbohydrates. In Part 2, the components of fats, proteins, vitamins, minerals, and water, and a resource guide are provided for the occupational health nurse to assist in the implementation of employee education in the area of healthy nutrition. The intent of the articles is to acquaint and inform occupational health nurses on the current guidelines for healthy eating so they can better appraise their employee population, thus creating a healthier workforce. The information provided is not all-inclusive on the topics discussed, but provides a foundation to understand the requirements for a healthier workforce.

Culture diversity/a mobile workforce command creative leadership, new partnerships, and innovative approaches to integration.

PubMed

Foley, Regina; Wurmser, Theresa A

2004-01-01

Today's healthcare environment requires that nursing leaders meet the needs of a growing multicultural workforce and patient population. Cultural factors may be overlooked as healthcare delivery becomes increasingly dominated by technological, economic, and social changes. Through creative leadership, the chief nurse executive (CNE) can encourage staff to pay closer attention to cultural factors that will impact on patient, staff, and hospital outcomes. The CNE can begin by enhancing his/her own multicultural competency, building these competencies in his/her staff, and then empowering staff to respect and accommodate cultural differences. An understanding to transcultural nursing theory can enhance the development and maintenance of a multicultural perspective. The use of Madeline Leininger's Culture Care modalities can assist staff in making culturally competent decisions and in implementing actions. This article will provide an overview of one community hospital's experiences in integrating a multicultural perspective to better meet the needs of specific patient populations.

Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review.

PubMed

Dawson, A J; Nkowane, A M; Whelan, A

2015-12-18

Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between nurses and midwives and other health providers and organizations, across sectors, and with communities and individuals that resulted in improved health care and outcomes. The findings of this review confirm the importance of a conceptual framework for understanding and planning leadership and governance approaches, management strategies and collaboration and education and training efforts to scale up and support nurses and midwives in existing or expanded roles to improve access to PHC for vulnerable populations.