National Nurse Shortage. Outline. Impact of Economy on the Nursing Shortage

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1 National Nurse Shortage Carole C. Jakeway, MPH, RN, NEA-BC Chief Nurse Georgia June 15, Outline Stats and Status Impact of nursing shortage Coping with the shortage Recruitment strategies Retention strategies What needs to happen 2 Impact of Economy on the Nursing Shortage Part-time nurses changing to full-time Retired nurses returning to work Nurses are delaying planned retirement Nurses are working extra shifts Beware of the shortage lull Source: Dr. Peter Buerhaus, Journal of the American Medical Association, Nov 26,

2 Future Nursing Workforce Needs By 2016, need 1 million+ new/replacement RNs By 2016, need 587,000+ new RN positions (23.5% increase) Source: US Bureau of Labor Statistics, November Shortage of Nurse Faculty , US nursing schools turned away 48,948 qualified applicants Insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints Source: American Association of Colleges of Nursing, April Shortage of BSN-Prepared Nurses Significantly lower mortality and failure to rescue rates in hospitals where more BSN-prepared nurses provide direct patient care At least 1700 preventable deaths could have been realized in PA hospitals if BSN-prepared nurses had comprised 60% of the nursing staff and the nurse-to-patient ratios had been 1:4 Source: Journal of the American Medical Association, September 24, 2003, Dr. Linda Aiken 6 2

3 Public Health Nurses: Critical to Directly Observed Therapy 7 Directly Observed Therapy in the Field 8 Domain Personal/Preventive Health Population Health Leadership Scope of PHN Practice Emergency Preparedness Components Include: Health Screenings, Treatment, Order and Dispense Drugs, Case Management, Contact Investigation, Referral Participate in EP Planning, Complete EP Training, Coordinate Mass Vaccination/Dispensing Sites, Staff Shelters Community Health Assessment, Health Education, Policy Development, Working with Community Groups/Coalitions Promote Team Learning, Create Shared Vision, Influence System Change, Facilitate Collaboration 9 3

4 Number of PHNs in US to Meet 1:5000 Standard Compared to Actual, 2007 Number of PHNs to Meet 1:5000 Ratio* for US Population Number of PHNs in US** 80,000 80,000 70,000 60,000 60,324 70,000 60,000 50,000 40,000 50,000 40,000 Est. 40,000 30,000 30,000 20,000 20,000 10,000 10, *Based on Association of State and Territorial Directors of Nursing, 2008 **Based on U.S. Population of 301,621,157, Est Georgia s Population Grows While Public Health Nurse Workforce Falls Georgia Population Georgia Public Health Nurses 10,000,000 9,000,000 8,000,000 7,000,000 6,000,000 6,478,216 9,685, ,000, ,000,000 3,000, ,000, ,000, Est Public Health Nursing Workforce PHNs = single largest component of PH workforce (approx. 23%) Average age of PHN is 46.6 years Expect 45-50% of PHNs to retire in next 5 years Source: Quad Council of Public Health Nursing Organizations,

5 Impact of Public Health Nursing Shortage on Public Health Increase in TB, HIV, Syphilis, Gonorrhea Delay or lack of response to disasters Increase in number of inappropriate ER visits Increase in teen pregnancies, infant mortality Increase in strokes among those with high BP Increase in breast and cervical cancer Increase in child abuse Community work will be limited or eliminated 13 Coping with the PHN Shortage Streamlining the work: electronic records Cutting services: clinical preventive and population based (focus on mandatory) Supporting job-sharing Allowing flexible work hours Using non-licensed nursing personnel Recruiting retired nurses Accelerating orientation for new nurses Advocating for Public Health Nursing Creating State Center for Nursing 14 Recruitment and Retention Challenges Widening salary gap Limited career steps within bureaucracies Increased demand for services + budget cuts = increased workload, delays in services Revolving Door after PH training completed Fewer experienced nurses to train new nurses Decreasing fringe benefits Mandatory furlough 15 5

6 Recruitment Activities PHNs make presentations to Nursing Schools regarding PHN programs and achievements Mentor student nurses at all levels Online applications Word-of-mouth 16 Retention Activities Active community-based advocacy Partnerships with academia Mentor new nurses Public recognition of achievements 17 Recruitment and Retention Initiatives: Georgia Words of Encouragement Melisa s Story (DVD) Proposed PHN Salary Guidelines, Jan 2009 Proposed PHN Career Track, Feb 2009 Proposed New PHN Database, May 2009 Population Health Pilot Projects PHNs in the BSN Classroom Toolkit Excellence Awards Nurses Week Celebration 18 6

7 PHN Collaborative with CDC: Population Health Template In 2007, established a Georgia DPH and CDC Collaborative for Nursing Practice In 2008, completed the Georgia Population Health Templates (e.g., Immunization, TB, Hepatitis, STD, HIV) In 2009, CDC using HP 2010 goals to identify expected outcomes for each program In fall 2009, pilot test with Georgia State U. with BSN students 19 Robert Wood Johnson Foundation 1. Reverse nursing and nurse faculty shortages 2. Develop clear link between nursing care and high-quality outcomes 3. Create next generation of nurse leaders 4. Provide nursing solutions for a reformed and more effective health and health care system 20 Institute of Medicine: Initiative on the Future of Nursing Seek ways to attract and retain well-prepared nurses in multiple settings, including PH Provide information, insight and guidance on the future role of nursing in the delivery of care

8 What Needs to Happen Better salaries for PHNs and faculty Funding for nurse faculty preparation Funding to achieve 1:5000 PHN staffing Each state needs a Chief Nurse for PH Measure cost-saving PHN interventions Evidence-based research for PHN practice Recognition of PHN activities Centers for Nursing Persuasive and powerful partners 22 Shaping Health Policy 23 Carole Jakeway Public Health Nurses: For emergencies. For everyday. For life. 24 8

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