White Paper: Nursing In New Mexico 2011

Transcription

1 White Paper: Nursing In New Mexico 2011 This document provides a brief overview of nursing in New Mexico and initiatives underway to strengthen nursing to better serve the people of New Mexico. A short description of the Institute of Medicine s recommendations for advancing nursing is presented along with New Mexico s work in meeting those recommendations Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

2 Nursing In New Mexico 2011 General. Nurses are the largest segment of the healthcare workforce in the United States and New Mexico. Working in a variety of settings across communities, nurses are pivotal to safe, quality patient care, issues of disease/case management, transitions in care, health promotion, and new models of healthcare delivery. Advanced practice nurses, such as nurse practitioners, midwives, certified nurse anesthetists, and clinical nurse specialists, can provide access to primary care and other critical services. New Mexico ranks 49 of 51 (50 states plus the District of Columbia) for registered nurses per 100,000 population (614 versus the national average of 842). There are 19,840 registered nurses, 3,086 licensed practical nurses, and 1,254 advanced practice nurses with active licenses living in New Mexico. The Nursing Shortage. There are short term and long term perspectives to the nursing shortage. In the short term, some would argue that there is not a nursing shortage. Historically, nursing vacancies inversely reflect the economic status of the country. When economic times are good, there are higher vacancies for nurses; when there is an economic downturn, nurse vacancies fall. Particularly during this economic downturn, nurses are postponing retirement, switching from part time to full time employment, working more than one nursing job, and are re-entering the workforce. Anecdotally, new graduates/licensed nurses are finding it difficult to find employment as a nurse as employers opt for more experienced nurses. This has yet to be documented with research (pending) and may be geographic. In the long term, there is significant concern that we are fast approaching a more severe shortage as the economic situation improves. Over 49 % of the New Mexico workforce is over age 50, driving increasing retirements over the next several years. At the same time, demand for healthcare services will increase as baby boomers enter their retirement years. Regulation. The New Mexico Board of Nursing provides regulatory oversight of nursing licensure, education (entry to practice programs), and practice. They also provide oversight for non-licensed personnel to include medication aides and hemodialysis technicians. New Mexico is one of 15 states that have a progressive nurse practice act that embraces independent practice for advanced practice nurses and encourages practice to the full extent of education. Education. Nursing Education Programs. (See attachment 1) There are 13 practical nurse education programs 9 public institutions and 4 private institutions. There are 21 education institutions with entry-to practice registered nurse programs: o 2 Bachelor degree programs through public universities. o 15 Associate degree programs through public community colleges. o 4 Associate degree programs through private institutions Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

3 7 schools offer RN to BSN programs, advancing associate degree nurses to a bachelor degree: 5 public institutions and 2 private institutions. 3 schools offer advanced practice nursing education: 2 public universities and 1 private institution. 3 schools offer master degrees in nursing (other than advanced practice): 2 public universities and 1 private institution. 2 public universities offer a doctorate in nursing (PhD; DNP) Enrollment and Licensure For the fiscal year, enrollment was 1,625 for associate degree (ADN) programs, 559 for generic entry-to-practice bachelor (BSN) program, and 298 RN to BSN, for a total of 2,482. For the fiscal year, New Mexico schools/colleges of nursing were unable to admit 395 qualified students due to insufficient resources. National Council Licensure Examination (NCLEX) results for calendar year (Passing NLCEX is required to receive licensure to practice.) o Practical nurse graduates: 165 passed, with a pass rate of 98.21% o Registered nurse graduates: 743 passed, with a pass rate of 86.49% Challenges Funding of nursing education is critical to meet future demands. There are two primary sources of state funding for public schools. The funding formula provides the majority of funding. There is no transparency of how the funding formula is applied at the program level within an institution. In addition to the funding formula, the legislature has, over the last several years, appropriated $3.2 million per year (allocated in 2-year increments) for nursing program expansion. These funds are awarded directly to the nursing programs through a grant process within the NM Higher Education Department. These funds are used to support students, enhance faculty salaries, faculty development, and integrating technology into nursing education. Faculty recruitment and retention is a primary constraining issue for nursing education programs. Faculty salaries, particularly in community colleges, are significantly lower than counterparts practicing in the community. Hiring a sufficient number of appropriately educated nurses is also a challenge. Because of the hands-on clinical education required, close supervision of nursing students with a ratio not to exceed 1 faculty for every 8 students in a clinical setting is required. Nurse educators must have a master degree in nursing. Clinical education sites are another primary restraining factor. Nursing education programs partner with health care provider institutions (hospitals, clinics, long term care facilities, and other agencies) to provide clinical experience and learning for students. The need to increase student cohorts has put additional stress on the health care community to provide clinical education Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

4 Innovation In December 2009, the New Mexico Nursing Education Consortium (NMNEC) was created. With most schools signing memorandums of understanding for membership, the NMNEC is focused on developing a common system of nursing education for the state. The goals are to encourage, support, and provide advanced nursing education (bachelor degree and above) in communities through partnerships between community colleges and universities, provide a seamless transition through nursing education for students, and to maximize efficiencies through a common curriculum, sharing of faculty, technology, and other resources. (See attachment 2). Rural Nurse Residency Program. The New Mexico Center for Nursing Excellence has partnered with Idaho State University to participate in a federal Health Resources and Services Administration (HRSA) grant to support new graduates as they transition into nursing practice. The year-long program focuses on rural facilities and rural nursing practice. The goals are to strengthen the new nurse s confidence and competence, and improve nurse retention in rural facilities. (See attachment 3) Nursing Workforce Data. The New Mexico Center for Nursing Excellence, the New Mexico Board of Nursing and the New Mexico Higher Education Department have been working for several years to develop meaningful nursing workforce data. While some progress has been made, a more cohesive and comprehensive data collection, analysis and modeling system must be developed. Nationally there has been the development of minimum nursing data sets for workforce supply, demand and education. Workforce Supply Data: The New Mexico Board of Nursing collects data from nurses during the re-licensure process. The data collected is in alignment with the national nursing minimum data set. Education Data: The New Mexico Higher Education Department and the New Mexico Center for Nursing Excellence collaborated to develop an education data collection tool as part of the nursing enhancement grant reporting process. It is aligned with the national nursing minimum data set for education. Demand Data: There is not a formalized system to collect demand data from employers at this time. The New Mexico Center for Nursing Excellence has targeted its focus on this area of data collection for HRSA Health Professions Workforce Planning Grant: The New Mexico Department of Workforce Solutions was a awarded a HRSA planning grant to develop a system for health professions workforce data collection, analysis and planning. The status of the work around this grant is unknown. Senate Bill 14: SB 14 has been introduced for the 2011 Legislative session to require health professions licensing boards to collect data, creation of a health care work force data base, and creation of a health care work force work group Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

5 Nursing Practice. As stated previously, New Mexico is one of 15 states that have a proactive nurse practice act that embraces independent practice for advanced practice nurses and encourages practice to the full extent of education. As the state explores new models of providing health care, such as medical homes, accountable care organizations, and other models, nurses have much to offer in these creative environments and need to be at the planning table. Nurse practitioners are a resource for providing primary care services. There are system barriers that if addressed, would facilitate advanced practice nurse independent practice, such as streamlining the credentialing process. Public and community health nursing is pivotal to the well-being of New Mexico communities. The public health department has 171 nurses, nurse practitioners, supervisors and program staff to cover the state s public health needs, with a vacancy rate averaging 15%. With the large number of un-and under insured New Mexican coupled with poverty levels and growing immigrant populations, public health nurses are crucial to ensuring quality health care in NM. Ensuring critical public health nurse vacancies are filled and developing strategies to recruit and retain public health nurses are critical to success. To provide quality care, health care employers must be able to recruit and retain qualified personnel, to include nurses. Those segments of the health care delivery system that rely heavily on Medicaid funding, such as long term care and home care, require appropriate reimbursement to be able to hire appropriate staff. National Initiative. The Institute of Medicine (IOM) recently released their report The Future of Nursing: Leading Change, Advancing Health (See attachment 4). The IOM report made several evidence-based recommendations to enhance nurses ability to lead change and advance health. IOM Recommendation: Nurses should practice to the full extent of their education and training. Work at the federal and state levels to establish scope of practice that reflects education. Implement transition to practice residency programs for acute care and community settings. IOM Recommendation: Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Increase the proportion of bachelor degree nurses to 80% by Double the number of nurses with doctoral degrees by Promote interdisciplinary education. Increase the diversity of the nursing workforce in relation to gender and race/ethnicity. Develop nurse residency programs across communities. IOM Recommendation: Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

6 IOM Recommendation: Effective workforce planning and policy making require better data collection and an improved information infrastructure. New Mexico is well positioned to build on the IOM recommendations for nursing. While there is significant strategic work for the long term, there are some actions that would have impact in the short term. State Recommendations: 1. Nursing Education. a. While the NM Nursing Education Consortium (NMNEC) is making great strides on the state plan for nursing education, we recommend action (legislation/memorial) for the primary recommendation of HM 50 asking HED to address administrative issues and a process for the transparency of nursing education funding. (HB 103) b. Financial support of the NM Nursing Education Consortium (NMNEC). A background of the NMNEC is at attachment 2. The NMNEC received funding for their first year through a grant from the Nursing Excellence Fund of the NM Board of Nursing. Support of the NMNEC in the future is tenuous. This work is critical to revolutionizing nursing education to be seamless for students, encourage and support obtainment of bachelor and higher degrees in their communities, and improve efficiency. For this work to succeed, it is critical to have dedicated administrative support, consultants, and work meetings. NMNEC projects $200,000 for their 2011 budget (personnel, consultants, meetings, technology, travel). 2. Primary Care/Advanced Practice Nursing. Nurse Practitioners and other advanced practice nurses can play a major role in access to primary health care throughout the state. a. Support SB 22 that would streamline credentialing of nursing practitioners and other nurses providing independent services to ensure timely employment and the ability to bill for services in a timely manner. b. Recommend a memorial that would focus attention on: 1. Strategies to increase number of APNs and establish need/goals. 2. Explore ways to invest in models/incentives for APN practice in rural areas. 3. Develop an implementation plan for a transition to practice residency program for new APNs and/or those going into rural practice. 3. Nursing Workforce Data while we continue to make progress we still have a lot of work in this area. We need data, particularly demand data, to determine future needs and to assess progress Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

7 a. Health Professions Planning Grant in Workforce Solutions. The Dept of Workforce Solutions received a planning grant for health professions data collection and planning this grant is to prepare a proposal for a larger implementation grant. To date, there has been little action on this grant. We request continued interest and pressure on WFS to execute grant. b. Support Senate Bill 14, Health Care Work Force Data Collection, Analysis, and Policy Act. 4. Public Health/Community Health. The public health department has 171 nurses, nurse practitioners, supervisors and program staff to cover the state s public health needs, with a vacancy rate averaging 15%. With the large number of un-and under insured New Mexican coupled with poverty levels and growing immigrant populations, public health nurses are critical to ensuring quality health care in NM. a. Prioritize nurse vacancies within the Department of Health Public Health Department and hire nurses needed for critical functions. b. Develop a plan for supporting advanced education (bachelor and above), with the strategic goal of requiring a bachelor degree for entry to public health nursing. c. Develop a transition to practice residency program for public/community health in partnership with the NM Rural Nurse Residency program. 5. Medicaid Provider rates. Having the appropriate staff to care for patients requires appropriate compensation to attract and retain qualified personnel. a. Request Medicaid study the feasibility and impact of adjusting provider rates to assure reimbursement of compensation for nurses and other health care professionals is at least covering median salary ranges as determined by the Dept of Workforce Solutions. 6. NM Board of Nursing. The IOM report strongly recommends that nurses practice to the full extent of their education. This applies to registered nurses as well as advanced practice nurses. Having an independent Board of Nursing is paramount to ensuring regulatory vision and oversight that would support this IOM recommendation. a. Do not support legislation that would subsume the Board of Nursing under other regulatory boards or super-board. Nursing Points of Contact See attachment Carlisle NE, Ste 205, Albuquerque, NM Office: Fax: nmnursingexcellence.org/info@nmnursingexcellence.org

8 Nursing Program Location Practical Nurse Associate Degree (ADN) Bachelor (entry to practice) Nursing Degree RN BSN Master Degree Advanced Practice Albuquerque Public Schools Albuquerque X Anamarc Educational Institute* Santa Teresa X X Carrington College (Apollo)* Albuquerque X X Central NM Community College Albuquerque X X Clovis Community College Clovis X X Dona Ana Community College Las Cruces X X Eastern NM University Roswell X X (Roswell) Grand Canyon University* Albuquerque X X Highlands University Las Vegas X ITT Technical Institute* Albuquerque X Luna Community College Las Vegas X X New Mexico Junior College Hobbs X X New Mexico State University Las Cruces X X X X X New Mexico State University Alamogordo X Alamogordo New Mexico State University Carlsbad X X Carlsbad Northern NM College Espanola X X X Pima Medical Institute* Albuquerque X X San Juan College Farmington X Santa Fe Community College Santa Fe X St Francis University* Albuquerque X University of New Mexico Albuquerque X X X X X University of New Mexico Gallup X Gallup University of New Mexico Taos Taos X University of New Mexico Las Lunas X Valencia University of Phoenix* Multiple sites X X Vista College* Las Cruces X Western NM University Silver City X X *Proprietary school Attachment 1 Doctoral

9 Who We Are The New Mexico Nursing Education Consortium (NMNEC) is a collaborative of nearly every nursing program across the state creating a common core curriculum in nursing education, transforming the current structure into a resource-efficient and easily-accessible baccalaureate program for students. NMNEC is an incubator for excellence in nursing, sustainability in education, and innovation in connecting communities with high quality healthcare. New Mexico nursing programs can expand curriculum and degree offerings, while making their communities healthier and dynamic. Goals 1. Increase number of nurses with baccalaureate and graduate degrees in New Mexico. 2. Improve efficiency, quality, and educational outcomes of nursing education across the state through cooperation among community colleges and universities. 3. Increase workforce diversity by improving nursing education for minorities, particularly in rural areas. Nursing Education Through improvements in nursing education, shared faculty, resources, and a common curriculum, students will have increased access to advanced nursing degrees in rural communities, and have the opportunity to transfer between schools easily. Quality Healthcare NMNEC benefits New Mexico with quality and accessible healthcare. An increase in advanced nurse practitioners makes rural access to healthcare a reality for many New Mexicans. Diversity With advanced nursing education reaching rural communities, schools and the nursing workforce experience an increase of underrepresented minorities. A diverse nursing workforce creates high quality healthcare for all populations in New Mexico.

10 Mission The mission of the New Mexico Nursing Education Consortium is to prepare nurses for entry and educational advancement through developing and sustaining a resource-efficient and unified system of accessible, innovative, and state-of-the-art nursing education. Vision The New Mexico Nursing Education Consortium is a collaborative partnership with a vision for nursing education that addresses the healthcare needs of New Mexicans by preparing a qualified, diverse, and professional nursing workforce. Member Schools Albuquerque Public Schools Central New Mexico Community College Clovis Community College Dona Ana Community College (NMSU) Eastern New Mexico University Eastern New Mexico University (Roswell) ITT Technical Institute Luna Community College New Mexico Highlands University New Mexico Junior College New Mexico State University New Mexico State University (Alamogordo) New Mexico State University (Carlsbad) Northern New Mexico College Pima Medical Institute San Juan College Santa Fe Community College University of New Mexico University of New Mexico (Gallup) University of New Mexico (Taos) University of New Mexico (Valencia) University of Phoenix Western New Mexico University Member Organizations New Mexico Board of Nursing New Mexico Center for Nursing Excellence New Mexico Nursing Education Consortium c/o University of New Mexico, College of Nursing MSC University of New Mexico Albuquerque, NM Phone: (505) Fax: (505) SFNorth@salud.unm.edu

11 Attachment 3 Overview of the NW Rural Nurse Residency program (NWRNR) In January of 2010 a committee of nurses affiliated with the NM Center for Nursing Excellence partnered with the Northwest Rural Nurse Residency program for use in NM. The benefits of this model were that it is tailored to rural nursing and uses rural nursing theory; 28 of New Mexico s 33 counties are classified as rural and 30 counties have a moderate to severe shortage of health professionals (Con Alma Health Foundation, census data). The NWRNR is evidence-based, focuses on critical thinking and follows Quality and Safety Education for Nurses (QSEN) and National Council of State Boards of Nursing guidelines. Course content is designed around crisis assessment and management in OB, pediatrics, gerontology, psych, pharmacology, medical-surgical, emergency-trauma. This is a one year program; the courses are fully delivered via the internet and by software programs. The program takes a newly licensed registered nurse through the difficult acclamation into the complex world of nursing with the goal of attaining competence and confidence in their first year of nursing practice. Each nurse resident is paired with a nurse preceptor working in the same facility to follow and guide progress. Preceptors are given a two-day preceptor workshop at the start of each class and are assigned a mentor. The year-long program begins every January, June, and September; residents must be hired by a facility which offers the program. For additional information call the NM Center for Nursing Excellence at

12 REPORT BRIEF OCTOBER 2010 Advising the nation / Improving health For more information visit The Future of Nursing Leading Change, Advancing Health With more than 3 million members, the nursing profession is the largest segment of the nation s health care workforce. Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act, legislation that represents the broadest health care overhaul since the 1965 creation of the Medicare and Medicaid programs. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are wellpositioned to lead change and advance health. In 2008, The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched a two-year initiative to respond to the need to assess and transform the nursing profession. The IOM appointed the Committee on the RWJF Initiative on the Future of Nursing, at the IOM, with the purpose of producing a report that would make recommendations for an action-oriented blueprint for the future of nursing. Nurses practice in many settings, including hospitals, schools, homes, retail health clinics, long-term care facilities, battlefields, and community and public health centers. They have varying levels of education and competencies from licensed practical nurses, who greatly contribute to direct patient care in nursing homes, to nurse scientists, who research and evaluate more effective ways of caring for patients and promoting health. The committee considered nurses across roles, settings, and education levels in its effort to envision the future of the profession. Through its deliberations, the committee developed four key messages that structure the recommendations presented in this report: A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are wellpositioned to lead change and advance health.

13 1) Nurses should practice to the full extent of their education and training. While most nurses are registered nurses (RNs), more than a quarter million nurses are advanced practice registered nurses (APRNs), who have master s or doctoral degrees and pass national certification exams. Nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives all are licensed as APRNs. Because licensing and practice rules vary across states, the regulations regarding scope-ofpractice which defines the activities that a qualified nurse may perform have varying effects on different types of nurses in different parts of the country. For example, while some states have regulations that allow nurse practitioners to see patients and prescribe medications without a physician s supervision, a majority of states do not. Consequently, the tasks nurse practitioners are allowed to perform are determined not by their education and training but by the unique state laws under which they work. The report offers recommendations for a variety of stakeholders from state legislators to the Centers for Medicare & Medicaid Services to the Congress to ensure that nurses can practice to the full extent of their education and training. The federal government is particularly well suited to promote reform of states scopeof-practice laws by sharing and providing incentives for the adoption of best practices. One subrecommendation is directed to the Federal Trade Commission, which has long targeted anticompetitive conduct in the health care market, including restrictions on the business practices of health care providers, as well as policies that could act as a barrier to entry for new competitors in the market. High turnover rates among new nurses underscore the importance of transition-topractice residency programs, which help manage the transition from nursing school to practice and help new graduates further develop the skills needed to deliver safe, quality care. While nurse residency programs sometimes are supported in hospitals and large health systems, they focus primarily on acute care. However, residency programs need to be developed and evaluated in community settings. 2) Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. To ensure the delivery of safe, patient-centered care across settings, the nursing education system must be improved. Patient needs have become more complicated, and nurses need to attain requisite competencies to deliver high-quality care. These competencies include leadership, health policy, system improvement, research and evidence-based practice, and teamwork and collaboration, as well as competency in specific content areas including community and public health and geriatrics. Nurses also are being called upon to fill expanding roles and to master technological tools and information management systems while collaborating and coordinating care across teams of health professionals. Nurses must achieve higher levels of education and training to respond to these increasing demands. Education should include opportunities for seamless transition into higher degree programs from licensed practical nurse (LPN)/ licensed vocational nurse (LVN) diplomas; to the associate s (ADN) and bachelor s (BSN) degrees; to master s, PhD, and doctor of nursing practice (DNP) degrees. Nurses also should be educated with physicians and other health professionals both as students and throughout their careers in lifelong learning opportunities. And to improve the quality of patient care, a greater emphasis must be placed on making the nursing workforce more diverse, particularly in the areas of gender and race/ethnicity. 2

14 To ensure the delivery of safe, patient-centered care across settings, the nursing education system must be improved. Patient needs have become more complicated, and nurses need to attain requisite competencies to deliver high-quality care. 3) Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. Efforts to cultivate and promote leaders within the nursing profession from the front lines of care to the boardroom will prepare nurses with the skills needed to help improve health care and advance their profession. As leaders, nurses must act as full partners in redesign efforts, be accountable for their own contributions to delivering high-quality care, and work collaboratively with leaders from other health professions. Being a full partner involves taking responsibility for identifying problems and areas of system waste, devising and implementing improvement plans, tracking improvement over time, and making necessary adjustments to realize established goals. In the health policy arena, nurses should participate in, and sometimes lead, decision making and be engaged in health care reform-related implementation efforts. Nurses also should serve actively on advisory boards on which policy decisions are made to advance health systems and improve patient care. In order to ensure that nurses are ready to assume leadership roles, nursing education programs need to embed leadership-related competencies throughout. In addition, leadership development and mentoring programs need to be made available for nurses at all levels, and a culture that promotes and values leadership needs to be fostered. All nurses must take responsibility for their personal and professional growth by developing leadership competencies and exercising these competencies across all care settings. 4) Effective workforce planning and policy making require better data collection and an improved information infrastructure. Planning for fundamental, wide-ranging changes in the education and deployment of the nursing workforce will require comprehensive data on the numbers and types of health professionals including nurses currently available and required to meet future needs. Once an improved infrastructure for collecting and analyzing workforce data is in place, systematic assessment and projection of workforce requirements by role, skill mix, region, and demographics will be needed to inform changes in nursing practice and education. The 2010 Affordable Care Act mandates the creation of both a National Health Care Workforce Commission to help gauge the demand for health care workers and a National Center for Workforce Analysis to support workforce data collection and analysis. These programs should place a priority on systematic monitoring of the supply of health care workers across professions, review of the data and methods needed to develop 3

15 Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine Donna E. Shalala (Chair) President, University of Miami, Coral Gables, FL Linda Burnes Bolton (Vice Chair) Vice President and Chief Nursing Officer, Cedars-Sinai Health System and Research Institute, Los Angeles, CA Michael R. Bleich Dean and Dr. Carol A. Lindeman Distinguished Professor, Vice Provost for Interprofessional Education and Development Oregon Health and Science University School of Nursing, Portland Troyen A. Brennan Executive Vice President, Chief Medical Officer, CVS Caremark, Woonsocket, RI Robert E. Campbell Vice Chairman (retired), Johnson & Johnson, New Brunswick, NJ Leah Devlin Professor of the Practice, University of North Carolina School of Public Health, Raleigh Catherine Dower Associate Director of Research, Center for the Health Professions, University of California, San Francisco Rosa Gonzalez-Guarda Assistant Professor, School of Nursing and Health Studies, University of Miami, Coral Gables, FL David C. Goodman Professor of Pediatric and of Community and Family Medicine, Children s Hospital at Dartmouth, The Dartmouth Institute for Policy and Clinical Practice, Hanover, NH Study Staff Jennie Chin Hansen Chief Executive Officer, American Geriatrics Society, New York C. Martin Harris Chief Information Officer, Cleveland Clinic, Cleveland, OH Anjli Aurora Hinman Alumni Chair, Health Students Taking Action Together, Duluth, GA William D. Novelli Distinguished Professor, McDonough School of Business, Georgetown University, Washington, DC Liana Orsolini-Hain Nursing Instructor, City College of San Francisco, CA Yolanda Partida Director, National Center, Hablamos Juntos, Assistant Adjunct Professor, University of California, San Francisco, Fresno, Center for Medical Education and Research Robert D. Reischauer President, The Urban Institute, Washington, DC John W. Rowe Professor, Mailman School of Public Health, Department of Health Policy and Management, Columbia University, New York Bruce C. Vladeck Senior Advisor, Nexera Consulting, New York accurate predictions of workforce needs, and coordination of the collection of data on the health care workforce at the state and regional levels. All data collected must be timely and publicly accessible. Conclusion The United States has the opportunity to transform its health care system, and nurses can and should play a fundamental role in this transformation. However, the power to improve the current regulatory, business, and organizational conditions does not rest solely with nurses; government, businesses, health care organizations, professional associations, and the insurance industry all must play a role. The recommendations presented in this report are directed to individual policy makers; national, state, and local government leaders; payers; and health care researchers, executives, and professionals including nurses and others as well as to larger groups such as licensing bodies, educational institutions, philanthropic organizations, and consumer advocacy organizations. Working together, these many diverse parties can help ensure that the health care system provides seamless, affordable, quality care that is accessible to all and leads to improved health. f Susan Hassmiller Study Director Adrienne Stith Butler Senior Program Officer Andrea M. Schultz Associate Program Officer Katharine Bothner Research Associate Thelma L. Cox Administrative Assistant Tonia E. Dickerson Senior Program Assistant Gina Ivey Communications Director Lori Melichar Research Director Julie Fairman Nurse Scholar-in-Residence Judith A. Salerno Executive Officer, IOM Consultants Christine Gorman Technical Writer Rona Briere Consultant Editor Study Sponsor The Robert Wood Johnson Foundation Advising the nation / Improving health 500 Fifth Street, NW Washington, DC TEL FAX The Institute of Medicine serves as adviser to the nation to improve health. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policy makers, health professionals, the private sector, and the public. Copyright 2010 by the National Academy of Sciences. All rights reserved.

16 Attachment 5 New Mexico Nursing Points of Contact 2011 NM Association for Home and Hospice Care Joie Glenn Executive Director (505) joieg@nmahc.org NM Board of Nursing Nancy Darbro Interim Executive Director (505) nancy.darbro@state.nm.us NM Center for Nursing Excellence Pat Boyle Executive Director (505) pboyle@nmnursingexcellence.org NM Department of Health Barbara Hickok Chief Nurse (505) Barbara.Hickok@state.nm.us NM Health Care Association (Long Term Care) NM Nurse Anesthetist Organization NM Nurse Practitioner Council Linda Sechovec Executive Director (505) lsechovec@nmhca.org Christian Felt President chris@feltonline.com Philomena Marcus President 505) president@nmnpc.org NM Nurses Association Carrie Roberts Executive Director (505) carrie@nmna.org NM Nursing Education Consortium NM Organization of Nurse Executives Sarah North Program Manager (505) SFNorth@salud.unm.edu Sheena Ferguson President (505) SMFerguson@salud.unm.edu NM Primary Care Association Eileen Goode Clinical Programs Director (505) ext EGoode@nmpca.org