Making Nursing Education the Public Agenda

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Making Nursing Education the Public Agenda

• SREB Council on Collegiate Education for Nursing
• Harold L. Martin
• Senior Vice President
• Academic Affairs
• October 8, 2007

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Outline

• Institute of Medicine Task Force on the NC
  Nursing Workforce - Report and Recommendations
• UNC Board of Governors Committee on the Future of
  Nursing
• UNC Response to Committees Recommendations
• Legislative Investments in Nursing Education
• Results to Date

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Task Force on NC Nursing Workforce

• In January 2003, The Duke Endowment granted
  support to the NC Institute of Medicine to
  convene the Task Force on the NC Nursing
  Workforce. The Institute partnered with the North
  Carolina Area Health Education Centers (AHEC),
  the North Carolina Center for Nursing, the North
  Carolina Hospital Association, and the North
  Carolina Nurses Association in this effort.

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Task Force Findings
The combination of an aging population, increased
demands for nursing care, and an aging nursing
workforce portends an impending nursing workforce
crisis. Long-range forecasts of RN supply and
demand in North Carolina predict a shortage of
anywhere from 9,000 nurses in 2015 to almost
18,000 by 2020.
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Highest Priority Recommendations

• Nursing Faculty Recruitment and Retention
• The average age of faculty in all of North
  Carolinas nursing education programs is becoming
  older a high proportion of nursing faculty
  across all levels of programs has retirement
  plans within the next 10 years.
• Improve faculty salaries in UNC System and
  Community College nursing education programs
• It has been hard to recruit MSN-level faculty in
  some community college programs, especially in
  rural counties.

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Highest Priority Recommendations Cont

• Nursing Education Programs
• The overall goals for nursing education should
  include
• Producing the numbers of nurses needed to meet
  the states needs
• 2. Creating opportunities for every practicing
  nurse to advance her/his education credentials
  thereby
• 3. Elevating the overall level of education of
  the entire North Carolina nursing workforce.

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Highest Priority Recommendations Cont
Transitions from Nursing School-to-Work Many
recent graduates from nursing schools reported
difficulties in assuming full-time clinical
responsibilities upon graduation from nursing
school. A view expressed by nursing employers
and supervisors as well. There appears to be a
need for more supervised transitional work
experience, much like a clinical internship, for
newly graduated nurses.
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Highest Priority Recommendations Cont
Recruiting Diverse Populations into the
Profession Existing programs (via AHEC the
health science programs in community colleges,
universities and colleges the NC Center for
Nursing and employers) that target a diverse mix
of middle and high school students to encourage
them to consider health careers and prepare them
for entry into programs of higher learning need
to be strengthened and expanded.
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Highest Priority Recommendations Cont
Racial Composition of Licensed RNs and LPNs In NC
Workforce (2001) Race RNs LPNs White
87.8 73.3 African American 8.7
23.2 American Indian 0.6 1.2 Asian or
Pacific Islander 1.6 0.4 Hispanic 0.5
0.7 Other 0.5 0.6 Unknown 0.3
0.3 Lacey, LM. and Shaver, K. NC Trends in
Nursing 1982-2001. RN and LPN Workforce
Demographics. March, 2003.
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Highest Priority Recommendations Cont

• Nursing Work Environments
• Employers should take steps to create positive
  work environments (meeting several defining
  criteria).
• AHEC and the professional nursing schools should
  offer educational opportunities for leadership
  development, conflict resolution and
  communication skills training, interdisciplinary
  team building, and preceptor training.
• The NC BON and the NC Division of Facility
  Services should implement regulations to prohibit
  nurses from providing direct patient care for
  more than 12 hours in a 24 hour time period, or
  60 hours in a 7 day time period.

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UNC Committee on the Future of Nursing

• The University of North Carolina Board of
  Governors appointed the Committee on the Future
  of Nursing in March 2004 to review the Institute
  of Medicine Nursing Workforce Report and other
  information to address issues of nursing and make
  recommendations to the Board regarding the steps
  UNC nursing programs need to take to help North
  Carolina avoid a nursing shortage.

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UNC Committee Recommendations
Graduating More Nurses The Office of the
President in collaboration with UNC nursing
programs will establish enrollment and graduation
targets that will increase the production of
pre-licensure BSNs by UNC to exceed the 25
increase in the production of new RNs by the
2007-08 goal set by the Task Force on Nursing and
to double the number of pre-licensure BSN
graduates from UNC programs by 2009-10.
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UNC Committee Recommendations
This goal will be met by a combination of an
increase in undergraduates in pre-licensure BSN
programs and by expansion of accelerated BSN
programs. Targets will be measured against the
base year of 2002-03 documented in the IOM
Nursing Task Force Report. Doubling the number
of pre-licensure BSN graduates will result in a
production level of 1,132 graduates in 2009-10
from UNC institutions with nursing programs.
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UNC Committee Recommendations
UNC campuses with masters-level programs in
nursing education should expand the number of
graduates of MSN nursing education programs to at
least 60 or more per year for UNC by 2009-10 in
order to increase the pool of potential nursing
faculty members available, both for community
college nursing programs and for university
programs. Campuses should make masters nursing
education programs more accessible by time and
place of scheduling, including opportunities for
earning a masters degree online in order to
accommodate the work schedules of their students.
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UNC Committee Recommendations

• The number of graduates in specialized masters
  programs should be expanded, as needed to serve
  as faculty. UNC campuses with doctoral programs
  should double their production of doctoral
  graduates to approximately 16 per year by 2009-10.

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UNC Committee Recommendations

• Increasing Nursing Faculty
• The University of North Carolina needs to add
  faculty to accommodate the growth in its
  pre-licensure programs, RN to BSN programs, and
  masters and doctoral programs. In addition, UNC
  needs to produce additional faculty for the
  community colleges so their ADN programs can
  expand and over time replace faculty who retire.
  It is important to use faculty as effectively and
  efficiently as possible in order to maximize the
  number of new nurses that can be produced and to
  remove barriers to increasing the number of
  nursing students wherever possible.

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UNC Committee Recommendations

• Clinical Sites for Nursing Education
• Discussions among UNC and NCCCS nursing
  administrators suggested that at least 200
  additional students per year for the next five
  years needed to be accommodated in clinical sites
  to support the proposed increases in UNC and the
  community colleges. It is recommended that
  appropriate leadership
• Identify units/services within the agency that
  are not currently being used for nursing students
  or are underutilized,
• review times of day and days of the week when all
  units/services within that agency are being used
  and ascertain any gaps that might provide for
  additional placements, and
• identify areas that could accommodate more
  students, i.e., both BSN and ADN students at the
  same time. Nursing programs at both the
  community colleges and in UNC should carefully
  review their policies, traditions, faculty
  preferences, etc. that might inhibit the maximum
  utilization of clinical sites by all programs.

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UNC Committee Recommendations

• Expansion of Educational Programs at All Levels
• The Task Force Report recommended that the
  educational level of nurses should be increased.
  This means expanding opportunities for community
  college trained RNs to pursue a BSN, for BSN
  students to pursue masters-level training, and
  for MSN students to pursue doctoral-level
  training.
• Recommendation That UNC nursing programs should
  increase the graduates of RN to BSN programs by
  50 by 2009-10.

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UNC Committee Recommendations

• Expansion of Educational Programs at All Levels
  Cont.
• Recommendation That UNC work with the NCCCS
  through the Transfer Advisory Committee to review
  the current articulation agreements in nursing
  and make needed adjustments to facilitate
  expansion of educational opportunity for ADN
  graduates.
• Recommendation That campuses should expand
  enrollment in MSN advanced practice programs by
  increasing opportunities in the programs and
  making them more accessible by time and place of
  scheduling, including additional opportunities
  for earning a masters degree online or through
  blended offerings.

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UNC Committee Recommendations

• Incentives for Nursing Programs to Expand
• Due to the small ratio of students to faculty,
  clinical courses are expensive and time
  intensive. Funding these courses at an
  appropriately higher level will allow the nursing
  programs to expand at a more rapid pace. Funding
  for recruitment, marketing, expansion of clinical
  sites, an innovation fund for the use of
  technology in clinical education, and for moving
  clinical courses to level 4 in the funding matrix
  will address expansion needs and allow campuses
  to ramp up the production of nurses more rapidly.
• Recommendation That if the funding request in
  the Expansion Budget for clinical courses is
  approved, it is understood that a primary use of
  these funds is to expand the production of
  nursing graduates in accord with each campuss
  approved implementation plan.

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UNC Committee Recommendations

• Incentives for Nursing Programs to Expand Cont.
• Recommendation That a special legislative
  appropriation be allocated by the Board of
  Governors based on the approved implementation
  plans developed by the UNC nursing programs in
  response to the criteria identified by the
  Committee on the Future of Nursing and on the
  added responsibilities for AHEC.

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UNC Committee Recommendations

• Financial and Scholarship Support
• Financial incentives, while not likely to solve
  the shortage problem by themselves, are a central
  element in bringing more students into nursing,
  expanding the diversity of the discipline, and
  recruiting nurses to faculty roles.
• Recommendation That UNC seek funding for a
  community college fellowship program that will
  provide fellowships for training nursing faculty
  for community colleges in North Carolina. For
  each year of support, a year of full-time
  employment in a community college nursing program
  will be required. The proposed fellowships would
  provide the student 15,000 per year.

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UNC Committee Recommendations

• Financial and Scholarship Support Cont.
• Recommendation That UNC propose a new
  scholarship program directed to improving
  diversity in all its forms in the nursing student
  bodygeographical (especially with attention to
  rural areas) male-female ratios
  underrepresented minorities and other forms of
  diversity as identified in campus diversity
  assessments.
• Recommendation That the Board of Governors
  endorses the call by the Nursing Task Force for
  the General Assembly to increase funding for the
  current nursing scholarship program.
• Recommendation That the Board of Governors
  endorses the call by the Task Force on Nursing
  for a faculty fellowship program that would
  expand opportunity for graduate study to prepare
  more faculty members in nursing at all levels.
  Funding for each year of full-time study would be
  based on a commitment to serve as a faculty
  member for a year in a North Carolina nursing
  degree program.

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Plans to Increase Nursing Graduates2005-06 to
2009-10
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Plans to Increase Nursing Graduates2005-06 to
2009-10
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Plans to Increase Nursing Graduates2005-06 to
2009-10
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Plans to Increase Nursing Graduates2005-06 to
2009-10
New Programs
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Plans to Increase Nursing Graduates2005-06 to
2009-10
New Programs
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Plans to Increase Nursing Graduates2005-06 to
2009-10
New Programs
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New State Appropriations

• 2005-06
• The UNC BOG approves the inclusion of increases
  in nursing enrollment to be funded in the highest
  category of the enrollment funding model.
• 2006-07
• 1.3M (recurring portion) to AHEC, (nonrecurring
  portion) funding to address allied health,
  dentistry, nursing and pharmacy shortages, as
  well as clinical training for ECSU PharmD
  students.

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New State Appropriations

• 1.2M (recurring) to create the Graduate Nurse
  Scholarship Program - to fill the gap of nursing
  faculty to educate future nurses.
• 850,000 nonrecurring for startup funding for new
  programs (new BSN FSU and UNCP, new RN to BSN
  ASU).
• 2007-08
• 1.2M (recurring) to expand the Graduate Nurse
  Scholarship Program bringing the total amount
  for this program to 2.4M.

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UNC Nursing Enrollment (Actual)
30 Increase
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UNC Degree Productivity (Actual)
30.1 Increase
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• Questions