|
|
A
Review of Nursing Workforce Issues in North Carolina and
Related Initiatives of the NC Center for Nursing
Introduction
The North Carolina General Assembly created the
North Carolina Center for Nursing in 1991 “to address
issues of supply and demand for nursing, including issues
of recruitment, retention, and utilization of nurse resources.”
The mission of the North Carolina Center for Nursing is
to assure that the State
of North Carolina has the nursing resources necessary
to meet the healthcare needs of its citizens.
Legislatively mandated goals include:
1. Develop a strategic
statewide nursing workforce plan for North Carolina,
addressing issues of supply and demand.
2.
Convene various groups that include representatives
from nursing service and education, other healthcare
professions, the business community, consumer groups,
and the General Assembly to review the policy implications
of the Center’s work.
3. Enhance and promote recognition, reward and renewal
activities for nurses in North Carolina, through a comprehensive
statewide recruitment and retention program.
-
Hospitals continue to be the major labor market for
RNs, employing 59% of North Carolina’s RN workforce.
Nursing homes and physician
offices employ the majority of LPNs.
-
The
NC Center for Nursing 2004
Employer Survey revealed an average vacancy rate for
RNs of 6.9% in North Carolina hospitals.
However, vacancy rates are higher in public
health, home and hospice care, and nursing homes
(with the latter healthcare sector experiencing the
highest average RN vacancy rate at 10.6%).
-
There is growing concern
about the dwindling supply of nurses in the state, owing
to the relatively high average age of nurses in North
Carolina (44.4 for RNs and 46.7 for
LPNs in 2003). The aging of our nursing workforce, combined
with a growing number of competing career choices, challenges
us to prepare sufficient numbers to replace nurses retiring
in the next 10–15 years. The
challenge is heightened by the projected increase in
healthcare demand by aging baby boomers.
-
There
is also growing concern about our future nursing pipeline,
especially in light of two factors: 1) We are
turning away applicants to the state’s nursing
programs, and need to increase the capacity
of our infrastructure for preparing more nurses, in
an environment of tight fiscal resources and an evolving
faculty shortage; and 2)
Too many nursing students are not completing their education
programs; thus, we need to assure that
applicants are qualified for the academic rigors of
nursing education and
that we provide sufficient student support services.
-
The
nursing shortage is not just about numbers; only
38% of North Carolina’s RN workforce held baccalaureate
or higher degrees in nursing in 2003 and just over 12%
represented racial and ethnic minorities.
The LPN population, with nearly 27% minority representation,
is in greater parity with the state’s population
in general. Additionally, only 6% of the state’s
licensed nurse workforce is composed of men.
A
profession that is “exporting” women due to
the expanding number of career opportunities available cannot
meet escalating demand without “importing” men.
-
According
to a 2001 sample survey, staff nurses in North Carolina
who are responsible for large patient loads or who work
in environments where short staffing frequently interferes
with their ability to care for their patients are less
satisfied with both their jobs and their careers than
colleagues in better work environments. Paperwork
loads are also increasing, as reflected in the time
available for direct care decreasing by 6% from 1999
to 2001.
Workforce
planning and development initiatives:
1. Greater collaboration between education and
practice
2. Better preparation
of new graduates in:
3. A formal
transition from school to work
4. Support for
better articulation and access in nursing education
5. Addressing the capacity of nursing education,
with emphasis on faculty resources
6. Healthier workplaces
7. Innovative, cost-effective strategies to reduce
nurse workload and paperwork
8. Better management
of the effects of staffing, both in terms of numbers and
credentials, on patient outcomes
A collaborative
Taskforce on the Nursing Workforce, funded by The Duke
Endowment and convened by the NC Institute of Medicine,
in partnership with the NC Center for Nursing, the NC
Nurses Association, the NC Board of Nursing, the NC Hospital
Association, and the NC Area Health Education Program,
developed 46 recommendations that were released in 2004
for addressing an evolving nursing shortage. (http://www.nciom.org)
In 2005,
the NC Center for Nursing collaborated with the NC Board
of Nursing and the NC Area Health Education Centers Program
to secure funding from the Agency for Healthcare Research
and Quality that will support a Fall conference on nurse
internships/residencies.
The Center
offers a comprehensive array of Recruitment and Retention
initiatives:
-
Recruitment
and Retention Grant Program
-
Institute for Nursing Excellence (to recognize
and retain exemplary nurses in NC)
-
Image Campaign: Nursing—The Power to Make a Difference
-
TV
and Radio Public Service Announcements
-
“Newspapers in Education” program
-
Award-winning nursing video available to all
NC schools
-
“Nursing in North Carolina” Internet site
-
“Nursing Exploration” patch program
-
Elementary school poster
-
Middle / High School posters
-
Book cover project, promoting nursing and other health
careers, underwritten by Eli Lilly
-
“Talk with Kids about Nursing” ambassador
cards
-
“Fact” sheets (in English & Spanish)
and information packets for school counselors and health
occupations teachers
-
State
Fair booth
The
NC Center for Nursing has become the model for 30 other
states that are creating permanent infrastructures for
addressing nursing workforce issues. We
are also leading the creation of a national forum that
will allow states to collectively create a minimum data
set for nursing and to disseminate best practices in workforce
development.
|
|
|
 Brenda
Lewis Cleary received a BSN and MSN from Indiana University and a PhD
in Nursing from The University of Texas at Austin. Until July of 1994,
Dr. Cleary was Regional Dean and Professor at Texas Tech University
Health Sciences Center School of Nursing. While at TTUHSC, she received
the Excellence in Teaching Award and the President’s Academic
Achievement Award. She currently holds the position of Executive Director
of the North Carolina Center for Nursing, a state funded agency committed
to assuring nursing resources to meet the health care needs of the citizens
of North Carolina. Dr. Cleary served as project director for a Robert
Wood Johnson Foundation (Colleagues in Caring) funded initiative, the
NC Nurse Workforce Planning Model, and currently serves as a Magnet
appraiser for the American Nurses Credentialing Center. She also serves
on the North Carolina Institute of Medicine, a gubernatorial appointment,
and is a Sigma Theta Tau Virginia Henderson fellow as well as a fellow
in the American Academy of Nursing.
|
|
|
Other
recent honors include the NC Nurses Association Nurse Researcher of
the Year Award (1997), distinguished alumna awards from University of
Texas at Austin and Indiana University Schools of Nursing, in 1998 and
1999 respectively, recognition as being among the Great 100 Nurses of
North Carolina (2000), Leadership America, Class of 2001, and selection
as a Robert Wood Johnson Executive Nurse Fellow, 2002 cohort.
 Dr.
Cleary has published numerous articles and book chapters and is the
co-editor of a new book related to the nursing workforce and nursing
leadership. She is also published in the field of gerontology, her clinical
passion, having published a 2004 AJN Book of the Year on conducting
research in long term care settings.
Brenda L. Cleary,
PhD, RN, FAAN
Executive Director, NC Center for Nursing
222 North Person Street
Raleigh, NC 27601
(919) 715-3523
Nursing: The Power to Make a Difference
www.nccenterfornursing.org bcleary@northcarolina.edu
|
|
|
