ABSTRACT
Today's health care environment requires registered nurses to be prepared for an array of practice settings, providing care outside the hospital and directly in the community. There is increasing focus on wellness, prevention, access to care, and mental health services for an aging and more diverse population. To improve alignment of education with increasingly complex needs, donor-advised funding supported four prelicensure nursing schools to transform their curricula. Selected schools were guided through a curriculum redesign process emphasizing community and continuum of care. This innovation was consistent with meeting challenges to realize the Institute of Medicine's 2011 Future of Nursing recommendations.
Subject(s)
Education, Nursing , Curriculum , HumansABSTRACT
A legacy project was launched in 2016 to research, capture, and record the history and voice of Kaiser Foundation School of Nursing alumni. The inspirational stories of these early nursing pioneers emerged within a disruptive and innovative health care system known as Kaiser Permanente. Led by a doctorally prepared nurse director, the new school boldly rejected the dominant social norms of the 1940s by welcoming minorities and offering an unprecedented curriculum that prioritized prevention, health promotion, and wellness over conventional institutionalized sick care models. Kaiser Foundation School of Nursing alumni became Kaiser Permanente's earliest nurse leaders, educators, and care advocates. They helped revolutionize the key concepts of integrated patient care. As early innovators, many graduates pursued advanced degrees and were instrumental in defining expanded nursing roles, including the introduction of nurse practitioners in California. How Kaiser Foundation School of Nursing transcended the traditions and cultural norms of the day offers a reflective narrative on the enduring leadership attributes of disruptive innovation and the nurse executive's role in reimagining care for future generations.
Subject(s)
Education, Nursing/history , Schools, Nursing/history , Education, Nursing/trends , History, 20th Century , History, 21st Century , HumansABSTRACT
The California Collaborative Model for Nursing Education (CCMNE) promotes seamless ADN-BSN academic progression as the most effective means by which the state can educate the numbers of BSN-prepared nurses needed in the future. Accelerated by state legislation and a national commitment to a higher-educated nursing workforce, the framework is sufficiently flexible to accommodate a variety of strategies that meet the intent of each Core Component, and can be implemented at local, regional, or state levels. Six percent of all current ADN students in California are dual enrolled in CCMNE BSN programs. CCMNE has a positive effect on ADN-BSN completions and will support increasing nursing workforce diversity in California.
Subject(s)
Cooperative Behavior , Education, Nursing/organization & administration , Models, Educational , CaliforniaABSTRACT
OBJECTIVE: To forecast the shortage of registered nurses (RNs) of the 24 Primary Metropolitan Statistical Areas (PMSA) and Metropolitan Statistical Areas (MSA) in California. BACKGROUND: A nursing shortage prevails nationally and is most serious in the state of California. Successful interventions in the alleviation of the RN shortage will require effective resource allocation and academic program development in various regions throughout the state. While various published studies have focused on nursing workforce development at the state and even regional levels, there are no studies focused on identifying RN shortages at the PMSA or MSA (P/MSA) level. In this report, a forecasting model is developed to systematically analyze the future supply and demand of the RN workforce within each California P/MSA. METHODS: Using accessible public databases, forecasting models were constructed to project the demand and supply of RN jobs in California P/MSAs. In the demand model, population age and size were used as determinants of regionally required RN jobs. In the RN jobs (supply) model, a region's supply of RNs was the net sum of factors increasing and decreasing the regional presence of RN jobs, including RN graduations, migration, and aging of the RN workforce. The combination of these supply and demand models was used to produce regional RN shortage forecasts for future years. RESULTS: Almost all regions exhibited growing shortages by 2020 at rates ranging from 3% to 600%. Using a modified version of the grading rubric of the California Regional Registered Nurse Workforce Report Card (Lin, Lee, Juraschek, & Jones, 2006), only two regions will receive a grade above "C" in 2020. The number of "F" grades will grow to nine. CONCLUSIONS: California has the lowest RN ratio in the United States (Fletcher, Guzley, Barnhill, & Philhour, 2004; Health Resources and Services Administration, 2004a) and this RN workforce forecasting model shows that over the next 15 years, the majority of P/MSAs in California will have increasing RN shortages. This analysis has significant policy implications including the need to create specific plans to mitigate the effect of the California shortage.
Subject(s)
Nurses/supply & distribution , California , Forecasting , Health Services Needs and Demand , Models, Theoretical , Population DynamicsABSTRACT
Various reports and opinion papers have offered suggestions to alleviate the national and California RN shortages. The methodology of using the report card concept for comparing the number of RN jobs per 100,000 populations regionally with the national database further highlights the severe shortage of RN's in various regions in California. This report card method may potentially be used as a planning or forecasting tool, as well as a monitoring tool to initiate workforce development strategies and projects, and to evaluate their effectiveness over time.
Subject(s)
Employment/organization & administration , Nursing Staff, Hospital/supply & distribution , Personnel Staffing and Scheduling/organization & administration , Age Factors , California , Forecasting , Humans , Licensure, Nursing , Needs Assessment , Nursing Administration Research , Population Density , Population Growth , Quality of Health Care/organization & administration , Regional Health Planning/organization & administration , Residence Characteristics/statistics & numerical data , Workload/statistics & numerical dataABSTRACT
This article reviews long-range, strategic nursing workforce initiatives developing in 5 states. It also summarizes progress in establishing a national network of state nursing centers for sharing workforce data, and new education, workplace, and policy initiatives being undertaken by and on behalf of the nursing profession.
