Preparing our Future Workforce: What Americans Need from Nurses in the 21st Century

NM 6/3/09

Brenda L Cleary, PhD, RN, FAANDirector, Center to Champion Nursing in America

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Objectives

1. Discuss the work of the Center to Champion Nursing in America and harnessing the power of strategic partnerships.

2. Describe our partner base, beyond the “usual suspects”.

3. Identify ways that strategic partnerships, especially with consumer groups, can help us advance nursing to better meet healthcare needs in the 21st Century.

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The Center to Champion Nursing in America - a joint initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation - is committed to ensuring that Americans have the highly skilled nurses we need to provide affordable, quality health care now and in the future.  

The Center, a consumer-driven, national force for change, works to increase the nation’s capacity to educate and retain nurses that are prepared and empowered to positively impact health care access, quality, and costs.

The Center is made possible by a $10 million grant to the AARP Foundation from RWJF and dedicated funding from AARP.

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Addressing the Nursing Shortage

Specifically, the Center to Champion Nursing in America creates and supports partnerships, policies and activities that:

> Help raise the voice of nurses in planning and leading healthcare reform.

> At the state and national level, seek funding to support expanded nursing education programs with an emphasis on preparing more nurses at the graduate level for faculty positions and advanced practice and leadership roles.

> Build a diverse coalition of nursing leaders, education and health care organizations, business leaders, and policy makers to devise a comprehensive strategy for workforce development, using the powerful voice of consumers to advocate for the resources to expand nursing education capacity.

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Addressing the nursingshortage (cont’d)

> Boost nurse job satisfaction and retention by seeking ways to increase the involvement of nurses in decision making about care delivery and management, including assuring more prominent roles for nursing leaders, such as on governing boards, to provide a critically-needed perspective on improving safety and quality of care for patients.

> Increase the number of nurses remaining in the workforce past traditional retirement age.

> Decrease turnover among new nursing graduates by increasing the number of nurse residencies to ensure a formal transition to practice.

Critical Nursing Workforce Issues

Emerging shortage driven by limitations in educational capacity

Diversity (includes men in nursing)

Educational mix, including APRNs

Initial and sustained competence Practice issues, including workplace issues and scope of practice

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Creating Strategic Partnerships and Leveraging Stakeholder Resources

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Typical and Less Typical Partners

Nursing Service Workforce Investment System

Nursing Education Business/Chamber of Commerce

Nurses Association Government Agencies

Boards of Nursing Policy makers

Other Healthcare Consumer Advocates

Organizations Philanthropic Organizations

Other Health Disciplines Other?

Center to Champion Nursing in America

Aligning with Consumers and Other Stakeholders in Addressing Challenges for the Future

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Americans Agree Nurses Critical to Successful Health Care Reform

> Nearly nine out of 10 Americans (87%) say that when Congress and the president write health reform laws, it is important for them to address the current shortage of nurses and nursing faculty. Nearly two-thirds (65%) say that it is extremely or very important.

> In the same vein, 88% agree – and 56% strongly agree – that making sure there are enough nurses to monitor patient conditions, coordinate care and educate patients should be a part of the effort to improve the quality of health care. Agreement is strong regardless of region, sex/age, party affiliation, voter type, income or race.

> Americans clearly perceive the value of nurses. In all, 87% agree – 55%

strongly – that nurses can play an important role in reducing health care costs in the areas of patient safety, preventing medical errors, care coordination and providing primary and preventive care.

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Priorities focus on addressing the faculty shortage and other strategies for expanding capacity of nursing education programs to produce the nursing workforce for 21st century health care; and high level strategies for retention.

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Nursing Workforce in the 21st Century

>Community Health and Public Health>Primary Care and Chronic Disease Management>Care Coordination >Transitional Care>Support for family caregivers>End of life care that is markedly different from the 20th

century

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Work for Change

>Build Coalitions

>Engage Federal and State Policy-Makers

>Develop a Clearinghouse for Data

>Support State and Grassroots Efforts

>Encourage Innovation

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Federal Wins

The American Economic Recovery and Reinvestment Act includes $500 million to address critical health care workforce shortages. Approximately $200 million of this funding will be dedicated to tackling the growing nursing and other primary care provider shortages by providing a much needed funding increase for the Title VII & VIII nursing and other health care workforce development programs administered by the Division of Health Resources and Services Administration within the Department of Health & Human Services.

In addition, $250 million is allocated to the Department of Labor for competitive grants for job training and placement in high growth sectors with priority given to health care jobs. This is another area of opportunity for creative and innovative thinking about nursing education.

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> The Omnibus Appropriations Act of 2009 provides a nearly 10 percent boost for nursing education funding in fiscal year 2009. And the legislation provides a 46 percent increase in funding for the Title VIII faculty loan repayment program to help reduce the nursing faculty shortage.

> Overall, Title VIII nursing education programs will receive $171.031 million, an increase of $14.985 over FY 2008. This increase is on top of the $500 million in funding provided to address health workforce shortages in the economic stimulus legislation recently signed into law.

> President Obama released his proposed budget for FY 2010 on May 7, 2009 that would allocate $263.4 million for the Title VIII programs, which are currently funded at $171 million. The two programs that would receive the increase are the Nursing Faculty Loan Program and Nurse Education Loan Repayment & Nurse Scholarships.

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In the Works

AARP PROPOSALS FOR NURSE EDUCATION AND HEALTH CARE REFORM:

1) Modernize Medicare so that funding for nurse education targets “advanced practice” nursing skills such as primary care, prevention, chronic care and transitional care. These skills are often needed in non-hospital settings, but MOST current funding goes to hospital-based care.

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2) Create a permanent, dedicated source of funding (up to $200 million annually, over and above Title VIII*) to expand nurse education. to increase the number of nurses nationwide by expanding nurse faculty. Funding should make faculty salaries more competitive and target funding to increase the pipeline of nurses pursuing advanced degrees.

*Title VIII of the Public Health Services Act has to be re-appropriated every year, and the amount of funding is variable.

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Recent State Wins, Despite Economic Downturn

Arkansas

California

Massachusetts

Texas

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