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Leading beyond your comfort zone: Is nursing recession proof?

Leading beyond your comfort zone: Is nursing recession proof?. Marcia Hern, EdD, CNS, RN Dean, School of Nursing University of Louisville. Overview. Update about national trends and nursing shortage Update about the SON and KY Future nursing workforce

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Leading beyond your comfort zone: Is nursing recession proof?

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  1. Leading beyond your comfort zone: Is nursing recession proof? Marcia Hern, EdD, CNS, RN Dean, School of Nursing University of Louisville

  2. Overview • Update about national trends and nursing shortage • Update about the SON and KY • Future nursing workforce • How you can lead your own unique health care journey, especially working with nurses

  3. External forces to health • 47 Million without health care (15%) • US population 307 Million (7.20.09) • US unemployment rate near 10% • >98,000/year patients die from medical errors (IOM, 2000) • System measures improving patient safety & quality

  4. States with Projected Shortages of FTE RNs in 2020 http://bhpr.hrsa.gov/healthworkforce/reports/rnproject/report.htm

  5. Projected FTE RN bhpr.hrsa.gov

  6. American Association of Colleges of Nursing (2009) • 2003 BSN enrollment ↑ 16.6% • 2007-08 BSN enrollment ↑ 2%: faculty shortage • Deny 50,000 qualified BSN applications • MSN enrollment ↓ • PhD ↓ DNP ↑ • Be(a)ware economic indicators $$$$$$

  7. Stretching nursing comfort zone • HIGH impact, critical mass profession • Front line caregivers; 24 X 7 • Most intimate profession that serves through science and art of caring • Most honest profession • Cost effective & high quality health care • Best health care value $$ and ROI

  8. Kentucky RN Education • Lags the nation in BSN nurses at 28% • Only Mississippi has less BSN • 50% 52,223 RNs with Associate degrees • 8 % master’s prepared APNs and doctoral nurses (www.kbn.ky.gov)

  9. SON Educational Programs • Baccalaureate: traditional 1st degree; 2nd degree career; RN-BSN • Master’s: Nurse practitioners- Adult, family, neonatal, psych; • Starting acute care NP Jan. 2010 • Master’s as nurse educators • PhD: first three graduates

  10. SON BSN Applications

  11. New Programs & Partnerships

  12. Owensboro BSN Program & Partnership Owensboro Medical Health System (OMHS) and new SON 159 seat auditorium: synchronous audio/video First baccalaureate distance education program in KY!

  13. Joint psychiatric mental health nurse practitioner (NP) major in Bowling Green • Post Traumatic Stress Disorder ↑ and Depression

  14. Scottsville clinical placement with pediatric patients with chronic health conditions MSN with Certificate Health Professions Education. New Programs & Partnerships

  15. Mutual alumnae events: Keeneland • & Louisville Boat Club • Research collaborators • Neonatal NP • Acute care NP • UofL 2009 distinguished Alumna: Dr. Pat Howard

  16. Digital Natives Wants & Needs · Students and new RN hires · Perform best networked · Web: 1st source of information during this data tsunami · Thrive on instant gratification and frequent rewards · Prefer games to “serious” work

  17. Digital Immigrants • Faculty and late and mid career RNs • Digital immigrants: maintaining some of our accent and traditions of the past • We cannot afford to teach as we were once taught • We cannot afford to practice as we have once practiced

  18. Simulation & EHRs

  19. Nurses will always have a job! • Largest group of health care providers (2.5M) • February, 2009: 27,000 new RN jobs • Bureau of Labor Statistics www.bls.gov 587,000 RN jobs needed through 2016 • But what kind of job will they have?

  20. New RN economic competitors • May not get 1st pick job as new grad • Retired RNs returning to work • Delaying retirement • Increased shift in part-time to full-time • Working harder, faster, more shifts • Hospital patient volume down but more acutely ill, some RN downsizing

  21. New RN challenges • Move beyond educational comfort zone • Earn MSN as Nurse Practitioner • (only 2% of 4th medical students plan to work in primary care) • Expand knowledge of genetics, informatics, geriatrics & forensic nursing • Earn PhD to teach/conduct research

  22. Ask about the education of your RN • Aiken, L. JAMA (2004; 2003) • N= 232,342 general, orthopedic, vascular surgery pts from 168 PA hospitals • Education: 10% ↑BSN nurses → 5%↓surgical mortalities and morbidities 30 days post admit. • Practice:  magnet hospitals: recruit/retain RNs/MDS • Policy: advocacy for lower pt/RN ratios • 4:1 rather than 8:1

  23. Evidence Based Practice • Translates nursing research and other disciplines’ research to practice • Promotes data driven decisions • Supports PhD nurse scientists and future DNP & practitioners

  24. New areas: Informatics • Integration of healthcare sciences, computer science, information science, and  cognitive science to assist in the management of massive healthcare information.  • Nursing informatics • Dental informatics • Medical informatics • Pharmacy informatics • Allows health care providers to make improved clinical decisions • Saba, V. & McMormick, K. 4th ed, (2006). Essentials of nursing informatics. New York; McGraw Hill.

  25. New areas: Genomics • Almost every disease has a genetic component • Nurses need to do 3 generation pedigrees on every patient • Nurses need to consider pharmogenomic properties

  26. What does this mean to you? • Lead your own health care journey • Focus on own health with • diet, exercise, stress relief • Obese children in Ky 21%; Tx 20.4% • Listen to your own body and follow scheduled preventive exams • Become a digital immigrant and search WebMD.com or Netwellness.org

  27. What does all this mean to you? • Know thy nurse! • BSN or AD • Ask questions, write them down, take a friend/ spouse to your health care visits • Use NPs and advocate for NP reimbursement at 100% • Support nursing students’ scholarships and faculty to educate more students

  28. Summary • Medicine = cure of illness • Nursing = care and prevention • Both: once avocations, now industries • Health care now much like housing, auto and bank industries • 17% GNP 2009; 20%-2015; 50%-2050 • Older adults double in 2030

  29. Summary • Out of balance health care • US health care is quite good, but is most expensive in the world • 1/5 of ER visits are uninsured (Secy. HHS Kathleen Sebelius) • Health care (insurance) reform for costs and access • Nurses can play a significant role!

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