Creating Our Preferred Future - Together

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Creating Our Preferred Future - Together

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1. Creating Our Preferred Future - Together Lynne M. Dunphy, PhD, FNP Routhier Chair of Practice & Professor of Nursing University of Rhode Island College of Nursing

2. “It is impossible to mandate RNs who do not exist” - American Hospital Association

4. Dean Dayle Joseph, EdD, RN Early Leadership Chaired Shape II Study – early identification of workforce shortages for the state – follow up conference June 2006 Conference on RI Workforce at URI w/Sen Jack Reed Created & funded Routhier Chair of Practice to focus on workforce issues for the state

5. Quality and Safety Current and projected RN shortage is unprecedented Political and economic forces – focusing on the need for more instead of focusing on what Just increasing the numbers of nurses will never achieve the desired patient outcomes

6. Expanded Educational Capacity Have doubled BS pop – applications soaring Will be graduating approx 120 BS traditional students per academic year

7. Masters Education Nursing Education – increasing #s of nursing faculty – includes Certificate program in Nursing Education for nurses w/a masters in another area of nursing Nursing Administration – leadership Nurse Practitioners – Family and Gerontology – Plans to add Adult concentration to Gero Midwifery (thru 2007) Clinical Nurse Specialist – Psych Mental-Health [– inc adding Child & Adol] and Gerontology

8. PhD Education since 1980 Adds to nursing faculty pool locally, regionally & nationally Builds the science of nursing

9. Collaborative Educational Initiatives URI-Miriam Hospital onsite RN-BS – began 2003 – 41 grads by 2006; 29 enrolled for 08 graduation URI-RIH onsite masters degree in Nursing Administration – graduated 44 students Marlene Dufault, PhD, RN

10. New Roles Clinical Nurse Leader (CNL) – a masters-prepared generalist with a focus on providing clinical leadership & bringing evidence to the bedside Accountability for patient-care outcomes at the point of care One of original 57 national programs approved by the American Association of Colleges of Nursing (AACN) to develop & implement CNL curriculum in concert w/clinical partners

11. Clinical Nurse Leader Con’t Have graduated 4 students w/ 16 currently enrolled Laurie Lauzon Clabo, PhD, RN Director Undergraduate Studies Coordinator, CNL

12. New Roles con’t Doctorate of Nursing Practice (DNP) – mandated by nursing accrediting bodies that by 2015 all advanced practice nurses are educated at this level Approximately 80 post-baccalaureate credits, some similarity to Pharm Ds and Doctorate of Physical Therapy Program planned for Fall 08 at URI

13. Clinical Teaching Models A new initiative at the Miriam Hospital was piloted Spring 06 and is ongoing 12 identified preceptors were partnered with a doctorally prepared URI CON faculty to expand educational capacity A win-win situation: faculty provided education in evidence-based practice & facilitated hands-on teaching; students able to work directly w/nursing staff

14. Senior Med-Surg Nursing Pilot Project URI NUR 464 & Miriam Hospital – Spring 07, con’t at present Barbara O’Brien, PhD, RN Research & Evaluation component

15. Collaborative Research Initiatives Newport Hospital, Miriam, Women & Infants, RIH Prisons More to come!

16. Working in health care delivery is not always pleasant. People have options and unless we improve the environment we will not find adequate staff.

17. Paradigm Shift Necessary Still wedded to service, but without the independence or accountability to be able actually to improve that service, nursing has dramatically advanced the education and research base of the profession, but for a variety of reasons remain outside the very decision-making processes that could improve the system. Until the paradigm changes, the structural shortage of nurses will remain unchanged – from “Healthcare’s Human Crisis: The American Nursing Shortage” – RWJF, April 2002

18. Future Initiatives Create unique Fast-Track Masters focused on leadership competencies for students who are baccalaureate prepared in another discipline

19. & More to Come Develop a collaborative Center for Nursing Leadership & Faculty Development as a “think-tank” for emerging models of leadership & clinical teaching w/an emphasis on research & evaluation of new models Exploration of joint appointments to increase synergy between education-practice environments

20. Increased Collaboration Increased research collaboration w/URI faculty from Colleges such as Business & Schmidt Labor Center, as well as College of Nursing

22. Three Good Reasons to Keep Laughing during Workforce Crisis #1 – Things are not getting worse – things have always been bad 1968 – the nation is undergoing health care reform. Medicare, Medicaid. The AMA predicts a drift toward Socialism 1982 – the nation is undergoing healthcare reform again. DRGs. Hospitals become competitive corporations. AMA predicts drift toward Socialism 1992 – we all know this story! AMA warns of rationing! 2006 – desperate need for healthcare reform – “Crossing the Quality Chasm”; IOM Reports

23. Reasons to Keep Laughing… #2 – Things could be worse – we’ve had some improvements in work environments as reported by Buerhaus (2005) for example & potential students are clamoring at our doors #3 – Adversity will improve our characters – what doesn’t kill you makes you stronger! Finding nursing’s VOICE & making visible the invisible

24. Year 2020 Newspaper Headlines Nurse Accreditors close 5 medical schools – not enough emphasis on prevention Nurse Lobbyists successful in securing legislation to support patient safety & quality care Nurse Researcher at w/joint URI-Lifespan appointment wins Nobel prize for research on health disparities

25. What We Need to Get There Increased nursing faculty salaries in ALL nursing education settings Increased shared simulation A NEW building! Service Learning Competency-based assessments

26. How wonderful it is that nobody need wait a single moment before starting to improve the world. Anne Frank

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