Addressing Community Health Nursing Workforce: Strategies for Educational Institutions

1. Accepting the Challenges of Paradigm Shifts in Community and Public Health Nursing Canadian Association of Schools of Nursing May, 2009 J. Underwood, D. Meagher-Stewart, M. MacDonald, L.L. Stamler, B. Schoenfeld, K. Knibbs

2. Background • Adequate community health capacity can mitigate pressures on acute care and long-term care • Health Care System shift: • from hospital to community • to health promotion, disease prevention

3. Purpose of our research To examine: • Existing community health nursing (CHN) workforce capacity, including public health nursing • Strategies for optimizing utilization of CHN workforce

4. What does this meanfor Schools of Nursing?

5. Methods

6. Demographic Profile • In 2007, 16% (53,404) 327,670 nurses in Canada were CHNs (46,273 RNs; 7,131 LPNs) • CHN workforce older LPNs: ~9.5% >60 years old (compared to 7% of all LPNs) RN: ~28% >55 years old (compared to 22% of all RNs) • Fewer younger CHNs RNs: ~ 5% <30 years (compared to 10% of all RNs)

7. Survey results: Enablers

8. Survey results: Potential Barriers

9. Focus Group Results: Organizational attributes that support PHN practice

10. Conclusions • CHNs~ 16 per cent of the nursing workforce. • CHNs thrive in workplaces that collaboratively share vision/goals and support creative, autonomous practice. • CHNs work well together, but need time, flexible funding and management support to develop relationships with community/clients, and other professionals. • Employers and managers should encourage CHNs to keep up-to-date, provide more access to continuing education, policies, evidence and debriefing sessions, (assure competency & professional confidence)

11. Why is this important for Schools of Nursing? • Educational institutions who offer basic and continuing nursing education will: • Provide relevant education to student nurses • Facilitate educators staying up-to-date • Have new funding opportunities consistent with focus on sustainability and entrepreneurial approaches within some universities

12. Implications:undergraduate education • Continue to build confidence in nursing abilities relative to community health nursing practice • Continue to work on team relationship skills

13. Implications:Undergraduate curricula Preparing for system shift includes: • Determinants of health • Primary health care • Health Promotion • Disease Prevention • Emergency preparedness • Other

14. Implications:Continuing Education • Improve access to evidence and continuing education • Teach practitioners about knowledge translation and exchange • Update knowledge, e.g. social determinants of health

15. Implications:Management Development • Effective human resource planning • Coordination and planning • Creating an ongoing learning culture • Creating a supportive work environment • Facilitating autonomous practice

16. Implications: Leadership Education • Public health leadership • Visionary and responsive to community needs • Champions for Public Health

17. Conclusions • The comprehensive national research program of study about community health nursing (CHN) produced results relevant to Nursing Educators • Nursing Education Programs have opportunities to be creative and innovative

18. Opportunity • Schools of Nursing • Masters of Public Health Programs could partner with: Employers, health organizations and governments

19. The Goals of the Partnership:

20. Jane Underwood (McMaster University) PI, co-lead Dr. Andrea Baumann (McMaster University) Dr. Donna Ciliska (McMaster University) Dr. Donna Meagher-Stewart (Dalhousie University) Dr. Raisa Deber (University of Toronto) Mary MacDonald (University of Saskatchewan) Anne Ehrlich (McMaster University) Bonnie Schoenfeld (University of Saskatchewan) Dr. Melanie Lavoie-Tremblay (McGill University) Dr. Jennifer Blythe (McMaster University) Dr. Audrey LaPorte (University of Toronto) Val Munroe (Vancouver Coastal Health) Kristin Knibbs (University ofSaskatchewan) Dr. David Mowat (Peel Public Health), co- lead Dr. David Butler-Jones (Public Health Agency of Canada ) Sandra McDonald Rencz (Office of Nursing Policy, Health Canada) Barbara Oke ( First Nations and Inuit Health Branch ) Valerie St. John ( British Columbia Ministry of Health Services) Dr. Susan Matthews ( Niagara Health System) Carla Troy (Public Health Agency of Canada) Lynn Jobin (Quebec Direction générale de la santé publique) Lynnette Leeseberg Stamler (Canadian Ass’n Schools of Nursing) Rosemarie Goodyear (Community Health Nurses Association of Canada/ Central Health Region, NFLD) Dr. John Blatherwick ( retired, Vancouver Coastal Health) Dr. Cory Neudorf (Saskatoon Health Region) Paul Fisher (Canadian Council for Practical Nurse Regulators) Dr. Ron Wall (Public Health Agency of Canada) Decision Makers Researchers

21. Funders • Canadian Health Services Research Foundation • Health Canada • Public Health Agency for Canada • Health Human Resources Strategy Division • Office of Nursing Policy • Health Canada First Nations & Inuit Health Branch • British Columbia Ministry of Health • Nursing Directorate • Communicable Diseases & Addictions Prevention Branch • McMaster Nursing Health Services Research Unit • Vancouver Coastal Health Authority

22. Contact Jane Underwood BScN, MBA Consultant/ Co-Investigator, Nursing Health Services Research Unit Phone: (905) 525-9140 x 22380 Email:undrwood@mcmaster.ca