Opportunities for Nursing Education and Practice
The complexity of the nursing workforce issues and the urgent need for change provide leadership
opportunities for both education and practice. Healthcare and nursing programs are in a unique position
to take part in developing short-term and long-term strategies for the nursing workforce issues in Hawaii.
Changes are required not only in strategies that attract qualified students into the nursing profession but
also strategies that provide satisfying and rewarding workplace environments and career pathways for
professional nurses. The Education and Practice Collaborative recognizes that effective solutions must
address the core issues that currently impact the nursing profession: the professional image of nursing,
workplace environments, the relationship between education and practice, and education capacity issues.
As identified in the AACN 2003 report, several factors exist at the point where education and practice
integration occurs that create opportunities for close partnerships. First, healthcare organizations and
nursing education programs co-exist in healthcare delivery settings where education is valued and
preparation of the next generation of nurses is a priority goal. Second, schools of nursing prepare
registered nurses with associate, baccalaureate, and higher degrees, the educational product desired
throughout all sectors of healthcare. Third, a variety of different healthcare organizations are the primary
teaching and clinical placement sites for student education and have the potential to model professional
nursing practice. These commonalities at the point of integration provide the platform to formalize and
cement partnerships between nursing education and practice.
The Challenge: Attracting & Retaining a Highly Qualified/ Competent Nursing Workforce
The immediate need to expand enrollment to ensure an increasing supply of associate, baccalaureate,
and higher degree prepared registered nurses is the challenge nursing programs and healthcare facilities
face. The looming shortage of registered nurses influenced by factors such as the rapidly increasing aged
population and the aging of the nursing workforce itself necessitates that nursing programs must expand
enrollment in order to keep in step with the growing need for qualified nurse educators and nurse
workforce demand (AACN: Issue Bulletin, 2000). In December 2005 the National League for Nursing
(NLN) released its preliminary National Nursing Education Survey (NNES) report showing an increase in
applications, admissions, and enrollments in nursing programs at all levels. However, the NLN cautions
these figures do not tell the whole story and as the number of nursing faculty continue to decline in the
USA nursing programs will be forced to reject more qualified student applicants. In 2005, 147,000
qualified applicants were rejected an 18 percent increase from the 2003-04 NNES (National League for
Nursing, 2005). The ability to expand student enrollment and increase capacity in nursing programs is
dependent on a) adequate numbers of nursing faculty with the appropriate clinical expertise, b) adequate
access to quality clinical placement sites for clinical learning experiences, c) adequate classroom and
laboratory space, d) adequate or improved faculty salaries, and e) state budgets able to fund public
universities to accommodate increased enrollment demand.
The longer-range challenges beyond expanding nursing enrollments and increasing graduation may be
the improvement of practice environments and creation of rewarding professional career opportunities. In
2002, AACN published the Hallmarks of Professional Practice, a guide to help new graduates select
employment settings where their education and potential are recognized and used. This document also
serves as a guide for healthcare organizations seeking to improve recruitment and retention of nurses in
the organizations.
Issues of workplace redesign and improvement related to the nursing shortage have been reviewed in
several reports (American Nurses' Association, 2002; American Hospital Association, 2002; Association
of Academic Health Centers, 2002; Joint Commission on the Accreditation of Healthcare Organizations, 2002; Kimball 2005; Robert Wood Johnson Foundation, 2004; University of Illinois, 2001). Consistent
themes that emerge from these reports include: a) the nature of the work of nursing, b) workplace and
culture factors, c) recruitment and retention, d) need to support nursing education, and e) system
development and policy issues. Strategies for collaboration between education and practice are also
suggested. There is general agreement that long term sustainable solutions are required to correct the
underlying issues affecting nursing supply. The specific recommendations in these reports and examples
will be helpful to healthcare organizations and nursing education programs working in a partnership
model.
Taking up the Challenge: Building Partnerships in Nursing
The overall aim of partnership models in nursing is to use the unique position of healthcare organizations
to support and implement best practices in nursing education and practice. The Education and Practice
Collaborative identify the following objectives found to be positive in other settings to guide nursing
partnerships in Hawaii.
1. Collaborate to recruit, retain, and expand enrollment of students in associate, baccalaureate,
and higher degree programs in nursing.
2. Encourage and enhance coordination and collaboration between and among all educational
institutions in the state, including P-12 schools and associate and baccalaureate degree
programs, to facilitate transition from each educational level to the next.
2. Ensure a professional transition for newly graduated registered nurses through structured
support programs (such as preceptor programs; mentorship; residencies; internships).
3. Ensure a professional work environment that supports the development of best practices in
clinical practice and education.
4. Identify model(s) that are sustainable in and portable to a variety of settings. |
