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Balance: A Report on the
State of the Nursing Workforce

Hawaii State Center for Nursing

2528 McCarthy Mall
Webster Hall 432
Honolulu, Hawaii 96822 - Map -

Ph: (808) 956-5211
Fax: (808) 956-3257


Nursing Education and Practice:
Building Partnerships to Ensure a Stable Nursing Workforce in Hawai’i

(download pdf file)

Introduction | Nursing Workforce Shortage | Opportunities & Challenge

Strategies | Partnership | Summary & References | Summit Planning Group

Spotlight on UH System


Short-term Strategies.Presently in Hawaii the number of qualified students desiring to enter nursing outpaces the available places in the public sector. Many are discouraged and apply to schools on the mainland or choose an alternate career. Therefore, we cannot assume that there will always be a plentiful supply of qualified applicants. Successful sustained recruitment of qualified students to nursing programs will depend on their perception of nursing as a viable career choice where education is recognized, career advancement is possible, and work environments foster the Hallmarks of Professional Practice (AACN, 2002). Successful retention of students currently enrolled will ensure graduation.


Recruitment and Retention.In response to the immediate need for associate, baccalaureate, and higher degrees prepared registered nurses, numerous short-term strategies are identified as viable options attainable by partnership efforts.

• Targeting new student populations (e.g., underrepresented students, men, second-degree students, and undecided college students).

• Providing tuition support and incentives to enter nursing programs through collaborative efforts between healthcare and nursing programs.

• Removing barriers to admission for all qualified applicants (e.g., encourage regional referrals to schools with open spaces for qualified applicants not admitted due to space limitations).

• Communicating through media the specific message about the value of learning in a variety of clinical settings.

• Creating marketing strategies that demonstrate partnership efforts between healthcare facilities and nursing programs.

• Expanding access by student exchange programs (e.g., WICHE – Western Undergraduate Exchange, Professional Student Exchange Program, Western Regional Graduate Program).

• Eliminating barriers to progression of students in the nursing program (e.g., financial support and 7 personal and professional support through advising, mentoring, and educational case management).

• Ensuring stimulating and satisfying clinical learning experiences in healthcare delivery settings.


Creating New Programs & Accelerate Progression

• Exploring time-acceleration to graduation of existing programs.

• Exploring time-accelerated program options that are attractive to potential students and will quickly increase the number of graduations from existing programs.

• Creating new program options attractive to new populations of students (e.g., access to higher education programs for underrepresented and low income students, second-degree programs, master's entry programs, and individuals making a career change, military retirees, and specialty practice).


Creating Mentoring Programs for Nursing Faculty.The National League for Nursing (2006) identifies, in order to recruit and retain qualified nurse educators, mentoring may be a viable strategy to facilitate ongoing career development of nursing faculty.

• Exploring different mentoring models

• Establishing mentoring programs relevant across the career continuum.

• Designing clinical mentoring programs


Sharing Faculty & Increasing Access to Clinical Experiences. Some program initiatives have established integrated clinical partnerships that combine best practices in education and clinical practice that result in an improved working and clinical learning environment.

• Expanding faculty capacity by sharing clinical faculty and/or funding additional faculty positions.

• Designing clinical learning experiences that accommodate increased numbers of students and use of clinical space (such as, clinical preceptors).

• Collaboratively evaluate ways to increase access to clinical experiences through creative scheduling.

• Establishing linkages and sharing expertise between nursing programs and healthcare facilities across the continuum of healthcare delivery.


Redesigning Learning Using Technology and Simulations.In Hawaii and nationally, the exploration of various technologies is occurring to expand the ability to deliver instruction, redesign learning, and enhance clinical learning experiences (e.g., simulations, distance education, and podcasting). Increasing the use of technology and clinical simulation may prove useful as a way to increase the capacity to teach more students. Technological information systems that support the clinical practice of nursing are also being explored. The University of Texas School of Nursing at Houston, University of Maryland School of Nursing, and the Nursing Clinical Education Center are a few partnershipsattempting to redesign learning using state-of-the art technology.


Long-Term Strategies. Long term strategies are being established to address the core issues and problems creating barriers to recruitment, education, and retention of registered nurses. Initiatives across the country include:

• Establishing Consortia for Leadership in Practice, Education, and Research. An example of successful consortia is the UCSF Stanford Center for Innovation and Research in Patient Care, which combines efforts from UCSF Medical Center, UCSF School of Nursing, and the Departments of Nursing at Stanford and Packard. 8

• Creating new funding mechanisms to support nursing education.

• Creating innovative partnerships and other collaborations between higher education, state and local governments; private and public sectors of society to help meet nursing workforce needs.


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