Improving the Nursing Profession and the Future of Nursing - Essay Example

Improving the Nursing Profession: An Action Plan Improving the Nursing Profession: An Action Plan There is a dire need for increased number of skilled nursing practitioners in the dynamic environment of healthcare industry. Unfortunately, the current working conditions and lack of life career balance discourages Registered Nurses (RN) for opting for higher degrees in the field which is leading to a shortage of trained, educated nurses and nursing faculty. At an institutional level, the management needs support RNs with an education focused culture and financial and professional policies that incentivize them towards professional degrees. The goal to be reached is to increase the number of nurses with a baccalaureate degree to 80% and to double the number of nurses with a doctorate and the paper provides an action and an evaluation plan for achieving the goal. Introduction The health care landscape in the developed countries of the world is rapidly changing due an increase in the ageing workforce, better access to medical support due to government programs and life style changes that require more complex forms of technology led healthcare (Japsen, 2014). This has similarly led to a change in the kind of skills and education that are demanded from nurse practitioners, physician assistants, pharmacists and other health professionals; the services of these professionals is in great demand but at the same time it is coming under greater pressure and scrutiny than ever before. Nurse practitioners and registered nurses provide the bulk of patient care giving as well play a vital role in supporting the medical practitioners in adequately fulfilling their duties. However, studies have been pointing out for a long time that the work conditions and education requirements for registered nurses are not compatible with the benefits provided to them. Excessive pressure, lack of training, and low compensation are just a few reasons why work satisfaction among registered nurses is low (Albaugh, 2003) as is their motivation for obtaining higher degree in the practice. This is unfortunate as the nurses have an increasing part to play in providing health care services. ‘Advanced Practice Registered Nurses’ (APN) are recognized by the medical community as the emerging group of nursing professionals who are capable of providing care that can be delivered across diverse settings and is at the least equivalent to that of physician-delivered care as regarding safety and quality (O’Grady, 2008). Certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and nurse practitioners (NP) are all recognized under this label. A report from The American Association of Colleges of Nursing in 2006 declared that APN master’s-level programs should ideally have evolved to a doctorate of nursing practice (DNP) by 2015 (O’Grady, 2008). The reality is that while the number of students graduating from advanced nursing programs is increasing, the numbers are still too low to replace the number of faculty who are retiring from the institutes (AACN, 2011). An indepth study by Heather Cathro outlines the reasons for the reluctance of nurses to pursue higher education and the impact of these limitations for the industry. These factors can be summarized as lack of resources such as time and money as well as the perceived mismatch between the efforts and desired outcomes (2011). These reasons are supported by further studies which point out that there is a need for restructuring the compensation tiers in the healthcare industry where equivalent reimbursement should be paid for comparable services regardless of practitioner (Naylor and Kurtzman, 2010). While intrinsic motivation for advancement in career and education is an important factor which can drive professionals towards gaining an additional degree, workplace and institutional support is also required in form of financial, career and emotional support. Nursing practitioners cited “cost”, “family/children” and a “lack of time” as the most likely reasons that they would not pursue a higher degree, (Kovner et al, 2012) any program intended to change the education system must address these issues in order to be successful.  The Institutes of Medicine’s report on the future of nursing gives a few recommendations for how the industry can cope with changing demands and utilize the potential of nursing practitioners. Two of these recommendations tie in directly to the increasing complexity of the job, namely: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020. Double the number of nurses with a doctorate by 2020. This will provide a respite for medical professionals by increasing the pool of skilled workers for the industry and the necessary changes in the support system for nurses will also have an indirect effect by encouraging more young people to enter in the profession. A drastic change in how the traditional health professions education system work will be needed to accomplish these goals including “offering more programs with a focus in nursing education; financial support; flexible program delivery options, including more online graduate programs; mentoring; and collaborations between employers and academic institutions” (Cathro, 2011). While, mobilizing the nurse workforce towards academic achievement will likely require joint efforts from policy makers, educators and administrators throughout the industry (Kovner et al, 2012) individual institutions and organizations can still support the initiative on a case by case basis. Action plan Entry into the medical practice is a stressful experience for many first timers. Nursing graduates report feeling over whelmed and unable to cope with the work load as they transition from being students to being professional nurse (Casey et al, 2004). Feeling discouraged at the very beginning can significantly lower the chances that a nurse would opt to pursue higher studies in their field as it may not seem to be attractive career move. Health care organizations like hospitals and care centers need to provide a system of orientation and support for graduate nurses from the very beginning of their career to ensure motivation levels remain high and undue stress does not prevent them from gaining traction in their career. The hospital management should formally endorse their commitment towards increasing the count of baccalaureate and doctorate degree holding nurses by : Organizing a team of senior nursing staff (holding baccalaureate degree or higher, with work experience of 5-10 years) , working directly under a board member who will collect data about the nursing staff as well formulate the necessary policies and support systems required for the initiative. The team and the initiative will be formally introduced to the entire staff for maximum communication. The team (comprising of 5-7) members will be given a level of autonomy regarding their duties as well as the financial budget to support their policies; they will also act as mentors to the aspiring nurses. The mandate of the team will be to encourage nurses with associate’s and diploma degrees to enter baccalaureate nursing programs within 5 years of graduation by offering tuition reimbursement, and a salary differential and promotion (Naylor and Kurtzman, 2010) that will lower the financial burden for the students. These programs should ideally be rolled out by the next financial year. The same kind of options will also be provided to practitioners working towards doctorates in the field, with additional career support in the form of flexible working times and a guaranteed stipend for the duration of the degree. The promotion and salary differential will also be available to them as well as a further teaching position in the institutes own training programs. The team will also be responsible for creating a culture that indicates a high level of regard for continuing education and makes the professionals comfortable with the idea; the advocacy from senior nurse practitioners can convince a lot of new comers about the benefits of going for the degree. Nursing professionals will be provided with emotional support in form of at least 3 sessions of free education counseling and mentorship if they require it. The importance of the initiative will be communicated openly with all old and new employees through informative pamphlets, an administrative web page and bi-annual seminars. These efforts will be also be conducted by the nursing team. Finally, the team will commence talks about possible partnerships with academic nurse leader, personalities from primary and secondary school systems, and other community organizations to recruit and advance nursing students from diverse backgrounds. (Kovner et al, 2010). Evaluation Plan The success of this plan can be monitored thorough both qualitative and quantitative measures. The biggest indicator of success will be obviously the increase in number of higher degree holders among the nursing staff; however, since this result is time intensive, other tools to measure the effectiveness of the plan can be developed. The idea is that the initiative will not only encourage nurses towards higher education but also provide a more conducive and appreciative work environment for them. For Year 1-3: Bi annual surveys conducted with the nursing staff to gather insights about their reactions to the program and whether it has been personally helpful for them in their career planning, and how it might be modified. A tab on the number of professionals (new recruits as well as old employees) who had approached the nursing team for mentorship and counseling opportunities A tab on the number of professionals who had enrolled in either a baccalaureate or doctorate program and intended to pursue it to completion. Financial forecasts of the cost to the hospital for supporting the students (through salary reimbursement or tuition scholarships) and the benefits to be gained in increased quality of health care and low turnover. For Year 4 and beyond it is expected that the culture of mentorship and support should be fully ingrained into the hospital and being utilized effectively : The surveys to gauge employee reactions should continue but cut down to a detailed yearly survey. Tabs of the number of nursing professionals now with a baccalaureate degree or about to finish their doctorate. Financial reports on the cost effectiveness of the program. This action plan will help the hospital in developing its staff to meet the challenges of the healthcare system that requires increasing specialization from the practitioners. Qualified nurses who are initially well prepared and are given the opportunity to develop professionally throughout their career can have a large positive impact on overall patient care and hospital management should be concerned about providing them the necessary support. References AACN, (2011). Nursing faculty shortage fact sheet. American Association of Colleges of Nursing. Available at: www.aacn.nche.edu/Media/pdf/FacultyShortageFS.pdf Albaugh, J.A., (2003). Keeping nurses in nursing: the professions challenge for today. Urologic Nursing, 2003, 23(3):193-199, PMID:12861736. Cathro, H., (2011). Pursuing Graduate Studies in Nursing Education: Driving and Restraining Forces. OJIN: The Online Journal of Issues in Nursing Vol. 16 No. 3. DOI: 10.3912/OJIN.Vol16No03PPT02 Casey, K., Fink, R., Krugman, M. and Propst, J., (2004). The Graduate Nurse Experience. Journal of Nursing Administration, June 2004, Volume 34, issue 6 , pp 303-311. Japsen, B., (2014). Paging Nurse Practitioners As Demand Soars Under ObamaCare. Pharma and Healthcare, Forbes. Available at: http://www.forbes.com/sites/brucejapsen/2014/06/29/paging-nurse-practitioners-as- demand-soars-under-obamacare/  Kovner, C.T.,  Brewer, C., Katigbak, C.,  Djukic, M. and  Fatehi, F., (2012). Charting the Course for Nurses Achievement of Higher Education Levels. Journal of Professional Nursing, Volume 28, Issue 6 , Pages 333-343, November 2012Top of Form Naylor, M.D. and Kurtzman, E.T., (2010). The Role Of Nurse Practitioners In Reinventing Primary Care. Health Affairs,  May 2010 vol. 29 no. 5893-899. O’Grady E.T., (2008). Advanced Practice Registered Nurses: The Impact on Patient Safety and Quality. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US). Read More