Exploring the role of philanthropy in overcoming a nationwide nurse shortage
Regional One Health Foundation is paving the way for the next generation of nurses by establishing a Nurse Residency Program in conjunction with the University of Memphis. The program was made possible through a generous $40,000 gift from
Anne and John Stokes and the Community Foundation of Greater Memphis. Stokes’ gift was given in honor of Dr. Theresa Richardson for the impact she has made through her work as an inspiring nurse, teacher and mentor to nursing students at the University of Memphis.
The program provides the hands- on training new graduates need to successfully transition from the classroom into patient care. “I often hear residents comment that while school taught them the basic skills they needed, it’s totally different when you enter the ‘real world’ where patients’ lives depend on you,” said Olivia Johnson, Program Coordinator for Regional One Health’s new Nurse Residency Program.
As the demand for healthcare continues to increase, initiatives like the Nurse Residency Program are critical in attracting, retaining and growing the nursing workforce. The American Association of Colleges of Nursing (AACN) recently reported, “The U.S. is projected to experience a shortage of registered nurses that will intensify as Baby Boomers age and the need for healthcare grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform.”
Dr. Lin Zhan, Dean of the Loewenberg School of Nursing at the University of Memphis, commented on the local effects of this projected shortage. “The Bureau of Labor Statistics’ employment projections anticipate 1.1 million job openings for registered nurses and advanced nurse practitioners between 2012-2022. While we now have more than 81,000 registered nurses in Tennessee, by the year 2020 we expect to experience a shortage of about 14,000 nurses.”
There are several factors contributing to the shortage of nurses, according to Dean Zhan. Those factors include:
• Limited capacity in our nursing schools to accept all qualified applicants.
• A high number of registered nurses reaching retirement age.
• High turnover rate of new nursing graduates.
Regional One Health’s new Nurse Residency Program is helping provide a solution to turnover among new nurses. All new graduates hired by Regional One Health are automatically enrolled in the 12-month program. The inaugural class, which kicked off in July, includes 19 new graduates, while a second class began in November with 11 nurses enrolled.
The extensive program consists of a series of learning and work experiences designed to assist recently graduated nurses in the transition to their new patient care responsibilities. Residents are assigned a mentor and participate in guided clinical experiences and debriefing sessions to talk about and learn from situations they’ve encountered on the job.
“By investing in these graduates, we have a group of passionate and well- prepared nurses that transition well into their profession, making them much more likely to stay at Regional One Health,” said Pam Castleman, Senior Vice President and Chief Nursing Officer at Regional One Health. “They are very willing to be involved in improving their environment. They are very active on committees and their commitment to the organization has substantially improved. They become leaders in their units due to the experiences they’ve had. They quickly assimilate into more of a leadership role and sometimes become teachers for future nurses. As this level of commitment is passed down, we are ensuring future generations of nurses are confident and committed to the highest quality of patient care.”
Graduates are engaged and enthusiastic about the program.
There is evidence that nurse residency programs contribute to a reduction in turnover rates. Participants in a one- year post-baccalaureate nurse residency program developed by the University Health System Consortium and the American Association of Colleges of
Nursing showed improved communication and organization skills, less stress, higher perceived levels of support and lower turnover rates, according to the Journal of Nursing Administration.
“A major goal for the program is to eliminate costly turnover among new graduates,” said Program Coordinator Olivia Johnson. “Of the 54 graduates hired in 2013, almost 10 percent (five) left within the first year.
At a cost of $23,000 to replace each nurse, the program would have saved more than $100,000 if the graduates had received the training and mentorship they needed and decided to stay.”
The success of the program will also be measured by two assessments that participants will complete at the beginning and end of the program to measure improvements.
1. The Basic Knowledge Assessment Tool (BKAT) measures the participant’s basic knowledge in critical-care nursing.
2. The Casey-Fink Graduate Nurse Experience Survey gives nursing students a voice to express the difficulties they experience while adjusting to their roles in the acute care setting in order to advance their contributions as healthcare professionals.
“When we hear from participants that we have given them the resources that equipped them to grow as professionals and provide competent, quality patient care – the whole reason we are here – we will know we have been successful,” said Johnson.
Other ways Regional One Health is addressing costly turnover
Continuing education also plays a key role in addressing turnover and improving patient outcomes. Regional One Health’s Professional Accountability and Clinical Excellence (PACE) program encourages and supports nurses in obtaining their next-level degree. The program provides a clear career path to advance to the next level of education and obtain additional certifications. When requirements are met, nurses are reimbursed for certifications. As their levels of education increase, so does their pay, furthering their incentive to stay with the Regional One Health system.
Tuition reimbursement and flexible scheduling also help facilitate access to education programs. “A study released by Dr. Linda Aiken, Director of the Center for Health Outcomes and Policy Research, shows a strong link between RN education level and patient outcomes,” said
Betty Nelson, Vice President of Quality Improvement at Regional One Health. “The cited nurse researchers found that every 10 percent increase in the proportion of nurses with a bachelor of nursing
(BSN) degree on the hospital staff was associated with a four percent decrease in the risk of death.”
A team interview process addresses costly turnover by helping to ensure new hires are a good fit. As part of the hiring process, Regional One Health uses an interview approach that allows current staff to be actively involved in ensuring the best fit is hired to join their teams, those who share their passion for the vision and the mission of Regional One Health.
A shared governance program provides Regional One Health nurses autonomy over their professional practice decisions, making them part of decisions at the unit level. “It’s very important for nurses to have a voice in their practice by sharing their ideas,” said Castleman. “We get our best ideas from this process. Who better to know what will or won’t work than the ones at the bedside of our patients, day in and day out?”
All of these efforts to improve the quality of patient care and reduce nurse turnover take Regional One Health a step closer in the journey to becoming a Magnet hospital, the ultimate credential for high- quality nursing. The Magnet Recognition Program recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice.
Through generous gifts from our supporters, Regional One Health Foundation will continue to fund programs like these that help put highly-trained medical professionals in place to save the lives of even more mid-southerners. Who knows, the life they save just may be yours.