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Maryland Statewide Commission on the Crisis in Nursing Update and Future Directions June 5, 2002.

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Presentation on theme: "Maryland Statewide Commission on the Crisis in Nursing Update and Future Directions June 5, 2002."— Presentation transcript:

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2 Maryland Statewide Commission on the Crisis in Nursing Update and Future Directions June 5, 2002

3 Legislated Charge  Convene Summit “Do something”

4  “Do something” COMMISSION

5  “Do something” Subcommittees Formed Education Recruitment Retention Workplace Issues  Refined Commission Structure  Vice Chairs’ Leadership  Keeping Nurses Informed

6 Registered Nurses - Active Licenses* *Registered Nurses - Maryland Addresses Only

7 Licensed Practical Nurses-Active Licenses* *Licensed Practice Nurses with Maryland Addresses

8 RNs By Age Groups

9 LPNs BY AGE GROUPS

10 Inactive Licenses by Age 2001

11 Newly Licensed RNs by Type

12 Number of Newly Licensed RNs by Age

13 Workforce Diversity 2001 RNs 5% Males 24% Minority LPNs 11% Males 50% Minority

14 Admissions Registered Nursing Programs

15 Graduations Registered Nursing Programs Baccalaureate totals include RN to BSN students

16 Practical Nursing Programs Admissions & Graduations

17 Places of Employment - RNs

18 Places of Employment - LPNs

19 Statewide Commission on the Crisis in Nursing Solving the Nursing Shortage Recruitment  Collaborate to Recruit Image Web—disseminate Information Tool Kit Development Education Education Processes Scholarship & Financial Aid Finance & Marketing Mentoring Retention Adequate & Flexible Staffing Protocols Communication/respect/ Recognition Competitive Compensation & Flexible Benefits Workplace Issues Stress in the Workplace Clinical Practice Delivery Models & Quality of Care Regulatory Issues Participate in Decision Making  Scheduling & Lifestyle Issues Commission

20 Chair: Ann Possidente Vice Chair: Debra B. Doyle Recruitment Subcommittee

21 Recruitment – Summit 1. Poor public and media image Women’s profession What do nurses do? Promoted to middle & high schoolers as job vs career

22 Recruitment – Summit 2. Hospitals are a business 3. Lack respect as a profession by the public and among nurses

23 Maryland Commission on the Crisis in Nursing Project a more positive and professional image of nursing Attract middle and high school students into nursing as a career

24 Our Charge Develop statewide campaign Promote nursing as worthwhile career

25 Who are we trying to attract & retain? What is the competition doing? What do these coworkers want/value? What should we do?

26 The Nursing Profession’s Future 11 Y.O. 21 Y.O. 30 Y.O. Middle School 1) Students 2) Parents High School College 1) Non-Nsg Students 2) Nsg Students “Second Career” 1) People desiring a second career Nurses 1) Current Nurses Expected Outcomes: Understand current perceptions of the nursing profession Attract more students into the nursing profession

27 Recruitment—Middle/High Schools Participants N = Viewed Nursing as technical as opposed to professional (like a “shop”) 2. No Career advancement—58.7% 3. Unsure of “what it takes to become an RN” Educational requirements Differences in 2yr vs. 4yr programs

28 Recruitment—Middle/High Schools 4. “Scary” job with life and death decisions 5. Job security Computers and teaching “sure bet” If cut Medicare, hospitals will close 24.1% 6. “Girls” job %

29 Recruitment—Middle/High Schools 7. Wearing a uniform—unappealing 8. Unfavorable hours & tasks (work weekends and holidays) 9. Stressful—watching people die

30 Recruitment Subcommittee Accomplishments Nursing Image Videos Resources Library (www. marylandhealthcareers.org) Web Site Developed through MHA (www. marylandhealthcareers.org) & (mbon.org) Information for parents, teachers, students Facts about nursing, scholarships Hyperlinks to other nursing information

31 Recruitment Subcommittee Accomplishments Legislative Shadow Program Tool kits (middle and high school students, counselors, teachers and Parents) Student Volunteer Program Speakers Bureau Listening to constituents

32 Recruitment Subcommittee Accomplishments Working with Education Subcommittee on the best approach for recruiting faculty Healthcare settings to find clinical rotations

33 Ann Possidente, Chair Mona Bahouth Carolyn G. Baker Susan Battistoni Mary L.Beachley Sharan Lee Bidle Justin Bishop Jean L. Bridle Barbara Marx Brocato Melissa A. Brodeur Trena Brown Linda Brown-Sutphin Kathryn Buffington Ann T. Bures Debra B. Doyle, V.Chair Ann Byrne Martha R. Caputo Amy Chi Virginia R. Clark Harold Cohen Robb Cohen Carol Costante Judith Covich Frances Crites Catherine Crowley Regina M. Curran Parker David Jack Davisdon Mary H. Deeley Lynn M. Derrickson Mae Esh Jeffrey Friedman Susan E. Gibson Robyn Gilden Bruce N. Griffin Dorna P. Hairston Kathryn V. Hall John A. Harris Cheryl Heilman Sharon Hobson Mary Cathryn Hoffman M. Theresa Hommel Kay Hoskinson Recruitment Subcommittee Volunteers THANKS!

34 Recruitment Subcommittee Members Wayne Howard Cecelia Hughes Lorraine Hughes-Girandola Joan Humlock Emeka Ifemeje Linda Janzik Seth Johnson Stephanie Jourdan Laura L. Katz Kathy Kemper Lisa Lambert Lena Lee Fran Leibfreid Romona Lewis Amy L. Lohfield Montgomery Barbara Luminella Susan Lynott Kim Kathryn Lothschuetz- McCarron Christina McGann Janet Melson Fran Miller Berta R. Mitchell Donna Mueller Dawn Nally Kathleen N. Neely Jack Neil Matt Neiswanger Lola Null Kathleen Ogle Lisette K. Osborne Marc Palovitz Yvonne Paraway David Parker Karen M. Parrotte Karen C. Poisker Constance M. Pryor Jennifer B. Rainer Ann Regier Hope Ripkin George Rose Sharon M. Rossi Peter Russell Stephanie L. Sand Pat Saunders THANKS!

35 Amy Schaefer Carol Schatzman Mary Schriver Lisa Seldomridge Lynn Z. Sklar Jeanne Smoot Karen Sullivan Vicki L. Taliaferro Marion Taylor Lisa Tenney Lana Thomas Tammy J. Thompson Mary R. Towe Denise Tucker David Uhlfelder Recruitment Subcommittee Members Laura Van Syckle Lisa Wade Maureen Wakefield Mary Lou Watson Elizabeth Weglein Carol Wiggins Erica Williams Evelyn S. Wilmer Pat Wilmsen Bonnita D. Wilson Mark Woodard Emmaline T. Woodson Rhonda Wyskiel Gary Yakimov THANKS!

36 Recruitment Subcommittee Get involved We welcome additional volunteers Access the Maryland Board of Nursing (mbon.org)

37 Workplace Issues Subcommittee Chair: Donna Wilhelm Vice Chair: Maria Koszalka

38 Workplace Issues Subcommittee Members Micaela, M Aigner-Jacobs Nancy Allen Loretta Beckman Stephanie Bernard Susan D. Boettger Judith E. Breitenbach Jean L. Bridle Melissa A. Brodeur Deneen brown Angela T. Burden Ann Byrne Rosalyn G. Carter Filissa M. Caserta Phyllis Cassidy April C. Chase Nalini Cherian Deborah L. Chesser Virginia R. Clark Janet Cogliano Robb Cohen Harold Cohen Stacey M. Cook Catherine Crowley Regina M. Curran Carol A. Curran Donna Damico Sandra L. Dearholt Mary H. Deeley Connie A. Dennis Mary Dent Carole Derck Sarah S. Detmer Dottie Devine Sallie Dicus Elizabeth Ann Evins Beverly S. Francis Susan E. Gibson Beverly B. Goldsmith Sheila Greenwood Catherine M. Griswold Larry L. Grosser Beverly S. Guy Kathryn V. Hall Sharon G, Hameroff Elise Handelman Janet Holly Hoppenstein Ellen L. Horowits Kay Hoskinson Belinda D. Houston Paula A. James S. Nooshin Javan Michael Jenifer Sharon A. Johnson Seth Johnson Keith Jones Judith Karp Silvie Kassar Laura L. Katz Jack C. Keane Juanita Kennedy Vicky P. Kent Kathie Kloch Maria V. Koszalka Dina A. Krenzischek Pamela E. Kumar Mary J. Larkin Sandy Levy Mary A. Linton Kathryn Lothschuetz- Montgomery Sandra Lucci Suzan Lundy Marsha Marcus W. Christin McGann Kate McPhaul Judith Meyers Barbara Anne Miklewski Linda A. Miles Sharon Millar Linda Miller Berta Z. Mitchell Harriett Moore Toni Moore-Duggan Dawn Nally Moira Namuth Sandra Natolly Victoria B. Navarro Kathleen N. Neely Jack Neil Lois H. Neuman Robin Purdy Newhouse Catherine S. Novak Linda O'Hara Joann Oliver Carolyn R. Overcash Vanessa R. Pierre Carol Portner Curtis Price

39 Workplace Issues Subcommittee Members (cont.) Constance Sumpter Sandra Sundeen Cecile E. Sutherland Carol Swartz Tami W. Swearingen Irene Taylor Lana Thomas Tammy J. Thompson Lynn Z. Sklar Dianne C. Smith Lucie Smith Regina Smith-Yurek Annette E. Snyder Joan M. Spear Denise Stanback Cathy Stonebraker Eleanor Walker Joan Humlock Mary Zohlen Barbara Watts Patricia Watts-Kelley Beverly A. Wehmer Donna Wilhelm Erica Williams Marisa Wilson Helen Jane Wobbeking Heather Yockey Gloria Zarlenga Karen Tipton Cathy Toepfner Janis Trainor Denise Tucker David Uhlfelder Brenda Vitucci Maureen Wakefield Florine Marshel Delores M. Puno Donna Raimondi Ann Rasenberger Anne E. Rehfegd Robin H. Reid Susan Reiman Tina Roach George Rose Arlene Marie Rosen Stephanie L. Sand Genene Saxton Judy J. Schuur Ernestine Scott Carol Sheehan Denise Singleton Dawn Strecker Karen Sullivan

40 Workplace Issues Subcommittee Initial Charge Identify workplace issues causing nurse dissatisfaction Recommend ways to improve nurses’ work environments

41 Nurse Dissatisfaction Issues Identified Scheduling and Life Style Mandatory overtime Flexible scheduling On call Child care/sick child care Reassignment Scheduling Women-friendly issues Age appropriate assignments

42 Nurse Dissatisfaction Issues Identified Professional environment Difficulties with delegation Physician collaboration Autonomy Respect Agency nurse accountability/autonomy Skill mix LPN scope of practice Difference in practice settings

43 Nurse Dissatisfaction Issues Identified Regulatory Scope of practice for techs, extenders, etc Documentation requirements LPN scope of practice Inconsistent regulation for providers in different settings

44 Nurse Dissatisfaction Issues Identified Clinical Practice Delivery Model/ Quality of Care Nurse-patient ratio Quality of care Skill mix

45 Nurse Dissatisfaction Issues Identified Stress in the workplace Public expectations Support services Occupational health issues Self-care Injury protection Safety/violence/abuse

46 Workplace Issues Subcommittee Accomplishments 1.Survey validated nurses’ issues & concerns 2. Paper written that identified: Scope of the problems Impact on quality of care Strategies to address identified concerns

47 Workplace Issues Subcommittee Accomplishment 3.Developed Concept Paper to Support Legislation Mandatory overtime Whistleblower protection Nurses participating in organizational policies 4. Impact on Legislation-all legislation passed HB Healthcare Whistleblower Protection Act SB Nurses Involuntary Overtime Prohibition HB 590/SB 46 - Study of the Use of Technology to Assist Nurses in Caring for Patients 5. Established Workplace Subgroup to Address T echnology Issues

48 Next Steps 1. Address the following topics: Review information obtained from nursing survey to determine which areas of focus 2. Other areas to address are: Stress in the workplace Technology issues- Professional environment Regulations Clinical practice delivery model/quality of care 3. Respond to legislative updates to current legislation HB 329, SB 537, & HB 590/SB 46

49 Maryland Board of Nursing Website (Http://www.mbon.org) For Upcoming Meeting Dates and Locations

50 Workplace Issues Subcommittee Nursing Technology Workgroup Chairperson: Maria Koszalka

51 Nursing Technology Workgroup Committee Members Maria Koszalka Chairperson Mary Beachley Stephen Buckingham Bycoffe Marcia Robert Cohen Ernestine Cosby Brian Gugerty Toni Hughes Terry Herbert Dina Krenzischek Janet Marron Carol Mariglia Pat Maher Linda Miller Sandra Natolly Susan Newbold Carol Sheehan Mary Lou Watson Marisa Wilson

52 Nursing Technology Workgroup Initial Charge HB 590 – Taskforce to Study the Use of Technology to Assist Nurses in Caring for Patients Technological applications MUST: Maximize nursing productivity Increase quality of patient care Improve work environment infrastructure in health care settings

53 Nursing Technology Workgroup Purpose Establish Workplace Issues Taskforce Identify technology driven point of care applications Consultation with technology driven point of care application experts

54 Nursing Technology Workgroup Accomplishments Goal statements developed to support nursing practice through technology: Systems functional for nurses Maximize nursing time Maximize patient safety Bar coding standardized to support technology Reports allow for data extraction & electronic transferal Programs maximize information sharing via web-based technology

55 Nursing Technology Workgroup Accomplishments- Goal Statements ( continued) Hard and software adaptable to nursing workflow Nursing staff participate in hardware selection Clinical staff involved in development of clinical data base Acceptance of technology by nurses UAPs by on- the-job training (mandatory competency) Technology competency education supported by administration Basic informatics training occur in nursing education programs

56 Nursing Technology Workgroup Expected Outcomes How will information be used? Direct policy development Investigate funding for developing specific technology Develop criteria/parameters for selecting technology Healthcare organizations use criteria to select technology Develop resource manual

57 Nursing Technology Workgroup Expected Outcomes References will be developed to include Criteria for selection of information, clinical, robotics technology Information to determine benefits of integrated versus “best of breed” systems Recommendations for selection of basic technology required to provide safe nursing care Data on technology that support nursing practice

58 Nursing Technology Workgroup “ Big Impact” Focus: Support nursing practice and enhance patient safety Provider Order Management Electronic medical record Supported by: Leapfrog organization IOM report Professional nursing organizations

59 Nursing Technology Workgroup Next Steps Representation from Acute care hospitals Nurse managers IS Staff nurses Third party payer MNA Need representation LTC Home care Ambulatory Department of Health and Mental Hygiene IS nurses in clinical setting

60 Nursing Technology Workgroup Next Steps Develop: Criteria to evaluate technology (cost- benefit) Recommendations for basic technology required to provide nursing care List of technology currently used (survey)

61 Retention Subcommittee Chair: Jeff Jefferies Vice Chair: Nancy Dianis

62 We want to Thank our Volunteers Ruby AndersonGloria BarlowAnne BilderbackBramblee Bird Lorna BranchJean L. BridleAudrey ByrdTimothy Carey Amy ChiPat CimnoSandy CohenRobb Cohen Catherine CrowleyRegina M. CurranMary Kay DemarcoSarah S. Detmer Donna M. DorseyJoyce EmerickJill L. EnglandJoanne Evans Rebecca FaughanderJane H. FlowersSusan GibsonKathryn V. Hall DeLois G. HamiltonElise HandelmanElaine J. HolmanMike Holy Bernice HughesJeannette JefferiesBonita E. JenkinsH. Scott Johnson Susan KalaineTheresa A. KapetanovicJack KeaneEileen Lacijan Diane LiebeskindDora Long“Ski” LowerSandra Lucci Florine MarshelCarol MarsigliaSuellyn MasekChristina McGann Judith McMillanGrace McNealElaine MennitoSteve Morrison Rosemary MortimerDonna MuellerPat MynarskiKathy Neely Bonnie NeibauerBette NunnBette Carole O’ConnorLeigh Pancoast Julia PannellKaren M. ParrotteJanet Passley-HarpTina Patrico Anne E. RehfegdTina RoachDeborah L. RoyaltyM. Judith Rudell Vicki RyanValerie ShearerCarol SheehanLeslie R. Simmons Lynn SklarDean SmithDawn SteckerKaren Sullivan Constance SumpterCecile E. SutherlandIrene TaylorMary R. Towe David UhlfelderDiane WalbridgeJan WattsElizabeth Whiting Carol WigginsDonna WilhelmMark Woodward

63 And a Special Thanks to Our Co-Chair: Nancy Dianis

64 Retention Subcommittee Initial Charge Review data that describes nurse retention issues Explore compensation as a nurse retainer Explore aspects of professional development as a nurse retainer

65 Retention Subcommittee Recommendations Total Compensation Guiding Principals: – Flexible and possibly transferable – Reduce salary compression – Review of salaries at specified intervals – Benefits menu – developed with RN input – Benefits reviewed annually – Career development plan – Non-selected benefits reinvested by RN into – additional educational days, retirement account, etc.

66 Retention Subcommittee Recommendations “Holistic” Compensation Models by Generation – 401 (k) – Medical Coverage – Pension – Clear sense of Organizational purpose – Compensation that grows with the RN

67 Retention Subcommittee Recommendations Career Path Development Within current workplace Across healthcare organizations Coaching/mentoring Work Place Safety Create safe environment Create resources for RN to handle safety issues (threatening behaviors, verbal and physical abuse)

68 Retention Subcommittee: the Next Steps Create a “product” that represents the compensation package recommendations Written information disseminated to stakeholders – Create a “tool kit” to be used for presentations – Create materials focused on each stakeholder – Hold compensation forums to present information – Include total compensation package information in the Commission’s Annual Report – Design a “Nurses Compensation Hot-Line” via web or phone that provides nurses with a venue to learn about compensation and to ask questions

69 Retention Subcommittee: the Next Steps Develop plans to overcome barriers to a comprehensive compensation plan Develop Career Path options Explore Nursing Care Delivery Systems – to enhance the work environment Encourage participation of RN volunteers to develop these programs

70 The Education Subcommittee Report Chair: Patricia Watts-Kelley Vice Chair: Peggy Soderstrom

71 The Goals of the Education Subcommittee Facilitate the education of qualified individuals Ensure that pool of qualified, accessible nurses continues to alleviate the existing void Prepare future nurses with the competency based skills to meet the healthcare needs

72 Background Working groups of the Subcommittee Education Financial Mentoring Faculty

73 Background Working groups of the Subcommittee Education Financial Mentoring Faculty

74 Accomplishments to date Scholarship legislation Financial assistance enhances many students’ ability to finish a nursing program often leading to early entry into the workforce Measuring successful completion outcomes (Scholarships are a crucial factor) Supported an increase in funding of the nursing scholarship to include all eligible students

75 Work Priority Fall 2001 Identify a credible method for determining the number of nurses needed to meet the healthcare needs of Maryland’s citizens Explore an accurate method to measure need related to demand Develop outcome-based recommendations to address the nursing shortage

76 On Going Work-Outcomes Developing a forecasting model A credible method to calculate the number of nurses needed Project the supply and demand/need Analyze trend data Use forecasting model for future educational adjustments

77 Forecasting Model Forecasting Model Estimates the future supply of nurses Forecasts the size, the age and the educational level of the nursing workforce New graduates are added, as well as in-migration Predicts impact of retirements, deaths and out- migration of experienced nurses

78 Present Data Collection Occupational Projections of RNs, LPNs and nursing faculty Nursing student enrollment (LPN, AD, BSN, Advanced degrees) Faculty Salaries Preliminary data analysis indicate a widening of the gap between clinical service and faculty salaries 2002 year first time licensure exam takers RN & LPN candidates

79 Monitor, Evaluate, Revise What is succeeding? What can be improved upon? What additional issues and areas need to be addressed?

80 Future Work Diversity (geographic, ethnic, cultural, physiologic, and gender) Questions for future consideration are: What is the extent of the need for a more diverse nursing faculty? How do nursing educators address the needs of diverse students?

81 PamelaAmbush Lynda A.Bartko Madeliene Becker Rosemarie O.Berman Sharon L.Bernier TeresaBianco Barbara Marx Brocato Trena Brown Martha R.Caputo Virginia R.Clark Mary Clisham Robb Cohen Harold Cohen Frances Crites Catherine Crowley Regina M. Curran Barbara P. Daniel Mary H.Deeley Thomas James DeGraba Rosie Delegrotti Mary Dent Carol G.Dignon Elizabeth Dunne Eugenie J.Dunnells SandraDunnington Linda Epstein Judith Feustle Jane Garvin Susan E.Gibson Bruce N.Griffin Kathryn V.Hall Donna Helfferich Gertrude T.Hodges Janice Hoffman DorothyHolley Marie T.Holley Robyn E.Holley Education Subcommittee Members Thank YOU Ellen L. Horowits Kay Hoskinson M. Patricia Howard Joan Humlock S. Nooshin Javan Bonita E. Jenkins Beth Jernigan Seth Johnson Kathleen Jones Johnnye S. Jonhson Goar Karami Silvie Kassar Laura L. Katz Barbara H.Kemerer Cynthia E.Kielinen Michael Kiphart Kathryn Lothschuetz- Montgomery Sandra Lucci Susan Lynott Erin Marek Denise Marshall Joyce B. McAdoo Blanka McClammer Christina McGann Judith McMillan Cheryl McNamara Grace McNeal Earlene B. Merrill Fran Miller Nancy Monahan Toni Moore-Duggan Rosemary E. S. Mortimer Marion Mulholland Robert Murray Dawn Nally Sandra Natolly

82 Thank YOU Members Kathleen N. Neely Jack Neil Ronnie Netteburg Jean Nichols Janice Oliver Kathleen Parsons Edith Patten Carol Bryant Payne Lesley Perry Nayna Phillipsen Karen C.Poisker Barbara C.Poniatowski Ann Possidente Constance M. Pryor Ann Rasenberger Robin H. Reid Bernadette Rock Stephanie L. Sand Georgeanne C. Santolla Amy Schaefer Terri Schreyer Marge Schueler Judy J. Schuur B. Joan Scott Lisa Seldomridge Valerie Shearer DarleneShoemaker Dianne C. Smith Peggy Soderstrom Karen Sullivan Sandra Sundeen Lana Thomas Tammy J.Thompson PatriciaTravis EleanorWalker Robin Wantz Joan Warren Jan Watts Elizabeth Weathington Anna White Carol Wiggins Erica Williams Karen Wons

83 Please Join Us !!! questions about subcommittee activities Check the MBON website for meeting schedules and subcommittee Volunteer Form mbon.org

84 Major Focus Education Subcommittee MORE Students Faculty Scholarships Basic Graduates

85 Major Focus Recruitment Subcommittee Collaborate! Collaborate! Collaborate! Youth Help from nurses and nursing students Develop recruitment tools

86 Major Focus Retention Subcommittee Value nurses Respect nurses Take control of career

87 Major Focus Workplace Issues Give nurses their “due” Acknowledge Needs Fears Lifestyle

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89 Thanks VOLUNTEERS!

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