1. Task Force on the North Carolina Nursing Workforce & UNC Response SHEEO Professional Development Conference August 14, 2004 Dr. Alan Mabe Vice President for Academic Planning The University of North Carolina Office of the President

2. 1 UNC-OP Academic Planning/ARM-wmd/02-12-04 Organization and Funding for the Task Force Organized by the North Carolina Institute of Medicine Partners for Organizing the Task Force:  North Carolina Center for Nursing  North Carolina Area Health Education Centers  North Carolina Nurses Association  North Carolina Board of Nursing  North Carolina Hospital Association Funding: Duke Foundation Organized by the North Carolina Institute of Medicine Partners for Organizing the Task Force:  North Carolina Center for Nursing  North Carolina Area Health Education Centers  North Carolina Nurses Association  North Carolina Board of Nursing  North Carolina Hospital Association Funding: Duke Foundation

3. The University of North Carolina Office of the President 2 UNC-OP Academic Planning/ARM-wmd/02-12-04 Composition of the Task Force All segments and stakeholders involved Nurses, doctors, nursing educators, NCCCS, UNC, private colleges and universities, nursing deans, diploma programs, hospital administrators, long-term care facilities, hospital chiefs of nursing, LPN organizations, senators and representatives from General Assembly, NC Health and Human Services, representatives of organizing entities All segments and stakeholders involved Nurses, doctors, nursing educators, NCCCS, UNC, private colleges and universities, nursing deans, diploma programs, hospital administrators, long-term care facilities, hospital chiefs of nursing, LPN organizations, senators and representatives from General Assembly, NC Health and Human Services, representatives of organizing entities

4. The University of North Carolina Office of the President 3 UNC-OP Academic Planning/ARM-wmd/02-12-04 Leadership of Task Force Project Director from NC IOM: Dr. Gordon DeFriese Co-Chairs of Task Force:  Dr. Cynthia M. Freund, Professor and Dean Emerita, School of Nursing, UNC-CH; nursing educator and nurse practitioner in NC  Mr. Joseph D. Crocker, Senior Vice President, Wachovia Bank, hospital trustee; member, NC Medical Care Commission, and past chair, WCU Board of Trustees Workgroup Chairs: :  Nursing Educations Programs: Dr. Gordon DeFriese  Work Environment for Nursing Personnel: Dr. Pam C. Silberman, VP, NC IOM Project Director from NC IOM: Dr. Gordon DeFriese Co-Chairs of Task Force:  Dr. Cynthia M. Freund, Professor and Dean Emerita, School of Nursing, UNC-CH; nursing educator and nurse practitioner in NC  Mr. Joseph D. Crocker, Senior Vice President, Wachovia Bank, hospital trustee; member, NC Medical Care Commission, and past chair, WCU Board of Trustees Workgroup Chairs: :  Nursing Educations Programs: Dr. Gordon DeFriese  Work Environment for Nursing Personnel: Dr. Pam C. Silberman, VP, NC IOM

5. The University of North Carolina Office of the President 4 UNC-OP Academic Planning/ARM-wmd/02-12-04 Registered Nurses per 10,000 Population, US and NC, 1979 to 2002

6. The University of North Carolina Office of the President 5 UNC-OP Academic Planning/ARM-wmd/02-12-04 Licensed Practical Nurses per 10,000 Population, US and NC, 1979 to 2002

7. The University of North Carolina Office of the President 6 UNC-OP Academic Planning/ARM-wmd/02-12-04 Registered Nurses by Basic Nursing Educational Award, North Carolina 2002 N=74,971 Source: North Carolina Health Professions Data System, 2003. Includes active, in-state RNs.

8. The University of North Carolina Office of the President 7 UNC-OP Academic Planning/ARM-wmd/02-12-04 Registered Nurses by Highest Degree Held, North Carolina 2002 N=74,971 Source: North Carolina Health Professions Data System, 2003. Includes active, in-state RNs.

9. The University of North Carolina Office of the President 8 UNC-OP Academic Planning/ARM-wmd/02-12-04 Major Findings While the nursing shortage may not yet be critical, it is very likely, due to the aging of the workforce and the population and to the expected retirement of many nurses in the next few years, to move to the critical stage unless steps are taken immediately. The educational system will need to produce more nurses and educate them to higher levels, with the burden falling on the community colleges and the universities, with some help from private institutions. Employing agencies in the State must address the issue of retention of nurses so that working conditions will support retention rather than inhibit it. Models such as “magnet hospitals” have succeeded in this regard. A combination of expansion of supply and improvement of retention can reverse the trends toward a critical shortage of nurses in North Carolina. While the nursing shortage may not yet be critical, it is very likely, due to the aging of the workforce and the population and to the expected retirement of many nurses in the next few years, to move to the critical stage unless steps are taken immediately. The educational system will need to produce more nurses and educate them to higher levels, with the burden falling on the community colleges and the universities, with some help from private institutions. Employing agencies in the State must address the issue of retention of nurses so that working conditions will support retention rather than inhibit it. Models such as “magnet hospitals” have succeeded in this regard. A combination of expansion of supply and improvement of retention can reverse the trends toward a critical shortage of nurses in North Carolina.

10. The University of North Carolina Office of the President 9 UNC-OP Academic Planning/ARM-wmd/02-12-04 Recommendations Nursing Faculty Recruitment/Retention Nursing Education Programs Transition from Nursing School to Nursing Practice Nursing Work Environment Licensed Practical Nurses (LPNs) and PNE Programs Nursing Assistants (Nurse Aids) Building an Interest in Nursing as a Career Nursing Faculty Recruitment/Retention Nursing Education Programs Transition from Nursing School to Nursing Practice Nursing Work Environment Licensed Practical Nurses (LPNs) and PNE Programs Nursing Assistants (Nurse Aids) Building an Interest in Nursing as a Career

11. The University of North Carolina Office of the President 10 UNC-OP Academic Planning/ARM-wmd/02-12-04 UNC Nursing Programs East Carolina University BSN in Nursing MSN in Nursing Adult Health Nursing Clinical Services Administration Community Health Nursing Family Nurse Practitioner Neonatal Nurse Practitioner Nurse Midwifery Nurse Anesthesia Nursing Education Post Masters Programs Nurse Midwifery Family Nurse Practitioner Nursing Education PhD in Nursing East Carolina University BSN in Nursing MSN in Nursing Adult Health Nursing Clinical Services Administration Community Health Nursing Family Nurse Practitioner Neonatal Nurse Practitioner Nurse Midwifery Nurse Anesthesia Nursing Education Post Masters Programs Nurse Midwifery Family Nurse Practitioner Nursing Education PhD in Nursing Fayetteville State University BSN in Nursing (RN/BSN; joint program with UNCP) BSN in Nursing (BOG approved effective May 20050 NC A&T State University BSN in Nursing NC Central University BSN in Nursing Fayetteville State University BSN in Nursing (RN/BSN; joint program with UNCP) BSN in Nursing (BOG approved effective May 20050 NC A&T State University BSN in Nursing NC Central University BSN in Nursing

12. The University of North Carolina Office of the President 11 UNC-OP Academic Planning/ARM-wmd/02-12-04 UNC Nursing Programs UNC Charlotte BSN in Nursing MSN in Nursing Adult Nurse Practitioner/ Clinical Nurse Specialist Community Health Nursing Family Nurse Practitioner Nurse Anesthesia Psychiatric/Mental Health MSN/MHA Dual Degree Post Masters Programs Adult Nurse Practitioner/ Clinical Nurse Specialist Family Nurse Practitioner Nurse Anesthesia UNC Charlotte BSN in Nursing MSN in Nursing Adult Nurse Practitioner/ Clinical Nurse Specialist Community Health Nursing Family Nurse Practitioner Nurse Anesthesia Psychiatric/Mental Health MSN/MHA Dual Degree Post Masters Programs Adult Nurse Practitioner/ Clinical Nurse Specialist Family Nurse Practitioner Nurse Anesthesia UNC Chapel Hill BSN in Nursing MSN in Nursing Adult Nurse Practitioner Health Care Systems Children’s Health Primary Care–Family Nurse Practitioner Psychiatric/Mental Health Women’s Health Post Masters Programs Adult Nurse Practitioner Health Care Systems Neonatal Nurse Practitioner Pediatric Nurse Practitioner Primary Care–Family Nurse Practitioner Psychiatric/Mental Health Women’s Health Care Nurse Practitioner PhD in Nursing UNC Chapel Hill BSN in Nursing MSN in Nursing Adult Nurse Practitioner Health Care Systems Children’s Health Primary Care–Family Nurse Practitioner Psychiatric/Mental Health Women’s Health Post Masters Programs Adult Nurse Practitioner Health Care Systems Neonatal Nurse Practitioner Pediatric Nurse Practitioner Primary Care–Family Nurse Practitioner Psychiatric/Mental Health Women’s Health Care Nurse Practitioner PhD in Nursing

13. The University of North Carolina Office of the President 12 UNC-OP Academic Planning/ARM-wmd/02-12-04 UNC Nursing Programs UNC Wilmington BSN in Nursing MSN in Nursing Nursing Education Family Nurse Practitioner Western Carolina University BSN in Nursing MSN in Family Nurse Practitioner Winston-Salem State University BSN in Nursing MSN in Family Nurse Practitioner UNC Wilmington BSN in Nursing MSN in Nursing Nursing Education Family Nurse Practitioner Western Carolina University BSN in Nursing MSN in Family Nurse Practitioner Winston-Salem State University BSN in Nursing MSN in Family Nurse Practitioner UNC Greensboro BSN in Nursing MSN in Nursing Nursing Administration Adult/Gerontological Nurse Practitioner Nurse Anesthesia Nursing Education MSN/MBA Dual Degree Programs Post Masters Certificates in Nursing Nursing Administration Nursing Case Management Nursing Education Gerontological Nursing UNC Pembroke BSN in Nursing (RN/BSN; joint program with FSU) UNC Greensboro BSN in Nursing MSN in Nursing Nursing Administration Adult/Gerontological Nurse Practitioner Nurse Anesthesia Nursing Education MSN/MBA Dual Degree Programs Post Masters Certificates in Nursing Nursing Administration Nursing Case Management Nursing Education Gerontological Nursing UNC Pembroke BSN in Nursing (RN/BSN; joint program with FSU)

14. The University of North Carolina Office of the President 13 UNC-OP Academic Planning/ARM-wmd/02-12-04 Distance Learning Nursing Programs Baccalaureate (RN to BSN) FSU/UNCP ECU NCCU UNC-CH UNCC UNCG UNCW WCU WSSU Master’s (MSN) ECU UNC-CH UNCC UNCG Master’s (MPH Nursing) UNC-CH Baccalaureate (RN to BSN) FSU/UNCP ECU NCCU UNC-CH UNCC UNCG UNCW WCU WSSU Master’s (MSN) ECU UNC-CH UNCC UNCG Master’s (MPH Nursing) UNC-CH Moore Pasquotank, Wayne, Online Franklin, Person, Vance, Wake Guilford, Johnston, Montgomery Online Catawba Onslow, Internet Online (fall ’03) Davidson, Rockingham, Rowan, Watauga, Wilkes Online Wake Cabarrus, Gaston, Online Catawba, Online Online Moore Pasquotank, Wayne, Online Franklin, Person, Vance, Wake Guilford, Johnston, Montgomery Online Catawba Onslow, Internet Online (fall ’03) Davidson, Rockingham, Rowan, Watauga, Wilkes Online Wake Cabarrus, Gaston, Online Catawba, Online Online

15. The University of North Carolina Office of the President 14 UNC-OP Academic Planning/ARM-wmd/02-12-04 UNC Nursing Programs UNC Campuses with Nursing Degrees Off-Campus Sites for UNC Nursing Degrees

16. UNC Nursing Enrollment: Degree Credit Headcount, 1990-91 through 2002-03 The University of North Carolina Office of the President 15 UNC-OP Academic Planning/ARM-wmd/02-12-04

17. UNC Nursing Degrees Conferred: 1990-91 through 2002-03 The University of North Carolina Office of the President 16 UNC-OP Academic Planning/ARM-wmd/02-12-04

18. The University of North Carolina Office of the President 17 UNC-OP Academic Planning/ARM-wmd/02-12-04 Proposed UNC Response Expand enrollment and graduates at every level:  Work with campuses to establish enrollment targets  Seek special funding to accommodate enrollment and cost of clinical faculty  Expedite the development of online BSN programs  Add additional BSN programs where justified Expand production of nursing faculty for community colleges and universities:  Increase enrollment in online masters in nursing education programs  Continue expansion of the new doctoral program at ECU  Expedite establishment of doctoral nursing program at UNCG  Support funding for Faculty Fellowship program Expand enrollment and graduates at every level:  Work with campuses to establish enrollment targets  Seek special funding to accommodate enrollment and cost of clinical faculty  Expedite the development of online BSN programs  Add additional BSN programs where justified Expand production of nursing faculty for community colleges and universities:  Increase enrollment in online masters in nursing education programs  Continue expansion of the new doctoral program at ECU  Expedite establishment of doctoral nursing program at UNCG  Support funding for Faculty Fellowship program

19. The University of North Carolina Office of the President 18 UNC-OP Academic Planning/ARM-wmd/02-12-04 Proposed UNC Response Enlist help of AHEC in expanding clinical sites for nurses Expand nursing scholarship program and explore innovative ways to add incentives to enter nursing and remain in the field Work with community colleges and Articulation Committee to solve any remaining problems of articulation:  Expedite the development and expansion of cooperative online RN to BSN degree Nursing deans should explore the transition from education to the workplace to determine whether changes can be made from the educational side to improve the transition Take steps to diversify the nursing workforce Enlist help of AHEC in expanding clinical sites for nurses Expand nursing scholarship program and explore innovative ways to add incentives to enter nursing and remain in the field Work with community colleges and Articulation Committee to solve any remaining problems of articulation:  Expedite the development and expansion of cooperative online RN to BSN degree Nursing deans should explore the transition from education to the workplace to determine whether changes can be made from the educational side to improve the transition Take steps to diversify the nursing workforce