Developing an Educational Pipeline for Public Health Nursing Cherie Rector, PhD, RN, PHN Kathleen Gilchrist, PhD, FNP-C, CCRN, RN, PHN California State University, Bakersfield

Focus Ethnically diverse, disadvantaged K-12 students in Southern San Joaquin Valley, California Ethnically diverse, disadvantaged K-12 students in Southern San Joaquin Valley, California Bakersfield (Kern) & Visalia (Tulare) Bakersfield (Kern) & Visalia (Tulare) One component of a larger grant program One component of a larger grant program Funding Source: Funding Source: HRSA Nursing Workforce Diversity Grant # #D19HP

About Us---Kern Co. Ethnically diverse; High poverty; High joblessness; Agricultural area Ethnically diverse; High poverty; High joblessness; Agricultural area High Schools High Schools 48% Hispanic (Kern Co.) 48% Hispanic (Kern Co.) 51% Hispanic (Tulare Co.) 51% Hispanic (Tulare Co.) Over 8,000 square miles Over 8,000 square miles 42% rural; 84 persons/square mile 42% rural; 84 persons/square mile Almost 40% of residents < 18 yrs. Almost 40% of residents < 18 yrs.

More Kern County Info Medically Underserved Area Medically Underserved Area RN Rate 407 (California has 619) RN Rate 407 (California has 619) Economically & Educationally Disadvantaged Economically & Educationally Disadvantaged Only 13.5% of residents have College Degree (California is over 25%) Only 13.5% of residents have College Degree (California is over 25%) CSU Bakersfield is only university for 110 miles; Hispanic Serving Institution CSU Bakersfield is only university for 110 miles; Hispanic Serving Institution Almost 40% of 1st time Freshmen require remediation in Math &/or English Almost 40% of 1st time Freshmen require remediation in Math &/or English

Nursing Shortage RN shortage continues, despite growth of Nursing School admissions RN shortage continues, despite growth of Nursing School admissions HRSA projects shortage of 1,000,000 by 2020; Auerbach study says 340,000 HRSA projects shortage of 1,000,000 by 2020; Auerbach study says 340,000 Auerbach, D. (Jan/Feb, 2007) Health Affairs. Auerbach, D. (Jan/Feb, 2007) Health Affairs. BSN enrollment >7.6% in 2006 over previous year (still not enough to meet projected needs) BSN enrollment >7.6% in 2006 over previous year (still not enough to meet projected needs) AACN, October 2007 AACN, October 2007

Affects on Public Health Nursing Competition with Acute Care Competition with Acute Care About 118,000 RNs needed to fill openings About 118,000 RNs needed to fill openings Many offering high salaries & signing bonuses, other perks Many offering high salaries & signing bonuses, other perks AHA, 2007 Public Health Public Health Affected by overall shortage, poorly funded system, noncompetitive salaries, overlooked & not well known Affected by overall shortage, poorly funded system, noncompetitive salaries, overlooked & not well known QUAD Council; February, 2007

The Reality The Reality Difficult to compete with Acute Care Difficult to compete with Acute Care Signing Bonuses Signing Bonuses Immediate Benefits Immediate Benefits Tuition Forgiveness Tuition Forgiveness Off-Shift/Weekend Bonuses Off-Shift/Weekend Bonuses Referral Bonuses Referral Bonuses

Innovative Ideas Needed We need to gain a ‘market share’ We need to gain a ‘market share’ How do we get our message out there? How do we get our message out there? We need to ‘sell’ Public Health Nursing We need to ‘sell’ Public Health Nursing Need to begin early Need to begin early

‘Selling’ PHN ‘Selling’ PHN Johnson & Johnson’s Johnson & Johnson’s The Campaign for Nursing’s Future The Campaign for Nursing’s Future U of Illinois, Chicago U of Illinois, Chicago Posters for PHN Posters for PHN

Marketing PHN “Strategic Marketing attempts to determine how an organization competes against its competitors in a market place. In particular, it aims at generating a competitive advantage relative to its competitors.” Wikipedia, 2007 “Strategic Marketing attempts to determine how an organization competes against its competitors in a market place. In particular, it aims at generating a competitive advantage relative to its competitors.” Wikipedia, 2007 Competitive Analysis---note strengths & weaknesses of PHN/RN Competitive Analysis---note strengths & weaknesses of PHN/RN

Basics Know your market Know your market Adolescents, college students, etc. Adolescents, college students, etc. Know what they want Know what they want Education, ‘things’, connection Education, ‘things’, connection Timing is essential (interest) Timing is essential (interest) Messenger that can relate Messenger that can relate Clear, Concise Message Clear, Concise Message Personal Connection (stories) Personal Connection (stories)

Our Goal Increase awareness & interest in Nursing (& PHN) among ethnically diverse/disadvantaged K-12 students Increase awareness & interest in Nursing (& PHN) among ethnically diverse/disadvantaged K-12 students

Educational Pipeline Health Careers Academies (350) Health Careers Academies (350) Two large area high schools (Bakersfield, Visalia) Two large area high schools (Bakersfield, Visalia) Active, longstanding programs Active, longstanding programs RN Explorer Post (100) RN Explorer Post (100) Newly organized, sponsored by STT, hospitals, other agencies (Bakersfield) Newly organized, sponsored by STT, hospitals, other agencies (Bakersfield)

Health Careers Academies Guest speakers; Information on Health Careers; Learn Skills Guest speakers; Information on Health Careers; Learn Skills Emphasize basic skills needed for college entry & success Emphasize basic skills needed for college entry & success Courses: medical terminology, anatomy, advanced math/science, English, computer skills, etc. Courses: medical terminology, anatomy, advanced math/science, English, computer skills, etc. Presentations & Projects Presentations & Projects

More on HCAs… Partner with Agencies to offer: Partner with Agencies to offer: Internships Internships Job Shadowing Job Shadowing Advising & Program Planning Advising & Program Planning Volunteering Volunteering Mentors; some find part-time work locally in healthcare field Mentors; some find part-time work locally in healthcare field

RN Explorer Post Boy Scouts of America Boy Scouts of America Sponsoring agency, other partners Sponsoring agency, other partners Donations to cover costs, scholarships Donations to cover costs, scholarships Lectures & presentations Lectures & presentations Ethical issues, personal growth, HC jobs & education required Ethical issues, personal growth, HC jobs & education required Field trips (UCLA, Children’s Hospital) Field trips (UCLA, Children’s Hospital)

Grant Activities--HCAs Campus Tours (Nursing Presentation) Campus Tours (Nursing Presentation) Pizza or Cookies/Punch Pizza or Cookies/Punch Faculty Outreach Presentations Faculty Outreach Presentations Videos, Discussions, Q & A Videos, Discussions, Q & A “Public Health Nursing--It’s For You” “Public Health Nursing--It’s For You” Minnesota Department of Health Minnesota Department of Health Presentations by Graduates, others Presentations by Graduates, others Intensive Advising & Availability Intensive Advising & Availability Support (supplies/teaching materials) Support (supplies/teaching materials)

Reaching Downward HCAs Given Information on (HRSA) “Kids Into Health Careers” HCAs Given Information on (HRSA) “Kids Into Health Careers” HCAs presented information to K-8 HCAs presented information to K-8 Some as part of other K-6 Health Presentations (tobacco, fitness, etc.) Some as part of other K-6 Health Presentations (tobacco, fitness, etc.) Others as part of HCA Recruitment Presentation to 8th graders Others as part of HCA Recruitment Presentation to 8th graders

Golden West High School

HCA Results Over 1800 K-8 students were given information about nursing & Over 1800 K-8 students were given information about nursing & Kids Into Health Careers Kids Into Health Careers CSUB BSN class entering F/06 CSUB BSN class entering F/06 9% graduates of East High School 9% graduates of East High School One GWHS graduate applied One GWHS graduate applied One GWHS graduate on campus, enrolled in prerequisites at CSUB One GWHS graduate on campus, enrolled in prerequisites at CSUB

More HCA Results… East High School East High School Male Student interest in RN Male Student interest in RN > expressed interest in Nursing > expressed interest in Nursing Golden West High School Golden West High School 10 students entering nursing 10 students entering nursing 5 students entering other HC fields 5 students entering other HC fields

Program Activities: RN Explorers Faculty Mentor; Nursing Students Faculty Mentor; Nursing Students Monthly meetings Monthly meetings Tours of hospitals, other agencies Tours of hospitals, other agencies Nursing Skills demonstrations Nursing Skills demonstrations Videos (including PHN video) Videos (including PHN video) Presentations by local nurses, nursing students, & other health care professionals Presentations by local nurses, nursing students, & other health care professionals Yearly field trip (UCLA, Children’s) Yearly field trip (UCLA, Children’s)

RN Explorer Post RN Explorer Post

Outcomes of RN Explorers One student entering BC nursing program this Fall. One student entering BC nursing program this Fall. One student entering another BSN program this Fall. One student entering another BSN program this Fall. Three Explorers taking the prerequisites for the CSUB BSN program this Fall. Three Explorers taking the prerequisites for the CSUB BSN program this Fall. Three Explorers currently at BC in the pre-requisite courses. Three Explorers currently at BC in the pre-requisite courses. The mother of an Explorer is entering BC this Fall. The mother of an Explorer is entering BC this Fall.

Increased Interest Connected to county HCA group Connected to county HCA group Small grant awarded Small grant awarded Connections with other HCAs Connections with other HCAs Tours & presentations to other HCAs and groups Tours & presentations to other HCAs and groups Delano High School HCA & ROP Delano High School HCA & ROP Arvin High School HCA Arvin High School HCA

Overall Feedback Longitudinal---cannot yet determine numbers of students entering PHN Longitudinal---cannot yet determine numbers of students entering PHN Feedback from Teachers/Advisors: Feedback from Teachers/Advisors: Most Enjoyed---- Most Enjoyed---- Presentations by nursing students & recent graduates Presentations by nursing students & recent graduates Campus & Hospital Tours Campus & Hospital Tours Field Trips Field Trips

Overall Outcomes Increased interest in Nursing (M/F) Increased interest in Nursing (M/F) Increased awareness of Public Health Nursing Increased awareness of Public Health Nursing Potential increase in ethnically diverse nursing workforce. Potential increase in ethnically diverse nursing workforce.

Recommendations More formal partnerships with public health agencies, PHNs More formal partnerships with public health agencies, PHNs Public Health Agency sponsorship of HCAs, RNEPs Public Health Agency sponsorship of HCAs, RNEPs Volunteer with HCAs and RN Explorers; Serve as Mentors, on Advisory Boards Volunteer with HCAs and RN Explorers; Serve as Mentors, on Advisory Boards Collaborate with School Nurses---Future Nurses Clubs Collaborate with School Nurses---Future Nurses Clubs