Websites of Interest (updated 6/14/02)

General Workforce Issues

Database for nursing workforce resources and links (national and regional). Sponsored by the New Hampshire Area Health Education Center. Can search for categories: nursing and patient care, nursing and professional environment, nursing and society, legislative activities. http://www.dartmouth.edu/~ahechome/workforce.html  Click on "The Nursing Shortage."

National Sample Survey of RNs. USDHHS Bureau of Health Professions Health Resources Services Administration. 2001 survey data available at http://www.bhpr.hrsa.gov/healthworkforce.rnsurvey 

NEW AACN FACULTY SHORTAGE FACT SHEET Faculty shortages at nursing schools across the country are contributing to the overall decline in new enrollments at a time when the need for nurses is continuing to grow. Budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this emerging crisis. To assist members in discussing the faculty shortage with legislators, the media, and stakeholders, a new fact sheet has been created and is now posted on the Web at http://www.aacn.nche.edu/Media/Backgrounders/facultyshortage.htm .

NPR link - Bob Edwards of Morning Edition interviewed Tim Hutchinson (R) Arkansas on his program in early November (2001) and he (Hutchinson) seems to have quite a command of the nursing shortage issue. http://search.npr.org/cf/cmn/cmnpd01fm.cfm?PrgDate=11/13/2001&PrgID=3 If you have a media player you can listen to the interview (about 3 minutes in length).

http://www.ons.org/images/Library/ons_publications/PDFs/PressReleases/Workforce.pdf Buerhaus, P., Donelan, K., DesRoches, C., Lamkin, L., Mallory, G. (2001). State of the oncology nursing workforce: problems and implications for strengthening the future. Nursing Economic$, 19(5). Survey responses from oncology nurses, oncologists, and nurse executives from cancer facilities regarding their perceptions of staffing adequacy, the influence of different venues of cancer care on these perceptions, and the implications for building the future workforce.

http://www.aft.org/fnhp/downloadfiles/Hart_Report.pdf FNHP/AFT nursing shortage and retention survey is now online. The nationwide survey, released April 19 by Federation of Nurses and Health Professionals (FNHP)/American Federation of Teachers (AFT), found that one in five nurses plans to leave the profession within the next five years because of poor working conditions. The FNHP is a division of the AFT and has a considerable interest in School Nurse Legislation . The survey, however looked at direct care nurses vs former direct care nurses and was not limited to school nurses.

The Vermont Blue Ribbon Nursing Commission Report (dated June 2001) can be found via: http://web.vsc.edu/vsc/athleticfacilities.html

http://www.healthaffairs.org/archives_library.htm Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, Giovannetti P, Hunt J, Marie Rafferty AM, Shamian J. (2001). Nurses' Reports On Hospital Care In Five Countries. Health Affairs. 20(3), 43-53. The current nursing shortage, high hospital nurse job dissatisfaction, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physicians appear satisfactory, core problems in work design and workforce management threaten the provision of care. Resolving these issues, which are amenable to managerial intervention, is essential to preserving patient safety and care of consistently high quality. Full text of report available.

http://www.aft.org/press/2001/041901.html A press release describing results of a survey of 700 direct care provider nurses and 207 former direct care provider nurses (commissioned by the Federation of Nurses and Health Professionals). Copies of the 25-page report can be requested at Federation of Nurses & Health Professionals 555 New Jersey Ave, NW Washington DC 20001-2079; (202) 879-4491.

http://bhpr.hrsa.gov/dn/staffstudy.htm Full report of commissioned study, Nurse Staffing and Patient Outcomes in Hospital (February 2001). Study is based on 1997 data from more than 5 million patient discharges from 799 hospitals in 11 states. It found a strong and consistent relationship between nurse staffing and five outcomes in medical patients -- urinary tract infection, pneumonia, shock, upper gastrointestinal bleeding, and length-of-stay. A higher number of registered nurses was associated with a 3 percent to 12 percent reduction in the rates of adverse outcomes, while higher staffing levels for all types of nurses was associated with a decrease in adverse outcomes from 2 percent to 25 percent.

http://www.uchsc.edu/ahec/cando/index.htm Colorado Alliance of Nursing workforce Development Opportunity is a formal venue to examine the Colorado Supply/Demand of nursing personnel.  Information about workforce data, differentiated practice model, and educational articulation.

"Why the scarcity of data about California's health care workforce should keep everyone awake at night." A monthly issue brief from the Center for the Health Professions News. http://futurehealth.ucsf.edu/from_the_director.html

The Congressional Policy Forum on Workforce, which was held March 26 in conjunction with AACN's Spring Meeting, is available via webcast (in audio and video formats) at George Mason University's Center for Health Policy Research and Ethics Web site: http://chpre.gmu.edu/webcastnotice.html. Slides used in the presentation also are available for viewing and downloading.

WHEN CARE BECOMES A BURDEN: Diminishing Access to Adequate Nursing Claire M. Fagin February 2001

This report synthesizes research studies, recent journalism, and the author's personal experience to address the problem of the increasing burden of care placed on nurses, patients, and families. Conclusions:

Experts in nursing reviewed a draft of the analytic section of this report. These experts then convened in conference calls to answer the major question raised by the analysis in this report: What can be done to alleviate the actual or potential harm to patients as a result of lack of access to adequate nursing care? The experts' recommendations for policy initiatives designed to prevent harm by improving patients' access to nursing care fell into broad categories:

The experts addressed their recommendations to a variety of audiences. The principal audiences for the recommended strategies are within the health care sector and include administrators of health services, physicians, nurses themselves, and hospital trustees as well as members of state boards of nursing. Other important audiences are state legislators and members of the U.S. Congress, public- and private-sector collective purchasers of health services, leaders of education in nursing and medicine, foundation executives, and officials of the federal agencies that subsidize higher education for the health professions as well as clinical and health services research. Some of the recommendations may also be of interest to journalists.

Fagin and staff of the Fund worked to understand why so many people complained about a problem that was so difficult to document. To assist in explaining this situation, the Fund commissioned Barbara Norrish and Thomas Rundall, of the School of Public Health of the University of California at Berkeley, to write a paper reviewing the extensive empirical literature about the impact of various restructuring projects on nursing care. Their paper, "Hospital Restructuring and the Work of Registered Nurses," is scheduled for publication in the Milbank Quarterly, volume 79.1, in March 2001.

Online Journal of Issues in Nursing (OJIN) "Nursing Shortage: Is this Cycle Different?" This series focuses on this national problem from the view point of changes in: health care organizations, nursing education, and workforce needs. Solutions are suggested with a specific look at the California Strategic Planning Committee for Nursing. Don't miss these articles (Go to: http://www.nursingworld.org/ojin/topic14/tpc14toc.htm)

THE NURSING SHORTAGE Susan Taft, PhD, RN (Jan. 31, 2001)

  • NURSING SHORTAGE: Not a Simple Problem - No Easy Answers Cheryl A. Peterson, MSN, RN (Jan. 31, 2001)
  • THE NURSING SHORTAGE IN CALIFORNIA: The Public Policy Role Of The California Strategic Planning Sarah B. Keating, RN, EdD, FAAN
    Karen R. Sechrist, RN, PhD, FAAN (Jan. 31, 2001)
  • A CONTINUING CHALLENGE: The Shortage of Educationally Prepared Nursing Faculty Ada Sue Hinshaw, PhD, RN, FAAN (Jan. 31, 2001)
  • THE NURSING SHORTAGE: Solutions for the Short and Long Term Brenda Nevidjon, RN, MSN Jeanette Ives Erickson, RN, MS, CNA (Jan. 31, 2001)

    • The California Workforce Initiative from the Center for the Health Professions has released three reports on Nursing in California this February:

    Colleagues In Caring Directory on the Web: http://www.aacn.nche.edu/CaringProject. Find out what is going on with CIC projects in other regions.This national project is sponsored by Robert Wood Johnson Foundation. http://www.aacn.nche.edu/Publications/issues/ib600wb.htm AACN ISSUE BULLETIN June 2000 Amid nursing shortages, schools employ strategies to boost enrollment.

    http://bhpr.hrsa.gov/healthworkforce/newslink.htm Links to Department of Health and Human Services newsletter which features nursing and the workforce shortage for Fall 2000. Click on Health Workforce Newslink. Features mostly Peter Buerhaus' work and that of J.Coffman at UCSF Center for Health Workforce Studies.

    http://www.nursingworld.org/snas/ca/calnoc/home.htm The CalNOC homepage with links to a recent report for 1998-99 data on outcomes across California.May not be an active site (4/13/01)

    http://futurehealth.ucsf.edu/AHexecsum.html The Hidden Health Care Workforce; Recognizing, Understanding and Improving the Allied and Auxiliary Healthcare Workforce (1999) (executive summary) by the Pew Health Professions Commission Taskforce on Health Care Workforce Regulation.

    http://www.rwjf.org/health/024683s.htm Role of Work Organizations, Human Resources Practices, and Industrial Relations in Hospitals' Adjustment to a Competitive Health Care Market (Gil Preus, PI), 1995-98.

    http://futurehealth.ucsf.edu/pdf_files/futwkreg.pdf Considering the Future of Health Care Workforce Regulation (1997) A summary of the written responses to the 1995 report Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century, by the Pew Health Professions Commission Taskforce on Health Care Workforce Regulation.

    http://futurehealth.ucsf.edu/summaries/challenges.html "Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century" by the Center for the Health Professions and the Pew Health Professions Commission, 1995. related projects: http://www.rwjf.org/health/021758.htm ; http://www.rwjf.org/health/021760.htm http://www.rwjf.org/health/021764.htm http://www.rwjf.org/health/021763.htm http://www.rwjf.org/health/021759.htm

    Nurse Recruitment/Retention

    Johnson & Johnson site aimed at getting young people interested in nursing as a career. http://www.discovernursing.com 

    Recruitment information: http://www.HealthCareRecruitment.com -- an excellent resource. When you go to this website you will find a link to O'Grady Peyton. The licensing staff at the California Board of Registered Nursing indicates this particular agency is reputable and has a long term track record in the recruitment field.

    http://www.CNCC.org Coalition for Nursing Careers in California. This coalition of health care organizations and educators aims to address the long term nursing shortage in California by attracting a pool of candidates for schools of nursing that reflect the diversity and demographics of the state. Seeking to fund a capaign to enhance the image of the nursing profession and to provide access to information about nursing careers. Check out http://www.cncc.org/choosenursing.htm

    http://www.rwjf.org/health/ladderse.htm Ladders in nursing careers program (LINC) RWJF Project, 1988-97. Career advancement and health care work force education program funded by the Robert Wood Johnson Foundation (RWJF).

    http://www.nursesource.org Nurses for a Healthier Tomorrow (NHT) is a coalition of 18 nursing and health care organizations working together to wage a 36-month national communications campaign to attract people to the nursing profession.

    Educational Articulation

    http://www.uchsc.edu/ahec/cando/articulation/index.htm describes articulation for nurses under the Colorado Nursing Articulation Model, includes a diagram of progression through programs.

    http://www.nursing2000inc.org/rnedumobilityguide.html Very thoughtful website. For the RN who may want to go back to school. Describes assets an RN brings to an educational setting, benefits of furthering RN education, and how to select a program, along with other important issues. It also includes a description of nursing programs in Indiana that offer RN educational mobility.

    http://www.hsc.wvu.edu/son/nwn/CEAM.htm The Coalition for Educational Articulation and Mobility (CEAM) is a group of West Virginia educators in the consortium who are committed to promoting the educational advancement of all levels of nurses in the nine county region.

    Role Based Differentiated Practice

    http://www.uchsc.edu/ahec/cando/diff/index.html The Colorado Differentiated Practice Model for Nurses and Care Partners

    Cultural Diversity or Cultural Competency/Sensitivity

    http://www.omhrc.gov/CLAS/ Assuring Cultural Competence in Health Care:Recommendations for National Standards and Outcomes-Focused Research Agenda Recommendations for National Standards and a National Public Comment Process (December 2001). Office of Minority Health, PHS, USDHHS.

    CENTER FOR HEALTH PROFESSIONS (AT UCSF) SET TO RELEASE CURRICULUM ON CULTURALLY APPROPRIATE HEALTH CARE The Center for Health Professions, based at the University of California - San Francisco, recently announced the upcoming 2nd edition release of their curriculum, "Culture and Communication in Health Care: A Curriculum for Teaching Culturally Appropriate Care to Health Professionals."  This curriculum integrates knowledge of diversity and cultural competency into a health care framework and provides a comprehensive guide to teaching culture and communication in the practice setting. It will be available at the end of the Summer and will include updated references, lecture topics, materials for didactic and experiential learning and a new section on evaluation. For more information about this and other curricula, visit their Web site: <http://futurehealth.ucsf.edu/cnetwork.html>

    http://www.healthaffairs.org/archives_library.htm Coffman JM, Rosenoff E, Grumbach K. (2001). Racial/Ethnic Disparities In Nursing. Health Affairs, 20(3), 263-272. The racial and ethnic composition of the registered nurse (RN) workforce in California is not at parity with the composition of the population. We find that the underrepresentation of African Americans in nursing in California appears to be due to lower overall educational attainment among African Americans. Underrepresentation of Latinos is due to lower overall educational attainment and, to a lesser extent, a lower percentage of college-educated Latinos pursuing careers in nursing. Improving the overall educational attainment of minority students is critical to increasing the number of minorities in nursing. Fulltext of the report available.

    http://bhpr.hrsa.gov/healthworkforce/newslink.htm Links to Department of Health and Human Services newsletter Spring 1999 "Increasing the competitive applicant pool of underrepresented minorities in the health care workforce."

    http://www.aacn.nche.edu/Media/NewsReleases/hspagwb.htm WASHINGTON, D.C., June 15, 2000 -- In a new collaborative agreement, the American Association of Colleges of Nursing (AACN) has joined with two major national associations to provide Hispanic students with expanded access to nursing education opportunities.

    Cultural Competence Compendium. Published 1999, American Medical Association. 460 pages. Product number OP209199. Access for request and access to downloadable sections of interest at http://www.ama-assn.org/ama/pub/category/2661.html

    Cultural Diversity in Nursing: Issues, Strategies, and Outcomes. Published 1997, American Nurses Publishing. 122 pages. Pub#G-195. Charge. Access for information and purchase at http://nursingworld.org/anp/palpha.cfm.

    Diversity, Marginalization and Culturally Competent Health Care: Issues in Knowledge Development. Published 1995, American Nurses Publishing. 35pages. Pub#G-189. Charge. Access for information and purchase at http://nursingworld.org/anp/palpha.cfm.

    Promoting Cultural Competence In and Through Nursing Education: A Critical Review and Comprehensive Plan for Action.. Published 1995, American Nurses Publishing. 49 pages. Pub#G-190. Charge. Access for information and purchase at http://nursingworld.org/anp/palpha.cfm.

    http://gucdc.georgetown.edu/document.html#cultural Series of publications about Promoting Cultural Diversity and Cultural Competency.

    http://www.bphc.hrsa.gov/culturalcompetence/Default.htm Bureau of Primary Health Care Ofice of Minority and Women's Health - essay about cultural competence; nice clinical examples. If you would like a copy of this publication, please call 1-800-400-BPHC.