Resolving the nursing shortage calls for new
initiatives for a new century.
The
current and evolving shortage of registered nurses in the
United States demands a new approach for resolution. In
past cyclical shortages, the federal government intervened
by increasing funding and programmatic authority for Title
VIII of the Public Health Service Act. This was an effective
strategy that brought new nurses into the workforce. In
2002 and for the foreseeable future, stakeholders must expand
their strategies to include not only federal efforts, but
also state initiatives, and public and/or private partnerships.
Advocate
for federal legislation.
Conference
the Nurse Reinvestment Act (S. 1864/H.R. 3487).
Congress must merge the House and Senate-passed versions
of this landmark shortage legislation for the President
to sign in 2002. AACN and other nursing organizations prefer
the Senate-passed version, which creates a Fast-Track Nursing
Faculty Loan and Scholarship Program so that individuals
seeking a master's or doctoral degree may receive financial
assistance in exchange for teaching at a school of nursing.
It also establishes a National Nurse Service Corps Scholarship
Program that provides scholarships to students enrolled
on a part- or full-time basis to feed the pipeline of entry-level
nursing students. The bill awards grants to carry out demonstration
projects of 'best practices' in nursing care and develop
innovative strategies to retain and improve the practice
for professional nurses.
Increase
FY 2003 Appropriations for Nurse Education Act (NEA) Programs
by $40 million. The NEA is the major federal statute
providing authority for the Department of Health and Human
Services to fund initiatives to expand or improve nursing
education. Recommended funding at a total of $122 million
is needed to boost enrollments in nursing education programs
supported by NEA grants in the areas of Advanced Education
Nursing, Nursing Workforce Diversity, and Basic Nurse Education
and Practice. Furthermore, AACN requests both the Nursing
Student Loan Program (NSL) and the Nurse Education Loan
Repayment Program (NELRP) receive an additional $10 million
each for FY 2003.
Reauthorize
the Public Health Service Act, Title VII and VIII Programs.
The laws governing Title VII and VIII programs expire
after four years and are due to be rewritten and reevaluated
in 2002. This reauthorization process will involve all interested
parties (legislators, federal agency staff, interest groups)
in an effort to update and develop new programs that will
effectively increase the access to care in underserved areas
by increasing quality, quantity, distribution, and racial
and ethnic diversity of the health care workforce. However,
due to the shortened legislative year and political forces,
this process will most likely be delayed until the next
legislative year. AACN recommends advancing a capitation-model
program in the reauthorization process.
Provide
the National Institute of Nursing Research (NINR) with $145
million in FY 2003. The NINR supports new dimensions
in nursing practice and attracts new students to the profession
by providing opportunities to conduct scientific research.
NINR is vital to the creation of a science base for the
profession of nursing and to communicate to potential students
that nursing is an intellectual endeavor with a base of
science for practice. With a $25 million increase above
the FY 2002 budget, the NINR could fund nurse researchers
to study health disparities, adolescent health promotion,
long-term care recipient health care, and to conduct end-of-life
research. NINR supports studies on the relationship between
staffing mix and patient outcomes which is important to
understanding and maintaining patient safety. NINR is also
working with other federal agencies to determine what actions
must be undertaken to the address nursing shortage.
Develop
state legislative and regulatory initiatives.
Work
with state governments to address the nursing shortage.
For the last few years our laboratories of health policy
innovation-- the states-- have been passing nursing shortage
legislation. In 2001, 19 states enacted nursing shortage
legislation including Arkansas, Connecticut, Florida, Illinois,
Indiana, Maryland, Massachusetts, Mississippi, Nebraska,
Nevada, New Hampshire, North Dakota, Oregon, Rhode Island,
South Carolina, Texas, Vermont, Virginia, and West Virginia.
These state governments have established scholarship and
loan repayment programs, commissions and studies on statewide
nursing shortages, and recruitment and retention grants.
Educate
state leaders and lawmakers on needs for nursing education
and research. In 2002, California, Colorado, Florida,
Hawaii, Illinois, New Jersey, New Mexico, and New York have
nursing shortage bills pending in their state legislatures.
Various bills provide loan and scholarship programs, create
centers for nursing excellence, expand and renovate schools
of nursing, and study statewide shortages. This creates
new opportunities for nurse educators to suggest innovative
ways to expand capacity in their school and resolve the
nursing shortage in their state. Nurse educators must think
politically and seek out state legislators, federal legislators,
governors and the media to share their ideas. Nursing organizations,
hospitals, college and university systems, long-term care
facilities, physician groups, the business community, patient
or disease-focused groups, state boards of nursing, pharmaceutical
companies and foundations are likely partners to join in
the effort to resolve state nursing shortages.
Work
collectively through public and/or private partnerships.
Hospital
Corporation of America (HCA) and the U.S. Department of
Labor. Announced in December of 2001, HCA and the Department
of Labor each contributed $5 million for scholarships to
fund education and training in areas affected by the economic
impact of September 11th. Those areas are Atlanta, South
Florida, Dallas, Houston, and Denver. Training will provided
for an estimated 2,000 people in nursing and clinical jobs.
The recipients will be guaranteed employment at HCA facilities.
The joining of a federal government agency and a private
corporation serves as a great example of innovative ways
to address the nursing shortage.
Johnson
& Johnson's Campaign for Nursing's Future. This
campaign was launched to enhance the image of the nursing
profession and help recruit new nurses, faculty members,
and second career seekers into the profession. Johnson &
Johnson has invested in a nationwide advertising campaign
that began during the 2002 Winter Olympics. Efforts include
a Web page (www.discovernursing.com)
that contains unique scholarship and career content, a national
scholarship fund for nursing students and faculty, development
and distribution of outreach materials to career centers,
and program assessment to measure consumer attitudes and
nursing school enrollment trends. Johnson & Johnson
has committed $20 million over two years to the campaign
and continues to seek further corporate partnerships.
Colleagues
in Caring (CIC). A national grant program, CIC is funded
by The Robert Wood Johnson Foundation to help states and
regions build systems of workforce assessments and development.
CIC through its regional and state consortiums, gathers
workforce data, anticipates future workforce requirements,
promotes educational mobility among all levels of nursing
graduates, fosters stable and satisfying practice environments
that promote career advancement and lifelong learning, and
creates a permanent forum for exploring evidence-based policy
measures regarding current and future nursing workforce
requirements.
Updated
March 21, 2002
