DiversityNursing Blog

When it comes to the cost and quality of hospital care, nurse tenure and teamwork matters. Patients get the best care when they are treated in units that are staffed by nurses who have extensive experience in their current job, according to a study from researchers at Columbia University School of Nursing and Columbia Business School. The study was published in the current issue of the American Economics Journal: Applied Economics.

The review of more than 900,000 patient admissions over four years at hospitals in the Veterans Administration Healthcare System is the largest study of its kind to link nurse staffing to patient outcomes. The researchers analyzed payroll records for each nurse and medical records for each patient to see how changes in nurse staffing impacted the length of stay for patients. Because length of stay is increased by delays in delivery of appropriate care and errors in care delivery, a shorter length of stay indicates that the hospital provided better treatment. At the same time, a shorter length of stay also makes care more cost-effective. The study found that a one-year increase in the average tenure of RNs on a hospital unit was associated with a 1.3 percent decrease in length of stay.

"Reducing length of stay is the holy grail of hospital management because it means patients are getting higher quality, more cost-effective care," says senior study author Patricia Stone, PhD, RN, FAAN, Centennial Professor of Health Policy at Columbia Nursing. "When the same team of nurses works together over the years, the nurses develop a rhythm and routines that lead to more efficient care. Hospitals need to keep this in mind when making staffing decisions – disrupting the balance of a team can make quality go down and costs go up."

While many hospitals rely on temporary staffing agencies at least some of the time to fill RN vacancies, the study found that it's more cost-effective for hospitals to pay staff RNs overtime to work more hours on their unit. RNs working overtime resulted in shorter lengths of stay than hours worked by nurses hired from staffing agencies, the study found.

Nursing skill also mattered, the study found. Length of stay decreased more in response to staffing by RNs than by unlicensed assistive personnel. Furthermore, the study showed that length of stay increased when a team of RNs was disrupted by the absence of an experienced member or the addition of a new member.

"This rigorous econometric analysis of nurse staffing shows that hospital chief executives should be considering policies to retain the most experienced nurses and create a work environment that encourages nurses to remain on their current units," says the senior economist on the study team, Ann Bartel, PhD, Merrill Lynch Professor of Workforce Transformation at Columbia Business School.

The researchers used the VA's Personnel and Accounting Integrated Data for information on each nurse's age, education, prior experience, VA hire date, start date at the current VA facility, and start date for the current unit at that facility. To assess patient outcomes, the researchers used the VA's Patient Treatment File for information on each patient including dates of admission and discharge for each unit and for the overall hospitalization, as well as age and diagnoses. The final sample accounts for 90 percent of all acute care stays in the VA system for the fiscal years 2003 to 2006.

More information: The paper is titled: "Human Capital and Productivity in a Team Environment: Evidence from the Healthcare Sector," and it was published in April 2014.

The American Association of Colleges of Nursing released preliminary survey data showing that enrollment in entry-level baccalaureate nursing programs increased by 2.6% from 2012 to 2013, which marks the lowest enrollment increase in professional RN programs over the past five years. 

Findings are based on data reported from 720 of the 858 schools of nursing in the U.S. with baccalaureate or graduate programs. Although RN enrollment increased for the 13th consecutive year, nursing schools have identified a shortage of faculty and clinical education sites as potential barriers to realizing future growth and meeting the nation’s need for healthcare providers.

“Given the calls for a more highly educated nursing workforce from the Institute of Medicine, the Tri-Council for Nursing, nurse employers and other stakeholders, we are pleased to see at least modest growth in the pipeline of new baccalaureate-prepared nurses,” AACN President Jane Kirschling, RN, PhD, FAAN, said in a news release.

Preliminary AACN data also show a strong enrollment surge in baccalaureate nursing programs designed for practicing nurses looking to expand their education in response to employer demands and patient expectations. 

The number of students enrolled in baccalaureate degree completion programs, also known as RN-to-BSN programs, increased by 12.4% last year (among 512 schools reporting). This year marks the 11th year of enrollment increases in these programs and offers further validation of the desire among nurses to advance their education to remain competitive in today’s workforce, according to the AACN.

Looking ahead, AACN plans to work collaboratively with stakeholders to ensure that enrollment in both baccalaureate and master’s level degree completion programs for RNs expands even further to meet the recommendations outlined in the 2010 “Future of Nursing” report prepared by the Institute of Medicine, including a goal of 80% of nurses having BSNs by 2020.

Enrollment changes since 1994: www.aacn.nche.edu/Media-Relations/EnrollChanges.pdf

Fact sheet: www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce

Source: Nurse.com 

Written by Sarah Okeson

Joe Long first thought of becoming a nurse when his wife was hospitalized for a week during her pregnancy with their second child. He now works at Mercy Hospital Springfield, taking care of patients in the intensive care unit.

“Nursing is manly,” Long said. “It’s not just for women.”

About 6.6 percent of nurses nationwide are male, according to the American Association of Colleges of Nursing. In Springfield, about 7.3 percent of nurses at CoxHealth are male. At Mercy, about 11.4 percent of the nurses are male.

The American Assembly of Men in Nursing was formed in 1971 in Michigan to provide support for male nurses. An Ozarks chapter is being started. There are also chapters in St. Louis and Kansas City. The organization also is open to women.

“It’s a very female-oriented world and we’re OK with that, but men still need to socialize,” said Paul Pope, the chapter president and a nursing instructor at Southwest Baptist University.

The executive director of nursing at Mercy Hospital Springfield is a male nurse, Kurtis Abbey.

Nurses like him have faced some of the obstacles that women entering predominantly male fields have faced. There have been lawsuits and complaints about isolation.

Rick Leroux, a nursing instructor at Southwest Baptist, got into nursing with the encouragement of his aunt. He learned how to make chitchat with children and to be absolutely honest about whether a medical procedure would hurt.

He treasures moments such as an encounter with the adult daughter of a man he had cared for who had a heart attack. She hugged Leroux and thanked him.

“Those are the moments we live for,” Leroux said.

Female employees at Mercy said they appreciate male nurses when it comes to lifting patients. They also value other qualities such as help in dealing with sometimes-disruptive families.

“We have a lot of difficult patients,” said Becky Pierce, who has worked at Mercy for about 40 years. “For each difficult patient, you have family members who sometimes need the physical presence of a man.”

Dr. Tobey Cronnell said male nurses tend to be more supportive of female doctors.

“I particularly enjoy working with male nurses as a female physician,” Cronnell said.

Long recently tended to John Goar, 73, who was admitted to Mercy Hospital Springfield after having trouble breathing.

Long gave him insulin and some other medication and then told Goar that his relatives were on their way to visit.

“He’s as good as a woman,” Goar said.

Long left Goar’s room. He was about halfway through his 12-hour shift. He doesn’t miss his previous career as a loan officer for a mortgage company.

“It’s the first time I have a job where I actually look forward to going to work,” he said.

Source: News-Leader.com

By Karren L. Johnson

After a nearly 15-year journey — which included raising three children and working full time as a registered nurse -- Terra Brown of Susquehanna Township is just months away from completing her bachelor’s of science degree in nursing.

“It took a lot of hard work but it was worth it,” said the 42-year-old Brown, who works at Penn State Hershey Heart and Vascular Institute in Lower Paxton Township and entered the nursing field with an associate’s degree. “It feels good to know I improved both my knowledge and myself.”

Brown said she wants to teach other nurses and plans to go on to earn a master’s in nursing.

According to a recent survey by the American Association of Colleges of Nursing, Brown isn't alone in her pursuit to further her nursing education. The number of students enrolled in baccalaureate degree completion programs — also known as RN to BSN programs — increased by 13.4 percent from 2010 to 2011, the study found. Master’s programs reported a 7.6 percent jump in enrollments in 2011.

For current nurses and those looking to enter the field, the future looks bright. A 26 percent increase in the demand for new nurses is expected between 2010 and 2020, equating to 711,900 new jobs, according to the U.S. Bureau of Labor Statistics.

“A driving force behind this increase in BSN enrollment is the Institute of Medicine’s “The Future of Nursing” report that calls for the number of nurses who hold BSNs to increase to 80 percent by 2020,” said Betsy Snook, a registered nurse and the CEO of the Pennsylvania State Nursing Association.

“To meet this goal, which will help meet the needs of our growing population and more complex health care environment, there has been a trend among hospitals to require nurses to complete a BSN degree or higher,” Snook said.

While this goal does take a certain amount of initiative from nurses, it isn’t on them alone to achieve, Snook said. It also requires the support from employers and organizations such as PSNA, as well as education institutions, to help nurses achieve a higher level of education and training.

A choice to advance

Armed with a BSN from York College of Pennsylvania, Patricia Himes was excited to begin providing care to people. She joined the staff of a local hospital where she worked as a charge nurse for about six years. While she loved her job, she found herself curious about opportunities for growth.

“I’ve always had an urge to learn more and do more,” said Himes, who had heard there was a growing need for certified nurse practitioners.

As a result, she went back to school while working full time, receiving a master’s degree and her nurse practitioner training from Widener University’s Harrisburg campus.

“We are seeing a very large growth in nurses seeking advanced degrees, particularly as nurse practitioners,” said Geraldine M. Budd, assistant dean in Widener University School of Nursing’s Harrisburg campus. Budd said nurse practitioners provide most of the same services as physicians, making them especially important for practices and hospitals in disadvantaged areas without many physicians.

For now, Himes wants to just continue her overall growth and development while working for PinnacleHealth FamilyCare in Lower Paxton Township. But she said she definitely sees herself getting a doctor of nursing practice down in the future.

Nurses who do get additional training will find themselves in demand.

“With many of the highest trained nurses in the teaching arena reaching retirement age, there is also going to be a real need for qualified nurses to step into roles as nurse educators,” Budd adds.

Enhanced educational programs

Among the BSN to RN programs seeing a surge in enrollment is the one offered by Penn State Harrisburg. The school has seen enrollment increase by 25 percent between 2011 and 2012, said Melissa Snyder, coordinator for the nursing bachelor’s program.

“To best meet the needs of our students, we offer an evening format, a hybrid format, which is a combination of online and face-to-face classes and periodic all-day formats,” Snyder said. “We also ensure that nurses are graduating with solid skills in leadership, critical thinking and research, all things that employers are looking for.”

While enrollment in its BSN programs has increased, Penn State recently announced that it is phasing out all of its associate nursing programs and transitioning them to four-year baccalaureate programs, Snyder said.

Some community colleges are finding other ways to appeal to students who want more than an associate degree. For example, Harrisburg Area Community Collegerecently created a dual admission partnership with Millersville University to keep their graduates competitive and to provide a seamless transition into a bachelor’s program.

“We have always been very clear with our students that an associate degree is not an end point and we encourage they should seek further education,” said Ron Rebuck, director of nursing at HACC’s Harrisburg Campus. “The trend that I’m seeing is that by the time our nursing students graduate, a majority of them are already enrolled in a BSN program.”

Ever since Jeremy Whitmer graduated from high school just over 10 years ago, he has made it his personal mission to advance his nursing career. Despite being deployed to Iraq with the National Guard, he was still able to earn an associate’s degree, as well as a BSN degree thanks to HACC’s dual admission program.

“It was the perfect route for me because it provided a lot of flexibility,” said Whitmer, who is now working in Holy Spirit Hospital’s cardiovascular operating room. “I feel that having a BSN degree has given me many more leadership opportunities, as well as critical thinking and time management skills that I apply to my job every day.”

Support from employers

Having recently applied for magnet status, a designation awarded by the American Nurses Association that denotes nursing excellence, Holy Spirit Health System takes pride in being in full support of helping its nurses reach a higher level of education, said Brenda Brown, director of human resources.

“We know there are a lot of great nurses coming out of associate programs,” Brown said. “When we see such a nurse who exemplifies our values, we will support them in completing their BSN within four years of their hire.”

In addition, Holy Spirit offers a tuition reimbursement and an RN scholarship program, as well as an education loan repayment program. It also pays for all certifications. Currently, 42 percent of the hospital’s nurses either have bachelor’s or master’s degrees in nursing, she said. There are currently 88 nurses enrolled in bachelor’s programs and 27 are working toward their master’s in nursing, she said.

Sherry Kwater, chief nursing officer for the Penn State Milton S. Hershey Medical Center, said 57 percent of the center’s more than 1,800 nurses have a BSN. She said many have advanced their education while working at the center, which is a magnet facility.

“At Penn State Hershey Medical Center, we have so many specialty patients who require nurses with a body of knowledge around that patient population,” Kwater said. “Education is our mission here, so we migrate towards hiring nurses who are educators or specialists with a focus in a specific area. This also helps raise the skill of the bedside nurse.”

 Himes, the nurse with PinnacleHealth, credits the support from her coworkers for enabling her to grow and gain increased confidence in her field.

“The physicians are very supportive and very willing to teach me how to do things that I’ve never done before or that I’m insecure about,” she said. “I couldn’t be happier about my career path. It’s been a great testament of how the field of nursing is growing and that the opportunities are endless."

Source: The Patriot News

The demand for nurses has significantly increased over the past few years and while the profession is mainly represented by females, more and more men have started to join the field as well. 

According to a study by the U.S. Census Bureau, male nurses are becoming increasingly more commonplace. 

In 1970, only 2.7 percent of nurses were male, compared to 9.6 percent today, meaning that the proportion of male nurses has more than tripled over the past 4 decades. The male proportion of practical and licensed vocational nurses has also increased over the same period, from 3.9 percent to 8.1 percent. 

The finding comes from a study of the 2011 American Community Survey which measured the proportion of men in each of the following nursing fields: nurse practitioner, nurse anesthetist, registered nurse, licensed vocational nurse and licensed practical nurse. 

The majority the 3.5 million employed nurses in 2011 were women - close to 3.2 million. However, the number of male nurses is on the rise - close to 330,000 at the last count. 

In addition, they analyzed the characteristics of men and women working in these fields, such as age, origin, race, education, earnings, industry, work hours and citizenship. 

The author of the report, Liana Christin Landivar, a sociologist in the Census Bureau's Industry and Occupation Statistics Branch, said: 

"The aging of our population has fueled an increasing demand for long-term care and end-of-life services. A predicted shortage has led to recruiting and retraining efforts to increase the pool of nurses. These efforts have included recruiting men into nursing."

Male nurses typically earn more than their female co-workers. For every dollar male nurses earned, female nurses earned 91 cents. This difference in earnings is a lot smaller than most across all occupations though, with women earning 77 cents for every dollar a man earns.

Healthcare is among the fastest growing industries and as people are living longer there is an increased demand for long-term care as well as end-of-life services. The unemployment rate among nurses is extremely low due to this increasing demand. Only 0.8 percent of nurse practitioners, 0.8 percent of nurse anesthetists, and 1.8 percent of registered nurses were unemployed in 2011. 

Some additional findings of the study, show that in 2011:

• The majority of employed nurses were registered nurses (78 percent), followed by licensed practical and licensed vocational nurses (19 percent).

• 41 percent of nurse anesthetists were male - the occupation with the highest male representation.

• Male nurses earned an average of $60,700 per annum compared to $51,100 per annum among women. 

According to researchers at the University of Pennsylvania School of Nursing's Center, nursing is a profession with an extremely high burnout rate and many nurses report feeling dissatisfied with their jobs. They say that it is imperative that hospital leaders and policy makers improve work environments for nurses, which in turn also improves quality of care for patients.

Source: Medical News Today

By LIANNA SERKO

School of Nursing graduates of the class of 2012 saw a significant increase in employment over the class of 2011.

The Career Plans Survey, released by Career Services, revealed that 75 percent of Nursing School graduates obtained full-time employment, a major increase from 59 percent full-time employment for graduates of the class of 2011.

This placed Nursing School graduates second behind Wharton graduates in full-time employment among the four undergraduate schools in 2012. Graduates of the Wharton School reported 84.6 percent full-time employment, while Engineering and College graduates reported 67.8 percent and 57 percent, respectively.

Sharon Fleshman, senior associate director at Career Services for the Nursing School, suggests the increase in full-time employment may be a reflection of a strengthening employment market for nurses with bachelor of science in nursing degrees, which had slowed down after the recession of 2009-2010.

“Over the past several years, there has been an issue with the job market for our new graduate nurses. Based on the recession, there has been less retirement and less turnover with registered nurses, with nurses coming back to the workforce,” she said. “There are a lot of dynamics that might have fed into the job market as it is.”

In regard to the seeming strength of the current job market for Nursing graduates, Fleshman noted increased efforts by Career Services as a causal element for higher employment rates. The department now places a heavier emphasis on networking and encourages students to connect with nurse managers, evidenced by the 2011 creation of Nurse Manager Panels, which make nurse managers more accessible to and approachable by Nursing students.

Contact with nurse managers allows students to “make the most of their clinical rotations,” which may lead to a more secure path to employment.

The response rate to the career plans survey decreased from 85 percent in 2011 to 72 percent in 2012.

The average starting salary decreased marginally from $56,665 in 2011 to $56,051 in 2012, with both of these numbers reflecting a substantial decrease from the average starting salary of $60,325 reported in 2010.

The number of Nursing graduates attending graduate school also dropped considerably from 26 percent in 2011 to only 9 percent in 2012, a statistic likely correlated to the higher employment rate, according to Rose and Fleshman.

“Many Penn Nursing students eventually do plan on going back to school, but I do think going to school right after undergraduate is impacted by the job market,” Fleshman said.

The remaining statistics closely mirror those of previous years.

The vast majority of Nursing graduates who found full-time employment will work in Pennsylvania, with 19 graduates working for the Hospital of the University of Pennsylvania. This may be a result of the clinical rotations that are part of the Nursing degree program. Additionally, 64 percent found employment in the Mid-Atlantic region, down from 70 percent in 2011.

Of the students surveyed, only 6 percent are still actively seeking employment, a statistic similar among the other undergraduate schools, with 7 percent of College graduates, 5 percent of Engineering graduates, and 5.5 percent of Wharton graduates also seeking employment at the time of the survey.

“Every year we hope we’ll get our job market back to where it was,” Fleshman said.

By: Jessica Opoien

School psychologists and nurse assistants in Oshkosh will receive the school district’s first-ever market-driven salary increases.

The school board approved a resolution, which grants three currently-employed school psychologists $20,000 raises each and boosts the hourly pay for nurse assistants by $1.50 or $2.50, depending onexperience, at its Wednesday meeting. The raises for school psychologists range from 37 percent to 43 percent more per employee.

The district has struggled to fill substantial vacancies throughout the last year-and-a-half. Five out of seven psychologists and five out of nine licensed practical nurses have left the district in that time, with three psychologists leaving since August. Postings for LPNs have yielded one applicant per vacancy, and there is virtually no candidate pool for psychologists.

There are 15 districts across Wisconsin with open psychologist positions, according to postings on the Wisconsin Educator Career Access Network. However, districts are in direct competition with medical facilities and private firms that employ psychologists, and no applicants have responded to Oshkosh’s four vacancies for psychologists.

The district is obligated to employ school psychologists for special education assessment and placement, said Superintendent Stan Mack during the meeting.

“As we well know just dealing with the issues in the last week, supporting students in crises demonstrates the need for psychologists well beyond the need of special ed assessment and special ed placement,” Mack said.

Six districts surrounding Oshkosh pay their psychologists an average salary of $67,000, according to a survey conducted by the Oshkosh district. Psychologists in Oshkosh earn an average salary of $47,000.

School nurse assistants face a similar situation. In Oshkosh, they earn between $14.98 and $15.85 per hour, while the regional average pay is between $16.33 and $20.77 per hour, depending on experience.

Mack said responsibilities for school nurses have increased as students’ medical conditions have grown more complex, adding that the current compensation rate is inadequate to recruit and retain LPNs in the district.

The raises follow a series of other compensation-related resolutions aimed at curbing turnover and attracting new employees to Oshkosh schools. The board over the past three years raised salaries for its top administrators 24 percent in direct response to difficulty retaining employees. Last month, the board voted to spend up to $350,000 next school year on raises for teachers who earned graduate credits during pay freezes.

Article from Jackson University

In economically challenging times, many nurses are looking for ways to boost salary and increase the versatility of their valuable skill set. Keeping skills current is a mandatory part of nursing but even with superior skills there is intense competition for top jobs.

Broadening your résumé with additional credentials can make you attractive to employers who want a versatile staff able to fill in where needed. As a result, nurses are finding creative ways to gain experience that makes their skills more attractive and, at the same time, opens the door to increased salary.

Boost Credentials

Many highly ranked and regionally accredited online programs provide a win-win situation for nurses, allowing them to bolster their résumé while remaining with their current employer.

Completing a BSN or MSN can increase employment flexibility and earning potential. Opportunities also exist for nurses who undertake additional training in specialty areas such as: Certified Nurse Midwife (CNM), Certified Registered Nurse Anesthetist (CRNA) and Certified Nurse Practitioner (CNP).

Consider the Whole Package

The versatility of nursing is a great selling point for those who enter the field. Qualified nurses with a reputable education and strong experience may find themselves comparing more than one employment offer at some point in their career.

Carefully examining benefit packages at prospective employers will help you choose the best fit for your needs. Better health insurance coverage, comprehensive tuition assistance packages and top-notch retirement plans have long-term financial advantages that can augment a salary offer.

The ability to adjust a compensation package as your needs change over the course of your professional career is also an important factor to consider.

When looking to increase salary, you may be overlooking options at your current employer. For instance, many employers offer a wide range of training and ongoing educational opportunities. There might be in-house technology or software training available that could bring extra income over time. Flex time while taking courses or tuition assistance for online and traditional courses is a common benefit in healthcare settings.

It is often more economical for an employer to invest in current employees than to hire someone new. Meet with a supervisor or HR professional to determine which advancement opportunities are available.

Be Creative

If you need extra money consider working night, weekend and holiday shifts. Becoming a traveling nurse where need is great also may boost your salary. If you prefer to stay close to home, many nursing training programs hire tutors or maintain a list of tutors for students who need extra help.

Some community organizations need health speakers and may pay for your services; community event organizers also often need to hire a nurse to work at a first aid station during a foot race or other special event.

In recent years, some health plans have begun offering work to nurses willing to field online questions, return phone calls or offer intermittent services to outpatients and those recovering from surgery.

In short, there is often a diversity of part-time opportunities available for making extra money once you take the time to start looking.

Taking a Holistic Approach

Nursing remains a great investment of tuition dollars even in a tough economy. Many top-notch, online nursing programs offer the versatility needed for busy nurses to boost their résumé and earning power.

Solid increases in salary typically coincide with securing additional skills and credentials that make you more valuable in the marketplace. For nurses, a holistic approach and a little creativity can often reveal short- and long-term ways to gain training and boost income potential for years to come.