task force on the north carolina nursing workforce & unc response

Task Force on the North Carolina Nursing Workforce & UNC Response

SHEEO Professional Development ConferenceSHEEO Professional Development ConferenceAugust 14, 2004August 14, 2004

Dr. Alan MabeDr. Alan MabeVice PresidentVice President

for Academic Planningfor Academic Planning

The University of North Carolina Office of the PresidentThe University of North Carolina Office of the President

The University of North Carolina Office of the President

2UNC-OP Academic Planning/ARM-wmd/02-12-04

Organization and Funding for the Task Force 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



Composition of the Task Force 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



Leadership of Task Force 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



Registered Nurses per 10,000 Population, US and NC, 1979 to 2002

78.2

89.990.0

10

20

30

40

50

60

70

80

90

100

19

79

19

80

19

81

19

82

19

83

19

84

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

Year

Re

gis

tere

d N

urs

es

Pe

r 1

0,0

00

Po

pu

lati

on

US Registered Nurses

NC Registered Nurses

Sources: North Carolina Health Professions Data System, 1979 to 2002; The Registered Nurse Population- Findings from the National Sample Survey of Registered Nurses,2000, 1996,1992, 1988, 1984, 1980; North Carolina Office of State PlanningFigures include all licensed active registered nurses



Licensed Practical Nurses per 10,000 Population, US and NC, 1979 to 2002

13.1

20.3

21.7

2468

10121416182022242628

19

79

19

80

19

81

19

82

19

83

19

84

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

Year

LP

Ns

pe

r 1

0,0

00

Po

pu

lati

on

US Licensed Practical Nurses

NC Licensed Practical Nurses

Sources: North Carolina Health Professions Data System, 1979 to 2002; HRSA, Bureau of Health Professions; US Bureau of the Census; North Carolina Office of State Planning

Figures include all licensed active licensed practical nurses. North Carolina population data are smoothed figures based on 1980, 1990 and 2000 Censuses.



Registered Nurses by Basic Nursing Educational Award, North Carolina 2002

N=74,971

20.3%

50.5%

28.2%

0.2%

0.9%

Diploma

Assoc Degree

Baccalaureate

Masters Nursing

Missing

Source: North Carolina Health Professions Data System, 2003.Includes active, in-state RNs.



Registered Nurses by Highest Degree Held, North Carolina 2002

N=74,971

13.6%

37.0%

27.0%

4.6%

5.6%

9.3%

2.3%

0.2%0.3%

Diploma

Assoc Degree

Bacc Nursing

Bacc Other

Masters Nursing

Masters Other

Doct Nursing

Doct Other

Missing

Source: North Carolina Health Professions Data System, 2003.Includes active, in-state RNs.



Major Findings 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.



Recommendations 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



UNC Nursing ProgramsUNC Nursing Programs

East Carolina UniversityBSN in Nursing

MSN in NursingAdult Health NursingClinical Services AdministrationCommunity Health NursingFamily Nurse PractitionerNeonatal Nurse PractitionerNurse MidwiferyNurse AnesthesiaNursing Education

Post Masters ProgramsNurse MidwiferyFamily Nurse PractitionerNursing Education

PhD in Nursing

East Carolina UniversityBSN in Nursing

MSN in NursingAdult Health NursingClinical Services AdministrationCommunity Health NursingFamily Nurse PractitionerNeonatal Nurse PractitionerNurse MidwiferyNurse AnesthesiaNursing Education

Post Masters ProgramsNurse MidwiferyFamily Nurse PractitionerNursing Education

PhD in Nursing

Fayetteville State UniversityBSN in Nursing (RN/BSN; joint program with UNCP)BSN in Nursing (BOG approved effectiveMay 20050

NC A&T State UniversityBSN in Nursing

NC Central UniversityBSN in Nursing

Fayetteville State UniversityBSN in Nursing (RN/BSN; joint program with UNCP)BSN in Nursing (BOG approved effectiveMay 20050

NC A&T State UniversityBSN in Nursing

NC Central UniversityBSN in Nursing




UNC CharlotteBSN in NursingMSN in Nursing

Adult Nurse Practitioner/ Clinical Nurse SpecialistCommunity Health NursingFamily Nurse PractitionerNurse AnesthesiaPsychiatric/Mental Health

MSN/MHA Dual DegreePost Masters Programs

Adult Nurse Practitioner/ Clinical Nurse SpecialistFamily Nurse PractitionerNurse Anesthesia

UNC CharlotteBSN in NursingMSN in Nursing

Adult Nurse Practitioner/ Clinical Nurse SpecialistCommunity Health NursingFamily Nurse PractitionerNurse AnesthesiaPsychiatric/Mental Health

MSN/MHA Dual DegreePost Masters Programs

Adult Nurse Practitioner/ Clinical Nurse SpecialistFamily Nurse PractitionerNurse Anesthesia

UNC Chapel HillBSN in Nursing

MSN in NursingAdult Nurse PractitionerHealth Care SystemsChildren’s HealthPrimary Care–Family Nurse PractitionerPsychiatric/Mental HealthWomen’s Health

Post Masters ProgramsAdult Nurse PractitionerHealth Care SystemsNeonatal Nurse PractitionerPediatric Nurse PractitionerPrimary Care–Family Nurse PractitionerPsychiatric/Mental HealthWomen’s Health Care Nurse Practitioner

PhD in Nursing

UNC Chapel HillBSN in Nursing

MSN in NursingAdult Nurse PractitionerHealth Care SystemsChildren’s HealthPrimary Care–Family Nurse PractitionerPsychiatric/Mental HealthWomen’s Health

Post Masters ProgramsAdult Nurse PractitionerHealth Care SystemsNeonatal Nurse PractitionerPediatric Nurse PractitionerPrimary Care–Family Nurse PractitionerPsychiatric/Mental HealthWomen’s Health Care Nurse Practitioner

PhD in Nursing




UNC WilmingtonBSN in NursingMSN in Nursing

Nursing Education

Family Nurse Practitioner

Western Carolina UniversityBSN in NursingMSN in Family Nurse Practitioner

Winston-Salem State UniversityBSN in NursingMSN in Family Nurse Practitioner

UNC WilmingtonBSN in NursingMSN in Nursing

Nursing Education

Family Nurse Practitioner

Western Carolina UniversityBSN in NursingMSN in Family Nurse Practitioner

Winston-Salem State UniversityBSN in NursingMSN in Family Nurse Practitioner

UNC GreensboroBSN in Nursing

MSN in NursingNursing AdministrationAdult/Gerontological Nurse PractitionerNurse AnesthesiaNursing Education

MSN/MBA Dual Degree Programs

Post Masters Certificates in NursingNursing AdministrationNursing Case ManagementNursing EducationGerontological Nursing

UNC PembrokeBSN in Nursing (RN/BSN; joint program with FSU)

UNC GreensboroBSN in Nursing

MSN in NursingNursing AdministrationAdult/Gerontological Nurse PractitionerNurse AnesthesiaNursing Education

MSN/MBA Dual Degree Programs

Post Masters Certificates in NursingNursing AdministrationNursing Case ManagementNursing EducationGerontological Nursing

UNC PembrokeBSN in Nursing (RN/BSN; joint program with FSU)



Distance Learning Nursing ProgramsDistance Learning Nursing Programs

Baccalaureate (RN to BSN)FSU/UNCPECUNCCUUNC-CHUNCCUNCGUNCWWCUWSSU

Master’s (MSN)ECUUNC-CHUNCCUNCG

Master’s (MPH Nursing)UNC-CH

Baccalaureate (RN to BSN)FSU/UNCPECUNCCUUNC-CHUNCCUNCGUNCWWCUWSSU

Master’s (MSN)ECUUNC-CHUNCCUNCG

Master’s (MPH Nursing)UNC-CH

MoorePasquotank, Wayne, OnlineFranklin, Person, Vance, WakeGuilford, Johnston, MontgomeryOnlineCatawbaOnslow, InternetOnline (fall ’03)Davidson, Rockingham, Rowan, Watauga, Wilkes

OnlineWakeCabarrus, Gaston, OnlineCatawba, Online

Online

MoorePasquotank, Wayne, OnlineFranklin, Person, Vance, WakeGuilford, Johnston, MontgomeryOnlineCatawbaOnslow, InternetOnline (fall ’03)Davidson, Rockingham, Rowan, Watauga, Wilkes

OnlineWakeCabarrus, Gaston, OnlineCatawba, Online

Online




Stokes

Guilford

Anson

BuncombeBurke

Avery

Watauga

Surry

Wilkes

Rowan

Davie

CabarrusStanly

Davidson

Moore

Caswell

Harnett

Nash

Martin

Yancy

Mitchell

Alexander

Cleveland

OrangeAlamance

Forsyth

Gates

CherokeeClay

Graham

Swain

Macon

Jackson

Polk

McDowell

Rutherford

Caldwell

AsheAlleghany

Yadkin

Iredell

Lincoln

Catawba

Gaston

Rockingham

UnionRichmond

ChathamRandolph

Lee

Hoke

Robeson

Person

Bladen

Wake

Columbus

Sampson

Pender

Johnston

Brunswick

Duplin

Onslow

Hanover New

Franklin

Warren

Wilson

Wayne

Halifax

Edgecombe

Lenoir

Pitt

Jones

Northampton

Craven

Hertford

Beaufort

Pamlico

Carteret

Hyde

TyrrellDare

Greene

Bertie

Haywood

Transylvania

Henderson

MecklenburgMontgomery

Scotland

Durham

GranvilleVance

Cumberland

Chowan

Perquimans PasquotankCurrituck

Washington

Camden

Madison

UNC Campuses with Nursing Degrees

Off-Campus Sites for UNC Nursing Degrees

UNC Nursing Enrollment: Degree Credit Headcount, 1990-91 through 2002-03

UNC Nursing Enrollment: Degree Credit Headcount, 1990-91 through 2002-03


16

Year Baccalaureate Master's Doctoral Total1990-91 1,728 546 26 2,3001991-92 1,905 621 33 2,5591992-93 2,136 719 36 2,8911993-94 2,184 717 34 2,9351994-95 2,395 730 32 3,1571995-96 2,247 515 30 2,7921996-97 2,297 639 27 2,9631997-98 2,301 702 36 3,0391998-99 2,231 740 39 3,010

1999-2000 2,109 772 42 2,9232000-01 2,055 736 50 2,8412001-02 1,972 679 53 2,7042002-03 2,303 794 62 3,159

UNC-OP Academic Planning/ARM-wmd/02-12-04

UNC Nursing Degrees Conferred: 1990-91 through 2002-03

UNC Nursing Degrees Conferred: 1990-91 through 2002-03

Year Baccalaureate Master's Doctoral Total1990-91 509 100 6091991-92 728 127 8551992-93 878 140 1,0181993-94 888 196 2 1,0861994-95 922 199 2 1,1231995-96 979 204 5 1,1881996-97 1,058 242 7 1,3071997-98 1,073 163 3 1,2391998-99 1,115 216 3 1,334

1999-2000 1,109 201 7 1,3172000-01 1,017 253 2 1,2722001-02 1,042 237 6 1,2852002-03 976 195 7 1,178





Proposed UNC Response 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



Proposed UNC Response 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

task force on the north carolina nursing workforce & unc response

Documents