vt. nurse workforce background information for the blue ribbon commission on nursing october 6, 2011...
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VT. Nurse Workforce Background Information
for theBlue Ribbon Commission on Nursing
October 6, 2011Mary Val Palumbo DNP, APRN
University of VermontAHEC Nursing Workforce Initiatives
Members of the Nursing Workforce
Licensed Nursing Assistant (LNA) 6 wks
Licensed Practice Nurse (LPN) 1 yr
Registered Nurse Diploma – 3 yr ADN – 2yr
Members of the Nursing WorkforceRegistered Nurse BS or BSN – 4 years
Members of the Nursing Workforce – Advanced Practice
MSN – Nurse Practitioner, Nurse Anesthetist, Nurse Midwife, Administrator or EducatorDNP – Doctor of Nursing PracticePhD – Nurse Scientist/Educator
Recent History
Blue Ribbon Nursing Commission January, 2001
“Vermont is in the midst of a crisis. The number of nursingstudents has declined at the same time the number of workingnurses who are retiring is increasing. The confluence of thesetwo dynamics has created unacceptably high nursing vacancyrates in hospitals, nursing homes, and home health agencies.” Vermont Association of Hospital and Health Systems
Vacancy rates has high as 19% reported in 2003
Recommendations of the Blue Ribbon Nursing Commission January 2001
Create an Office on Nursing Workforce Increase salaries Establish a marketing partnership and X Develop a Scholarship Program Fund a Loan Forgiveness Program Increase capacity of nursing schools Expand continuing education programs
Age of RN’s Working in VT
7%6%
20%
14%
42%
24%26%
38%
7%
19%
20-30 31-40 41-50 51-60 61+
Years of Age
2001
2009
Board of Nursing Relicensure Surveys in 2001 n = 6,008 (85% response rate) 2009 n = 3,627 (54% response rate)
The Nurse Age Dilemma
2%4%
7% 7%
10%14%
19%19%
12%
7%
0%
5%
10%
15%
20%
25%
30%
Employed Vermont nurses
Years of Age
2009 RN Relicensure Survey completed in March, 2009 by 3,627 VT employed nurses (54% response rate)
2001- 2003 Focus on Recruitment
Educational change over decade
Five Vermont schools of nursing VTC – online re-entry, LPN, ADN expandedSouthern VT college – ADN, RN to BSNUVM – BS, RN to BSN expanded, MS Castleton – ADN, new BSN, RN to BSNNorwich – BSN, MSN nursing admin/education
Plans: VTC - BSN, UVM - DNP
Educational Level of Vermont Nurses
From re-licensure survey was completed in March, 2009 by 3,627 VT employed nurses (54% response rate)
• 17% completed a Diploma program in nursing• 40% completed an Associate’s Degree in nursing• 35% completed a Bachelor’s Degree in nursing• 5% completed a Master’s Degree in nursing• <1% completed a Doctoral degree
129
0
50
100
150
200
250
300
350
Total RN
VTC LPN
UVM
CSC
S.VT.C
VTC AD
Norwich
Vermont Nurse Graduates1999-2011
301
169
Vermont Nurse Graduate by Type/Degree 2011
BS or BSN; 23%
Asso-ciates; 41%
LPN; 36%
BS or BSNAssociatesLPN
*Does not count – RN to BSN graduates in 2011
2011 RN Graduates in Vermont
BS or BSN; 35%
Associate Degree; 65%
BS or BSN
Associate Degree
VTC, CSC, SVC
UVM, Norwich
17 1026
1325
7786
131
154137
147134
0
20
40
60
80
100
120
140
160
180
Applicants toGraduate NursingProgram
Applications to UVM Masters Program in Nursing 2000 to 2011
21
10 612 10 7
12 8 4 3
18128
4
1
27
27
1 5
2
1
05
10152025303540455055
UVM Clinical SystemsManagement
NorwichAdministration/Educator
UVM Psych/Mental Health
UVM NP
Nursing Masters' Degrees in Vermont 1999 to 2011
2005-2009 Policy Work
• In Collaboration with AHEC and other stakeholders:– Nurse Faculty
Loan Repayment– October Designated as Health Care Career
Awareness Month– Workforce Development Partners (grant and
policy work)
Infrastructure to collect and analyze health care workforce data
• Office of Nursing Workforce collected 10 years of Vermont Supply and Demand data which is available at http://www.choosenursingvermont.org/
• Vermont Board of Nursing is now working with the National Council of State Boards of Nursing to collect a “Minimum Data Set” electronically with relicensure of RNs, LPNs, and APRNs.
• Office of Nursing Workforce (now AHEC)has published studies on educational determinants of satisfaction and retention, intention to leave, emergency preparedness, youth perceptions of a nursing career, nurse perceptions of their health and safety and their employers attention to same. (2004-11)
Implement nurse residency programs
Vermont Nurses In Partnership, Inc. (VNIP) provides an international forum for nurse leaders from academia, regulation and various practice settings that are working to improve transition to practice for direct care providers. The forum has grown from the initial 45 Vermont-based members, to a coalition of over 500 nurse leaders from across the nation and around the world.
http://www.vnip.org/
Remove scope-of-practice barriers
As of June 1, 2011, experienced nurse practitioners are no longer required to have a written “collaborative agreement” with an MD.
Scope of practice barriers remain for APRNs and RNs
22
Magnet Hospitals
• Southwestern Vermont Medical Center (X3)
• Rutland Regional Medical Center
• Dartmouth Hitchcock Medical Center (X2)
A hospital where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery . Segen's Medical Dictionary. © 2011
New challenges for Nurses
• Vermont Blue Print for Health requires attention to health promotion and population health
• Transition to Electronic Medical Records requiring nurse input
• Health care reform and primary care provider shortage.
Old Challenges
• Nursing faculty shortage• Availability of clinical
placement sites for nursing programs
• Nurse health and safety (older and younger)
• Pending retirement of half the workforce
• Interest in caring for elders
Why you? Why us? Why now?