Issue link: https://tmcpulse.uberflip.com/i/1152989
t m c » p u l s e | a u g u s t 2 0 1 9 t m c » p u l s e | a u g u s t 2 0 1 9 34 Passionate and focused, Sam was among the hordes of nurses nationwide who bristled against comments made by Washington state senator Maureen Walsh this spring. Walsh denounced a bill that would grant nurses uninterrupted rest and meal breaks, saying she suspected that nurses in some rural areas "probably play cards" during their shifts because they have so much down time. Nurses shot back on social media, laying out the breadth and scope of their work. Many, many nurses sent Walsh decks of cards. Managing the looming shortage Institutions are digging deep to educate incoming nurses and retain the nurses they have. In 2012, The University of St. Thomas opened the Carol and Odis Peavy School of Nursing with 28 undergraduate students. Six years later, the school added the doctorate of nursing practice— graduates of this program will become nursing professors. To keep a steady influx of pro- spective nurses, UTHealth's Cizik School of Nursing admits students to their baccalaureate program three times a year. "No summers off," Rozmus said. "There's always going to be that need for that nurse by the bedside. Patients are hospitalized for nursing care. In our baccalaureate education, that's what we're preparing people to do." Most hospitals offer residency programs that help new nurses get up to speed by pairing them with preceptors—experienced nurses. At Memorial Hermann Health System, a nurse residency program offers between six and 12 months of training for new nurses, pairing new graduates with experienced nurses before giving newbies their own patients. In addition, Memorial Hermann offers a nurse executive leadership academy that helps nurse managers and executives develop leadership skills. Because it is so difficult to find settings where nursing programs can give students hands-on time with patients, simulation training is catching on. Texas Woman's University College of Nursing created an immersive, 72-hour training, modeled after a program designed by NASA educators, in which nursing students are called on to juggle complex medical scenarios. Students also play the part of patients. In June, UTMB opened a simulation center on campus— a 92,000-square-foot building with high-tech mannequins and room for students and actors. What more could we do? All institutions should strive to accommodate the nurse who is 55 or 60 and wants to work, say, a 6-hour shift rather than a 12, Stokes asserted. "Let somebody job share with that nurse," he said. "You don't want that nurse to retire. That's the nurse who's training all the younger nurses. That's the brain trust. You want to be flexible in your scheduling." Zolnierek said she worked in a medical surgery unit with a clinical mentor program that paired new graduates with experienced nurses, including a nurse who celebrated her 80th birthday in the unit. The clinical mentors did not take any patients; they simply provided clini- cal oversight to the new nurses. "I thought that was an innovative approach," Zolnierek said. "We were trying to accelerate the skill development you only get through experience, and we offloaded the physical demands of the work. … Younger nurses weren't getting burned out because they had a level of support." Stokes also sees a local opportu- nity to nudge high school students from the Houston Independent School District (HISD) toward health care careers. "We need to work with HISD," he said. "During junior and senior years, if you want to be a nurse, you go to school in the morning and nursing school in the afternoon. When you graduate from high school, you can sit for your LPN [licensed practical nurse] boards and make $18 to $20 an hour as a liv- ing wage. … For some families this is about breaking the cycle of poverty. And if community colleges part- nered with high schools to get kids interested in health care, it would go a long way toward solving the allied health workers shortage." Nursing students also should be encouraged to consider jobs outside of major metropolitan areas. "A lot of underserved areas have to incentivize folks," Nibert said. "We've got real prob- lems with health care personnel concentrated in major cities and not so much in rural areas. If you are willing to go where the areas of highest demand are for nursing, it's not necessarily here in the Houston metro area where they're going to see the highest pay gains." One way to increase the number of sites where stu- dents can hone their clinical practice skills and get time with patients is to tap into non- traditional health care settings, Zolnierek said. Assisted living facilities, homeless shelters, primary health care clinics and other places that need nurses might offer valu- able opportunities. Most experts agree that the pro- fession would be able to keep more nurses at the bedside by devising more creative retention strategies. "We have to figure out ways to keep nurses at the bedside while they go back to school," Jones said. "We have to increase partnerships between nursing schools and hospitals and outpatient settings so we are working together. Maybe a school of nursing provides all those nurses with a master's degree with hospital-procured funding and the nurses stay in that hospital setting. That could be a win for everybody involved." There is no simple solution to the nursing shortage, but as the need for nurses grows more acute, patients and the health care community will feel the pain. "People see what nurses do. What they can't see is what's going on between a nurse's ears—what she is looking at, evaluating and thinking," Zolnierek said. "That's the real value of the nurse. The nurse can interpret what she is seeing and know what needs to be done to protect a patient and allow a body to heal." Ainslie Nibert, Ph.D., is associate dean of the Texas Woman's University nursing program in Houston. Credit: Courtesy photo Registered Nursing is among the top occupations in terms of job growth through 2026. The national RN workforce is expected to grow from 2.9 million in 2016 to 3.4 million in 2026, an increase of 438,100 or 15 percent. By contrast, the average growth rate for all occupations is 7 percent. An estimated 203,700 new RNs will be needed each year through 2026 to fill new positions and to replace retiring nurses. Source: Bureau of Labor Statistics