Newsletter Issue 8: September 2011

September 22, 2011

Category: Newsletter Archives

In This Issue

Back to School: From the Clinic to the Classroom
Leader’s Column – Education Update
Putting Their Dreams on a Fast Track: Two New Jersey Nursing Scholars Reach Professional Goals
Building a Stronger Nursing Workforce: The Case for Nurse Residency in NJ
All the News That’s Fit to Blog
New Publication from RWJF Focuses on IOM’s Recommendations for Nurses’ Educational Progression
Did You Know…?

Back to School: From the Clinic to the Classroom

Laptop? Check. Textbooks? Check. B.S.N.? M.S.N.? Ph.D.? In progress.
This fall, thousands of nurses in New Jersey are headed back to school. If last year is any indication, more than half will be enrolled in an R.N. to B.S.N. program, and more than 45 percent will be enrolled in a graduate program. Last year, 85 nursing students began pursuing a Ph.D. or D.N.P.

“I would like to extend a warm welcome to all nurses returning to academia,” said Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., interim provost of The College of New Jersey and New Jersey Nursing Initiative (NJNI) program director. “Their commitment to continuing education is exactly what is needed in New Jersey, to meet the demands for registered nurses with baccalaureate, master’s and doctoral degrees”

The state’s nurse faculty shortage is alarming, Bakewell-Sachs said. Many faculty members at New Jersey nursing schools are approaching retirement, and there are not enough people in the pipeline to fill their positions.

Filling nurse faculty positions is complicated by the fact that relatively few practicing nurses have the qualifications to teach. All nurse faculty in New Jersey must hold at least a master’s degree.

“We have seen some progress, but we are still a long way from where we need to be. Together with partners across the state, we’re working to make sure our nurses will be better prepared, our patients better attended and our health care system stronger,” Bakewell-Sachs added.

A Strong Push for Education
Last year the Institute of Medicine released a groundbreaking report—The Future of Nursing: Leading Change, Advancing Health—that provided recommendations for the nursing profession, including strengthening nurse education and training.

Under the guidance of the Robert Wood Johnson Foundation (RWJF), regional Action Coalitions are being established across the country to implement the report’s recommendations. NJNI is a partner in this effort in New Jersey, and serves as the coordinating office for the New Jersey Action Coalition, an advocacy organization led by a team of recognized and highly-respected leaders in health and health care. Of the Coalition’s four volunteer-led work groups, one is tasked with developing and implementing plans to advance and strengthen nurse education. It is doing so by exploring innovative models, such as a state-wide nurse residency pilot program. [See “Building a Stronger Nursing Workforce: The Case for Nurse Residency in NJ” in this issue of the newsletter.]

The work of the New Jersey Action Coalition builds upon the foundational work of NJNI to transform nursing education in the state. Since its launch in 2009, NJNI has been helping bridge the divide between nursing academia and practice, and has been successful in broadening the conversation and bringing new partners to the table, including business and philanthropy.

Getting to the Head of the Class
Through its Faculty Preparation Program, NJNI is attracting younger nurses to faculty roles and developing new curriculum models to enhance existing nurse education programs. In August, NJNI celebrated a milestone with the graduation of 18 Robert Wood Johnson Foundation New Jersey Nursing Scholars, the first from the program to graduate. Many of these new graduates will begin their careers as nurse faculty, teaching in New Jersey nursing schools this fall.

For those still enrolled in graduate programs, the Nursing Academic Resource Center of New Jersey, has become an integral part of their educational development. It is supported by the Partners Investing in Nursing’s Future program, a partnership of the Northwest Health Foundation and RWJF, and seven local funders, led by the Horizon Foundation for New Jersey, is housed within NJNI. It is a two-year pilot program that is providing support to graduate nursing students in scholarly writing at 12 institutions in the state. In its first year, it has become a tremendous resource for students, helping more than 800 receive the support they need to succeed in their careers. Faculty have benefited from the program also as they have appreciated having a tool to offer their students. To date, more than 50 faculty have been trained and are integrating the program into their courses.

“We have made great strides in making education more accessible to nurses and prospective nurses in New Jersey, graduating our first class of New Jersey Nursing Scholars who will go on to teach and simplifying the application process. These achievements are significant, and as their outcomes are felt across the state, our health care system and our citizens’ health will benefit,” said Bakewell-Sachs.

“Our successes are possible because of our exceptional partners. Business, philanthropic and civic leaders have all come to the table as real collaborators, providing invaluable insight and support. As the school year begins anew, we recommit to solving the challenges before us and making New Jersey a model for the country in nurse education,” she added.
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Leader’s Column – Education Update

By Edna Cadmus, Ph.D., R.N., N.E.A.-B.C., clinical professor and director, D.N.P. Program-Leadership Track of Rutgers University College of Nursing  and co-lead for the New Jersey Action Coalition

The New Jersey Action Coalition continues to work on the recommendations from the Institute of Medicine’s (IOM’s) nursing report under the four pillars ofscope of practice; education; leadership; and workforce data. Each working group addressing one of the pillars is guided by co-chairs who are working to ensure that we address the key recommendations from the report. I want to share with you the progress being made in the education work group along with the timelines.

Residency Program
The education pillar is led by Susan Salmond, Ed.D., R.N., C.N.E., C.T.N., dean of the University of Medicine and Dentistry of New Jersey – School of Nursing and Deanna Sperling, M.A.S., R.N., C.N.A., B.C., vice president of patient care services at Kimball Medical Center.  They have their sights set on having draft models crafted for two residency programs by the end of September. These programs include a transition into practice residency program for new nurses across all settings and an Advanced Practice Nurse primary care transitions model.

Subcommittees are defining the competencies needed and creating the business plans for the models.  The group is using the National Council of State Board of Nursing, Transitions to Practice Framework for new nurses, along with other documents such as the Hartford Institute geriatric competencies, to help inform their work. To read more on the Transitions to Practice Framework, go to www.ncsbn.org.

We will vet these models with key stakeholders in service and academia to ensure we have it right to meet future demands.  We plan to submit them to the Health Resources and Services Administration for funding opportunities and/or other key funders in the fall.

Academic Progression
It is time to tackle the IOM recommendation: 80 percent B.S.N. in 2020 in New Jersey.

We are far from this goal at present: New Jersey stands at approximately 47 percent baccalaureate preparation. We can and will do better.

In October during the New Jersey Nursing Initiative’s annual meeting we will begin a more in depth dialogue with stakeholders from the various groups to look at models being tested across the country and to answer thought-provoking questions to help us move forward.

At the end of the day we will have a game plan in place so that we can develop the model for New Jersey. If we keep consumers in the center and consider their needs, then I am sure we will achieve the desired outcome.
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Putting Their Dreams on a Fast Track: Two New Jersey Nursing Scholars Reach Professional Goals

Primerose Germain and Elizabeth Arnold come from different worlds; one is a middle–aged immigrant from Haiti, the other a new mom in small-town New Jersey.

But these two very different women crossed paths two years ago when they were accepted to a scholarship program for aspiring nurse educators, and now they are traveling the same road to academia. Arnold is a new full-time faculty member at Kean University, and Germain was recently hired as an adjunct professor at the University of Medicine and Dentistry of New Jersey.

“I’m excited to become a faculty member,” Arnold said. “I have a passion for teaching.”

Despite their differences, Arnold and Germain shared the same professional dream: teaching aspiring nurses and, in so doing, helping to curb a nurse shortage that threatens to undermine the quality of patient care.

But neither Arnold nor Germain was able to make her dream a reality—at least in the near term.

As working mothers, neither was able to attend graduate school on a full-time basis.

Germain, then a full-time clinical nurse and mother of three, could not afford to quit her job as a clinical nurse in East Orange, N.J., to go to school full-time, so she was working toward her master’s degree one slow course at a time at the University of Medicine and Dentistry of New Jersey. A native speaker of French Creole, she was also taking English language courses, which prolonged her education.

Arnold, meanwhile, had just given birth to her first son, and was not able to juggle the demands of a new baby with graduate school and a full-time job as a registered nurse and administrative nursing supervisor at Hunterdon Medical Center in Flemington, N.J.

Scholarship Helps Arnold, Germain Go to School on a Full-Time Basis
Then they got wind of an opportunity from the New Jersey Nursing Initiative (NJNI), supported by the Robert Wood Johnson Foundation (RWJF) and the New Jersey Chamber of Commerce Foundation, that provides select aspiring nurse educators with a scholarship for advanced studies covering tuition and fees, a $50,000-per-year stipend to cover living expenses over a period of two to four years, and a laptop computer.

The scholarship is part of NJNI, a multi-year, multi-million dollar project that is working to transform nursing education in the state. Its goal is to ensure that New Jersey has the well prepared, diverse nurse faculty it needs to educate nurses to meet the demand for health and health care in the 21st century.

Arnold and Germain applied and were two of 39 applicants accepted in the first cohort in 2009.

“I was ecstatic,” Arnold recalled. “I actually cried. It was like I won the lottery.”

Germain had a similar reaction. “For me,” she said, “it was a miracle.”

Both women said the scholarship enabled them to put their dreams on a fast track. Instead of postponing advanced education, as Arnold had decided to do, or taking courses one at a time, as Germain was doing, both women were able to quit their jobs and go to school on a full-time basis. That enabled them to accelerate their careers, save money, and spend more time at home with their families. Both women were also able to take advantage of mentoring and networking opportunities the scholarship offered.

“I was so happy,” Germain said. “If I hadn’t gotten the scholarship, it probably would have taken me three or four years, or longer, to finish my master’s degree and become a teacher.”

Now, Germain is working as a part-time clinical instructor at the University of Medicine and Dentistry of New Jersey and is plotting her next move to become a full professor.

It’s a dream that has been long in the making. Germain left Haiti at 18. When she arrived in the United States, she switched her career goals from business to nursing, but it took a long time to save enough money to cover the high cost of tuition at U.S. nursing schools. She took on stints as a bartender and as a cook to earn enough to become a Licensed Practical Nurse. From there, she earned her R.N., then a B.S.N., and now, her M.S.N.

She worked for periods in between her studies while raising a daughter and two sons and doing volunteer work. Last year, she traveled to her native Haiti to help out after the massive earthquake devastated the country. Now she is studying for the national certification examination and working part-time as an instructor in a clinical laboratory. She plans to begin work toward a terminal degree—her D.N.P.—in January.

“I’d like to become my students’ friend,” she said. “I want to make learning easy for my students, rather than stressful, as it was at times for me.”

Arnold, for her part, begins teaching a full course load this fall, including classes in nurse leadership, transcultural nursing and an independent practicum. She is excited to build on her experience as a teacher, which includes a course she designed and taught on nursing and oncology, her area of expertise.

She too plans to pursue her doctorate soon. “My plan is to take this year to learn the culture of a faculty position and then start looking at different Ph.D. programs in the area,” she said.

Both women say they could not have achieved so much so fast without the help of the scholarship. “It’s just been a very positive, wonderful experience,” Arnold said.  “I’m now eager to start the next chapter in my career.”
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Building a Stronger Nursing Workforce: The Case for Nurse Residency in NJ

Just as residencies help give doctors the knowledge, familiarity and comfort with the clinical environment to practice successfully, residencies can have value for nurses.  But in nursing today,
“there is no structured system of residency,” said Susan Salmond, Ed.D., R.N., C.N.E., C.T.N., dean of the University of Medicine and Dentistry of New Jersey – School of Nursing.   As a result, clinical agencies hiring nursing graduates into entry level positions have had to provide extended orientations and, in some cases, more structured residencies to prepare them to succeed.

Salmond co-chairs the New Jersey Action Coalition’s working group on education progression. It is a volunteer-led work group tasked with developing and implementing plans to advance nurse education— one of the recommendations in the Institute of Medicine’s groundbreaking report on the future of nursing released in the fall of 2010.

The report, Future of Nursing: Leading Change, Advancing Health, provides a blueprint for improving health and health care by transforming the nursing profession. A key strategy is to facilitate the educational progression of nurses. Salmond’s working group is beginning to identify initiatives that would strengthen nurse education in the state, including by establishing a system of nurse residencies.

“We’re looking at when nurses transfer from academia to clinical practice, or when they move from one degree level to the next,” she said. “When these transfers occur, it is not necessarily the case that they will have been prepared with the competencies needed to practice and be effective in a clinical setting.”

Establishing a Nurse Residency
Currently, orientation programs for nurses transitioning to clinical settings in New Jersey vary widely.  Some last three weeks; others last nine months.  There is little, if any, coordination between schools and hospitals or other clinical settings.  “Creating a standard residency program that integrates both academia and practice will create a better prepared nurse,” added Deanna Sperling, M.A.S., R.N., C.N.A., B.C., vice president of patient care services at Kimball Medical Center.  Sperling is co-chair, with Salmond, of the New Jersey Action Coalition’s working group on education progression.

“Participating in a residency program will empower nurses by providing them a structured transition in which they can adapt to a new work environment. Residency programs would improve the retention of nurses, since they will feel better supported within their institutions, and it would provide consistency to a system that varies tremendously from institution to institution,” Sperling said.

Many states are currently considering nurse residencies, but are enacting them in different ways. Salmond and Sperling are exploring ways to establish a residency system in New Jersey for both entry-level nurses and nurse practitioners. The residency could last anywhere from six months to one year. The aim is not to repeat content, but to assist the new practitioner in applying knowledge and enhancing skills.  The program would have a strong focus on evidence-based practice and safety.

The nurse residency program will also include competencies in gerontology, because there will be a greater need for geriatric care in the state in coming years. Acute care settings, long-term care and home care would also be addressed.

The New Jersey residency program is still in the initial planning phase, and would not likely begin pilot programs before late 2012 or early 2013.

Collaboration is Key
In order for a system of nurse residency programs to take hold in the state, those in academia and practice will need to closely collaborate. Schools of nursing will need to help with curriculum development. The goal would be to offer academic credit for residency participation so that it encourages nurses to move to the next degree level, Salmond said. Health care facilities will need to identify funding for individuals to receive this kind of professional development, and will need to provide sites for residencies to take place.

“The standardization of nurse residencies in New Jersey would have a significant impact on patient safety by strengthening the health care workforce,” said Salmond.

“This has been a long time in coming,” noted Sperling. “People are really excited about this and we have a lot of momentum and energy right now. There’s no doubt nurse residencies would help our profession grow, and make it stronger.”
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All the News That’s Fit to Blog

What do a school nurse researcher, the president of the chamber of commerce, the leader of an insurance provider, and a new nurse faculty member have in common? All have blogged for, or have been blogged about, on New Jersey’s latest source for nursing news.

In May the New Jersey Nursing Initiative (NJNI) launched the News & Notes on Nursing in NJ blog, a virtual space for news and updates on issues related to nursing in the state.

Throughout the summer, the blog has posted stories by and about nurse leaders, education challenges and triumphs,new resources, and more. A weekly news digest offers the top stories on nursing.
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New Publication from RWJF Focuses on IOM’s Recommendations for Nurses’ Educational Progression

Following up on recommendations from the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report, the latest edition of the Robert Wood Johnson Foundation’s Charting Nursing’s Future series focuses on increasing the formal education of the nation’s nursing workforce. Perhaps most notably, the report calls for greater emphasis on bachelor’s and doctoral degrees, and sets specific targets. Among those targets: 80 percent of the nursing workforce with a bachelor’s or higher degree by 2020 and doubling the current percentage of nurses with doctoral degrees by the same date.

As the new Charting Nursing’s Future observes, these goals “will require fundamental changes: new competency-based curricula; seamless educational progression; more funding for accelerated programs, educational capacity building, and student diversity; and stronger employer incentives to spur progression.” The publication covers each of these topics in detail, discussing key challenges and solutions, and offering success stories from programs already in place.

The issue is the first of four that will focus on implementing Future of Nursing recommendations. Charting Nursing’s Future is available for free download here. To subscribe to free delivery of future editions to your email inbox, click here.
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Did You Know…?

The New Jersey Nursing Initiative has just released the results of a statewide asset mapping project that has helped the Initiative identify people, places and other resources that can be brought to bear to help end New Jersey’s nursing shortage. See NJ Map in Resources Section.
This online database will help policy-makers and others determine which resources can be employed and where, to ensure that people all across the state have access to quality health care.
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