Nursing and Nursing Education Public Policies and Private Actions (1983) / Chapter Skim
Currently Skimming:
SUMMARY AND RECOMMENDATIONS
SUMMARY AND RECOMMENDATIONS
Pages 1-23
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
Should the federal government continue its specific support of generalist nursing education in order to assure the adequacy of their supply? What are the means to bring better nursing services to underserved populations in rural and inner city areas, as well as to elderly and minority populations who generally lack adequate access to nursing care?
|
From page 2... ...
RECOMMENDATION 1 No specific federal support is needed to increase the overall supply of registered nurses, because estimates indicate that the aggregate supply and demand for generalist nurses will be in reasonable balance during this decade. However, federal, state, and private actions are recommended throughout this report to alleviate particular kinds of shortages and maldistributions of nurse supply.
|
From page 3... ...
Shortages are often viewed by members of the nursing profession, employers, and others in terms of the need for RNs specifically prepared in one or more of the three different types of basic nursing education programs -- diploma, associate degree, and baccalaureate in nursing -- and of the additional need for LPNs. The committee concluded that there was no evidential basis for making national recommendations on the desired proportions of RNs to be prepared in each basic educational pathway, or on the distribution of RN and LPN nursing service personnel within and among diverse nurse employment settings.
|
From page 4... ...
It also is apparent that state studies estimating future supply and need mainly on the basis of professional judgments of numbers and kinds of nursing personnel needed (by type of educational preparation) produced widely different estimates in levels and mix of staffing (and of amounts of time required by nursing service personnel per patient day)
|
From page 5... ...
Nursing students, who are predominantly women, finance their tuition and living costs from a combination of sources: the very limited funding remaining under the Nurse Training Act scholarship and loan programs; general federal programs of financial aid for all postsecondary students; state and collegiate grant programs; earnings; and personal and family savings. Higher education -- and nursing education in particular -- is entering a period in which resources will be more constrained than in the past.
|
From page 6... ...
These considerations link this recommendation and the preceding ones, because it is essential to maintain a monitoring capacity at both national and state levels to track current supply and demand and to refine at the level of each state the continuing adjustments necessary in resource allocation to assure continuing adequate accretions to the pool of generalist nurses. Attracting New Recruits to Nursing RECOMMENDATION 5 are financed To assure a sufficient continuing supply of new applicants, nurse educators and national nursing organizations should adopt recruitment strategies that attract not only recent high school graduates but also nontraditional prospective students, such as those seeking late entry into a profession or seeking to change careers, and minorities.
|
From page 7... ...
Educational institutions will inevitably incur some added costs for steps taken to ease students' transitions from one educational program to another. On the other hand, where experienced nurses successfully challenge clinical requirements, educational institutions may also benefit from proportionately fewer enrollments in the more expensive clinical components of their nursing education programs.
|
From page 8... ...
Improving Collaboration Between Nursing Education and Nursing Services RECOMMENDATION 7 Closer collaboration between nurse educators and nurses who provide patient services is essential to give students an appropriate balance of academic and clinical practice perspectives and skills during their educational preparation. The federal government should offer grants to nursing education programs that, in association with the nursing services of hospitals and other health care providers, undertake to develop and implement collaborative educational, clinical, and/or research programs.
|
From page 9... ...
In examining the future need for nurses, the committee identified a wide range of problems that can be alleviated only by increasing substantially the supply of nurses with advanced education. The nation's cadre of professional nurses is short of persons who have been educationally prepared for advanced positions in the administration of nursing services and nursing education programs, in education (including research)
|
From page 10... ...
In times of severe economic constraints, states may be more willing to finance basic nursing education programs that are perceived as directly fulfilling local demand for nurses rather than to support master's and doctoral programs, whose graduates may leave a given state labor market because they have more opportunities. The committee believes that kNs with high quality graduate education are a scarce national resource and that their education merits continued federal support.
|
From page 11... ...
An important exception to the generalization that there is a sufficient existing supply of generalist nurses for direct patient care was noted in the discussion following Recommendation 1. That exception arises from the fact that the labor market cannot function properly when there are financial, geographic, and other barriers to the provision of medical care and other health services for disadvantaged segments of the population.
|
From page 12... ...
Encouraging Consortia of Nurse Educators and Nurse Employers in Shortage Areas to Increase Minority Student Opportunities RECOMMENDATION 10 To meet the nursing needs of specific population groups in medically underserved areas and to encourage better minority representation at all levels of nursing education, the federal government should institute a competitive program for state and private institutions that offers institutional and student support under the following principles: · Programs must be developed in close collaboration with, and include commitments from, providers of health services in shortage areas. · Scholarships and loans contingent on commitments to work in shortage areas should be targeted, though not limited, to members of minority and ethnic groups to the extent that they are likely to meet the needs of underserved populations, including non-English-speaking groups.
|
From page 13... ...
These goals require re-emphasis and new approaches through a redirection of authorization and funding available under the Nurse Training Act. Thus, in addition to general educational outreach efforts, nurse educators and health care employers should jointly develop programs to ensure that students are recruited from these special groups, that they will be given employment preference, and that they will gain clinical experience in shortage area facilities, e.g., rural and inner-city hospitals, nursing homes, and public health clinics.
|
From page 14... ...
RE COMMENDATION 12 Nursing Education for Care of the Elderly The rapidly growing elderly population requires many kinds of nursing services for preventive, acute, and long-term care. To augment the supply of new nurses interested in caring for the elderly, nursing education programs should provide more formal instruction and clinical experiences in geriatric nursing.
|
From page 15... ...
should restructure Medicare and Medicaid payments so as to encourage and support the delivery of long-term care nursing services provided to patients at home and in institutions. For skilled nursing facilities, such payment policies should encourage the continuing education of present staffs and the recruitment of more licensed nurses (RNs and LPNs)
|
From page 16... ...
Their conditions often require expert nursing services. By far the largest proportion of nursing service personnel in SNFs and combined SHF/ICFs are aides.
|
From page 17... ...
WHAT ACTIONS COULD BE TAKEN TO ENCOURAGE NURSES TO REMAIN OR RE-ENTER THE NURS ING PROFESSION, INCLUDING ACTIONS INVOLVING PRACTICE SETTINGS CONDUCIVE TO THE RETENTION OF NURSES? Improving the Use of Nursing Resources RE COMMENDATION 16 The proportion of nurses who choose to work in their profession is high, but examination of conventional management, organization, and salary structures indicates that employers could improve both supply and job tenure by the following: · providing opportunities for career advancement in clinical nursing as well as in administration · ensuring that merit and experience in direct patient care are rewarded by salary increases · assessing the need to raise nurse salaries if vacancies remain unfilled · encouraging greater involvement of nurses in decisions about patient care, management, and governance of the institution · identifying the major deterrents to nurse labor force participation in their own localities and responding by adapting conditions of work, child care, and compensation packages to encourage part-time nurses to increase their labor force participation and to attract inactive nurses back to work.
|
From page 18... ...
Attention must also be given to promotions and salaries progressively adjusted to reward merit and experience in direct patient care. Cost Accounting for Nursing Services REOOMMENDATTON 17 Lack of precise information about current costs and utilization of nursing service personnel makes it difficult for nursing service administrators and hospital managers to make the most appropriate and cost effective decisions about assignment of nurses.
|
From page 19... ...
This will require studies to determine the information requirements, costing procedures, effects on the delivery of nursing services, and cost impact of such developments. A Center for Nursing Research REOOMMENDATION 18 The federal government should establish an organizational entity to place nursing research in the mainstream of scientific investigation.
|
From page 20... ...
This creates problems for nurse educators planning curricula to encourage educational advancement, for nursing service administrators trying to utilize Pus and LPNs most efficiently, and for the various organized groups within nursing who are seeking to establish new levels of kc ensure or to retain the current ones. The current lack of consensus on objectives and performance measures and evidence seriously handicaps the efforts of higher education bodies and state university systems attempting to allocate resources for nursing education in ways that will best match demand or needs for nurses with different kinds of competencies.
|
From page 21... ...
The federal government, in cooperation with the nursing profession' nursing organizations, health care institutions, and state governments, should continue to provide leadership in nurse manpower data collection in order to maintain and improve definitional conformity, to provide a sense of priorities, and to minimize duplicative efforts.
|
From page 22... ...
They build on solid foundations of policy reassessment and, thus, are designed to obtain maximum return from investments in nursing education and nursing services. Three sources of federal support for the recommendations are discussed below: continued funding under the NTA, as amended; continued funding of student support for general higher education; and payment for services under Medicare and Medicaid.
|
From page 23... ...
The committee also has presented strategies that private sector groups and institutions should pursue, such as improving the management of nursing personnel, attracting to a career in nursing students from nontraditional sources, and improving collaboration between nursing education and nursing service. To encourage such efforts, we recommend modest federal demonstration, evaluation, and dissemination expenditures under the NTA authority in the range of $1-2 million per year.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.