Kansas nursing shortage: Recruitment efforts, The

August 25, 2003

Excerpts only from KSNA estimony to Long Term Care Task Force

General Overview

Kansas is not unique, all states are experiencing a nursing shortage. This shortage was predicted as the aging co-hort of the population increases (the greying of America), the technology and pharmacological tools available in the healthcare community to control chronic illness better and cure/maintain life-threatening illnesses expands, and the pool of traditional and non-traditional students has declined. The working conditions facing RN's has also had a significant impact, these include: increased workloads-caring for more acutely ill patients, salary compression, round-the clock 24-7-365 to deliver services, and the growth of other opportunities that RN's can pursue. For the past 7 years Kansas has experienced a decline in nursing school enrollments and graduations. RN's have left the workforce burned out and dissatisfied with the care they were daily challenged to provide, and many who have stayed, unfortunately have not been able to encourage young folks to tenter the profession due to their own levels of dissatisfaction.

Data About the Shortage: Reports

Numerous reports have been prepared at the national level, and some at the stat level studying/tracking the shortage. There is a report prepared by the Division of Nursing, U.S. Department of Health & Human Services (HHS) entitled "The National Sample Survey of Registered Nurses (March 2000)" every ten years. It uses statistically sound methodology, surveying RN's in every state, not relying on Boards of Nursing Licensure data due to its incompleteness and diversity state by state regarding the collection of workforce related data specifically.

The report was published in February of 2001 and it reveals that Kansas has 23, 779 RN's employed in nursing (81.6%), and has 18.4% of the RN workforce are not employed. Now from a statistically perspective, the Kansas numbers arc in the middle range compared with other states. This tells us a couple things, when compared to the national average per state of those not in the workforce (also 18%), we are probably not in a position to recruit those RN's back into the workforce (for now) - if our numbers in Kansas had been higher than 18%, then we might want to focus energies there, but not now. Kansas RN's are still, despite recruitment strategics for minorities and men, are predominantly Caucasian women (never falling below 96% statewide for gender), many of whom are sole family providers, heads of households, daughters, and mother with family and care giving responsibilities. In july 2002, another report entitled "Health Workforce Analysis Projected Supply, Demand and Shortages of Registered Nurses: 200-2020" by the Health Resources & Services Administration (A Divisions HHS) was released that gave predictions through 2020 about the projected demand for RN's in the country. Overall that report indicated that there was a shortage of 110,000 RN's (6%), and that without changes in the system, the shortage nation wide would grow to 12% by the year 2010, 20% by 2015, and 29% by 2020. Unfortunately, that HRSA report listed Kansas as one of the 5 state that according to their data was not going to have a nursing shortage, and that the supply of RN's exceeded demand.

Other studies have also been done, and reports prepared:

Kansas's current vacancy rate in hospitals is 11.3% for RN's these numbers are higher than in 2003 with 7.8 % for RN's. (KHA) The Joint Commission of the Accreditation of Health Care Organization, the Robert Wood Johnson Fund, and the American Hospital Association have all also completed reports and surveys in the recent past documenting, detailing and recommending strategies to curtail, and address this trend. Much of the same data is used in these reports, with slight variations on specific themes, and generally three areas emerge about what needs to be done to address the worsening shortage. Those areas are:

* Creating and maintaining workplace environment that retain nurses,

* Increasing the nursing education infrastructure (there is a significant aging of the RN educators nationwide and in Kansas, and Master's prepared RN's seeking ARNP positions paying higher salaries than pursuing education positions in our schools of nursing), and

* Increasing the financial investments for nursing (for salaries and compensation, and to increase staffing levels causing such great concern for the bedside staff nurse.)

Strategies to Address the Shortage and Actions to Date

KSNA convened a "Nursing Shortage Summit" in April 2001 with the stakeholders in the industry invited to participate. From that meeting a "Plan to Address the Kansas Nursing Shortage" was developed and is being implemented. We are working with industry representatives, educators and staff nurses to increase the RN workforce and encourage workplace environments that will retain them.

There have been two nationwide media campaign efforts in various states of implementation.

The large national nursing organizations formed an entity called "Nurses for a Healthier Tomorrow" to focus a recruitment campaign for nursing students and raise the public awareness of the contributions nurses make to communities. That campaign is using resources from foundations, the pharmaceutical industry and other interested parties to promote their message. It has several phases and needs funding to implement and go forward.

More recently the Johnson and Johnson Company conducted a nationwide media blitz to raise awareness about nursing as a career, and continues to make available very high quality promotional materials for use by organizations. Included in my presentation is a sample of the brochures they make available.

To capitalize on these media efforts KSNA, through our Foundation, the Kansas Nurses Foundation secured some grant funding from the Sunflower Foundation to create a "Resource Center" for Recruitment material and create a Kansas specific web-site that promotes nursing at all levels, beginning with nurses aides, through LPN and RN education. This web site is now up at "kansasnursingcarecrs.com" and links to all nursing programs in the state providing formal education and training, and materials to promote nursing among three audiences: school age children, high-school age career seeking individuals, and the non-traditional student going back to school or making a career adjustment. In the past couple of years we also conducted contest that senior nursing students could enter for the development of materials that could be used to promote nursing as career in Kansas to school age children of the current generation. Contest entries became the property of KSNA, and we are using these materials on the web site as well. The school age generation, as you can imagine has grown up with a different "high-tech" perspective and hopefully we will be successful in appealing to them with the materials and presentations developed. Ideally, we've talked about recommending all the Kansas Schools Nursing have their seniors (individually) conduct one presentation annually to a 5th grade glass about Nursing as Career and over a 5 year period of time we would be pretty successful at introducing this concept to a majority of the 30,000 5th graders each year.

The Nurse Educations in Kansas have also been working towards strategies that ease the transition for LPN's seeking to become RN's and Associate Degree Nurses to seek Bachelor's degrees. They have been successful in improving the articulation plans (required as a result of the 1202 Commission recommendations of 1976 in Kansas) so that credits arc more easily recognized and transferred and students seeking further education are spared the challenges that use to accompany transferring education credits and gaining recognition of previously completed course work. This endeavor demonstrates great leadership and commitment by our educators, representing the RN & LPN programs in the Vo-Technical schools, Community Colleges, Regents Schools, and public and private sector programs. Kansas has been a leader in "articulation" opportunities for nursing, and this work has taken us to a new level of sophistication for potential students.

The Board of Regents through a program promoted by the U.S. Department of Education are making available to primary and secondary schools curriculums that will support "Health Career Paths Model". This program is relatively new, but has great promise for preparing children to enter schools of nursing with the pre-requisite education necessary to be successful.

State Policy Issues

Nursing Student Scholarship Program: Started in 1990 from legislation passed under the Hayden Administration, this program provides a public/private partnership for the provision of nursing scholarship money to educate RN's and LPN's. Hospitals, Long Term Care facilities, state institutions, home health agencies and public health now participate by sponsoring a student and enjoying the benefits of a "work" payback arrangement for each year of educational support. For the 2001-2002 academic year 244 applications were received, 152 were funded, with 38 students added to the waiting list, the current academic year statistics include 247 applications received, 130 funded, with 89 on the waiting list. For the 2003-2004 academic year there were 110 funded, with 76 on the waiting list.

Copyright Kansas State Nurses Association Sep 2003
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