ALERT - Action Needed to Maintain $50 Million Increase for Nursing Education

Hellllllo Nurse, BSN, RN · Sep 28, 2003

I don't know if I support the Reinvestment Act or if it is even a good thing for nurses. It will just result in a whole lot of new nurses who will face the same terrible working conditions and abuse that the rest of us face.

The Powers That Be seem to feel that we older nurses are used up, and that they need a new crop of nurses who still have good backs and are naive as to how they will be treated as nurses.

What about us? The experienced nurses?

The Reinvestment Act does nothing to improve conditions for the nurses that are here, now. It does nothing to retain nurses, or to lure nurses whom have left back to the bedside.

Rapheal · Sep 28, 2003

I have a problem with the nurse reinvestment act. It seems (and correct me if I'm wrong) that this money is used primarily for recruitment. When I was in school they used these funds to recruit, recruit, recruit. We had so many more students after the first year I started.

The problem was that my school did not have the facilities nor the resources to handle these new students and their learning needs. So we had many more students failing out. A big waste of their time and money. This really bothers me because a nursing student sacrifices so much time and money. Time away from their family, lost wages due to working less or not at all to attend school. Then to fail out because the school did not adaquately address their needs. It is unfair and downright greedy of the schools to do this. The nurse reivestment act only helps to keep this cycle of many students enrolling, many students failing.

I would really be interested in the stats of how many students that enroll in any given school actually complete the program. My class had a less than 30% completion rate. The school (and many students) blame the failure on students who couldn't hack it. I feel differently. I feel many of these students could have been excellent nurses if given the resources and support to complete the program.

Right now schools are judged by their NCLEX passing ratios. This IMHO only encourages schools to weed out students who they feel will not pass NCLEX and reflect poorly on their passing ratios. This is not fair and not a way to obtain new nurses. This is just my opinion on the whole situation.

Home Health Columnist / Guide · Sep 29, 2003

originally posted by hellllllo nurse
what about us? the experienced nurses?

the reinvestment act does nothing to improve conditions for the nurses that are here, now. it does nothing to retain nurses, or to lure nurses whom have left back to the bedside.

stongly disagree here. have you read the law?

pub.l. 107-205 to amend the public health service act with respect to health professions programs regarding the field of nursing

scroll to law107-205:

http://www.access.gpo.gov/nara/publaw/107publ.html

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from what does the nurse reinvestment act mean to you?

http://www.nursingworld.org/ojin/topic14/tpc14_5.htm

title ii. nurse retention

title ii addresses the nursing shortage by emphasizing the role of the work place in retaining and enhancing the education and professional development of nurses.

title ii addresses nurse retention. this component of the nurse reinvestment act represents a significant departure from older versions of nurse training and nursing education laws described in title 8 of the public health service act. typical legislation relied on schools of nursing to address the cyclical nursing shortages, focusing on increasing the supply of nurses, preparing nurses for specified areas of practice, and encouraging work force diversity by the recruitment of minority students. the literature on the current nursing shortage identifies retention as a factor and proclaims that nurses change jobs and careers because of issues in the workplace (aiken et al., 2001). contemporary debate often cites the culture of the hospital workplace as a factor in the shortage. mandatory overtime became the mantra to focus attention on poor working conditions. newspapers reflected the charge that acute care hospitals are not good places for nurses or patients (fackelmann, 2001). on the positive side, the reawakened interest in the work place focused new attention on the value of magnet hospitals (mcclure, poulin, sovie, & wandelt, 1983). these institutions attracted and retained nurses because of the governance style of the organizations and their ability to engage nurses in decision making.

section 201, building career ladders and retaining quality nurses

the first section of title ii, nurse retention, looks to the work place for solutions to the diminished supply of nursing.

- section 831, nurse education, practice, and retention grants: this section, composed of parts a, b, and c, addresses funding priorities in education, practice and retention. it applies practice and educational frameworks to retention with two categories: (a) nurse education, practice, and retention, and (b)building career ladders and retaining quality nurses.

- section 831a, education priority areas: this section provides funds to expand enrollment in baccalaureate nursing programs, to develop internships and residency programs in nursing specialties, and to encourage new educational technologies.

under the heading of nurse education, section 831a targets funds to expand baccalaureate enrollment, to develop/implement internship and residency programs to encourage mentoring and specialization, and to provide education in new technologies, including distance-learning methods. while these strategies are familiar, they are endorsed by a wide constituency that includes the american association of colleges of nursing (aacn) and the joint commission on accreditation of healthcare organizations (jcaho), (jcaho, 2002; tri-council for nursing, 2001).

- section 831b. practice priority areas: this section describes the availability of grants to demonstrate new nursing practice arrangements that improve access to primary health care for underserved and high-risk populations and to develop skill in providing managed care and quality improvement in organized health systems.

section 831b introduces new ideas as it gives the secretary authority to award demonstration grants or contracts; to establish/expand practice arrangements in non-institutional settings; to improve access to primary health care in medically underserved communities; to provide care for underserved and high-risk groups, such as the elderly, persons with hiv/aids, substance abusers, the homeless, and victims of domestic violence; to provide managed care, quality improvement, and other skills needed to practice in existing/emerging health care systems; and to develop cultural competencies among nurses. recent manpower policies have justified support for nurses because of the need to provide care to underserved peoples, many of whom come from cultures different from their nurses (health resources and services administration [hrsa], 2002b). the multifaceted section 831 addresses many of these priorities. however, it introduces the idea that the health care delivery system - the work place - is in need of reform. study after study has shown that many staff nurses feel powerless because no one listens to their ideas for improvement or gives them support to initiate pilot projects or to demonstrate creative strategies (aiken et al., 2001). the nurse reinvestment act of 2002 calls for innovation in community health care highlighting the need to deliver culturally competent care in communities. it suggests that transformation and quality enhancement of new health care systems in hospitals and communities will create work sites attractive to young men and women.

no one expects contemporary law to create a vision for the future.

however, section 831b challenges the nursing community to envision and create practice environments that respond to contemporary and future demands, are more supportive of patients and their families, and create healthier places for nurses to practice their profession. along with this challenge comes grant funds to individuals or agencies that develop programs that are innovative and responsive to the categories identified in section 831b. this section invites cross-disciplinary co-operation between colleges of nursing and among health care settings.

- section 831c, retention priority areas: in this section, priority is given to the development of career ladder programs and the design of systems that enhance the delivery of patient care by improving collaboration and communication within the health care team .....

Hellllllo Nurse, BSN, RN · Oct 3, 2003

Career ladders, money for more nursing education... whatever.

I will not return to hospital work until reasonable and safe nurse to pt ratios are legally mandated and enforced. The Nurse Reinvestment Act does not address ratios and work load, which are, imo, the most important issues in nursing today.

NicuNsg · Oct 3, 2003

It would bring more nurses into the hospital for godsakes!!!!!!!!!!!

That would help ratios. I help with a resolution that we presented to the SNA here in Florida, which had to do with lobbying to get the funds in the bank (so to speak). The reinvestment act is not a cure-all but it is a start. Great to see that someone in Washington is making it priority.

Thanks Karen!