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Nationwide Nursing Shortage Spotlights Need for Retention Programs



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Apr 16, 2009 10:01 AM

Nationwide Nursing Shortage Spotlights Need for Retention Programs


from PRNewswire ..

-- Median Turnover Rate of 27.1 Percent for First-Year Nurses Jeopardizes Quality of Patient Care

-- UHC/AACN Nurse Residency Program(TM) Reduces Turnover Rate to Almost One-Fifth the National Average

-- Retention Efforts Save Houston Hospital More Than $700,000

OAK BROOK, Ill., April 15 /PRNewswire/ -- The recent health care summit at the White House spotlighted the nursing shortage, which threatens the quality of patient care throughout the nation's hospitals. Nearly 80 percent of registered nurses believe the shortage has a major impact on their ability to provide high- quality care, according to a recent study by nursing shortage expert Dr. Peter Buerhaus.

The University HealthSystem Consortium (UHC), an alliance of 103 academic medical centers and 210 of their affiliated hospitals, supports the Obama administration's call to action by imploring all hospitals to focus on nursing staff retention, especially during the economic downturn.

According to the latest projections from the U.S. Bureau of Labor Statistics, more than one million new and replacement nurses will be needed by 2016. For new nurses entering the profession, turnover is a major issue. In fact, the median voluntary turnover rate for first- year nurses is 27.1 percent, according to a July 2007 report from PricewaterhouseCoopers' Health Research Institute.

To address first-year nurse turnover, UHC worked in conjunction with the American Association of Colleges of Nursing (AACN) to develop the UHC/AACN Nurse Residency Program(TM), which offers a curriculum and support for new graduate nurses. This one-year program provides first-year nurses with tools to adjust to the high pressures of working as a hospital nurse and has shown remarkable success in nurse retention.

"First-year nurses often have a difficult transition into practice after graduation because of heavy case loads and patients who require more complicated care," said Cathy Krsek, RN, MSN, MBA, director of the UHC/AACN Nurse Residency Program(TM) and a registered nurse for more than 35 years. "The Nurse Residency Program helps first-year nurses adjust to the complex hospital environment and improves retention. As a result, patient care is not compromised, and hospitals save money on turnover costs."

Nearly 14,000 nurses have participated in the UHC/AACN Nurse Residency Program(TM) since its inception in 2002, and the average turnover rate for program participants has dropped to 5.6 percent-- almost one-fifth the national average.

"Like other health professionals, registered nurses benefit greatly from having a support structure to help them transition from college to the real world," said Polly Bednash, PhD, RN, FAAN, AACN's CEO and executive director. "New graduate nurses who complete the Nurse Residency Program demonstrate significant reductions in stress levels and improvements in organizational, prioritization, communication, and leadership skills."

At University of Wisconsin Hospital & Clinics, the new graduate turnover rate for nurses was 34 percent in 1999. After the organization joined the UHC/AACN Nurse Residency Program(TM), that turnover rate dropped to 10.8 percent in the first year and 6.8 percent in the second year.

In addition to reducing the turnover rate, the UHC/AACN Nurse Residency Program(TM) helps hospitals save money. The estimated cost to replace just one new graduate nurse is $88,000, as reported in the January 2008 issue of the Journal of Nursing Administration. Health care organizations spend an estimated $300,000 a year for every one percent increase in turnover, according to a PricewaterhouseCoopers' Health Research Institute report.

The Methodist Hospital System in Houston calculated financial benefits of more than $700,000 based on its participation in the UHC/ AACN Nurse Residency Program(TM) and the subsequent decline in its nurse turnover rate.

"As the government and the health care provider industry look to improve the quality of care for patients, taking care of our nurses should be a top priority," said Krsek. "As more hospitals adopt the Nurse Residency Program, more nurses will be helped, which in turn will have a positive impact on the nation's quality of patient care."

About UHC

Formed in 1984, UHC is an alliance of 103 academic medical centers and 210 of their affiliated hospitals, representing approximately 90 percent of the nation's nonprofit academic medical centers. UHC provides specific programs and services to help members improve clinical, operational, financial, and supply chain performance. Offering members the UHC Patient Safety Net(R) event- reporting tool, UHC is among the first 10 organizations designated as Patient Safety Organizations by the Agency for Healthcare Research and Quality. Visit "About UHC" at www.uhc.edu for more information.

About AACN

The American Association of Colleges of Nursing (AACN) is the national voice for baccalaureate and graduate programs in nursing. Representing 640 member schools of nursing nationwide, AACN's educational, research, government advocacy, data collection, publications, and special initiatives work to establish quality standards for nursing education, influence the nursing profession to improve health care, and promote public support of nursing education, research, and practice. Web: www.aacn.nche.edu

SOURCE University HealthSystem Consortium

Originally published by University HealthSystem Consortium.

(c) 2009 PRNewswire. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc.


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18 Comments
No. 1
Old Apr 17, 2009, 09:17 AM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Shortage my a$$ I can't get a job as a new grad anywhere right now. Actually the turnover is directly related to job satisfaction... as I hear from friends all the time about the "eat their young" syndrome and general negative stigma with the "new grads". Case in point - I had a phone interview with a hospital in another state - they offered me the position and told me to apply for endorsement so I spent close to $300 and they never return my calls and I finally receive a generic "we have filled this position," e-mail. Tragic. Myself and my friends have never had a problem with "complex patients," sure... it's a learning curve but that is a motivating factor to better ourselves not quit. It's the bad culture and horizontal violence.
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No. 2
from llg
Old Apr 17, 2009, 10:25 AM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
1. The "shortage" is changing dramatically as economic conditions change. The dynamics of today's situation are very different from what they were when all the data on our current nursing workforce was gathered. It will be interesting to see how everything evolves as the economic recovery happens. How many of those RN's who have recently increased their hours will drop them back to part time again? etc.

2. I have looked into a few Nurse Residency Programs and have found a few interesting facts -- confounding variables that suggest that the "before the program" and "after the program" data are a bit like comparing apples and oranges. For example, when a hospital institutes a residency program, they often change their hiring patterns ... perhaps waiting until people pass boards to hire them ... perhaps requiring a committment on the part of the new grad as a condition of employment ... etc. These things effect turnover too. Some of the decrease in turnover may be due to these "other" things and not to the education/support provided by the residency program itself.

As an extreme real-life example: I spoke with the directors of one well-publicized residency program that was claiming a dramatic drop in the "1st year" turnover. I learned that the "pre-program" data was measured from the date of hire to the 1 year mark. However, the "post-program" data was measured from the end of the residency to 1 year beyond that -- in other words, from the 6-month point to the 18-month point. They admitted that 11% of the residents dropped out of the program during that first 6th month period, but they didn't count that as "turnover" in their statistics! That completely invalidates their comparison. Not onlly that, but during their implementation of the residency program, their hospital instituted a whole series of measures designed to increase retention (significant pay raises, increased support for BSN completion, etc.). They couldn't possibly know how much know how much effect their residency program had on retention vs how much the retention was improved based on these other interventions. But yet ... they were crediting their residency program for a dramatic improvement in 1st year retention. Totally bogus.

I'm not against residency programs. In fact, I support them. But I think we going to regret it someday if we don't get smart about the way we analyze them. There are too many confounding variables that are not being taken into consideration sufficiently to draw many conclusions about them. The evaluators and writers are ignoring those factors in most of the articles I read.
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No. 3
from Mahage
Old Apr 17, 2009, 01:05 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
I don't know how to measure success of such a program but I know i would have certainly welcomed one over the "baptism by fire" that i got at my unit. Amazingly I have survived and even learned a lot but at great emotional cost for me and high risk for my patients. I am greatly indebted to some of the fantastic nurses on my unit for helping me put on my asbestos scrubs and to find the fire extinguishers,lol! I do hope to see these programs become the norm rather than the exception. I also think mentoring programs would be helpful.

Mahage
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No. 4
from gerry79
Old Apr 17, 2009, 01:56 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Please stop with the nursing shortage huey!! There are nurses who can find jobs!!!!! The jig is up with this supposed nursing shortage! THERE IS NO NURSING SHORTAGE!!!!!!!!
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No. 5
Old Apr 17, 2009, 07:19 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Someone needs to write a publication on how there is not a nursing shortage. Any volunteers?
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No. 6
from llg
Old Apr 17, 2009, 08:36 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Originally Posted by misswhitney View Post
Someone needs to write a publication on how there is not a nursing shortage. Any volunteers?
I am not focusing on the EXACT topic ... but I am in the middle of a research project looking at RN turnover in the first 2 years after employment (for both experienced nurses and new grads.) I hope to write and publish on the complexities of the turnover data sometime in 2010 after my data has been collected for a full year 2009. Then, I plan to track some things on an ongoing basis over the next few years to track changes as the economy recovers.

I would LOVE to do work on the "nursing shortage" that would include the complex confounding variables that most researchers and publishers seem to be ignoring. (Most just see open positions and assume there is a lack of RN's. They don't explore the attitudes of nurses who are not working in the hospital and why they aren't working -- or are not working more hours.) However, to do that, I would need to find an employer that would be willing to hire me as a full time researcher. Not many hospitals hire full time researchers. Schools don't either: they hire researchers who can also teach undergraduate clinicals (which I can't) ... or full time researchers who already have a long track record of research sufficient to bring in major grant dollars to cover the costs of their both their reseach and some of their salary.

So, I can find the time to only do a little research and/or publication at a time. Right now, I am trying to find the time to write an article on summer externs programs (using my own program as a case study) and also gathering data for the project to write up next year that I mentioned above. I wish I could do more.
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No. 7
from xj3nnerz
Old Apr 17, 2009, 09:21 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
no nursing shortage... more like a make a program to help new graduate nurses transition into a healthcare facility.
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No. 8
from 2btmanrn
Old Apr 18, 2009, 10:50 AM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Hello, everyone! Good morning. I have a classmate here with me and she would like to make several comments based on her experience with our school and the HESI exam. Please, be kind with your replies. Please. Note, this is her opinion and her experiences! Lets RESPECT that. Thank You!

The academic staff at one of the City Colleges of Chicago awarded me my grades, which indicates mastery of their nursing program.
I was unsuccessful with the HESI exit exam, an exam that was utilized to protect their own pass rates two months before my graduation. The City Colleges of Chicago is implementing this exam only as an obstacle to prevent myself and other qualified classmates from taking the NCLEX RN Exam. This strategy shows only one design, and that is only to give an artificially inflated pass rate for the school. Which indicates that the City Colleges of Chicago lacks concern of the success of their students, but is only concern in protecting their own pass rates. I am not arguing the importance of appropriate and relevant testings. But the City Colleges of Chicago is using this exam to deny me and other classmates who have SUCCESSFULLY completed the academic program the opportunity to graduate and sit for boards.


It all boils down to the City Colleges of Chicago not having confidence in their own academic program. They are trying to bolster their NCLEX pass rates by eliminating me and other classmates from the test pool. If they have legitimate reason to question me and other students' ability to pass NCLEX, then why have I passed all of their nursing classes? If I had any unsatisfactory performance I SHOULD have been weeded out of the program long before completing the program! I provided above standard care of my patients and received excellent evaluations/competency from my instructors for the two years that I was in the program. My family and I sacrificed a lot. I completed the program, and paid my tuitions. My score was 85%, which indicates the probability by percentage of passing the state boards exam (NCLEX RN). Olive Harvey College stated they will not allow me to sit for boards or give me my nursing degree unless I scored 87% or above. The HESI exam is NOT a competency exam. Only the NCLEX RN is the nationally recognized competency exam. I have accumulated over 100 college credit hours and most are nursing. Nursing courses are not transferable. There over 1 ½ yr. long waiting list in other nursing programs. I am in debt from college loans and with no degree to show for it. Does this sound fair to you?


In simple terms what am I talking about?
What is the HESI exit exam? Its an exam that determines the probability by percentage if you will pass the NCLEX RN exam. It is also used for both the faculty and students, to determine the student and nursing curriculum of their areas of weakness. In other words, it’s a probability and assessment exam.
For example, there are 43 students who completed the nursing program. Out of the 43 students only three passed the HESI exit exam. Out the three who passed the HESI exit exam, only two passed the NCLEX RN exam. Now, the school can state that they have 99% NCLEX pass rate. According to the state requirement, if nursing programs can show they have above 87% NCLEX first time test taker pass rate (I think that the%) they can attain more money from the state and it will bait more investors. But, what nobody knows is that, the 40 students who completed the program, cannot attain their nursing degree or take the NCLEX RN exam. Those 40 students are left with nothing but a student loan, low self esteem, and humiliation. Four years of nursing school down the drain.
One more thing, there are seven colleges within the city colleges of Chicago. Therefore, if there are 40 students who were unsuccessful, that would not include all the other six colleges. You can assume, 40 students times 6 colleges. Plus, students graduate in December and May. That’s 240 students times 2. You do the math. My classmates have been without their earned degree since 2006. I can assure you, currently, this sort of deceptive practice is still occurring city college wide. Those students who were not successful, were abandoned by the school.


Another thing, the city college policy is so subjective. They chose who can and cannot re-take the HESI exam. Nobody knows how and why, but its true.
Here is the kicker. You can take the NCLEX RN exam, according to the state licensing board up to twelve times within three years. But, the City Colleges of Chicago only counts those students who will pass NCLEX RN exam the first time. The second time test takers don’t count. I wonder how many excellent doctors, and lawyers passed their boards the first time? I would like to hear from other city colleges of Chicago nursing students who are going through this. We need to get together democratically and voice our concerns. This sort of diagnostic test is not being utilized in medical school. Mayor Daley I hope you will read this. How many times did it take you to pass your bar exam?

There are a lot of issues and concerns regarding the punitive uses of this exam. The creator of HESI, Susan Morrison has stated herself that she did not create these exams for punitive reasons, but as a learning tool. I hope I have a few supporters regarding this issue. If the City Colleges of Chicago truly wanted their students to be successful, they should have utilized the HESI exam throughout the curriculum and NOT just at the end. It should have been implemented after each nursing course, which will give the student familiarity base, and used accordingly as an assessment tool for both the faculty and student. Why did they have to wait until we have completed the program? Can you imagine? You received you final grades, than for the school to tell you, “Oh by the way, you have to take another test, if you don’t pass this one, you will not get your nursing degree and you won’t be able sit for your licensing board?”

I would like nothing more than your support. Help my classmates, please. If you have any question please ask away. You can research this issue, there are a lot of students who have voiced their concerns. I am afraid this sort of deceptive practice is becoming a trend with most nursing programs. Other programs, have taken accountability and fixed their mistakes. Unfortunately, the City Colleges of Chicago have not. I doubt that they will.
Contact Mayor Daley, Senator Dick Durbin, reporters, past, current students, nurses and anyone else you can think of to attend and advocate us. Please!
The next board meeting will be held THURSDAY, May 7, 2009 at 9:00 a.m. Room 300 District Office, 226 West Jackson Boulevard, Chicago, IL 60606.


My classmates and I do not have anymore money to take them to court and we don’t have the resources. Telling our story is all I, we have. I pray a savior will come. I have faith in the Lord in the people. Mind you, we are NOT asking for a free-ride. We asking for what we worked hard for – the opportunity to take the NCLEX RN Exam.

I am sorry if this is so lengthy. I am sure that some of you can understand how much pain I am in. I and my classmates are suffering fiancially. Please, help us.
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No. 9
Old Apr 18, 2009, 08:22 PM

Default Re: Nationwide Nursing Shortage Spotlights Need for Retention Programs
Thank you for the clarification of what the HESI really is used for. Our school implemented the HESI as part of the exit requirement for the graduating class. This was because our "mother" school had such a low pass rate for the NCLEX while our school had a 90% pass rate. So last year they started the HESI and now this year there will be another part added-a mentor who will be with us and they also decide if we are ready to sit for the NCLEX. My class (juniors) were unsure fo what else of this meant for us but after reading this, I will surely be educating them of what this really means!! Thank you!!!
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