Southern Oregon Nursing Summit World Café
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Transcript of Southern Oregon Nursing Summit World Café
Southern Oregon Nursing Summit World Café
Information OverviewJanuary 9 & 15, 2008Red Lion Inn Medford
Sponsored by:Gordon Elwood FoundationJefferson Regional Health AllianceRogue Valley Workforce Development Council
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Sponsors
Gordon Elwood Foundation Health Care Coalition of Southern Oregon Jefferson Regional Health Alliance
Ashland Community Hospital Asante Health System Jackson County Health & Human Services Josephine County Public Health OHSU School of Nursing - Ashland Campus Providence Medford Medical Center Rogue Community College Southern Oregon University Veterans Administration - SORCC
Rogue Valley Workforce Development Council Pacific Retirement Services The Job Council
Southern Oregon Cadre of Nurse Executives
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Why We’re Here Today
To promote connection and collaboration between individuals and institutions, employers, educators, and the public at large around the nursing workforce issue.
To identify fresh regional strategies for supporting a strong, excellent nursing workforce in southern Oregon.
To inspire institutional and community action that is aligned with these strategies
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Nursing Summit
Focus Areas Nurse Recruitment & Demand Nursing Education Nurse Retention -
Profession & Practice
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Nursing Summit
Focus Areas Nurse Recruitment & Demand Nursing Education Nurse Retention -
Profession & Practice
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Nurse Recruitment & Demand
National By 2010, the demand for full-time registered
nurses will exceed supply, and grow wider in ensuing years
Nationwide, there are 796 registered nurses per 100,000 persons in the population [1:126]
The national average age of a registered nurse is 44 years
Source: Bureau of Health Professions
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Nurse Recruitment & Demand
Oregon Currently 844 registered nurses employed in
healthcare per 100,000 Oregonians [1:118], nearly the highest level in a decade
This rate is significantly improved from 1996 when there were 777 registered nurses per 100,000 Oregonians [1:128]
However, the nurse-to-patient ratio increase is due mostly to nurses migrating into Oregon & nurses returning to the workforce, not increased capacity at Oregon’s schools of nursing
Source: Oregon’s Nursing Shortage - Northwest Health Foundation
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Nurse Recruitment & Demand
Oregon The average age of a registered nurse in Oregon
is 47 years 38% of Oregon’s nursing workforce is aged 50
years and older The demand for registered nurses will grow
steadily; an additional 15,700 registered nurse job openings are expected between 2007 and 2020
Source: Oregon Center for Nursing - 2007
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Nurse Recruitment & Demand
Oregon The age distribution of Oregon’s population will
change dramatically over the next 20 years Oregonians aged 65 or older just eclipsed one million,
accounting for 25% of all residents [OCN, 2007] By 2012, Oregon will be the fourth oldest state in the
nation with respect to age distribution [US Census Bureau, 2007]
Given that there is a nationwide nursing shortage, it may not be possible to attract out-of-state nurses to Oregon
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Nurse Recruitment & Demand
Oregon Hospitals:
55% of Oregon’s registered nurses practice in hospitals Percentage of Oregon’s hospitals reporting shortages:
– 60 % report shortages in ICU nurses– 55 % report shortages in surgical nurses– 30% report shortages in obstetrical nurses – Recruiting for float, relief, or night shift positions is
problematic for 40% of Oregon’s hospitals Average time to fill vacant positions: four months Turnover rates average 18% per year, with the highest
levels in newly graduated nursesSource: Northwest Health Foundation
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Nurse Recruitment & Demand
Oregon Ambulatory Care
15 % of Oregon’s registered nurses practice in physicians’ offices and clinics
Vacancy rates: 10 -15% Average time to fill vacant positions: 50 - 75 days Turnover rates average 18 – 22% Length of time required to fill positions reflects:
– Severity of the shortage; these positions were once easy to fill because of daytime hours and regular work schedules
– Ambulatory care salaries considerably lower than in hospitals
Source: Northwest Health Foundation
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Nurse Recruitment & Demand
Oregon Long Term Care:
10% of Oregon’s registered nurses practice in long-term care settings
35% of all long-term care facilities report a severe shortage of registered nurses
48% report a severe shortage of certified nursing assistants
20% report a severe shortage of licensed practical nurses
Average time to fill vacancies: 60 days for nurses Turnover rates are very high and average 48% Long-term care shortages escalated steeply between
1998 and 2007, and are expected to worsenSource: Northwest Health Foundation & National Commission on Nursing Workforce for Long Term Care
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Nurse Recruitment & Demand
Oregon Public Health
7% of Oregon’s registered nurses work in public and community health
Two-year turnover rates have increased from 18% in 2000 to 39% in 2007
Source: Northwest Health Foundation
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Nurse Recruitment & Demand
Local Hospitals
Anecdotally, Two-year turnover rates for newly graduated nurses range from 27% to 100%
Public Health and Safety Net Clinics There are 77 nurses and nurse practitioners for 78,995
low-income the medically uninsured persons, a nurse-to-population ratio of 1:1,025 compared to the 1:118 state ratio
Nurse practitioner positions have been open as long as two and one-half years
The shortage of baccalaureate prepared nurses will be most immediately felt in public and community health settings.
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Nurse Recruitment & Demand
Local The need for nurses in the Rogue Valley is expected to almost double
by 2015 (188% increase) and almost triple by 2020 (289% increase)
We are headed for a dangerous nursing workforce shortage
Community 2010 2015 2020Jackson County Supply Demand Shortage
1,1871,468 281
1,1181,648
530
1,4901,860
811
Josephine County Supply Demand Shortage
493609116
464684220
436772336
Both Counties Shortage 397 750 1,147
(projections based on Nursing Demand Model - HRSA- Bureau of Health Professionals)
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Nursing Summit
Focus Areas Nurse Recruitment & Demand Nursing Education Nurse Retention -
Profession & Practice
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Nursing Education
National With the tightening of the financial circumstances
in hospitals, there is a nationwide shortage of clinical training sites for student nurses
There is evidence that nursing is not attracting young people. Nationally, the average age at graduation is 31.7 years
The average age of new doctoral recipients in nursing is 45 years (compared to 39 years in all other health sciences), and 46% of all nursing professors are age 50 to 59
Source: American Association of Colleges of Nursing
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Nursing Education
Oregon Oregon’s nurse executives prefer employing nurses with
baccalaureate preparation, but also say they would hire a non-degreed, experienced nurse before hiring a new graduate [NWHF]
Enrollment of ethnic minorities in nursing programs has increased from 10% in 1995 to 15% in 2006; however, substantially higher attrition rates are reported [Oregon State Board of Nursing]
Oregon’s average age at graduation from nursing school is 32.1 years, resulting in a shorter work-life [OSBN]
As an alternative to schools of nursing in Oregon’s public education sector, contract nursing education programs are emerging in Oregon (i.e., the Providence system)
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Nursing Education
Oregon Oregon has a large pool of qualified nursing
school applicants - six qualified applicants for every position
Nursing education programs in Oregon expanded their capacity between 2001-2007 and increased the number of graduates by 75%
By 2010, an estimated 65 FTE nursing faculty positions in Oregon will be vacated due to retirement
Source: Oregon Center for Nursing
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Nursing Education
Local In spring 2007, Rogue Community College had
180 qualified applicants for 36 slots in its school of nursing for first year students [RCC]
A smaller number of Josephine County’s registered nurses elect to pursue BSN programs than do their cohorts in other Oregon communities [OSBN]
Local secondary schools lack an adequate ratio of academic advisement counselors, leaving many graduates unprepared for entry to nursing school
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Nursing Summit
Focus Areas Nurse Recruitment & Demand Nursing Education Nurse Retention -
Profession & Practice
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National The volume of work placed on nurses has increased,
adding to nurses’ perception of inadequate staffing and work overload Patients are sicker and discharged sooner There are significant reductions in nursing support staff State and federal regulatory requirements are greatly increased
Starting salaries for registered nurses are competitive and attractive, but salary compression practices result in most nurses reaching their maximum earning potential within seven years of graduation
Nurse Retention – Profession & Practice
Source: HRSA – 2004 National Sample Survey of Registered Nurses
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National Only 83% of currently-licensed registered nurses are
actively employed The average age of employed registered nurses is 43.3
years, with registered nurses less than 30 years old representing only 10% of the total working nurse population
Workplace issues (dissatisfaction with the supervisor, workload, and staffing patterns, limited career prospects) constitute the leading factor contributing to nurse turnover
Newly created positions in clinical informatics, radiographic imaging, quality management, utilization review, case management, and pharmaceutical sales are siphoning nurses from direct patient care.
Nurse Retention – Profession & Practice
Source: American Association of Colleges of Nursing
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Oregon Nurses in focus groups express concern about
providing safe patient care. They report inability to perform basic care, patient assessment & monitoring in a timely manner, or provide emotional support to patients or families.
Focus groups report a lack of mentoring available to new nurses, as the number of experienced nurses has substantially decreased.
Nurse Retention – Profession & Practice
Source: Northwest Health Foundation
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Oregon Nurses in focus groups clearly describe the lack of a
supportive working environment. Issues such as effective communication, a feeling of
esprit de corps, and a sense of respect and dignity were reported as diminished in current hospital work environments
Nurses in skilled care facilities reported that nurse managers were less visible and unavailable
Nurses in acute care settings conveyed a sense of powerlessness and frustration, and indicated that they were rarely involved in problem-solving on issues that affected their practice
Nurse Retention – Profession & Practice
Source: Northwest Health Foundation
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Oregon Nurses are frustrated by the lack of attempts to
retain qualified nurses in their practice settings: They point to sign-on bonuses and the payment of
premium wages to temporary staff while their own wages stagnate
They want salary schedules in which competence, advanced training, and experience are rewarded
Nurse Retention – Profession & Practice
Source: Northwest Health Foundation
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Oregon Nearly one-half of Oregon’s registered nurses are 50 years
of age or older; the proportion of older nurses has doubled in the past 20 years
An exodus of retiring nurses is now underway; by 2025, 41% of currently licensed registered nurses will retire
Oregon’s nurses are not leaving the workforce early
80% of nurses are currently employed in nursing Only 58.5% of Oregon’s nurses work full-time Oregon has the fourth highest proportion in the nation of
nurses employed part-time at 41.5%
Nurse Retention – Profession & Practice
Source: Oregon Center for Nursing
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Local Anecdotally, high turnover in nurse executive
positions (hospitals and education) lead to inconsistent progress in improving policy change, practice, organizational culture, work environment and empowerment issues
Nurse Retention – Profession & Practice
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Nursing Summit
Focus Areas Nurse Recruitment & Demand Nursing Education Nurse Retention -
Profession & PracticeNursing Workforce – Summary Analysis & Conclusions
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Nursing Workforce – Summary Analysis and Conclusions
The Rogue Valley is indeed headed for a dangerous nursing workforce shortage
The causes for this shortage are multi-dimensional and complex
The nursing shortage is adversely affecting patient care, safety and morale of the workforce, and driving up the cost of care
The impending decline in the supply of registered nurses will come at a time when the first of the 78 million “Baby Boomers” begin to retire and enroll in the Medicare program
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Nursing Workforce – Summary Analysis and Conclusions
This shortage will be unlike nursing shortages of the past: left unchallenged, it will not simply cycle back into an adequate supply; it will worsen over the next decade.
The lack of educated and experienced nurses will have profound impacts on every area of health care – most critically in (descending order) Intensive care units Elder care Surgical units Community-based safety net clinics Public health
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Nursing Workforce – Summary Analysis and Conclusions
The future depends on our community’s ability to draw together collective insight that will inform common action It is imperative to understand the causes of the shortage and
to collaborate with all sectors of the healthcare industry –consumers, government agencies, educational institutions, and health-providing organizations – to forge a path toward a solution
The health of all Oregonians and our Rogue Valley communities, is directly dependent on our combined capacities to craft innovative, enlightened, responsive, strategic, and effective solutions
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World Café
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Problem: Nursing Shortage
Strategy – an approach to an issue
Action Steps – ways to make that strategy happen
Example: Strategy: increase number of nursing faculty at OHSU
(Southern Region) and RCC Action Steps: increase salary by:
Lobbying legislature for additional funding Write a grant __________
Southern Oregon Nursing Summit World Café
Information OverviewJanuary 9 & 15, 2008Red Lion Inn Medford
Sponsored by:Gordon Elwood FoundationJefferson Regional Health AllianceRogue Valley Workforce Development Council
Southern Oregon Nursing Summit World Café
January 9 & 15, 2008Red Lion Inn Medford
Sponsored by:Gordon Elwood FoundationJefferson Regional Health AllianceRogue Valley Workforce Development Council
Thank you for attending, for your valuable input and your partnership and commitment in moving forward