Archive: Spring 2006 | Fall 2007 | Winter 2007

Newsletter, Spring 2006 (download pdf file)

From the Executive Director

The Hawai’i State Center for Nursing was established by the Legislature in 2003 by Act 198 (HB 422 HD2, SD@, CD1, SB2072), and became operational in April 2005, when revenue from the nursing licensing fees was sufficient to hire an Executive Director. The Center now has a full complement of staff including an Executive Director, a PhD Nurse Researcher and an Administrative Assistant. The infrastructure of the Center has been put in place and the Center is fully operational at this time. The Advisory Board meets on a monthly basis to provide oversight and guidance of all Center activities.

The work of the Center is being accomplished by five collaboratives which focus on the main functions of the Center. The collaboratives include: 1) Workforce Data; 2) Education and Practice; 3) Recruitment; 4) Workforce Environment/Retention; and 5) Nursing Shortage which had previously functioned under the auspices of the Healthcare Association of Hawai’i and the University of Hawai’i School of Nursing and Dental Hygiene.

The collaboratives have brought together multiple stakeholders from nursing and the community to focus on specific initiatives which will implement the functions of the Center. In addition, the Advisory Board provides active oversight of all activities and guidance in accomplishment of the Center goals.

The following is a brief summary of the Center activities:

1. A Fact Sheet on Hawaii’s Nursing Shortage has been updated from 2004 to provide current information on the nursing workforce. Testimony was provided to the Hawai’i State Legislature to advocate for increased educational capacity in the University of Hawai’i Schools of Nursing

2. An educational capacity survey has been completed of which 100% of the schools of nursing in Hawai’i have responded. The report will be available in June, 2006.

3. A survey has been completed of all Registered Nurses in the State of Hawai’i focusing on turnover and to identify issues. Data entry and analysis is being completed. The report will be available Summer, 2006.

4. A survey on the demand for nurses was distributed to all sectors of the healthcare industry including acute care, long term care, home care, hospice, community agencies, public health agencies and the military. The survey will help determine the nursing workforce needs for Hawai’i.

5. A Summit on Nursing Education and Practice was held to focus on integration, collaboration and community partnerships. Work has begun on the recommendations.

6. A 5-year longitudinal survey of new graduate nurses has been designed and is in the beginning phases of implementation. The survey will explore issues in the transition from education to practice and identify turnover rates and best practices in retention.

It has been an exciting and challenging year! We have involved many nurses from throughout our state and the response has been very gratifying! We are looking forward to bringing even more nurses into our Collaborative Workgroups…please join with others to strengthen our profession and deal with the many issues of the nursing shortage!

Barbara P. Mathews, MS, APRN, CNAA
Executive Director
Hawai’i State Center for Nursing

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The Hawai’i State Center for Nursing Workforce Survey of New Graduate Registered Nurses

Investigators: S.A. LeVasseur, B. Mathews, J. Itano

Introduction: The State of Hawai’i is experiencing a nursing shortage which is expected to worsen over the next fifteen years. According to the recent report Hawai’i’s Health in the Balance: A Report on the State of the Nursing Workforce², there will be a shortage of 2,267 nurses by 2010 and 4,593 nurses by 2020. Several key factors have been identified that impact on the growing shortage of nurses. These include the population of the State is aging at a higher rate than most states in the rest of the nation and the average age of nurses in the workforce is 49.3 ¹ years and increasing.

A key strategy to address the nursing workforce is retention of existing nurses and nowhere is the difficulty more pronounced than with new graduate RNs. Turnover in the new graduate workforce is considerably higher than the more experienced nursing workforce. Roche, Lamoreau and Teehan ³ highlight that between 35% - 60% of new nurses change jobs in their first year ⁴ and that despite a specialized internship program, 25% of new graduate registered nurses leave their first job within the first year. ⁵ Research also suggests that the first six months may be a crucial marker for measuring retention of newly hired nurses. ⁶ High turnover rates are not only costly for an organization, but create an unstable workforce which impacts patient outcomes, unit morale and productivity.

A variety of programs have been developed and implemented to enhance the experience of the new graduate registered nurse including enhanced preceptor/mentoring, ⁸ extended orientations ⁴ or residencies, ⁷ competency based
curriculum in schools of nursing, ⁹ and support/professional development groups. However, there exists little empirical evidence concerning new graduate registered nurses’ patterns of employment or perceptions of their jobs in the first five years of employment, and no data examining newly graduate registered nurses in Hawaii.

Purpose: This study will examine new graduate registered nurses employment patterns and perceptions of their jobs in the first five years of their nursing career in Hawai’i.

Methods: A longitudinal descriptive design will be used to explore graduating student nurses transition into nursing practice over 3.5 years. The project will utilize qualitative and quantitative research methodologies to identify and describe the
transitional experiences of new nurses from their graduation as student nurses until approximately three and half years after graduation. Data will be collected at graduation (baseline), 6 months, 18 months, 30 months, and 42 months.

Analysis: Descriptive statistics will be used to examine the perceptions of graduating students’ expectations of obtaining their first nursing positions, identify student’s perceptions of preparedness for nursing after completion of nursing education. In addition, descriptive statistics will be used to examine frequency of graduated registered nurses finding nursing employment; to identify whether educational experiences are perceived as valuable in obtaining nursing positions. The six month survey will analyze frequency of employers providing clinical orientation or some other form of support that assists in making the transition from student to professional nurse easier. Analyses will examine 6-month, 18-month, 30-month, and 42-month data to identify and describe rates of retention and turnover, variability in workplace support, frequency of employment in non-nursing positions or unemployment. Finally, the data will be examined to identify and describe new
nurses’ future plans to remain working in Hawaii or migration plans out of the State and trends in the number of nurses planning to continue their nursing education.

Funding: Hawai’i State Center for Nursing will support this project with internal staff. Additional funding will be sought from nursing and/or local foundations.

References:
¹. Kooker B., Winters-Moorhead C., Acosta M. & Hobbs S. “Nursing Workforce Supply Data Trends in Hawai’i.” Hawai’i Medical Journal. Sept. 2003: 193-197.
². Raynor CR. and the Hawai’i Nursing Shortage Taskforce. “Hawai’i’s Health in the Balance: A Report on the State of the Nursing Workforce.” Oct. 2004.
³. Roche JE., Lamoureux E. & Teehan T. “A Partnership Between Nursing Education and Practice: Using an Empowerment Model to Retain New Nurses.” Journal of Nursing Administration. 2004; 34(1):26-32.
⁴. Godinez G., Schweiger J., Gruver J. & Ryan P. “Role Transition from Graduate to Staff Nurse: A Qualitative Analysis.” Journal for Nurses in Staff Development. 1999; 15(3):97-110.
⁵. Owens D, Turjanica MA., Scanion MW., Herbert C. & Facteau L. “New Graduate RN Internship Program: A Collaborative Approach for System-wide Integration.” Journal for Nurses in Staff Development. 1999; 17(3):97-110.
⁶. Galt RG. “The value of training and orientation programs in large medical organizations.” Journal for Nurses in Staff Development. 2000; 16(4):151-156.
⁷. Goode, CJ. & Williams CA. “Post-Baccalaureate Nurse Residency Program.” Journal of Nursing Administration. 2004; 34(2):71-77
⁸. Nelson, D. & Godfrey L. “Using a mentorship program to recruit and retain student nurses” Journal of Nursing Administration. 2004; 34(12):551-53
⁹. Cadmus E., Dickson GL., Tuella C. & Rice B. “New Jersey Colleagues in Caring: An Integrated Competency-Based Nursing Practice Model.” New Jersey Colleagues in Caring, 2001.