Corporations, Foundations and Associations – Fixing the Nursing Shortage. Lori Ponoroff, US News Editor, in the third article on the nursing shortage, describes initiatives of Associations, Corporations and Foundations to encourage nursing as a career choice.

Associations, Foundations and Corporations are solving the nursing shortage problem in multiple ways as described by Halldale’s US News Editor, Lori Ponoroff.

They do it to help improve the practice of medicine, increase access to healthcare, advance the nursing profession – some do it to help their bottom line. Whatever the reason, hundreds of corporations, foundations and associations are donating millions of dollars and countless resources to help fix the nursing shortage.

Johnson & Johnson’s (J&J) reason for supporting the nursing shortage is simple. The US-based multinational manufacturer of medical devices, pharmaceutical products and consumer packaged goods has a company credo that says “Our first responsibility is to the doctors, nurses and patients, to the mothers and fathers and all others who use our products and services,” explains Andrea Higham, Senior Director of Corporate Equity at Johnson & Johnson. “So nurses have always had a very important spot in the heart of Johnson & Johnson.”

When the company first learned about the nursing crisis from their customers, it sent senior executives to ask healthcare providers what the biggest issues facing them were, Higham says, and “resoundingly what they got back was there aren’t enough nurses.”

That’s when J&J started working on its Campaign for Nursing’s Future – a $50 million multi-year national initiative launched in 2002 to enhance the nursing profession’s image, recruit new nurses and nurse faculty and help retain nurses currently in the profession. Thirteen years later, the campaign is still going strong with a multi-pronged approach to reach current and future nurses.

J&J’s DiscoverNursing.com website for those interested in pursuing a nursing career has searchable links to hundreds of nursing scholarships, more than 1,700 accredited nursing educational programs and information on more than 100 specialties and career paths for those with nursing degrees.

The campaign’s goals center around image enhancement, because the research J&J “has done showed nursing had fallen off the radar screen of young people,” according to Higham. So each month, it produces and distributes its monthly e-newsletter, Nursing Notes, to more than 60,000 recipients – with information on trends and issues impacting the profession, nurse profiles and educational resources. Nursing Notes also has a Facebook fan page, a Twitter handle and a podcast series.

The “Your Future in Nursing” program launched in 2010 is an interactive training tool that offers first-year nurses a risk-free job experience. It was developed, in part, because of the success of the "Virtual Nurse Manager," CD-ROM created in 2006 that was made available to every US hospital.

The campaign has recognition initiatives like “Amazing Nurses” that invites the public to nominate and vote for nurses who demonstrate and provide extraordinary care and make a difference every day in the lives of others and “Thank A Nurse,” an annual event held during Nursing Week that thanks and recognizes nurses for their dedication and passion.

Students from Thomas Edison State College on the New Careers in Nursing national scholarship program. (Photo: Thomas Edison State College)
Students from Thomas Edison State College on the New Careers in Nursing national scholarship program. (Photo: Thomas Edison State College)

It offers a series of educational brochures focusing on nursing specialties including public-health nursing, nurse education, long-term care nursing, visiting nurses and school nursing and a DVD it distributed to every nursing school in the US.

All told, J&J has circulated more than 32 million pieces of recruitment/retention materials in English and Spanish to schools, career centers and community health centers across the country and to every high school, nursing school, hospital and nursing organization and has attracted more than 750,000 to the profession. It extends that effort by distributing more than two million “You Can Be a Nurse” coloring books for children and a video for 9- to11-year-olds to create an early interest in nursing.

Education

To help new recruits get an education and current nurses continue theirs, J&J partners with other organizations on nursing scholarships and grants. Higham says the company realizes it’s essential to work with partners to alleviate the shortage because the affordable health care act is bringing more people into the healthcare system, baby boomers are aging, and thanks to advances in medicine people are living longer with more chronic conditions, and there’s not a great interest in going into general practice medicine. “What we’re finding,” she says, “is that advanced-practice nurses and physician’s assistants are providing the majority of primary care.”

In that vein, the Campaign worked with dozens of healthcare partners to host more than 31 Promise of Nursing galas and other regional events that raised $19 million for undergraduate student scholarships, educator fellowships and nursing school grants. Those partners include most of the nonprofit nursing organizations such as the American Association of Colleges of Nursing (AACN) and the National League for Nursing. J&J also does a good deal of work with the Robert Wood Johnson Foundation (RWJF) and although they share the same name, they are two completely separate organizations.

RWJF is the US largest philanthropy devoted solely to the public's health and “its mission is to improve health and healthcare for all Americans by building a culture of health in America,” explains Maryjoan Ladden, PhD, RN, FAAN and RWJF Senior Program Officer. “We believe since nurses make up the largest health profession – 3.1 million nurses in the US – they have a central role in helping communities build a culture of health, and improve health and healthcare in the US.” Given nurses trusted status and what nurses have the potential to do, she says, the Foundation believes it’s important to focus some of its resources on nurses.

In fact, RWJF spent $300 million over the last 10 years to develop strong nurse leaders and more nursing faculty. It worked with the Institute of Medicine (IOM) to address the challenges facing the nursing profession and improve the health of Americans by transforming the nursing profession, the results of which was the IOM “The Future of Nursing: Leading Change, Advancing Health” report in 2010 that recommended:

  • Nurses practice to the full extent of their education and training.
  • Nurses achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
  • Nurses become full partners with physicians and other health care professionals in redesigning health care.
  • Effective workforce planning and policy making require better data collection and information infrastructure.
After IOM released the report, RWJF partnered with the American Association of Retired People (AARP) to establish The Future of Nursing: Campaign for Action, a national initiative to guide implementation of the recommendations:
  • The campaign helped form action coalitions - groups of nurses and other health care providers, employers, patients, and others - in all 50 states and the District of Columbia that are focused on implementing the IOM's recommendation that 80 percent of the nursing workforce have a BSN degree by 2020. It identified four models to streamline academic progression, and 30 Action Coalitions have enrolled students in one of the four models.
  • The number of students enrolled in RN to BSN programs increased 53 percent, from 77,259 in 2010 to 118,176 in 2013.
  • For the first time, Medicare is paying to support the training of nurses with the $200 million Graduate Nurse Education Demonstration project designed to prepare more advanced practice registered nurses.
  • The Campaign developed a national nursing leadership strategy framework to increase the number of nurses on hospital, health system and national/federal boards, and convened nurse leaders and champions from 27 coalitions that helped get 268 nurses appointed to boards.
  • Six states removed statutory barriers that prevented nurse practitioners from providing care to the full extent of their education.
  • 41 Action Coalitions are working on diversity programs to recruit and prepare a more diverse and culturally competent nursing workforce.
  • Four major foundations – RWJF, the Gordon and Betty Moore Foundation, the Josiah Macy Foundation, and the John A. Hartford Foundation – collaborated to support Minnesota’s Health Resources and Services Administration Coordinating Center for Interprofessional Education and Collaborative Practice at the University of Minnesota.
Fostering interprofessional collaboration, one of the campaign’s guidelines, is really one of RWJF’s tenets. Just like J&J, RWJF partners with other organizations to bring programs to life. “Our Future of Nursing Scholars (FNS) program is a great example,” says Ladden. RWJF administers the FNS in partnership with the University of Pennsylvania School of Nursing, which provides the program’s direction and technical assistance and serves as the national office.

RWJF is “investing $20 million to increase the number of nurses who get PhD’s, partly in response to the IOM report that says we should double the number of nurses with doctorates by 2020 and because we need more nurse faculty,” Ladden continues. “There are two parts to that program: scholarships and leadership development for nurses to get their PhD and a strategic philanthropic collaborative, because while $20 million is a lot of money, it’s not enough to reach the goal,” so RWJF encourages other foundations and health systems to join in being program donors.

United Health Foundation, North Shore Long Island Jewish Health System and Rhode Island Foundation have all promised funding and J&J committed a million dollars over the next five years. Independent Blue Cross in southeastern Pennsylvania, a company that sees the value of having nurse PhD’s who understand the health insurance system, Ladden says, is sponsoring six PhD candidates who will do their research and dissertations around insurance company priorities and will communicate with Independent Blue Cross throughout the three years of their PhD programs.

Increasing the number of qualified nursing faculty to teach in the FNS program and those geared to students working on a BSN or Master’s is critical to helping schools accommodate the growing number of applicants – and RWJF has a program to assist with that. Its Nurse Faculty Scholars program is helping strengthen the academic productivity and excellence of nursing schools by providing mentorship, leadership training and salary and research support to young faculty.

The New Jersey Nursing Initiative (NJNI) is a multi-year, $30 million project of RWJF and the New Jersey Hospital Association/Health Research and Educational Trust working to transform nursing education in the state. It established Strategic Working Groups made up of experts in business, government, academia and health sectors to ensure New Jersey has the well prepared, diverse nurse faculty it needs to educate nurses to meet the demand for the 21st century. It also created the NJNI Faculty Preparation Program that’s helping increase the number of spaces available at New Jersey nursing schools.

J&J is working on the 80 percent BSN goal, too, says Higham. “We’re raising money, for example, with the galas we host to go directly towards programs encouraging and supporting nurses to go for their BSN – promoting the idea of getting more nurses into senior-level leadership, management and administrative positions.”

Scholarships

One of those programs is the New Careers in Nursing (NCIN) national scholarship program RWJF runs with the AACN. Through grants to nursing schools, the program will provide $10,000 scholarships to more than 1,500 college graduates without nursing degrees who are enrolled in accelerated baccalaureate and master's nursing programs.

Schools like Thomas Edison State College’s (TESC) W. Cary Edwards School of Nursing may apply for between five and 30 scholarships per year for students from underrepresented groups in nursing and disadvantaged backgrounds. TESC was one of 52 schools that received a NCIN grant last year. That $50,000 grant is supporting five students who plan to earn a BSN through the college’s Accelerated 2nd Degree BSN Program, designed for adults with non-nursing bachelor’s degrees who want to become BSN registered nurses.

TESC also got a three-year, $650,000 grant to provide scholarships for its Accelerated 2nd Degree BSN Program from the Helene Fuld Health Trust, one of the nation's largest private funders of programs exclusively for nursing education.

Another supporter of nursing education is The Rita & Alex Hillman Foundation that aims to improve the lives of patients and their families through nurse-led innovation. The foundation’s grant-making strategy focuses on education, research and implementation.

Health systems are huge supporters of nurse-education programs, like the University Health System Foundation in the San Antonio, Texas area that offers its own Nursing Scholarship Program for financially disadvantaged students with help from companies who pledge financial assistance to the company’s Nursing Scholarship Supporter fund. Other health systems support continuing education for their own nurses and local students by working with colleges and universities to create joint nursing education and simulation centers, like University of Iowa (UIHC) Hospitals and Clinics’ Department of Nursing Services and Patient Care and the University of Iowa College of Nursing.

Those two groups formed a joint venture to create the Nursing Clinical Education Center for both students and professionals in UIHC’s General Hospital. The $6 million, 20,000 square-foot center has 11 clinical simulation rooms and is available 24 hours a day, seven days a week. Instruction is provided by nurse educators, faculty and practicing clinicians, and both hospital staff and students use the facility for simulation training; educational enrichment; orientation; competency review and most importantly, learning how to provide safe, effective and compassionate care.

Children’s Hospital Los Angeles helped advance nursing in a new way in 2004, when it took a nurse residency pilot program it validated and created Versant Holdings to expand the program to other children’s hospitals to see if the same results would be replicated.

The goal was to see if structured internship- or transition-to-practice programs for graduate and transitioning nurses would make participants more confident, more competent and more likely to stay with the organization, explains Larissa Africa, President of Versant, which became its own entity in 2009, after proving the program’s success.

Now in 90 hospitals, Versant continues to deliver the graduate and transition residencies along with a new program that helps manage the competency of incumbent nurses. The outcome-based company updates its offerings based on the results it sees through research completed by its nonprofit Versant Center for the Advancement of Nursing. The center collects outcomes and research surrounding the nursing profession and the needs of the hospital organizations. It also works with and makes its data available to other researchers, and Master’s and PhD students, completing the philanthropic cycle and continuing the partnership philosophy that is advancing the nursing profession and helping to alleviate the nursing shortage.