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RN leader: California's regional approach 'key' to meeting report's recommendations

Monday August 8, 2011
Deloras Jones, RN
Deloras Jones, RN
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Although the recession has impacted the nursing workforce, an aging population, healthcare reform and an improving economy are about to make the looming nursing shortage an issue once again, said Deloras Jones, RN, MS.

Jones, president and executive director for the California Institute for Nursing & Healthcare, discussed the Institute of Medicine's recommendations for the future of nursing July 6 during a statewide webinar. The event, dubbed "California's Pathway to the Future of Nursing," was hosted by AfterCollege and the Northern California Association of Health Care Recruiters.

Jones described the nursing workforce as "elastic," saying when the economy is good, nurses work less, and when it's bad, they work more. Older nurses are delaying retirement plans, Jones said, while part-time nurses are working full-time and nonworking nurses have returned to the workforce. At 11.7 %, California has the second highest unemployment rate in the United States, Jones said.

"California's unemployment rate has fueled this elasticity of the nursing workforce," she said. "The figure that is really scary to us here in California is that with healthcare reform, over 6 million Californians are going to be added to the insurance rolls by 2014," Jones said. "That is going to increase our demand for healthcare."

Community-based transition to practice programs are key to keeping new grads engaged in the workforce and increasing their employability while building skills and confidence to bridge the gap between education and practice, Jones said. Jones also noted the importance of the California Institute for Nursing & Healthcare, which has a mission to transform the capacity of nurses to meet the evolving health need of Californians, she said.

She pointed out the progress of the California nursing workforce, saying nursing schools have become better prepared to meet the state's need for more nurses. Since 2003 and 2004, capacity in California nursing schools is up by 69%, enrollment has increased by 81% and completion has increased by 87%, Jones said. California is now ranked 47th in the nation for RNs per capita, with up to 630 RNs per capita, an increase from 580 per capita in 2004, she said. Progress also has been made in other crucial areas such as diversity and education, she said. The priority moving forward is to build upon work already underway, Jones said.

California was well represented on the committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, Jones said. Among the key messages of the report are that nurses should be able to practice to the full extent of their education and training and nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. This includes more BSN-trained nurses, ADN-to-BSN and ADN-to-MSN programs and increased student diversity, Jones said, adding that another key message of the report is that nurses should be full partners with physicians and others in redesigning U.S. healthcare.

"[A regional approach] is key to making changes in the state of California," Jones said. "This will take all of us to make this happen government, business, healthcare institutions, academia."

Geneva Slupski is a freelance writer.
CA group builds momentum

California is one of the first five states designated to pilot the implementation of the IOM recommendations from the "Future of Nursing" report. The California Action Coalition's work began in December to follow the recommendations, said Deloras Jones, RN, MS, executive director of CINHC, which is now the structural home of the CA AC. Groups have been formed, and include:

Executive Team: Designated by RWJF and AARP, serves as overall leadership for the CA AC.

Leadership Council: Provides input to Executive Team. Members are responsible for development and implementation of strategies to support completion of action.

Regional Champions: Serve as conduits of information about the work of the coalition in their regions and identify regional representatives to participate in various work groups.