Texas is one of nine states that will receive a two-year grant to create a more highly educated, diverse nursing workforce. The Robert Wood Johnson Foundation announced it would give the state $300,000 through its Academic Progression in Nursing (APIN) program.
Susan Sportsman, co-chair of the education committee for the Texas Team nursing coalition, said the grant money would help nursing leaders work with universities to create a standard curriculum to encourage nurses to return to school to earn their bachelor’s degree. She said only about one out of six registered nurses have returned to school to earn a four-year degree.
The Institute of Medicine, in its groundbreaking report The Future of Nursing: Leading Change, Advancing Health, recommended that 80 percent of U.S. nurses have baccalaureate or higher level degrees by 2020. About half of the nation’s nurses have achieved that academic level, according to the National League for Nursing.
Of the more than 100 nursing schools in Texas, Sportsman estimates about 50 percent offer programs that allow nurses to earn bachelor’s degrees.
“Many of them don’t have a whole lot of students,” she said. “This effort will increase their enrollment. We need every nurse we can get right now.”
In 2011, Texas ranked 44th out of the 50 states in the per-capita supply of RNs. There are 720 per 100,000 people in Texas, compared with 874 RNs per 100,000 in the U.S.
Sportsman said none of the grant money would go toward scholarships, although she said the effort would pull together a list of scholarship opportunities for prospective students. She said APIN wants to collaborate with healthcare organizations to help recruit nurses for educational advancement and offer tuition assistance.
She said a portion of the funds would be spent on creating a more diverse nursing workforce. About 12 percent of Texas nurses are black, which is roughly equivalent to the state’s black population. However, only 12 percent of Texas nurses are Hispanic, even though Hispanics comprise about 40 percent of the state’s population. The percent of Hispanic nurses in Dallas-Fort Worth is even lower at about 5 percent.
There will also be a greater effort toward recruiting men into the profession. About 90 percent of North Texas nurses are female, according to the Dallas Fort Worth Hospital Council Regional Workforce Planning Collaborative.
DFW has taken a leading role in advancing nursing academic achievement, Sportsman said. UT Arlington and Texas Woman’s University are two of the state’s top producers of nursing baccalaureates, and several of the local hospital systems have preferentially hired and promoted bachelor’s-degree holders. Hospitals are also pressing new associate-degree nursing hires to commit to completing a bachelor’s degree by a specific time.
DFW has a strong nursing workforce. The American Nurses Credentialing Center has cited fewer than 7 percent of U.S. hospitals in its Magnet Recognition Program, which acknowledges facilities with the highest level of nursing excellence. Nearly half of the Magnet hospitals in Texas are in North Texas.
Cole Edmonson, chief nursing officer and vice president of patient services at Texas Health Presbyterian Dallas, said he is confident that his hospital would meet the IOM’s goal by 2020. He said 62 percent of its nurses are at the baccalaureate or higher level, which represents a one-year increase of 12 percent.
Edmonson credited the facility’s close attention to nurse retention and special recognition for those who earn their four-year degree.
“There are benefits (of more highly educated nurses) for people who come to THR for care. Having the best-prepared nurses at the bedside means they are able to understand medical evidence, navigate medical complexities and provider better outcomes for patients,” he said.
A 2003 landmark study in the Journal of the American Medical Association found a clear link between higher levels of nursing education and better patient outcomes. It said that surgical patients have a “substantial survival advantage” if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level. It also calculated that for every 10 percent increase in the proportion of nurses with four-year degrees, there was a 5 percent decrease in risk of patient death and failure to rescue.
Sondra Flemming, vice president of health and economic development at El Centro College in Dallas, said a standardized curriculum would provider “fewer roadblocks” for nursing students to earn a four-year degree. Many programs are geared toward treating specialized populations, she said.
“When students transfer (now), it is hard to line up the courses,” she said.
In Texas, the demand for nurses is especially acute. As of May 2011, the demand for nurses exceeded the supply by 22,000. The Texas Nursing Workforce Shortage Coalition, which is composed of about 100 state medical centers and hospitals, warned in a letter that “without stable, continued funding for nursing education, this gap will widen by 70,000” by 2020.
There were fewer than 10,300 graduates from Texas RN programs in the 2010-2011 academic year, according to a report by the Texas Center for Nursing Workforce Studies. That report estimates the number would need to increase to more than 17,700 by 2015 and need to more than double by 2020.
However, DFW hospitals appear to have an ample supply of nurses. June Marshall, director of nursing research and education at UT Southwestern Medical Center, said the area’s strong nursing programs and competition for job openings have allowed local hospitals to set higher educational standards. She said UT Southwestern’s hospitals have had 500-700 applicants for 20-30 nurse residency slots.
“We can elect to choose who we hire. Others (in Texas) do not have that luxury,” she said.
Steve Jacob is editor of D Healthcare Daily and author of the new book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at [email protected]