Maryland Statewide Commission on the Crisis in Nursing

1. Maryland Statewide Commission on the Crisis in Nursing Update and Future Directions June 5, 2002

2. Legislated Charge • Convene Summit “Do something”

3.  “Do something” COMMISSION

4. Subcommittees Formed Education Recruitment Retention Workplace Issues Refined Commission Structure Vice Chairs’ Leadership Keeping Nurses Informed  “Do something”

5. Registered Nurses - Active Licenses*1996 - 2000 *Registered Nurses - Maryland Addresses Only

6. Licensed Practical Nurses-Active Licenses* 1996- 2000 *Licensed Practice Nurses with Maryland Addresses

7. RNs By Age Groups1997 - 2000

8. LPNs BY AGE GROUPS1996 - 2000

9. Inactive Licenses by Age2001

10. Newly Licensed RNs by Type

11. Number of Newly Licensed RNs by Age 1998 - 2001

12. Workforce Diversity 2001 • RNs • 5% Males • 24% Minority • LPNs • 11% Males • 50% Minority

13. Admissions 1997-2001Registered Nursing Programs

14. Graduations 1997-2001 Registered Nursing Programs Baccalaureate totals include RN to BSN students. 1997-1999

15. Practical Nursing ProgramsAdmissions & Graduations1997-2000

16. Places of Employment - RNs1996 - 2001

17. Places of Employment - LPNs1996 -2001

18. Statewide Commission on the Crisis in Nursing • Retention • Adequate & Flexible • Staffing Protocols • Communication/respect/ • Recognition • Competitive Compensation • & Flexible Benefits • Recruitment • Collaborate to Recruit • Image • Web—disseminate • Information • Tool Kit Development • Education • Education Processes • Scholarship & • Financial Aid • Finance & Marketing • Mentoring Solving the Nursing Shortage Commission • Workplace Issues • Stress in the Workplace • Clinical Practice Delivery Models & Quality of Care • Regulatory Issues • Participate in Decision Making • Scheduling & Lifestyle Issues

19. Recruitment Subcommittee Chair: Ann Possidente Vice Chair: Debra B. Doyle

20. Recruitment – Summit 1. Poor public and media image • Women’s profession • What do nurses do? • Promoted to middle & high schoolers as job vs career

21. Recruitment – Summit 2. Hospitals are a business 3. Lack respect as a profession by the public and among nurses

22. Maryland Commission on the Crisis in Nursing • Project a more positive and professional image of nursing • Attract middle and high school students into nursing as a career

23. Our Charge • Develop statewide campaign • Promote nursing as worthwhile career

24. Who are we trying to attract & retain? What should we do? What is the competition doing? What do these coworkers want/value?

25. The Nursing Profession’s Future 11 Y.O. 21 Y.O. 30 Y.O. College 1) Non-Nsg Students 2) Nsg Students “Second Career” 1) People desiring a second career Nurses 1) Current Nurses Middle School 1) Students 2) Parents High School • Expected Outcomes: • Understand current perceptions of the nursing profession • Attract more students into the nursing profession

26. Recruitment—Middle/High Schools Participants N = 219 1. Viewed Nursing as technical as opposed to professional (like a “shop”) 2. No Career advancement—58.7% 3. Unsure of “what it takes to become an RN” • Educational requirements • Differences in 2yr vs. 4yr programs

27. Recruitment—Middle/High Schools 4. “Scary” job with life and death decisions 5. Job security • Computers and teaching “sure bet” • If cut Medicare, hospitals will close 24.1% 6. “Girls” job - 79.9%

28. Recruitment—Middle/High Schools 7. Wearing a uniform—unappealing 8. Unfavorable hours & tasks (work weekends and holidays) 9. Stressful—watching people die

29. Recruitment Subcommittee Accomplishments Nursing Image Videos Resources Library (www. marylandhealthcareers.org) Web Site Developed through MHA (www. marylandhealthcareers.org) & (mbon.org) Information for parents, teachers, students Facts about nursing, scholarships Hyperlinks to other nursing information

30. Recruitment Subcommittee Accomplishments Legislative Shadow Program Tool kits (middle and high school students, counselors, teachers and Parents) Student Volunteer Program Speakers Bureau Listening to constituents

31. Recruitment Subcommittee Accomplishments • Working with • Education Subcommittee on the best approach for recruiting faculty • Healthcare settings to find clinical rotations

32. Recruitment Subcommittee Volunteers THANKS! • Ann Possidente, Chair • Mona Bahouth • Carolyn G. Baker • Susan Battistoni • Mary L.Beachley • Sharan Lee Bidle • Justin Bishop • Jean L. Bridle • Barbara Marx Brocato • Melissa A. Brodeur • Trena Brown • Linda Brown-Sutphin • Kathryn Buffington • Ann T. Bures • Debra B. Doyle, • V.Chair • Ann Byrne • Martha R. Caputo • Amy Chi • Virginia R. Clark • Harold Cohen • Robb Cohen • Carol Costante • Judith Covich • Frances Crites • Catherine Crowley • Regina M. Curran • Parker David • Jack Davisdon • Mary H. Deeley • Lynn M. Derrickson • Mae Esh • Jeffrey Friedman • Susan E. Gibson • Robyn Gilden • Bruce N. Griffin • Dorna P. Hairston • Kathryn V. Hall • John A. Harris • Cheryl Heilman • Sharon Hobson • Mary Cathryn Hoffman • M. Theresa Hommel • Kay Hoskinson

33. Recruitment Subcommittee Members THANKS! • Montgomery • Barbara Luminella • Susan Lynott • Kim Kathryn Lothschuetz- • McCarron • Christina McGann • Janet Melson • Fran Miller • Berta R. Mitchell • Donna Mueller • Dawn Nally • Kathleen N. Neely • Jack Neil • Matt Neiswanger • Lola Null • Kathleen Ogle • Wayne Howard • Cecelia Hughes • Lorraine Hughes-Girandola • Joan Humlock • Emeka Ifemeje • Linda Janzik • Seth Johnson • Stephanie Jourdan • Laura L. Katz • Kathy Kemper • Lisa Lambert • Lena Lee • Fran Leibfreid • Romona Lewis • Amy L. Lohfield • Lisette K. Osborne • Marc Palovitz • Yvonne Paraway • David Parker • Karen M. Parrotte • Karen C. Poisker • Constance M. Pryor • Jennifer B. Rainer • Ann Regier • Hope Ripkin • George Rose • Sharon M. Rossi • Peter Russell • Stephanie L. Sand • Pat Saunders

34. Recruitment Subcommittee Members THANKS! • Laura Van Syckle • Lisa Wade • Maureen Wakefield • Mary Lou Watson • Elizabeth Weglein • Carol Wiggins • Erica Williams • Evelyn S. Wilmer • Pat Wilmsen • Bonnita D. Wilson • Mark Woodard • Emmaline T. Woodson • Rhonda Wyskiel • Gary Yakimov • Amy Schaefer • Carol Schatzman • Mary Schriver • Lisa Seldomridge • Lynn Z. Sklar • Jeanne Smoot • Karen Sullivan • Vicki L. Taliaferro • Marion Taylor • Lisa Tenney • Lana Thomas • Tammy J. Thompson • Mary R. Towe • Denise Tucker • David Uhlfelder

35. Recruitment Subcommittee • Get involved • We welcome additional volunteers • Access the Maryland Board of Nursing (mbon.org)

36. Workplace Issues Subcommittee Chair: Donna Wilhelm Vice Chair: Maria Koszalka

37. Micaela, M Aigner-Jacobs Nancy Allen Loretta Beckman Stephanie Bernard Susan D. Boettger Judith E. Breitenbach Jean L. Bridle Melissa A. Brodeur Deneen brown Angela T. Burden Ann Byrne Rosalyn G. Carter Filissa M. Caserta Phyllis Cassidy April C. Chase Nalini Cherian Deborah L. Chesser Virginia R. Clark Janet Cogliano Robb Cohen Harold Cohen Stacey M. Cook Catherine Crowley Regina M. Curran Carol A. Curran Workplace Issues Subcommittee Members Christin McGann Kate McPhaul Judith Meyers Barbara Anne Miklewski Linda A. Miles Sharon Millar Linda Miller Berta Z. Mitchell Harriett Moore Toni Moore-Duggan Dawn Nally Moira Namuth Sandra Natolly Victoria B. Navarro Kathleen N. Neely Jack Neil Lois H. Neuman Robin Purdy Newhouse Catherine S. Novak Linda O'Hara Joann Oliver Carolyn R. Overcash Vanessa R. Pierre Carol Portner Curtis Price Donna Damico Sandra L. Dearholt Mary H. Deeley Connie A. Dennis Mary Dent Carole Derck Sarah S. Detmer Dottie Devine Sallie Dicus Elizabeth Ann Evins Beverly S. Francis Susan E. Gibson Beverly B. Goldsmith Sheila Greenwood Catherine M. Griswold Larry L. Grosser Beverly S. Guy Kathryn V. Hall Sharon G, Hameroff Elise Handelman Janet Holly Hoppenstein Ellen L. Horowits Kay Hoskinson Belinda D. Houston Paula A. James S. Nooshin Javan Michael Jenifer Sharon A. Johnson Seth Johnson Keith Jones Judith Karp Silvie Kassar Laura L. Katz Jack C. Keane Juanita Kennedy Vicky P. Kent Kathie Kloch Maria V. Koszalka Dina A. Krenzischek Pamela E. Kumar Mary J. Larkin Sandy Levy Mary A. Linton Kathryn Lothschuetz-Montgomery Sandra Lucci Suzan Lundy Marsha Marcus W. Christin McGann

38. Workplace Issues Subcommittee Members (cont.) Mary Zohlen Barbara Watts Patricia Watts-Kelley Beverly A. Wehmer Donna Wilhelm Erica Williams Marisa Wilson Helen Jane Wobbeking Heather Yockey Gloria Zarlenga Karen Tipton Cathy Toepfner Janis Trainor Denise Tucker David Uhlfelder Brenda Vitucci Maureen Wakefield Florine Marshel Constance Sumpter Sandra Sundeen Cecile E. Sutherland Carol Swartz Tami W. Swearingen Irene Taylor Lana Thomas Tammy J. Thompson Lynn Z. Sklar Dianne C. Smith Lucie Smith Regina Smith-Yurek Annette E. Snyder Joan M. Spear Denise Stanback Cathy Stonebraker Eleanor Walker Joan Humlock Delores M. Puno Donna Raimondi Ann Rasenberger Anne E. Rehfegd Robin H. Reid Susan Reiman Tina Roach George Rose Arlene Marie Rosen Stephanie L. Sand Genene Saxton Judy J. Schuur Ernestine Scott Carol Sheehan Denise Singleton Dawn Strecker Karen Sullivan

39. Workplace Issues SubcommitteeInitial Charge • Identify workplace issues causing nurse dissatisfaction • Recommend ways to improve nurses’ work environments

40. Nurse Dissatisfaction Issues Identified • Scheduling and Life Style • Mandatory overtime • Flexible scheduling • On call • Child care/sick child care • Reassignment • Scheduling • Women-friendly issues • Age appropriate assignments

41. Nurse Dissatisfaction Issues Identified • Professional environment • Difficulties with delegation • Physician collaboration • Autonomy • Respect • Agency nurse accountability/autonomy • Skill mix • LPN scope of practice • Difference in practice settings

42. Nurse Dissatisfaction Issues Identified • Regulatory • Scope of practice for techs, extenders, etc • Documentation requirements • LPN scope of practice • Inconsistent regulation for providers in different settings

43. Nurse Dissatisfaction Issues Identified • Clinical Practice Delivery Model/ Quality of Care • Nurse-patient ratio • Quality of care • Skill mix

44. Nurse Dissatisfaction Issues Identified • Stress in the workplace • Public expectations • Support services • Occupational health issues • Self-care • Injury protection • Safety/violence/abuse

45. Workplace Issues SubcommitteeAccomplishments 1.Survey validated nurses’ issues & concerns 2. Paper written that identified: • Scope of the problems • Impact on quality of care • Strategies to address identified concerns

46. Workplace Issues SubcommitteeAccomplishment 3. Developed Concept Paper to Support Legislation • Mandatory overtime • Whistleblower protection • Nurses participating in organizational policies 4. Impact on Legislation-all legislation passed • HB 329 - Healthcare Whistleblower Protection Act • SB 537 - Nurses Involuntary Overtime Prohibition • HB 590/SB 46 - Study of the Use of Technology to Assist Nurses in Caring for Patients 5. Established Workplace Subgroup to Address Technology Issues

47. Next Steps 1. Address the following topics: • Review information obtained from nursing survey to determine which areas of focus 2. Other areas to address are: • Stress in the workplace • Technology issues- Professional environment • Regulations • Clinical practice delivery model/quality of care 3. Respond to legislative updates to current legislation • HB 329, SB 537, & HB 590/SB 46

48. Maryland Board of Nursing Website (Http://www.mbon.org) For Upcoming Meeting Dates and Locations

49. Workplace Issues Subcommittee Nursing Technology Workgroup Chairperson: Maria Koszalka

50. Maria Koszalka Chairperson Mary Beachley Stephen Buckingham Bycoffe Marcia Robert Cohen Ernestine Cosby Brian Gugerty Toni Hughes Terry Herbert Dina Krenzischek Janet Marron Carol Mariglia Pat Maher Linda Miller Sandra Natolly Susan Newbold Carol Sheehan Mary Lou Watson Marisa Wilson Nursing Technology WorkgroupCommittee Members