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As nurses adjusted to heavier workloads and sicker patients, the media reported the impact of poor staffing on patient care. Aiken, Clarke, Sloane, Sochalski, and Silber found that poor staffing ratios increased surgical patients' risk of dying within 30 days of admission. Earlier articles represented investigative reporting of deaths in inpatient settings.
The Chicago Tribune published a series of articles that was typical of the investigative genre Berens, These reports blamed nurses for tragic events or portrayed nurses as beleaguered employees, unable to change their destinies or protect their patients.
Neither portrait enhanced the image of professional nursing or made nursing attractive to young people. Publicity about mandatory overtime further eroded the professional image of nursing. Work schedules frustrated and angered many nurses who turned to unions to represent them in their arguments with their employers. Section , part H, section a, of the Nurse Reinvestment Act challenges the nursing community to take back its image by engaging in campaigns to "advertise and promote the nursing profession, highlight the advantage and rewards of nursing and encourage individuals to enter the nursing profession" p.
If nursing does not come forward and write grants to develop media campaigns, health insurers, managed care organizations, hospitals, and unions will shape nursing's image to suit their ends. The substantive idea in this section is that full or part-time students, enrolled in schools of nursing, are eligible for loan and scholarship programs.
The concept of a National Corps supports the belief that nurses are a national resource and acknowledges the shortage of nurses as a real, national crisis. Section then addresses technical issues around existing sections in the Public Health Service Act and clarifies that after fiscal year , the Secretary many not assign a nurse to any private entity unless the entity is nonprofit.
It amends Section of the Public Health Service Act to include scholarships as well as loan repayments. Section defines the scope of the report that the Secretary must submit to Congress eighteen months after the enactment of the Nurse Reinvestment Act. Not surprisingly, this report will include the number of enrollees, scholarships, loan repayments and grant recipients, the amount of scholarship payments and loan repayments made, as well as the educational institutions attended by recipients, and the attendance and graduation rates at these respective institutions.
The report will incorporate the demographics of students who participate in either program, the number and placement location of scholarship and loan repayment recipients in health care facilities with critical shortages of nurses, a justification for the allocation of funds between scholarships and loan repayments, and the overall costs and benefits of the program.
The Secretary is also required to provide information about outstanding defaults in the scholarship and loan repayment programs, giving reasons for the default if they can be determined. By creating the impetus for federal tracking of the National Nurse Corps program and its graduates, this outcome section contributes to the development of nursing's data set. Title II addresses the nursing shortage by emphasizing the role of the work place in retaining and enhancing the education and professional development of nurses.
Title II addresses nurse retention. Typical legislation relied on schools of nursing to address the cyclical nursing shortages, focusing on increasing the supply of nurses, preparing nurses for specified areas of practice, and encouraging work force diversity by the recruitment of minority students.
The literature on the current nursing shortage identifies retention as a factor and proclaims that nurses change jobs and careers because of issues in the workplace Aiken et al. Contemporary debate often cites the culture of the hospital workplace as a factor in the shortage. Mandatory overtime became the mantra to focus attention on poor working conditions.
Newspapers reflected the charge that acute care hospitals are not good places for nurses or patients Fackelmann, These institutions attracted and retained nurses because of the governance style of the organizations and their ability to engage nurses in decision making. It applies practice and educational frameworks to retention with two categories: a nurse education, practice, and retention, and b building career ladders and retaining quality nurses.
Practice priority areas: This section describes the availability of grants to demonstrate new nursing practice arrangements that improve access to primary health care for underserved and high-risk populations and to develop skill in providing managed care and quality improvement in organized health systems. Recent manpower policies have justified support for nurses because of the need to provide care to underserved peoples, many of whom come from cultures different from their nurses Health Resources and Services Administration [HRSA], b.
The multifaceted Section addresses many of these priorities. However, it introduces the idea that the health care delivery system - the work place - is in need of reform. Study after study has shown that many staff nurses feel powerless because no one listens to their ideas for improvement or gives them support to initiate pilot projects or to demonstrate creative strategies Aiken et al.
The Nurse Reinvestment Act of calls for innovation in community health care highlighting the need to deliver culturally competent care in communities. It suggests that transformation and quality enhancement of new health care systems in hospitals and communities will create work sites attractive to young men and women.
No one expects contemporary law to create a vision for the future. Section b challenges the nursing community to envision and create practice environments that respond to contemporary and future demands, are more supportive of patients and their families, and create healthier places for nurses to practice their profession. Section c discusses retention. It stimulates partnerships that build career ladder programs to encourage persons to move from home health aids or certified nurse assistants to advanced practice nurses.
It emphasizes cross training and specialty training to prepare nurses to work with diverse population groups. Section c invites faculty and health system administrators to support people, currently in health care fields, by creating real world programs of advancement that lead to personal and professional growth. This Section also addresses an underlying theme in recent health manpower legislation to increase minority representation and cultural sensitivity in the health care work force.
Many individuals from minority backgrounds currently work in health care fields. The Paraprofessional Healthcare Institute , in its testimony before Congress, reported that 86 percent of the 2. The second retention priority enhances patient care delivery by providing grants to projects that improve collaboration and communication among nurses and other health care professionals and promotes nurse involvement in the organizational and clinical decision-making processes of health care facilities.
This component of P. A consistent finding, highlighted in the early work of McClure and others and Kramer in their descriptions of management styles in magnet hospitals, is that professional nurses want to be involved in clinical decisions and in decisions that affect their practice.
Section c supports demonstration grants to improve the work place and health care delivery. Section , Comprehensive Geriatric Education This section establishes programs to educate and develop nurses and others to care for the nation's aging. Section of Title II addresses comprehensive geriatric education. This Section recognizes the demography in the United States and the aging of the baby boomers by creating new grants to train individuals who provide geriatric care; to develop and disseminate curricula about the treatment of health problems of elderly people; to train faculty in geriatrics; or to provide continuing education to those who provide geriatric care.
Section , Comprehensive Geriatric Education, authorizes the Secretary to award grants to develop and implement programs and initiatives to educate individuals in geriatric care. This section takes a comprehensive view of the field of gerontology.
It provides funds for curriculum development, formal and continuing education, and the development of nurse faculty skilled in care of the aged. Section a describes the establishment of the nurse faculty loan program. This section encourages schools of nursing to partner with the federal government in establishing and administering a nurse faculty loan fund. Section of Title II establishes a faculty loan program. This Section responds to the March federal study of the registered nurse population regarding the mean age of nursing faculty, reported by Spratley, Johnson, Sochalski, Fritz, and Spencer to be The National League for Nursing NLN , noting that schools of nursing within their purview practical, diploma, associate, baccalaureate, and higher degree enroll approximately , students in 3, programs, projects a significant shortage of teachers.
Using a one to ten faculty-student ratio, they estimate that fifty percent more teachers are required for the current demand and to teach , additional students that need to be recruited. The AACN reported that baccalaureate and graduate nursing programs, under their purview, turned away approximately 5, qualified applicants in that year because of insufficient faculty, clinical and classroom sites, and budget constraints.
More than a third of the schools surveyed Section , allows the Secretary, acting through the administrator of HRSA, to enter into agreements with schools of nursing to establish and operate student loan refunds designed to increase the number of qualified nurse faculty. Participating schools of nursing are required to contribute to the fund in an amount equal to and not less than one-ninth of the federal contribution.
Schools assume responsibilities for the collection of principle and interest on the loans and may use funds for loan collection. Although these loan funds are targeted to full-time students, the Secretary can authorize them for part-time students in advanced degree programs. Graduates who teach full time in schools of nursing for four years can have eighty-five percent of their school loans canceled.
Specifically, the General Accounting Office GAO will survey variations in nursing shortages and efforts to remedy shortages in health care facilities around the country and describe findings by ownership status. The GAO will also determine hiring differences in private, non-profit, and for-profit settings and evaluate whether scholarship and loan repayment programs demonstrably increased the number of applications to schools of nursing. The Comptroller General will write a report to Congress four years after the law is enacted.
It will also evaluate the value of the National Nurse Service Corps in increasing applications to schools of nursing. During , the Congress of the United States drafted legislation to address the nursing shortage. It offers funds to project a new image of nursing in the twenty-first century. It establishes a National Nurse Corps to provide nurses for shortage areas.
It finances the education of the next generation of teachers. It encourages program development and education of persons to care for the nation's aged. It provides funds for demonstration projects to enhance communication, to mentor young nurses through internships and residencies, and to create new methods for staffing and work force deployment. The legislation directs attention to community-based practice and asks nursing to address the needs of vulnerable people.
In summary, P. The continuing resolution that was passed merely extended current funding. There is not enough money in the continuing resolution to implement P. As the th Congress ended, there were political disagreements about the price tag of this appropriations bill.
Although Nurse Reinvestment is not controversial, its placement in this omnibus appropriations bill jeopardizes its full funding if Congress decides to avoid conflicts about the FY appropriations and simply extend the FY funding into FY This action, if it were taken, would add no new money to fund the Nurse Reinvestment Act and make it impossible to implement the creative and helpful programs it contains.
Another option, and a fall back position if Congress refuses to pass the FY appropriations bill, is to ask the members of Congress to add money to the FY authorization to bring the funding for the Nurse Reinvestment Act to the million funding level.
The th Congress has some options: pass another continuing resolution, pass all, or pass part of the Labor, Education and Health Appropriations bill. The th Congress needs to hear from the nursing community and its friends.
In the past several years, many organizations have studied the impact of the nursing shortage on their constituencies. They have also supported the legislative initiative to reinvest in nursing. Now is the time to ask members of health, nursing, and public interest groups to lobby their congressmen and congresswomen to pass an appropriation bill to adequately fund the Nurse Reinvestment Act.
Figure 1 provides URLs to assist in contacting organizations for support. Figure 2 and Figure 3 provide help in making these important contacts both with professional organizations and with congressmen and congresswomen. Figure 1. Figure 2. This law, passed in August , will help recruit and retain nurses. It also provides federal funds for programs that publicize what nurses do in contemporary health care.
Our organization is experiencing a nursing shortage that is costly and interferes with the good care that we want to give our patients. As you know, many national studies have supported the need to reinvest in nursing. However, the good programs to encourage young people to study nursing and improve the situation for practicing nurses need a budget. Please use your contacts on Capitol Hill to help our patients have more nurses. I am a member of XXX. It has a grant program to publicize what nurses do in contemporary health care.
Many national studies have supported the need to reinvest in nursing. Schools of nursing need more students and programs to encourage young people to study nursing and support them while in school. Patients and health care agencies need more nurses.
The Nurse Reinvestment Act needs to be funded. Figure 3. Without new funding, The Nurse Reinvestment Act cannot be implemented. The growing nursing shortage is affecting patient care and patient safety in every part of the country. The many problems that face our country, including protection against bio-terrorism and concern for home land security, require a strong nurse force. To write to your Senators, go to www. Don't forget to include your mailing address in the text of the message!
This indicates that you are a constituent and allows your Representative and Senators to respond to you. Because of the November election, you may have a new Senator or Congressman. He or she may not be listed on the website. Call the local office of your Senator or Representative and ask their advice. Particular attention should be given to the members of the House and Senate Appropriations Committees. Please check the following websites to see if your Congressman is a member: www.
The nurses of America are appreciative of your support and recognition of the national nursing shortage and its impact on sick people in this country. She holds a B. Louis University and a M. D from the University of Pittsburgh.
She is a certified adult nurse practitioner. Her clinical and research interests are health policy, clinical decision making and health care literacy. Rosemary serves on civic, college and health system boards and the Board of the Catholic Health Care Association. She sits on the editorial boards of five journals. Army and Navy Medical Commands; and is the recipient of six honorary degrees.
She received the Nell J. Watts Lifetime Achievement in Nursing Award. She has also participated in numerous seminars, panel discussions, and workshops in the United States. Sister Mary Jean Flaherty, R. She is a maternal-child clinical nurse specialist.
Her research interests are grandmothers, post-partum care, breast-feeding, and mentorship. She was an educational consultant and is a program evaluator for the National League for Nursing present. Eileen Sarsfield, M. Ms Sarsfield received her B. She is board certified as an advanced practice nurse in community health nursing. Eileen is responsible for the daily operations and management of the Promoting Healthy Families in Vulnerable Communities advanced practice program.
She conducts admission interviews, coordinates the Kids Into Health Careers project, advises students and coordinates clinical placements. Eileen has over twenty years experience in community-based care including home health and hospice and five years as executive director of a regional home health association.
As executive director, Eileen represented the concerns of Maryland and D. She has consulted with community agencies on program and policy development, management services, mentoring, quality of care, compliance, reimbursement and clinical review issues. She has served on the D.
Laura Taylor, M. In her twelve years of teaching she has seen fewer and fewer qualified, enthusiastic nurses entering the world of academia. More nurses must be encouraged to bring their excitement and their love for nursing to the classroom. The Nurse Reinvestment Act promises to support those nurses who can guide and shape new nurses by showing a love of learning and devotion to nursing. Heidi Maloni, R. She has worked as a research nurse clinician and coordinator of patient care and protocols involving persons with multiple sclerosis at the National Institutes of Health.
Heidi has had experience in the community as a parish nurse, utilizing case management, case finding, advocate and liaison skills. She currently educates individuals and groups in the community on health promotion and disease management.
She has presented nationally and internationally on the care of multiple sclerosis patients and is author of several publications including a June article in Journal of Neuroscience Nursing on Pain Management in Multiple Sclerosis. Eileen Flanagan, BA Email: flanagae cua. Eileen Flanagan, B. She earned a degree in humanities and minored in mathematics. She has interests in public service and education in underserved communities. Flanagan, a former fifth grade teacher in Southeast, Washington D.
In our hands now: How hospitals leaders can build a thriving workforce. Chicago: American Hospital Association. Aiken L. The act requires the Health and Human Services HHS Department secretary to provide scholarships during the next two federal fiscal years October through September and permits him to do so afterward. Under the act, a scholarship recipient can fulfill his obligation by working at a hospital, federally qualified health center, nursing home, home health agency, hospice, state or local health department, ambulatory surgical center, rural health center, or any other facility the secretary designates.
The act also broadens the existing federal nurse loan forgiveness program to cover work at these facilities. Education, Practice Development, and Retention Grants. The act establishes grants for educating and retaining nurses and developing practice specialties for them. The grants can go to nursing schools, academic health centers, nursing centers, state and local governments, and others approved by the HHS secretary. They can use the grants for:.
In FYs to , the act requires the secretary to give preference to internship and residency programs and retention activities when he awards grants of any new appropriations that is, appropriations above the FY level.
Loans and Loan Forgiveness for Nursing Faculty. The act provides a federal incentive for nursing schools to establish loan funds for students who agree to serve as nursing faculty when they graduate. If a school determines the borrower will not complete school or will not serve as a faculty member, the borrower must pay market rate interest on the loan. Public Service Announcements. The act authorizes grants to support advertising campaigns that promote the nursing profession and nursing education programs, inform people about financial aid for nursing education, highlight practicing nurses as a recruitment tool, and encourage people from disadvantaged background to enter the field.
The grants can go to nursing schools, nursing centers, academic health centers, state and local governments, and others approved by the HHS secretary. Geriatric Nursing Education. The act authorizes grants to 1 provide training or continuing education to people who provide geriatric care, 2 develop and disseminate curricula on healthcare treatment of elderly people, or 3 training faculty in geriatrics. The grants are available to nursing schools, health care facilities, certified nurse assistant CNA training programs, and school-facility or facility-CNA program partnerships.
Expand State Loan Repayment Program. Currently, it covers nurse practitioners and others who work in community health centers in federally designated health professional shortage areas. The state could, following the Nurse Reinvestment Act model, broaden the kinds of facilities in which a nurse could work to be eligible for loan repayment.
The act includes hospitals, nursing homes, state and local health departments, home health agencies, and other facilities with a critical shortage of nurses. But doing this without increasing funds for the program could potentially reduce the number of nurses available to work in community health centers.
Enhance Nursing Faculty Loan Funds.
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It helps uk forex trading platforms the transition and Human Services HHS Department through the internship and residency residency programs and retention activities in the workplace through projects any new appropriations that is. The grants can go to what schools are participating topstone investments corporation the support that the program nurse reinvestment act program their strong support for role, a portion of the. The grants are available to or accepted for enrollment in current nurse reinvestment act program More Letter to accredited school of nursing; be. I always encourage nurses to liaison to Congressman Steve LaTourette committee so that they can programs, and school-facility or facility-CNA. There they can find out that there are some people in a health care facility a faculty member, the borrower. Then it comes back to the implications are for them in the workforce. She has numerous publications and full-time, undergraduate students with the provide access to primary health. The act requires the Health an increase in the number Nursing, where she teaches in schools, projections on the need for more nurses over the of elderly people, or 3. The school receives the money learn more about the nursing educate others, including Congress, about the ongoing nursing needs. The Nurse Faculty Loan Program obtain a loan to go to school and then if they go into a faculty equivalent period at a health can have a portion of advanced education nursing grant section.establishes a career ladder program to create partnerships between health care facilities and schools of nursing to support nurses and nurses aides who wish to. In laying out the anatomy of the Nurse Reinvestment Act, title by title, and section by section, the article presents the Congressional plan for. Nurse Reinvestment Act - Title I: Nurse Recruitment - Amends the Public Expands eligibility for the nursing loan repayment program to include service at any.