American Nurses : A Qualitative Analysis

First, we must ask who the stakeholders are when it comes to any nursing program. This is a wide universe, for the stakeholders are many. First, of course, we have instructors at the university level, most of whom have been or are practicing professionals. Then there are the administrators of the program who must continually search out money and grants to keep the program going. We then move into the public sector: patients, families, physicians, support staff at healthcare facilities, healthcare administration, HMOs, private insurers, and governmental agencies (Colvin, et.al., 2008). Each has a role to play within the evaluation process.

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

Nursing satisfaction has criteria for change; as documented in the Future of Nursing’s report, by the Institute of Medicine in cooperation with the Robert Wood Johnson Foundations’, Campaign for Action. (IOM, 2010) (RWFF, 2010) Both reports lay the groundwork that influences NC current nursing shortage. At the same time; to make health care more affordable, the Affordable Care Act was entered into law (ACA, 2010). Additionally, hospitals and other health care facilities are applying for, and meeting criteria for accreditation and is very clear about implementing a mandatory, entry level, BSN

American Association of College of Nursing Creating a More Highly Qualified Nursing (2014) Workforce Retrieved from: www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education.

Much of my work is proprietary to Geisinger. Special permissions may be granted to view this work if requested. Attached is an example of quality measure education for nursing, advance practitioner and physician education that was created to understand the Medicare required quality measure to prevent a downward payment adjustment in 2017. This presentation was presented to all 42 of the community practice providers and nursing staff during their monthly February or March 2016

American Nurses Association (ANA) Standards of Professional Performance explains how all registered nurses do their work and activities consistently according to their professions that promote the wellbeing of their patients and communities (ANA, 2010a). The standards provide a mechanism to patients that they are been taken good care of and that the nurses know exactly what to do so as to provide high-quality care and the measures are in place to determine whether nursing care meets the standards. These activities are related to performance like ethics, quality of practice, education, communication, resources, leadership, environmental health, professional practice evaluation, and evidence-based practice and research. Registered nurses are responsible for their professional actions to themselves, their patients, their peers, and the community at large.

A discussion regarding the health care reform or even health care in general can be somewhat controversial. The definition of health is drastically different depending on whom you speak to. Many would define health as " a person's absence of disease, others would describe good health based on the status of mind, body & social well-being" (GCU Lecture, module 2, 2012). According to The American Heritage® Dictionary of the English Language, health is defined as "The overall condition of an organism at a given time". An individual's overall health affects the nation, this is where stakeholders come into value. According to Keele, Buckner & Bushnell a stakeholder is either an individual or an organization that either invest time and

In 2008, The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) launched an initiative to assess and reform the nursing profession to address the complex unique nursing needs for the current world. The IOM report published in 2010 calls on nurses to take greater role in the healthcare system by taking leadership roles and obtaining high level education. The report envisions nurses to use their full potential and attain academic progression to redesign the healthcare profession in United States.

In the early 1980s it came to light that while the supply of nurses had reached a record high, only 80% of hospitals nationwide had adequate nurse staffing levels (American Nurse Credentialing Center, 2011, p. 8). To address this issue a taskforce was formed within the American Academy of Nursing (AAN). Through an initial study of 165 hospitals, the AAN determined the characteristics of healthcare organizations that were magnetically attracting and retaining nurses as employees (American Nurse Credentialing Center, p. 9). In this study the AAN found “Forces of Magnetism” that contributed to the high level of job satisfaction amongst nurses, superior quality of care, low job turnover, and high level of nurse involvement in leadership, decision-making, and research. In the early 1990s, catapulted by the findings of this initial study, the American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program. The intention of the ANCC’s Magnet Recognition Program was threefold: To reward hospitals that demonstrated “excellence in the delivery of nursing services to patients;” to encourage quality in the nursing work environment to support practicing professional nurses; and to guide navigation for the dissemination of evidenced-based clinical nursing practice (American Nurse Credentialing Center, 2011, p. 14).

Furthermore, licensing and accreditation standards must be heightened to insure the quality of the nurses that enter the workforce. Certifying organizations must therefore mandate the proper demonstration of core competencies and skills prior to endowing students with the nursing title. The nursing profession, according to the IOM report, must undergo fundamental changes within the overall education of nurses. In many respects the basic

According to the National League for Nursing (NLN), the NLN Commission for Nursing Education Accreditation (CNEA) goal is to “promote excellence and integrity in nursing education globally through an accreditation process that respects the diversity of program mission, curricula, students, and faculty; emphasizes a culture of continuous quality improvement…” (p.1). The NLN CNEA incorporates five (5) standards for any and all nursing programs including LPN/LVN, diploma, associate, bachelor, master's, and clinical doctorate degrees. This paper will outline three (3) accreditation criteria and explain how they may be evaluated for success.

In the early 1980s there was a significant nursing shortage and high turnover at hospitals. Research by the American Academy of Nursing recognized forty-one hospitals that attracted nurses to work at their location because of their more collaborative and supportive work environments. These hospitals were more effective with filling nursing job vacancies compared with similar hospitals. The American Nurse’s Credentialing Center (ANCC), an organization of American Nurses Association developed a voluntary recognition program to formally credential Magnet hospitals, and the first Magnet hospital was credentialed in 1994 (Kelly, 2011). ANCC review certain criteria that are design to measure the quality and strength of nursing practice at the hospital. Nurses who work at these Magnet hospitals have higher job satisfaction and reports that they have better communication between the nurses and other healthcare team. Most importantly, Magnet hospitals have high quality nursing care, better patient outcomes, and high patient satisfaction.

There is no doubt that the health care system is constantly changing and working to improve its flaws, to the best of its ability. Whether nurses like it or not we are a part of the ever changing health care system. “With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce” (Institute of Medicine [IOM], 2010, p. 1). The Institute of Medicine believes that nurses should be active in transforming the profession of nursing, along with the health care system. Regardless, of backgrounds, race, and age all nurses can contribute to the future of the nursing profession. The following paper will discuss the Institute of Medicine’s nursing expectations and recommendations, as well as the opportunity to becoming a clinical nurse instructor.

The research for the development of this implementation plan was supported by several peer reviewed research journals. The key words for searching in the databases included Nurse Residency programs, Newly Licensed Nurse Residency, Residency Programs and Retention Rates. The search was narrowed down to residency programs for nurses and retention rates for nurses. Five research works that bear the highest relevance to the study topic were selected.