WEBVTT 00:00:07.070 --> 00:00:11.430 position:50% align:middle - [Moderator] Good morning, everyone, and thank you for all that are attending here live 00:00:11.430 --> 00:00:14.330 position:50% align:middle in Chicago and viewing digitally. 00:00:14.330 --> 00:00:20.580 position:50% align:middle We're here today to provide solutions to the greatest healthcare challenges we are facing today. 00:00:20.580 --> 00:00:25.695 position:50% align:middle For any media or interested parties that are seeking to collaborate or report on the solutions 00:00:25.695 --> 00:00:33.080 position:50% align:middle provided today, please contact ncsbn@reputationpartners.com. 00:00:33.080 --> 00:00:36.840 position:50% align:middle Without further ado, I'll pass the baton to Maryann Alexander, 00:00:36.840 --> 00:00:45.960 position:50% align:middle chief officer of Nursing Regulation for NCSBN. 00:00:45.960 --> 00:00:50.226 position:50% align:middle - [Maryann] Thank you, and let me begin by extending a warm welcome to all of you, 00:00:50.226 --> 00:00:55.140 position:50% align:middle to our panelists, and to those who are watching digitally. 00:00:55.140 --> 00:00:57.070 position:50% align:middle Today is an important day. 00:00:57.070 --> 00:01:04.890 position:50% align:middle We are addressing an important topic that is going to affect the future of health care. 00:01:04.890 --> 00:01:13.730 position:50% align:middle In April of 2023, NCSBN released the results of our National Nursing Workforce Study. 00:01:13.730 --> 00:01:22.570 position:50% align:middle NCSBN is a world leader in nursing regulation, exam development, and nursing research. 00:01:22.570 --> 00:01:29.895 position:50% align:middle The result of that study was alarming, and I'm going to recap some of the results to you 00:01:29.895 --> 00:01:33.330 position:50% align:middle that we want you to pay close attention to. 00:01:33.330 --> 00:01:40.170 position:50% align:middle And it shows the impact of COVID-19 on the nursing workforce. 00:01:40.170 --> 00:01:47.530 position:50% align:middle So, as a result of the pandemic, 100,000 nurses left the workforce, 00:01:47.530 --> 00:01:51.580 position:50% align:middle and this is in addition to nurses that left due to normal reasons, 00:01:51.580 --> 00:01:55.360 position:50% align:middle such as retirement or going back to school. 00:01:55.360 --> 00:02:01.700 position:50% align:middle During that time, the nurses showed that they had an extraordinary increase in their workload. 00:02:01.700 --> 00:02:03.780 position:50% align:middle They changed practice settings. 00:02:03.780 --> 00:02:09.070 position:50% align:middle Many retired because of COVID-19. 00:02:09.070 --> 00:02:19.550 position:50% align:middle More, even more alarming are the fact that 45% to 56% of the nurses in our study said they are 00:02:19.550 --> 00:02:33.410 position:50% align:middle emotionally drained, used up, fatigued, or burned out. 29% say they are at the end of their rope. 00:02:33.410 --> 00:02:47.511 position:50% align:middle What we want to call your attention to is that, by 2027, over 800,000 RNs and almost 200,000 LPNs, 00:02:47.511 --> 00:02:55.510 position:50% align:middle that is, 1 million nurses say they have an intent to leave the nursing profession. 00:02:55.510 --> 00:03:00.975 position:50% align:middle This is equivalent to 20% of the total licensed nursing workforce. 00:03:00.975 --> 00:03:07.810 position:50% align:middle And what is even more alarming is we are seeing something that we have never seen before, 00:03:07.810 --> 00:03:21.520 position:50% align:middle 24% of those nurses that want to leave nursing have less than 10 years of experience. 00:03:21.520 --> 00:03:30.340 position:50% align:middle The reasons for leaving are burnout, understaffing, concern for patient safety, 00:03:30.340 --> 00:03:38.200 position:50% align:middle a lack of educational preparation for entering the workforce, and violence in the workplace, and bullying. 00:03:38.200 --> 00:03:42.170 position:50% align:middle And I want to call to your attention that these are basic needs. 00:03:42.170 --> 00:03:51.200 position:50% align:middle These are not things that are extraordinary requests. 00:03:51.200 --> 00:03:55.680 position:50% align:middle Thus, all of this adds up to the fact that the U.S. 00:03:55.680 --> 00:04:04.510 position:50% align:middle will experience a national healthcare crisis within the next five years if we don't see this as a 00:04:04.510 --> 00:04:07.800 position:50% align:middle call to action. 00:04:07.800 --> 00:04:16.153 position:50% align:middle So, in the wake of COVID-19, the nursing workforce has lost hundreds of thousands of nurses, 00:04:16.153 --> 00:04:21.470 position:50% align:middle potentially up to 1 million in the next 5 years. 00:04:21.470 --> 00:04:26.450 position:50% align:middle We are asking healthcare leaders to take heed. 00:04:26.450 --> 00:04:28.640 position:50% align:middle We need to think differently. 00:04:28.640 --> 00:04:36.260 position:50% align:middle We need to build new models of care and make enhancements so that our profession is stronger, 00:04:36.260 --> 00:04:41.740 position:50% align:middle better, and even more rewarding for generations to come. 00:04:41.740 --> 00:04:44.750 position:50% align:middle Today is a day about solutions. 00:04:44.750 --> 00:04:51.320 position:50% align:middle We are going to have three panel discussions that address these basic needs of nursing, 00:04:51.320 --> 00:04:58.200 position:50% align:middle staffing and entry to practice, violence in the workplace, and mental health issues. 00:04:58.200 --> 00:05:04.380 position:50% align:middle And we have brought thought leaders from around the world together to bring us their innovations 00:05:04.380 --> 00:05:12.710 position:50% align:middle from their institutions, their ideas, and their inspiring thoughts as to how we can lead 00:05:12.710 --> 00:05:15.080 position:50% align:middle nursing into the future. 00:05:15.080 --> 00:05:41.650 position:50% align:middle And so, without further ado, I'd like to have our panelists come up and introduce them. 00:05:41.650 --> 00:05:47.201 position:50% align:middle We'll begin with you and have you introduce yourself, and then let's go around our panel 00:05:47.201 --> 00:05:50.651 position:50% align:middle so everyone can meet you. 00:05:50.651 --> 00:05:51.900 position:50% align:middle - [Lavonia] Good morning. 00:05:51.900 --> 00:05:53.360 position:50% align:middle My name is Lavonia Thomas. 00:05:53.360 --> 00:05:59.550 position:50% align:middle I am the Nursing Informatics Officer at MD Anderson Cancer Center in Houston, Texas. 00:05:59.550 --> 00:06:03.850 position:50% align:middle I do have responsibility for all things in the electronic health record and health IT, 00:06:03.850 --> 00:06:09.410 position:50% align:middle but in addition, I am the operational lead that has introduced and is moving virtual nursing forward 00:06:09.410 --> 00:06:11.830 position:50% align:middle at the organization. 00:06:11.830 --> 00:06:14.580 position:50% align:middle - [Beverly] My name is Beverly Malone. 00:06:14.580 --> 00:06:19.770 position:50% align:middle I'm the President and CEO for the National League for Nursing. 00:06:19.770 --> 00:06:23.650 position:50% align:middle And our organization is 130 years old right now. 00:06:23.650 --> 00:06:25.730 position:50% align:middle And I'm happy to say, that's not my age. 00:06:25.730 --> 00:06:29.717 position:50% align:middle Good morning. 00:06:29.717 --> 00:06:30.540 position:50% align:middle - [Karen] I'm Karen Lyon. 00:06:30.540 --> 00:06:35.080 position:50% align:middle I'm the Chief Executive Officer of the Louisiana State Board of Nursing. 00:06:35.080 --> 00:06:43.298 position:50% align:middle I have regulatory authority for 70,000 RNs, 9,000 of whom are advanced practice RNs, 00:06:43.298 --> 00:06:53.096 position:50% align:middle 31 pre-licensure undergraduate programs, and I believe, now, it's 15 graduate MSN and DNP programs 00:06:53.096 --> 00:06:56.730 position:50% align:middle that provide APRN licensure. 00:06:56.730 --> 00:06:57.390 position:50% align:middle - [Eileen] Good morning. 00:06:57.390 --> 00:06:58.960 position:50% align:middle My name is Eileen Fry-Bowers. 00:06:58.960 --> 00:07:02.133 position:50% align:middle I am the Dean of the School of Nursing and Health Professions 00:07:02.133 --> 00:07:05.190 position:50% align:middle at the University of San Francisco in California. 00:07:05.190 --> 00:07:11.710 position:50% align:middle And at our school, we educate pre-licensure and post-licensure advanced practice nurses. 00:07:11.710 --> 00:07:15.590 position:50% align:middle - Well, thank you all very much for being here. 00:07:15.590 --> 00:07:19.010 position:50% align:middle Lavonia, I'd like to begin with you. 00:07:19.010 --> 00:07:23.350 position:50% align:middle I'm going to quote you some of the data that I just talked about. 00:07:23.350 --> 00:07:28.870 position:50% align:middle One hundred thousand RNs have left the workforce due to COVID-19. 00:07:28.870 --> 00:07:37.160 position:50% align:middle Potentially, another 800,000 RNs plan on leaving the workforce in the next 5 years. 00:07:37.160 --> 00:07:44.360 position:50% align:middle A large percentage of them say this is due to understaffing and, in fact, unsafe staffing, 00:07:44.360 --> 00:07:50.880 position:50% align:middle where not only they are overworked, they feel their patients are at risk. 00:07:50.880 --> 00:07:57.250 position:50% align:middle Does this retention issue concern you and the administrators at MD Anderson? 00:07:57.250 --> 00:08:04.840 position:50% align:middle - As a nurse for more than 35 years, what impacts my profession and my sisters and brothers 00:08:04.840 --> 00:08:08.720 position:50% align:middle in this profession certainly touched my soul. 00:08:08.720 --> 00:08:16.585 position:50% align:middle At MD Anderson, we have put forth opportunities that we have harnessed from our monitoring of national 00:08:16.585 --> 00:08:26.589 position:50% align:middle and local trends, as well as the work we have done to establish contact ongoing through formal structures 00:08:26.589 --> 00:08:31.103 position:50% align:middle to tap into what our nurses are telling us they want us to do. 00:08:31.103 --> 00:08:37.560 position:50% align:middle As a result, we have launched nursing transformation efforts with at least eight different work streams 00:08:37.560 --> 00:08:44.470 position:50% align:middle to address the issues that our MD Anderson nurses are telling us that they want us to address. 00:08:44.470 --> 00:08:51.680 position:50% align:middle Largely, the message we are getting is they want holistic addressing of them as a whole person, 00:08:51.680 --> 00:08:56.950 position:50% align:middle not just when they come to work but their needs above and beyond in this profession. 00:08:56.950 --> 00:08:58.860 position:50% align:middle And that's what we're doing. 00:08:58.860 --> 00:09:04.180 position:50% align:middle - Karen, I talked a lot about patient safety. 00:09:04.180 --> 00:09:09.670 position:50% align:middle Tell me why this is a regulatory issue and regulators should be worried about it. 00:09:09.670 --> 00:09:17.060 position:50% align:middle - Well, I don't think there's a bigger safety issue in terms of taking care of patients than nurse staffing 00:09:17.060 --> 00:09:24.020 position:50% align:middle who provide the majority of care both in our hospitals and in our healthcare organizations. 00:09:24.020 --> 00:09:31.420 position:50% align:middle So a nursing shortage like this, either because nurses are dropping out or young people 00:09:31.420 --> 00:09:37.730 position:50% align:middle aren't coming into the profession, is a very dangerous trend for us because we have 00:09:37.730 --> 00:09:43.100 position:50% align:middle patients in our hospitals and in our healthcare organizations and even in community care where we're 00:09:43.100 --> 00:09:50.730 position:50% align:middle moving patients that are older, sicker, and have many comorbid conditions that make their 00:09:50.730 --> 00:09:52.720 position:50% align:middle care more complicated. 00:09:52.720 --> 00:09:57.700 position:50% align:middle So we need sufficient staffing to take care of those people. 00:09:57.700 --> 00:10:06.550 position:50% align:middle And having had family members at MD Anderson and in institutions at Ochsner in Louisiana, 00:10:06.550 --> 00:10:11.590 position:50% align:middle I know when care suffers, when there's not enough staff there to take care 00:10:11.590 --> 00:10:13.030 position:50% align:middle of the patients. 00:10:13.030 --> 00:10:16.970 position:50% align:middle And I know that our newly licensed nurses are very, very concerned. 00:10:16.970 --> 00:10:25.680 position:50% align:middle And our survey that preceded the one we did showed some very concerning trends in the narrative data that our 00:10:25.680 --> 00:10:32.580 position:50% align:middle newly licensed, less than two-year licensed nurses told us about how they were treated during COVID, 00:10:32.580 --> 00:10:36.590 position:50% align:middle what they were faced with during COVID, and that they wanted out, 00:10:36.590 --> 00:10:39.550 position:50% align:middle and they were only in the profession for two years. 00:10:39.550 --> 00:10:40.540 position:50% align:middle It's very concerning. 00:10:40.540 --> 00:10:42.300 position:50% align:middle - Absolutely. 00:10:42.300 --> 00:10:47.600 position:50% align:middle Bev and Eileen, I know this is probably impacting education as well. 00:10:47.600 --> 00:10:48.900 position:50% align:middle Tell me about it. 00:10:48.900 --> 00:10:49.470 position:50% align:middle Bev? 00:10:49.470 --> 00:10:57.950 position:50% align:middle - Well, when everyone does the analysis of the workforce issues, they come up with two basic 00:10:57.950 --> 00:10:59.070 position:50% align:middle reasons for it. 00:10:59.070 --> 00:11:06.450 position:50% align:middle One is not enough nurse educators, and the second is not enough clinical placements. 00:11:06.450 --> 00:11:11.900 position:50% align:middle And so that, if we go to the root of the problem, I think that's where we'll find it in terms of, 00:11:11.900 --> 00:11:17.340 position:50% align:middle in my area, nurse education and having access to clinical placements is a huge issue. 00:11:17.340 --> 00:11:21.020 position:50% align:middle And I know that, digitally, you're working on it, and virtually. 00:11:21.020 --> 00:11:23.430 position:50% align:middle And so I'm really happy about that. 00:11:23.430 --> 00:11:29.750 position:50% align:middle I'm thinking that we've got to make sure health equity is in there too, and diversity and inclusion are also 00:11:29.750 --> 00:11:31.380 position:50% align:middle part of that calculation. 00:11:31.380 --> 00:11:36.770 position:50% align:middle It's usually not printed out that way, but it's embedded in it, that we know, 00:11:36.770 --> 00:11:40.510 position:50% align:middle unless we make that inclusion, it won't help. 00:11:40.510 --> 00:11:42.790 position:50% align:middle So, are we to the solutions yet? 00:11:42.790 --> 00:11:46.260 position:50% align:middle Should I mention a possible solution, or should we hold off on that? 00:11:46.260 --> 00:11:47.090 position:50% align:middle - Hold off. 00:11:47.090 --> 00:11:50.270 position:50% align:middle I want to give everybody the grand scope of the problem. 00:11:50.270 --> 00:11:50.900 position:50% align:middle - Okay. 00:11:50.900 --> 00:11:52.910 position:50% align:middle - But we'll get to it. - So the only other thing that I...I'm sorry. 00:11:52.910 --> 00:11:57.180 position:50% align:middle The only other thing that I would say is that it's not just our problem. 00:11:57.180 --> 00:11:58.660 position:50% align:middle It's not just a nursing problem. 00:11:58.660 --> 00:12:03.800 position:50% align:middle When you talk about that it's going to affect health care, it becomes a nationwide, 00:12:03.800 --> 00:12:08.860 position:50% align:middle global issue that will require all of us working together on this. 00:12:08.860 --> 00:12:10.250 position:50% align:middle - Absolutely. 00:12:10.250 --> 00:12:10.920 position:50% align:middle Eileen? 00:12:10.920 --> 00:12:11.500 position:50% align:middle - Yes. 00:12:11.500 --> 00:12:15.750 position:50% align:middle I would like to dive in a little bit more on this issue of clinical placements just so 00:12:15.750 --> 00:12:17.460 position:50% align:middle that everybody understands. 00:12:17.460 --> 00:12:24.130 position:50% align:middle In nursing education, our students have, of course, the classroom kind of education, 00:12:24.130 --> 00:12:28.800 position:50% align:middle but a huge percent of the education really takes place in the clinical setting. 00:12:28.800 --> 00:12:33.430 position:50% align:middle And in order to do that, we need to be able to come into hospitals or healthcare 00:12:33.430 --> 00:12:39.230 position:50% align:middle agencies or community agencies, and we need to have our students work with the nurses 00:12:39.230 --> 00:12:41.450 position:50% align:middle that are working in those spaces. 00:12:41.450 --> 00:12:49.050 position:50% align:middle When those nurses are fatigued or burned out, the ability of them to be able to work with our 00:12:49.050 --> 00:12:51.860 position:50% align:middle students is reduced. 00:12:51.860 --> 00:12:59.620 position:50% align:middle And oftentimes, many of our clinical agencies then say, in an effort to alleviate some of the stress that the 00:12:59.620 --> 00:13:05.330 position:50% align:middle staff are having that we're not going to take, you know, more students or we're going to have our 00:13:05.330 --> 00:13:06.820 position:50% align:middle nurses take a break. 00:13:06.820 --> 00:13:15.200 position:50% align:middle And while this is really important, what it does is it backs up the students who can then 00:13:15.200 --> 00:13:17.120 position:50% align:middle be educated and continue to move forward. 00:13:17.120 --> 00:13:19.970 position:50% align:middle So it really clogs up the pipeline. 00:13:19.970 --> 00:13:25.390 position:50% align:middle And so we really need to focus on ways that we can support the nurses who are functioning in these 00:13:25.390 --> 00:13:32.250 position:50% align:middle settings as preceptors, but also, you know, we need to partner with our clinical agencies to be 00:13:32.250 --> 00:13:38.920 position:50% align:middle able to bring in our students in larger numbers so that we can, again, move them through the educational 00:13:38.920 --> 00:13:43.310 position:50% align:middle process so that they're successfully entering into the workforce. 00:13:43.310 --> 00:13:44.180 position:50% align:middle - Great, thank you. 00:13:44.180 --> 00:13:48.030 position:50% align:middle And now I want to turn to solutions. 00:13:48.030 --> 00:13:52.610 position:50% align:middle Lavonia, please tell us what's happening at MD Anderson. 00:13:52.610 --> 00:13:58.048 position:50% align:middle - Well, at MD Anderson, some time ago, we engaged in nursing transformation efforts 00:13:58.048 --> 00:14:06.920 position:50% align:middle based on our feedback from our staff nurses, such activities as focusing on leadership training, 00:14:06.920 --> 00:14:11.730 position:50% align:middle first off, focusing on those that were hired in the last three years, because they were hired during the 00:14:11.730 --> 00:14:17.440 position:50% align:middle pandemic and needing to focus some of their skills, and then moving forward to those with more experience 00:14:17.440 --> 00:14:23.390 position:50% align:middle to build their skills, and then to all nurses, because nurses are leaders in whatever job 00:14:23.390 --> 00:14:24.550 position:50% align:middle that they hold. 00:14:24.550 --> 00:14:30.687 position:50% align:middle In addition, we've introduced the virtual nursing platform to layer on a registered nurse with experience 00:14:30.687 --> 00:14:36.010 position:50% align:middle to the care team to support those that are delivering hands-on patient care. 00:14:36.010 --> 00:14:42.260 position:50% align:middle Our nurses spoke about the need to ensure that when we place resources in place like technicians that we make 00:14:42.260 --> 00:14:48.930 position:50% align:middle sure that we have those people with some level of dependability, because the work falls back to the nurse 00:14:48.930 --> 00:14:54.110 position:50% align:middle when those people are not available and also that they are trained to do that which we need 00:14:54.110 --> 00:14:56.230 position:50% align:middle to delegate to them. 00:14:56.230 --> 00:15:02.700 position:50% align:middle In addition, I am proud to say today, MD Anderson is announcing, 00:15:02.700 --> 00:15:08.040 position:50% align:middle through a generous $25 million gift, the launching of the Meyers Institute 00:15:08.040 --> 00:15:11.960 position:50% align:middle for Oncology Nurses, and it is designed... 00:15:11.960 --> 00:15:12.590 position:50% align:middle It's wonderful. 00:15:12.590 --> 00:15:16.810 position:50% align:middle Philanthropic efforts toward nursing are wonderful. 00:15:16.810 --> 00:15:23.160 position:50% align:middle This institute is designed to look at the nurse as a whole person, both professional development as well 00:15:23.160 --> 00:15:25.370 position:50% align:middle as providing wellness resources. 00:15:25.370 --> 00:15:31.090 position:50% align:middle We want nurses to come to MD Anderson and retire from MD Anderson, and to do that, 00:15:31.090 --> 00:15:36.160 position:50% align:middle we need to support all of their needs, not just what they come to work to do 00:15:36.160 --> 00:15:37.430 position:50% align:middle but also their wellness. 00:15:37.430 --> 00:15:40.050 position:50% align:middle - Absolutely. 00:15:40.050 --> 00:15:43.450 position:50% align:middle Could you tell us a little bit more about virtual nursing? 00:15:43.450 --> 00:15:46.700 position:50% align:middle - Absolutely. 00:15:46.700 --> 00:15:51.080 position:50% align:middle After a career of over 35 years, this is really something I'm excited about, 00:15:51.080 --> 00:15:54.490 position:50% align:middle almost like when I first went to the ICU many years ago. 00:15:54.490 --> 00:16:00.030 position:50% align:middle It has enabled us to hire...we have now hired 10 virtual nurses for the organization, 00:16:00.030 --> 00:16:07.630 position:50% align:middle and we are using a sprint methodology to introduce, right now, admission and discharge support 00:16:07.630 --> 00:16:08.890 position:50% align:middle for our frontline nurses. 00:16:08.890 --> 00:16:16.220 position:50% align:middle Again, this was based on their feedback of things that they felt someone could assist them with but it needed 00:16:16.220 --> 00:16:17.620 position:50% align:middle to be a nurse. 00:16:17.620 --> 00:16:23.820 position:50% align:middle We have been able to hire nurses that have got a great deal of longevity at MD Anderson, 00:16:23.820 --> 00:16:29.170 position:50% align:middle and an oncology nurse is a valuable member of the MD Anderson family because of the work they 00:16:29.170 --> 00:16:30.530 position:50% align:middle do with patients. 00:16:30.530 --> 00:16:36.350 position:50% align:middle So we have now come across four units, and we are going to slowly implement admission 00:16:36.350 --> 00:16:39.200 position:50% align:middle and discharge work utilizing this virtual platform. 00:16:39.200 --> 00:16:40.730 position:50% align:middle But that's just the beginning. 00:16:40.730 --> 00:16:45.040 position:50% align:middle There's so much potential, and we are listening to the voice of our nurses both 00:16:45.040 --> 00:16:51.590 position:50% align:middle through in-person forms plus surveys that we're sending out for them to tell us, as a nurse, 00:16:51.590 --> 00:16:57.160 position:50% align:middle what can we partner with and create a virtual member of this team to assist with? 00:16:57.160 --> 00:16:59.250 position:50% align:middle We've received some excellent feedback. 00:16:59.250 --> 00:17:05.370 position:50% align:middle I can't say enough. The feedback the nurses have said, one actually said, "I don't know how we'd get 00:17:05.370 --> 00:17:11.180 position:50% align:middle through some of my busiest days without my virtual nurse, and it has enabled me," and this is directly 00:17:11.180 --> 00:17:17.700 position:50% align:middle from nurses, "It has enabled me to spend time with my patient and do a more thorough assessment with having 00:17:17.700 --> 00:17:18.750 position:50% align:middle this individual on board." 00:17:18.750 --> 00:17:26.420 position:50% align:middle - Have you had any assessment yet of retention and the impact of any of these interventions? 00:17:26.420 --> 00:17:35.430 position:50% align:middle - MD Anderson has seen a stabilization of our turnover, and we are pleased with that. 00:17:35.430 --> 00:17:41.630 position:50% align:middle But we are continuing our efforts to continue to listen to our nurses and provide the resources that they need. 00:17:41.630 --> 00:17:44.170 position:50% align:middle - And we'll be looking forward to the results. 00:17:44.170 --> 00:17:44.900 position:50% align:middle - Absolutely. 00:17:44.900 --> 00:17:49.100 position:50% align:middle - Bev, you began talking about diversity. 00:17:49.100 --> 00:17:50.350 position:50% align:middle We know we need that. 00:17:50.350 --> 00:17:54.630 position:50% align:middle We have better outcomes when we have a diverse workforce. 00:17:54.630 --> 00:17:56.060 position:50% align:middle Share your thoughts on that. 00:17:56.060 --> 00:17:56.610 position:50% align:middle - Yeah. 00:17:56.610 --> 00:18:02.270 position:50% align:middle Well, you know, I've got so much in my mind and my heart about this that I will get to diversity, 00:18:02.270 --> 00:18:11.870 position:50% align:middle but I want to start with some topic that people cringe at, especially nurses, pay in terms of nurse educators, 00:18:11.870 --> 00:18:19.980 position:50% align:middle an acknowledgment that in the university systems and college programs, community colleges, other places, 00:18:19.980 --> 00:18:24.350 position:50% align:middle nursing is not valued the same way that other departments are, and yet, frequently, 00:18:24.350 --> 00:18:29.840 position:50% align:middle they're bringing in more money into those programs, into those universities than any other program. 00:18:29.840 --> 00:18:33.070 position:50% align:middle And if not the most, they're right up there with the top in terms of the 00:18:33.070 --> 00:18:36.990 position:50% align:middle number of students, and they take biology, they take chemistry. 00:18:36.990 --> 00:18:45.600 position:50% align:middle I mean, they are like the material of the university and yet not acknowledged in the same way our physician 00:18:45.600 --> 00:18:50.860 position:50% align:middle colleagues or even the legal colleagues that we have, professional programs are. 00:18:50.860 --> 00:18:53.767 position:50% align:middle So that's one issue that we've got to face. 00:18:53.767 --> 00:18:56.790 position:50% align:middle And I say cringe because nurses, we're so good. 00:18:56.790 --> 00:18:57.740 position:50% align:middle We're so angelic. 00:18:57.740 --> 00:18:58.770 position:50% align:middle We don't need money. 00:18:58.770 --> 00:19:04.240 position:50% align:middle But the truth is money makes a difference in terms of this whole thing. 00:19:04.240 --> 00:19:09.180 position:50% align:middle Secondly, there just aren't enough nurse educators of color. 00:19:09.180 --> 00:19:11.000 position:50% align:middle The diversity is not there. 00:19:11.000 --> 00:19:18.040 position:50% align:middle I always say that some people are praying that that educator of color will turn up the next day because if 00:19:18.040 --> 00:19:20.360 position:50% align:middle that person doesn't, there's no one there. 00:19:20.360 --> 00:19:23.140 position:50% align:middle It's like I got one or I got two. 00:19:23.140 --> 00:19:27.850 position:50% align:middle We've got to work on that pipeline, and I don't know if people have some aversion 00:19:27.850 --> 00:19:32.980 position:50% align:middle to pipeline, but I still see it as something that runs through, that's prepared, that's leveled, 00:19:32.980 --> 00:19:37.010 position:50% align:middle that you don't wait till the last minute to say, "Do we have enough?" 00:19:37.010 --> 00:19:42.380 position:50% align:middle And so we've got...and I think one of the things that we did...I used to be Dean of Nursing at North Carolina 00:19:42.380 --> 00:19:44.810 position:50% align:middle A&T State University. 00:19:44.810 --> 00:19:46.910 position:50% align:middle For 10 years, I suffered. 00:19:46.910 --> 00:19:55.320 position:50% align:middle And I was told that we can't go into the community and talk to the high schools because the principals will 00:19:55.320 --> 00:19:55.930 position:50% align:middle not let us in. 00:19:55.930 --> 00:19:59.660 position:50% align:middle And so, of course, anytime I get a challenge like that, I went to the principal. 00:19:59.660 --> 00:20:02.180 position:50% align:middle They'll say, "Oh, sure, come on in." 00:20:02.180 --> 00:20:05.700 position:50% align:middle We need to investigate and get into our communities. 00:20:05.700 --> 00:20:09.640 position:50% align:middle We got into the schools, into the high schools, we talked to the students. 00:20:09.640 --> 00:20:17.400 position:50% align:middle We found that the key person in terms of getting that diversity issue there, it was the counselors. 00:20:17.400 --> 00:20:22.220 position:50% align:middle They are the ones who take those bright students who are taking biology and chemistry, and they say, "Oh, 00:20:22.220 --> 00:20:23.340 position:50% align:middle darling, no, you're too bright. 00:20:23.340 --> 00:20:24.430 position:50% align:middle You don't want to go into nursing. 00:20:24.430 --> 00:20:26.450 position:50% align:middle You need to go this way and that way." 00:20:26.450 --> 00:20:32.090 position:50% align:middle We have got to feed those people and help them to understand that nursing is the program they need 00:20:32.090 --> 00:20:32.850 position:50% align:middle to go in. 00:20:32.850 --> 00:20:39.260 position:50% align:middle It is the go card to your profession and a lifetime of learning and opportunity. 00:20:39.260 --> 00:20:43.640 position:50% align:middle So we went in and crashed those courses. 00:20:43.640 --> 00:20:47.360 position:50% align:middle Those wonderful counselors, we got them breakfast every morning. 00:20:47.360 --> 00:20:50.040 position:50% align:middle They started bringing students to us. 00:20:50.040 --> 00:20:53.990 position:50% align:middle We have got to understand...I said, it's not just a nursing problem. 00:20:53.990 --> 00:20:57.110 position:50% align:middle We've got to involve our communities in solving this. 00:20:57.110 --> 00:20:57.920 position:50% align:middle And they're ready to. 00:20:57.920 --> 00:21:03.180 position:50% align:middle They know the difference when I take my family member to the hospital and there's just not enough. 00:21:03.180 --> 00:21:09.090 position:50% align:middle Nobody comes in because the nurses that do come in look like you want to say, "Please, go get some rest." 00:21:09.090 --> 00:21:16.350 position:50% align:middle So we've got to make sure that we are joining together, nurse to nurse, all the different groups, practice, 00:21:16.350 --> 00:21:20.900 position:50% align:middle education, and regulation, to face this issue and to make sure that we bring 00:21:20.900 --> 00:21:28.830 position:50% align:middle in more nurses of color but more nurses also and more nurse educators to prepare those nurses for practice. 00:21:28.830 --> 00:21:30.907 position:50% align:middle - Thank you very much for that. 00:21:30.907 --> 00:21:41.113 position:50% align:middle And one thing I want to talk about is our data from NCSBN's workforce does show that the LPN workforce 00:21:41.113 --> 00:21:50.030 position:50% align:middle is far more diverse and far more mimics the overall population of the U.S. 00:21:50.030 --> 00:21:52.960 position:50% align:middle as opposed to the RN workforce. 00:21:52.960 --> 00:22:02.800 position:50% align:middle So that seems to me that we need more of a pipeline to get those nurses that are LPNs into the RN workforce 00:22:02.800 --> 00:22:06.480 position:50% align:middle and keep advancing careers of nurses. 00:22:06.480 --> 00:22:14.180 position:50% align:middle - I just want to mention that we had a program called LPN to BSN 20 years ago, 00:22:14.180 --> 00:22:17.800 position:50% align:middle and it was about getting LPNs to the baccalaureate. 00:22:17.800 --> 00:22:23.050 position:50% align:middle And we were funded for that program at A&T, $6 million to do that. 00:22:23.050 --> 00:22:24.860 position:50% align:middle It was a nine-year program. 00:22:24.860 --> 00:22:26.630 position:50% align:middle We got a lot of nurses that way. 00:22:26.630 --> 00:22:28.190 position:50% align:middle That's not an outdated idea. 00:22:28.190 --> 00:22:30.410 position:50% align:middle - Thank you. 00:22:30.410 --> 00:22:34.760 position:50% align:middle Well, I want to turn to some other statistics. 00:22:34.760 --> 00:22:44.530 position:50% align:middle We have not only issues with experienced nurses, as I said, but 24% of RNs say they plan on leaving the 00:22:44.530 --> 00:22:47.480 position:50% align:middle profession in the next 5 years. 00:22:47.480 --> 00:22:51.040 position:50% align:middle They have less than 10 years of experience. 00:22:51.040 --> 00:22:52.890 position:50% align:middle They're our future. 00:22:52.890 --> 00:23:00.830 position:50% align:middle In that study, one of the main reasons younger nurses are stressed is because they feel ill-prepared 00:23:00.830 --> 00:23:02.630 position:50% align:middle to enter the workforce. 00:23:02.630 --> 00:23:07.040 position:50% align:middle Clearly, we need to address the needs of this group. 00:23:07.040 --> 00:23:10.060 position:50% align:middle So, Eileen, I'm going to begin with you. 00:23:10.060 --> 00:23:12.720 position:50% align:middle Talk about how educators... 00:23:12.720 --> 00:23:17.730 position:50% align:middle And, Karen, I want you also to talk about the need for transition to practice. 00:23:17.730 --> 00:23:18.760 position:50% align:middle But, Eileen. 00:23:18.760 --> 00:23:21.000 position:50% align:middle - Yes, thank you so much, Maryann. 00:23:21.000 --> 00:23:26.820 position:50% align:middle I think one of the things that we're really focusing on at the education level is really ensuring that we're 00:23:26.820 --> 00:23:29.630 position:50% align:middle graduating practice-ready nurses. 00:23:29.630 --> 00:23:35.630 position:50% align:middle So, at the University of San Francisco right now, we're revising our nursing curriculum, 00:23:35.630 --> 00:23:42.080 position:50% align:middle and we're doing this in conjunction with our clinical agencies in our region to really make sure that what 00:23:42.080 --> 00:23:46.980 position:50% align:middle we're teaching in the classroom reflects the needs of health systems today. 00:23:46.980 --> 00:23:55.210 position:50% align:middle You know, health care and the work of health systems evolves so quickly, and academia doesn't quite 00:23:55.210 --> 00:23:56.520 position:50% align:middle move that fast. 00:23:56.520 --> 00:24:02.450 position:50% align:middle And so we're really trying to make sure that what we're teaching in the classroom really prepares the students. 00:24:02.450 --> 00:24:09.000 position:50% align:middle And that goes back to that clinical placement issue, really working with our clinical agencies to find 00:24:09.000 --> 00:24:14.520 position:50% align:middle innovative ways to involve their staff nurses in the education of our students, again, 00:24:14.520 --> 00:24:23.390 position:50% align:middle making sure that what the students are learning is preparing them for their work when they do graduate. 00:24:23.390 --> 00:24:27.990 position:50% align:middle I think one of the other things that we're also incorporating at USF is really thinking 00:24:27.990 --> 00:24:29.320 position:50% align:middle about the whole person. 00:24:29.320 --> 00:24:36.010 position:50% align:middle So it's not just about making sure that they're studying and memorizing what it means to take care 00:24:36.010 --> 00:24:40.240 position:50% align:middle of a patient, but they're also learning ways to take care of themselves. 00:24:40.240 --> 00:24:48.010 position:50% align:middle So we're trying to integrate from day one things that they can do to ensure that they're going to be able 00:24:48.010 --> 00:24:53.700 position:50% align:middle to sustain their own mental health, their own physical health, to prioritize themselves. 00:24:53.700 --> 00:24:58.650 position:50% align:middle Because if they don't prioritize themselves, they are not going to be able to have a long career 00:24:58.650 --> 00:25:02.150 position:50% align:middle in nursing, and they're not going to be able to give their best to the patients. 00:25:02.150 --> 00:25:09.650 position:50% align:middle So those are just a few of the areas that we're working on, recognizing that we need to ensure that we can get 00:25:09.650 --> 00:25:13.390 position:50% align:middle nurses over that hump, you know, sort of that transition, 00:25:13.390 --> 00:25:19.350 position:50% align:middle and that they can realize that nursing can be a very, you know, great career for them. 00:25:19.350 --> 00:25:20.450 position:50% align:middle There's many options. 00:25:20.450 --> 00:25:22.150 position:50% align:middle You don't just have to work in one area. 00:25:22.150 --> 00:25:28.120 position:50% align:middle You can change throughout your career to be able to find, you know, something, a new challenge, 00:25:28.120 --> 00:25:32.750 position:50% align:middle or if you're sort of burned out in one area, you move on to a new area. 00:25:32.750 --> 00:25:37.650 position:50% align:middle And so we want to make sure that we keep them long enough so that they can learn that those are options. 00:25:37.650 --> 00:25:39.290 position:50% align:middle - Karen? 00:25:39.290 --> 00:25:47.380 position:50% align:middle - You know, having spent 20 years in academia, I always say that it's not so much that I don't believe 00:25:47.380 --> 00:25:52.030 position:50% align:middle our graduates are prepared for practice. 00:25:52.030 --> 00:25:54.270 position:50% align:middle It's the transition. 00:25:54.270 --> 00:25:59.270 position:50% align:middle I've always said that they have had a safety net their entire time in nursing school. 00:25:59.270 --> 00:26:00.870 position:50% align:middle They have faculty members. 00:26:00.870 --> 00:26:05.370 position:50% align:middle They have nursing preceptors in the hospitals and in the clinical areas where they are. 00:26:05.370 --> 00:26:09.400 position:50% align:middle They have experts all throughout the hospital that can be there for them. 00:26:09.400 --> 00:26:15.180 position:50% align:middle When they transition and if they don't have a transition to practice program at the institutions, 00:26:15.180 --> 00:26:19.310 position:50% align:middle and our larger institutions have those, although they lost them during COVID, I mean, 00:26:19.310 --> 00:26:22.020 position:50% align:middle you just couldn't support all of that, they're coming back. 00:26:22.020 --> 00:26:25.800 position:50% align:middle But our smaller hospitals, our rural hospitals, do not have that. 00:26:25.800 --> 00:26:32.909 position:50% align:middle And it's our nurses or new nurses that are going to those areas that feel like they don't have 00:26:32.909 --> 00:26:33.690 position:50% align:middle that safety net. 00:26:33.690 --> 00:26:35.370 position:50% align:middle They don't have people to call on. 00:26:35.370 --> 00:26:38.210 position:50% align:middle They're working the 7p to 7a shift. 00:26:38.210 --> 00:26:39.860 position:50% align:middle There's not as many experts around. 00:26:39.860 --> 00:26:41.880 position:50% align:middle There's not as many people to call on. 00:26:41.880 --> 00:26:48.020 position:50% align:middle And so, I think, it's not that I don't think that they're academically prepared well, 00:26:48.020 --> 00:26:53.290 position:50% align:middle and I will just say that, having looked at the second and third quarters of the 00:26:53.290 --> 00:26:59.490 position:50% align:middle next generation NCLEX that was launched April 1st, we had eight schools on probation for not meeting 00:26:59.490 --> 00:27:00.890 position:50% align:middle our 80% mark. 00:27:00.890 --> 00:27:08.410 position:50% align:middle We now have nine schools for the third quarter, all of which were in those eight that had 100% pass rate 00:27:08.410 --> 00:27:17.102 position:50% align:middle on the next generation NCLEX, and 29 of our 31 schools all met the 80% benchmark 00:27:17.102 --> 00:27:20.520 position:50% align:middle and they're doing really well on that test. 00:27:20.520 --> 00:27:21.620 position:50% align:middle And that's just one test. 00:27:21.620 --> 00:27:23.580 position:50% align:middle I don't believe in teaching to test. 00:27:23.580 --> 00:27:31.810 position:50% align:middle I just believe that we've got to have a better way to try to transition them and match them 00:27:31.810 --> 00:27:33.380 position:50% align:middle up with experienced nurses. 00:27:33.380 --> 00:27:36.080 position:50% align:middle And we've got some of those programs going on. 00:27:36.080 --> 00:27:40.950 position:50% align:middle Ochsner has a wonderful program for students. 00:27:40.950 --> 00:27:45.610 position:50% align:middle And you know, one of the questions you asked me was about, do I think some of our rules are antiquated? 00:27:45.610 --> 00:27:47.100 position:50% align:middle Well, absolutely, I do. 00:27:47.100 --> 00:27:52.510 position:50% align:middle Too rigid, outdated, and one of those was we were treating student nurses 00:27:52.510 --> 00:27:57.810 position:50% align:middle who have demonstrated competencies the same way we treat every other unlicensed assistant 00:27:57.810 --> 00:27:59.320 position:50% align:middle personnel in Louisiana. 00:27:59.320 --> 00:28:02.830 position:50% align:middle And I said, you know, there's no reason why these people can't work as nurse 00:28:02.830 --> 00:28:08.840 position:50% align:middle techs using the competencies that they have already demonstrated, that, you know, at every semester, 00:28:08.840 --> 00:28:16.130 position:50% align:middle they have validated competencies from their faculty, and we can use them to create dyads with experienced 00:28:16.130 --> 00:28:23.450 position:50% align:middle nurses to be able to take care of more patients and do a better job in terms of staffing hospitals. 00:28:23.450 --> 00:28:30.990 position:50% align:middle Not only does it help them to get more experience, they get to be paid for that during those processes. 00:28:30.990 --> 00:28:33.440 position:50% align:middle And so, you know, Ochsner has it. 00:28:33.440 --> 00:28:34.810 position:50% align:middle Our Lady of the Lake has it. 00:28:34.810 --> 00:28:41.830 position:50% align:middle We have many programs now starting those kind of paid programs, including LPN to RN programs that want to pay 00:28:41.830 --> 00:28:48.220 position:50% align:middle our LPNs while they're doing their student clinicals as LPNs in their institutions where they work as nurses. 00:28:48.220 --> 00:28:49.840 position:50% align:middle - That's great. 00:28:49.840 --> 00:28:50.570 position:50% align:middle Eileen? - Yes. 00:28:50.570 --> 00:28:55.930 position:50% align:middle I was just going to mention, I think, again, this is another area that we need to look at the 00:28:55.930 --> 00:28:58.640 position:50% align:middle well-being of the existing workforce. 00:28:58.640 --> 00:29:06.360 position:50% align:middle Because, again, when students move into the practice setting, again, they're going to be working 00:29:06.360 --> 00:29:14.320 position:50% align:middle with colleagues and preceptors, and if those individuals are not at their best health 00:29:14.320 --> 00:29:19.210 position:50% align:middle mentally and physically, they are not going to have the ability to support 00:29:19.210 --> 00:29:20.530 position:50% align:middle the newer nurse. 00:29:20.530 --> 00:29:29.540 position:50% align:middle And so that's where you start to hear stories of bullying and accelerated burnout among our new nurses, 00:29:29.540 --> 00:29:38.860 position:50% align:middle is because they're not coming into a supportive environment because the current situation doesn't 00:29:38.860 --> 00:29:40.810 position:50% align:middle support the current workforce. 00:29:40.810 --> 00:29:45.792 position:50% align:middle - And it shows how each of these issues are all interconnected. 00:29:45.792 --> 00:29:46.442 position:50% align:middle - They are. 00:29:46.442 --> 00:29:51.120 position:50% align:middle Lavonia, what's going on at MD Anderson with your new graduates? 00:29:51.120 --> 00:29:58.770 position:50% align:middle - So we are, and we've heard the feedback as far as entry and taking care of our existing workforce. 00:29:58.770 --> 00:30:05.170 position:50% align:middle We do have year-long residencies but also, then, looking at how long do we go beyond that. 00:30:05.170 --> 00:30:08.380 position:50% align:middle To be honest with you, we all need a form of safety net as we move 00:30:08.380 --> 00:30:13.230 position:50% align:middle through our careers, because we make transitions, we take new jobs, and we all need that backup 00:30:13.230 --> 00:30:14.350 position:50% align:middle and safety net. 00:30:14.350 --> 00:30:17.160 position:50% align:middle So why not build that in for experienced nurses as well? 00:30:17.160 --> 00:30:19.850 position:50% align:middle Because if I, as an experienced nurse, feel that safety net, 00:30:19.850 --> 00:30:23.530 position:50% align:middle I'm going to generously share that with you. 00:30:23.530 --> 00:30:26.480 position:50% align:middle And so we do, we are looking to expand our residency. 00:30:26.480 --> 00:30:28.480 position:50% align:middle How do we support beyond that year? 00:30:28.480 --> 00:30:36.520 position:50% align:middle One of our work streams around nursing transformation is dealing with encouraging the heart. 00:30:36.520 --> 00:30:37.440 position:50% align:middle And what does that mean? 00:30:37.440 --> 00:30:43.680 position:50% align:middle It means allowing people to feel like they belong, they have a place here, they're welcome to this team. 00:30:43.680 --> 00:30:45.870 position:50% align:middle They do come out of school practice-ready. 00:30:45.870 --> 00:30:47.360 position:50% align:middle Absolutely, they do. 00:30:47.360 --> 00:30:54.350 position:50% align:middle However, we need to then create that safety net where they feel welcomed onto the team so that they can then 00:30:54.350 --> 00:30:56.400 position:50% align:middle continue to grow in practice. 00:30:56.400 --> 00:31:01.650 position:50% align:middle And that's some of the work streams that we are working on not just training and education, 00:31:01.650 --> 00:31:05.670 position:50% align:middle not just through professional development, but looking at nurses across their career 00:31:05.670 --> 00:31:07.220 position:50% align:middle and what they need. 00:31:07.220 --> 00:31:08.590 position:50% align:middle - Karen. 00:31:08.590 --> 00:31:12.920 position:50% align:middle - I just want to build on that for just a second, because we were talking about technology and the use 00:31:12.920 --> 00:31:16.070 position:50% align:middle of technology and virtual nursing and how that can help. 00:31:16.070 --> 00:31:21.260 position:50% align:middle And again, Ochsner, really, in our state, has taken the lead because they are the biggest 00:31:21.260 --> 00:31:22.550 position:50% align:middle employer of nurses. 00:31:22.550 --> 00:31:23.950 position:50% align:middle And they now are using that. 00:31:23.950 --> 00:31:26.200 position:50% align:middle They have a thing called iPad on a stick. 00:31:26.200 --> 00:31:32.448 position:50% align:middle But I'm thinking that all of those new nurses, as they transition, if they had a virtual nurse 00:31:32.448 --> 00:31:36.570 position:50% align:middle that they could always call on, take their little iPad into the room, 00:31:36.570 --> 00:31:44.220 position:50% align:middle answer the questions, help them assess, just be there, a real experienced nurse that's been in the trenches 00:31:44.220 --> 00:31:49.160 position:50% align:middle for a while, has all of those good skills, and that's with them all the time that they can 00:31:49.160 --> 00:31:51.017 position:50% align:middle call on 24/7. 00:31:51.017 --> 00:31:56.760 position:50% align:middle And I just think that's a use of technology and, you know, coming AI, 00:31:56.760 --> 00:31:59.150 position:50% align:middle I don't know if anybody wants to talk about AI. 00:31:59.150 --> 00:32:01.955 position:50% align:middle But virtual nursing, you know, when I first heard about it, I thought, 00:32:01.955 --> 00:32:03.490 position:50% align:middle "Oh, this is not a good idea." 00:32:03.490 --> 00:32:06.180 position:50% align:middle But now I think it's a really good idea. 00:32:06.180 --> 00:32:10.080 position:50% align:middle - And it's for the nurse that wants to work from home that has to work. 00:32:10.080 --> 00:32:12.110 position:50% align:middle - That's what I think I'm going to do when I retire. 00:32:12.110 --> 00:32:15.390 position:50% align:middle - And I couldn't agree with you more. 00:32:15.390 --> 00:32:20.830 position:50% align:middle And one of the things that we are building in and we're working toward with our virtual nurse program is 00:32:20.830 --> 00:32:23.910 position:50% align:middle exactly that, where we can have that experienced nurse. 00:32:23.910 --> 00:32:26.460 position:50% align:middle And I'm telling you, the experienced nurses on the other side of that camera 00:32:26.460 --> 00:32:33.000 position:50% align:middle are so excited to be a part of the onboarding and the ongoing support. 00:32:33.000 --> 00:32:38.900 position:50% align:middle One thing we have found is, with the busy workday, nurses feel very rushed in everything that they do. 00:32:38.900 --> 00:32:42.820 position:50% align:middle And so having that person to back them up, that they, in their mind, is like, "Okay, 00:32:42.820 --> 00:32:47.800 position:50% align:middle I'm not taking you away from another patient," has really been well received. 00:32:47.800 --> 00:32:53.300 position:50% align:middle We're actually starting it at MD Anderson with the admission process because, 00:32:53.300 --> 00:32:58.720 position:50% align:middle since the virtual nurses are doing everything with the hands-on assessment, for admission, you know, 00:32:58.720 --> 00:33:01.280 position:50% align:middle the new nurses that are onboarding aren't learning that. 00:33:01.280 --> 00:33:07.440 position:50% align:middle So we're going to be partnering so that we teach them across that screen and they can participate with us 00:33:07.440 --> 00:33:08.330 position:50% align:middle for that piece of it. 00:33:08.330 --> 00:33:14.030 position:50% align:middle So we're hoping to grow that expert advice piece, but virtual nursing absolutely does have a place in our 00:33:14.030 --> 00:33:19.970 position:50% align:middle future to maintain the health and wellness of our existing workforce, create new career paths for nurses, 00:33:19.970 --> 00:33:24.710 position:50% align:middle create opportunities for nurses who need to work modified work schedules. 00:33:24.710 --> 00:33:26.640 position:50% align:middle There's lots of opportunities around it. 00:33:26.640 --> 00:33:27.850 position:50% align:middle - Bev, did you? 00:33:27.850 --> 00:33:29.140 position:50% align:middle - Yeah. 00:33:29.140 --> 00:33:34.030 position:50% align:middle Listening to my colleagues, a thought came to me that it's really operationalizing 00:33:34.030 --> 00:33:38.710 position:50% align:middle Pat Benner's "Novice to Expert," that the virtual nursing can do that. 00:33:38.710 --> 00:33:43.320 position:50% align:middle So you have your expert there with your novice in a different way. 00:33:43.320 --> 00:33:49.450 position:50% align:middle And I think that taking existing theories and applying, that's the kind of problem-solving we're going 00:33:49.450 --> 00:33:50.500 position:50% align:middle to need to do. 00:33:50.500 --> 00:33:56.790 position:50% align:middle The other thought that came to my mind is that there's concentrated effort on the clinical setting 00:33:56.790 --> 00:34:02.990 position:50% align:middle about making sure that the culture there is supportive of growth not just for new nurses but for those who 00:34:02.990 --> 00:34:04.790 position:50% align:middle are already there. 00:34:04.790 --> 00:34:11.800 position:50% align:middle I'm not sure there's that concentration of effort on university faculties and community college faculties, 00:34:11.800 --> 00:34:18.760 position:50% align:middle that there's that effort to make sure that it is a welcoming, warm, cuddly environment there for faculty. 00:34:18.760 --> 00:34:23.380 position:50% align:middle There's the assumption that these are grownups and they should know how to behave. 00:34:23.380 --> 00:34:26.010 position:50% align:middle And that just doesn't prove to be true all the time. 00:34:26.010 --> 00:34:32.460 position:50% align:middle There is a need to focus on, and I know our dean at UCSF is thinking about this, 00:34:32.460 --> 00:34:35.150 position:50% align:middle to focus on, how does that faculty work together? 00:34:35.150 --> 00:34:37.210 position:50% align:middle How does the faculty treat students? 00:34:37.210 --> 00:34:39.680 position:50% align:middle Does the faculty actually have biases? 00:34:39.680 --> 00:34:40.720 position:50% align:middle Oh, my goodness, they're a human. 00:34:40.720 --> 00:34:42.110 position:50% align:middle That's right, they do. 00:34:42.110 --> 00:34:49.090 position:50% align:middle So it's that concentration about the problem-solving can't be done just at one part of the system. 00:34:49.090 --> 00:34:55.500 position:50% align:middle It's going to take multiple fingers into all aspects of the system for us to get to where we need to go, 00:34:55.500 --> 00:35:00.060 position:50% align:middle to retain our nurses, to improve how faculty and educators are teaching, 00:35:00.060 --> 00:35:04.690 position:50% align:middle and that you cannot just be a great clinician and become a great teacher. 00:35:04.690 --> 00:35:09.740 position:50% align:middle There are some that are unusual and like that, but usually, you have to learn how to teach. 00:35:09.740 --> 00:35:10.690 position:50% align:middle It's just helpful. 00:35:10.690 --> 00:35:16.250 position:50% align:middle And there is a science to nursing education, and our students deserve that science. 00:35:16.250 --> 00:35:21.500 position:50% align:middle They deserve educators who are prepared to teach and to care. 00:35:21.500 --> 00:35:24.120 position:50% align:middle - Absolutely. 00:35:24.120 --> 00:35:28.520 position:50% align:middle I do have to ask this question about staffing ratios. 00:35:28.520 --> 00:35:34.560 position:50% align:middle This is a huge controversial subject right now. 00:35:34.560 --> 00:35:40.940 position:50% align:middle Patients hospitalized in California, the only state that has enacted safe 00:35:40.940 --> 00:35:46.520 position:50% align:middle staffing legislation, say they get two to three more hours of RN care per day 00:35:46.520 --> 00:35:48.930 position:50% align:middle than patients in other states. 00:35:48.930 --> 00:35:52.220 position:50% align:middle Is this a solution for our workforce? 00:35:52.220 --> 00:35:56.380 position:50% align:middle Lavonia, do you have staffing ratios at MD Anderson? 00:35:56.380 --> 00:36:00.420 position:50% align:middle - We do have staffing ratios at MD Anderson. 00:36:00.420 --> 00:36:08.570 position:50% align:middle However, we also have leaders who are empowered to make decisions about staffing based on their patient need. 00:36:08.570 --> 00:36:11.840 position:50% align:middle Our patient population is complex. 00:36:11.840 --> 00:36:15.590 position:50% align:middle We are the largest research facility. 00:36:15.590 --> 00:36:21.130 position:50% align:middle We do a great deal of phase I trials, and no two patients are the same. 00:36:21.130 --> 00:36:27.340 position:50% align:middle So, in addition to have the ratios that you have to build to develop a budget, which we all have to do, 00:36:27.340 --> 00:36:32.880 position:50% align:middle we also, at MD Anderson, afford our leaders and our frontline teams the ability 00:36:32.880 --> 00:36:35.730 position:50% align:middle to staff based on what the patients need. 00:36:35.730 --> 00:36:37.540 position:50% align:middle - Eileen, you're from California. 00:36:37.540 --> 00:36:39.100 position:50% align:middle What do you see? 00:36:39.100 --> 00:36:51.120 position:50% align:middle - You know, I think staffing ratios do make a difference, obviously, and the data shows that. 00:36:51.120 --> 00:36:58.340 position:50% align:middle But I do agree with Lavonia that it really does need to be in the hands of the nurse leaders, you know, 00:36:58.340 --> 00:37:05.650 position:50% align:middle that can assess the patients on a minute-by-minute basis to be able to ensure that staffing is meeting the 00:37:05.650 --> 00:37:08.110 position:50% align:middle needs at that particular time. 00:37:08.110 --> 00:37:14.160 position:50% align:middle I think the challenge with staffing ratios is that, you know, it's a double-edged sword. 00:37:14.160 --> 00:37:20.800 position:50% align:middle You can say that we're going to provide you with this ratio, but is that all that we're going to provide 00:37:20.800 --> 00:37:26.580 position:50% align:middle instead of allowing that flex that needs to be considered throughout a shift? 00:37:26.580 --> 00:37:33.230 position:50% align:middle So I think, as long as it still remains in the hands of those who are caring for the patients, 00:37:33.230 --> 00:37:36.130 position:50% align:middle that final decision needs to rest there. 00:37:36.130 --> 00:37:37.880 position:50% align:middle - Karen or Bev, any thoughts? 00:37:37.880 --> 00:37:40.310 position:50% align:middle - Yeah. 00:37:40.310 --> 00:37:46.850 position:50% align:middle Staffing ratios, I think there needs to be some level of assurance that patients are getting care, right, 00:37:46.850 --> 00:37:47.940 position:50% align:middle the numbers that are needed. 00:37:47.940 --> 00:37:52.160 position:50% align:middle But I, and like my colleagues here, believe that leadership should be 00:37:52.160 --> 00:37:54.280 position:50% align:middle providing that guidance. 00:37:54.280 --> 00:38:03.180 position:50% align:middle And the thing that I heard Lavonia saying was that it's at MD Anderson that they have their staffing ratios. 00:38:03.180 --> 00:38:08.370 position:50% align:middle It's not some state legislature that has made a decision about, boom, "For all of you, 00:38:08.370 --> 00:38:10.310 position:50% align:middle this is going to be it, colleagues." 00:38:10.310 --> 00:38:14.930 position:50% align:middle And that's pretty far away from the clinical area to be making that decision. 00:38:14.930 --> 00:38:21.220 position:50% align:middle So I'm thinking that there's a place for them, but it's not just the only thing, 00:38:21.220 --> 00:38:26.780 position:50% align:middle that it has to be within the context of the system you're working in, and it has to be with the leadership 00:38:26.780 --> 00:38:32.090 position:50% align:middle of those who are providing and saying on a day-to-day basis, "Hey, this is an emergency. 00:38:32.090 --> 00:38:34.470 position:50% align:middle We need more than anything you can tell." 00:38:34.470 --> 00:38:39.870 position:50% align:middle But, no, the state or the federal system says, "We only need this much. 00:38:39.870 --> 00:38:42.510 position:50% align:middle So you're only going to get this much." 00:38:42.510 --> 00:38:48.090 position:50% align:middle To me, that endangers the patient, and it is all about quality patient care, 00:38:48.090 --> 00:38:49.480 position:50% align:middle that we start there. 00:38:49.480 --> 00:38:55.650 position:50% align:middle And I know that those who are proponents of staff ratios are saying it's about quality patient care. 00:38:55.650 --> 00:39:03.270 position:50% align:middle But I'm thinking that we still need the leadership of on-site people who are making decisions on a day-to-day 00:39:03.270 --> 00:39:06.480 position:50% align:middle basis about, what is the situation here? 00:39:06.480 --> 00:39:11.200 position:50% align:middle So if you're going to put them in, have your escape clause in there somewhere that says 00:39:11.200 --> 00:39:17.590 position:50% align:middle that it really is up to those who are monitoring the day-to-day situation that goes on. 00:39:17.590 --> 00:39:23.450 position:50% align:middle - Well, what I would add is, spending a lot of my time in front 00:39:23.450 --> 00:39:26.970 position:50% align:middle of legislative committees, giving testimony to legislators, 00:39:26.970 --> 00:39:32.900 position:50% align:middle the last people on earth I want doing staffing ratios for nurses is legislators. 00:39:32.900 --> 00:39:38.880 position:50% align:middle So I absolutely agree with my colleagues, and I just go back to what I said, you know, 00:39:38.880 --> 00:39:45.030 position:50% align:middle the patients we see in hospitals are not the patients I saw in hospitals 49 years ago when I graduated. 00:39:45.030 --> 00:39:50.390 position:50% align:middle These are sicker, older patients with so many comorbid conditions. 00:39:50.390 --> 00:39:55.320 position:50% align:middle And you could have five patients, all with the same diagnoses and maybe the 00:39:55.320 --> 00:39:58.030 position:50% align:middle same comorbidities, and they're all different. 00:39:58.030 --> 00:40:05.340 position:50% align:middle And you've got to be able to do that staffing and develop that based on the needs of your patient 00:40:05.340 --> 00:40:11.460 position:50% align:middle population in your hospital and your setting, and I want nursing in control of that. 00:40:11.460 --> 00:40:15.830 position:50% align:middle - And if I could add to that, it's not just the patients. 00:40:15.830 --> 00:40:20.020 position:50% align:middle The patients are number one, but we also have to...we talk about our new workforce. 00:40:20.020 --> 00:40:28.420 position:50% align:middle When you have a complexion of a shift that has newer nurses, you may need more. 00:40:28.420 --> 00:40:33.570 position:50% align:middle You may need more for a whole lot of reasons, but when we speak about supporting our newer workforce, 00:40:33.570 --> 00:40:35.980 position:50% align:middle that is one thing we need to take into consideration. 00:40:35.980 --> 00:40:37.830 position:50% align:middle The numbers are just the numbers. 00:40:37.830 --> 00:40:39.740 position:50% align:middle Nursing is a profession. 00:40:39.740 --> 00:40:43.120 position:50% align:middle It's not about numbers, and that's where we need to get ourselves to. 00:40:43.120 --> 00:40:44.480 position:50% align:middle - Great, thank you. 00:40:44.480 --> 00:40:53.290 position:50% align:middle Well, I want to open now the questions up to the audience to see if you all have any questions 00:40:53.290 --> 00:41:12.090 position:50% align:middle for our panelists. 00:41:12.090 --> 00:41:13.660 position:50% align:middle - [Brendan] Good morning. 00:41:13.660 --> 00:41:17.220 position:50% align:middle First of all, I'd just like to preface this all with this is a wonderful conversation. 00:41:17.220 --> 00:41:20.680 position:50% align:middle I've taken a lot away from this, and so I think I love being here. 00:41:20.680 --> 00:41:22.060 position:50% align:middle My name is Brendan Martin. 00:41:22.060 --> 00:41:24.420 position:50% align:middle I'm in the research department at NCSBN. 00:41:24.420 --> 00:41:28.240 position:50% align:middle And one of the things, when you were discussing transition to practice and 00:41:28.240 --> 00:41:31.890 position:50% align:middle residency programs, one of the things that you mentioned about MD Anderson, in particular, 00:41:31.890 --> 00:41:38.100 position:50% align:middle is that you had a focus on new graduates who were perhaps trained in kind of a pre-licensure setting 00:41:38.100 --> 00:41:39.720 position:50% align:middle during the COVID-19 pandemic. 00:41:39.720 --> 00:41:45.550 position:50% align:middle And it seemed as though you kind of set that apart as kind of an extra set of training or an extra 00:41:45.550 --> 00:41:46.280 position:50% align:middle set of attention. 00:41:46.280 --> 00:41:51.180 position:50% align:middle And I was hoping maybe any of the panelists but maybe beginning with MD Anderson, 00:41:51.180 --> 00:41:58.020 position:50% align:middle if you could extrapolate on that a little bit as to what was maybe lost or what maybe wasn't on par 00:41:58.020 --> 00:42:02.960 position:50% align:middle with kind of pre-pandemic training for those graduates, in particular, you know, 00:42:02.960 --> 00:42:07.190 position:50% align:middle when some of those clinical site restrictions were in place, when programs were often relying on things 00:42:07.190 --> 00:42:12.930 position:50% align:middle like virtual clinical simulation at higher rates or higher rates of simulation-based education. 00:42:12.930 --> 00:42:14.820 position:50% align:middle - So let me clarify. 00:42:14.820 --> 00:42:16.580 position:50% align:middle I must have created some confusion. 00:42:16.580 --> 00:42:22.280 position:50% align:middle Our residency program was in place before the pandemic, and we have continued it, 00:42:22.280 --> 00:42:28.620 position:50% align:middle albeit making some changes based on what our nurses that were hired during the pandemic and post-pandemic 00:42:28.620 --> 00:42:30.610 position:50% align:middle have given us as what we need to do. 00:42:30.610 --> 00:42:35.460 position:50% align:middle What we focused on with our leadership training is we launched our Leadership Institute, 00:42:35.460 --> 00:42:39.690 position:50% align:middle and we focused first on those new leaders that are within three years of being hired, 00:42:39.690 --> 00:42:44.240 position:50% align:middle because they were hired during the pandemic, during a time when we didn't have some of the same 00:42:44.240 --> 00:42:46.200 position:50% align:middle things in place for obvious reasons. 00:42:46.200 --> 00:42:53.900 position:50% align:middle And so now we want to ensure that we give them the skills they need in order to lead, manage. 00:42:53.900 --> 00:42:57.990 position:50% align:middle And then we moved to some of them more experienced who may need to improve their skillsets. 00:42:57.990 --> 00:43:00.500 position:50% align:middle So hopefully, I clarified. 00:43:00.500 --> 00:43:04.650 position:50% align:middle - Anyone else with a question? 00:43:04.650 --> 00:43:05.600 position:50% align:middle - Yeah. 00:43:05.600 --> 00:43:09.270 position:50% align:middle Let me just say, Brendan, we did have issues. 00:43:09.270 --> 00:43:14.490 position:50% align:middle You know, I'm always really glad that my post-doc was an MBA, because when they started talking about supply 00:43:14.490 --> 00:43:16.690 position:50% align:middle chain issues, I actually knew what they were talking about. 00:43:16.690 --> 00:43:23.240 position:50% align:middle And you know, we had our students literally not allowed to come into clinical at the beginning of the pandemic, 00:43:23.240 --> 00:43:28.080 position:50% align:middle and so, all of a sudden, we transitioned didactic onto computers, 00:43:28.080 --> 00:43:29.290 position:50% align:middle and that was okay. 00:43:29.290 --> 00:43:33.780 position:50% align:middle We could do the theory, but in terms of clinical, relying on simulation, 00:43:33.780 --> 00:43:35.550 position:50% align:middle they weren't allowed in clinical. 00:43:35.550 --> 00:43:37.000 position:50% align:middle I mean, the hospitals didn't know. 00:43:37.000 --> 00:43:42.170 position:50% align:middle It was a pandemic, and we were flying by the seat of our pants at the beginning. 00:43:42.170 --> 00:43:47.070 position:50% align:middle And so we did have people graduate that didn't have as many of the clinical skills, 00:43:47.070 --> 00:43:49.110 position:50% align:middle so they did need more help. 00:43:49.110 --> 00:43:54.240 position:50% align:middle And so that's one of the reasons why that happened early on in the pandemic. 00:43:54.240 --> 00:44:01.210 position:50% align:middle - I think one of the things that was most missing is that, you know, nursing education is the theory and is 00:44:01.210 --> 00:44:06.810 position:50% align:middle the practice, but more importantly, the two of them have to be learned concurrently 00:44:06.810 --> 00:44:09.170 position:50% align:middle and practiced concurrently. 00:44:09.170 --> 00:44:15.030 position:50% align:middle And the learner needs to be able to respond and react to changes. 00:44:15.030 --> 00:44:19.690 position:50% align:middle While we can use simulation, we can't simulate every single kind of interaction that 00:44:19.690 --> 00:44:26.160 position:50% align:middle they might have had throughout their nursing education that really helps prepare them to be competent 00:44:26.160 --> 00:44:28.200 position:50% align:middle practitioners when they graduate. 00:44:28.200 --> 00:44:34.960 position:50% align:middle And so, you know, you could think of it as time or a volume, but that's really those experiences were 00:44:34.960 --> 00:44:37.490 position:50% align:middle missing for those students. 00:44:37.490 --> 00:44:43.320 position:50% align:middle And that's what we're seeing, you know, in terms of them coming out and needing 00:44:43.320 --> 00:44:44.460 position:50% align:middle that extra support. 00:44:44.460 --> 00:44:46.410 position:50% align:middle - Yeah. 00:44:46.410 --> 00:44:53.560 position:50% align:middle Just wanted to mention that there is going to have to be an exploration and determination of new 00:44:53.560 --> 00:44:58.150 position:50% align:middle clinical placements, new places that we have not considered sending our 00:44:58.150 --> 00:45:03.590 position:50% align:middle students or only a few people consider, a few schools consider sending their students. 00:45:03.590 --> 00:45:11.260 position:50% align:middle So there's a whole prison health system that has not been used to any great degree. 00:45:11.260 --> 00:45:15.160 position:50% align:middle There are some schools that are starting to do that, but we're going to have to think out of the box 00:45:15.160 --> 00:45:16.800 position:50% align:middle about clinical placements. 00:45:16.800 --> 00:45:21.030 position:50% align:middle Even if everybody opened their door to us, we still don't have enough, 00:45:21.030 --> 00:45:24.630 position:50% align:middle with competition from other provider groups that are needed. 00:45:24.630 --> 00:45:29.880 position:50% align:middle So it's going to be a revolutionary kind of thing that nursing is going to have to give some strong 00:45:29.880 --> 00:45:35.980 position:50% align:middle consideration too about innovative new places of clinical learning. 00:45:35.980 --> 00:45:41.720 position:50% align:middle And I do want to put a plug-in for clinical nurse specialists who were, in my day, 00:45:41.720 --> 00:45:47.700 position:50% align:middle they were the expert on the units who provided assistance to the staff in figuring out the culture 00:45:47.700 --> 00:45:50.490 position:50% align:middle of the area and the expert nature of it. 00:45:50.490 --> 00:45:54.000 position:50% align:middle I'm a psych nurse, so mine was just to go around and knock on people's heads and say, 00:45:54.000 --> 00:45:56.730 position:50% align:middle "Are you all there today?" 00:45:56.730 --> 00:45:59.970 position:50% align:middle But there are other types that are just incredibly helpful and useful. 00:45:59.970 --> 00:46:02.320 position:50% align:middle Wound care, I mean, amazing. 00:46:02.320 --> 00:46:05.170 position:50% align:middle Everybody gets bed sores if you stay in bed long enough. 00:46:05.170 --> 00:46:10.970 position:50% align:middle But just different types of experts, as clinical nurse specialists, to assist the units, 00:46:10.970 --> 00:46:15.580 position:50% align:middle to assist the staff, so... 00:46:15.580 --> 00:46:22.150 position:50% align:middle - I was just going to say, I think, to Bev's point about finding other opportunities, 00:46:22.150 --> 00:46:29.410 position:50% align:middle we also need to recognize that education and clinical practice does not just occur in the hospital setting. 00:46:29.410 --> 00:46:35.080 position:50% align:middle I think we often default to that, but so much is happening out in the community now. 00:46:35.080 --> 00:46:42.150 position:50% align:middle And so, at the University of San Francisco, we're really partnering with other agencies to put our 00:46:42.150 --> 00:46:50.410 position:50% align:middle learners out in places like with the farm workers up in the Central Valley and in, you know, 00:46:50.410 --> 00:46:56.070 position:50% align:middle other types of community settings, because that's really where health is being developed 00:46:56.070 --> 00:46:58.610 position:50% align:middle and where care is being delivered. 00:46:58.610 --> 00:47:01.150 position:50% align:middle - Thank you. 00:47:01.150 --> 00:47:02.420 position:50% align:middle Any more questions? 00:47:02.420 --> 00:47:03.330 position:50% align:middle - [Amy] Hello. 00:47:03.330 --> 00:47:04.940 position:50% align:middle I'm Amy Lippert. 00:47:04.940 --> 00:47:13.070 position:50% align:middle I'm also at NCSBN as an education outreach associate with ICRS or Center for Regulatory Scholarship. 00:47:13.070 --> 00:47:18.610 position:50% align:middle I wanted to echo my colleague Brendan's comments to thank all of you for a really illuminating morning. 00:47:18.610 --> 00:47:25.390 position:50% align:middle And I guess I just wanted to follow up on the second half of the core issues that you identified, Bev. 00:47:25.390 --> 00:47:31.400 position:50% align:middle We've talked about clinical placement now, and I wanted to follow up on the nurse educator aspect 00:47:31.400 --> 00:47:34.440 position:50% align:middle of this, with all of you really. 00:47:34.440 --> 00:47:43.610 position:50% align:middle So I'm wondering, you know, if insufficient pay or valuation, in a larger sense, 00:47:43.610 --> 00:47:52.980 position:50% align:middle is a central issue in attracting and retaining quality nurse educators, then who and how might we effectively 00:47:52.980 --> 00:47:55.860 position:50% align:middle lobby in order to rectify that problem? 00:47:55.860 --> 00:48:00.860 position:50% align:middle It sounds like you're pointing towards university administrators, for instance, 00:48:00.860 --> 00:48:08.040 position:50% align:middle who seem to value colleagues in the medical school or the law school differently than the school of nursing. 00:48:08.040 --> 00:48:10.760 position:50% align:middle So that might be a good place to start. 00:48:10.760 --> 00:48:17.580 position:50% align:middle I'm just thinking in terms of the nursing profession as a whole, regulators, nurses themselves. 00:48:17.580 --> 00:48:24.060 position:50% align:middle If an educator or a potential educator can get better pay in clinical practice, 00:48:24.060 --> 00:48:31.390 position:50% align:middle then are we falling on an appeal to their good graces to do this anyway? 00:48:31.390 --> 00:48:33.530 position:50% align:middle Or how can we go about rectifying that? 00:48:33.530 --> 00:48:39.650 position:50% align:middle - Well, you know, there are educator colleagues that say that their students graduate, and in three years, 00:48:39.650 --> 00:48:44.610 position:50% align:middle they're making more than they do, or in two years, and they know they're novices still, you know. 00:48:44.610 --> 00:48:52.000 position:50% align:middle And it's very discouraging for those faculty to be turning out students in that way. 00:48:52.000 --> 00:48:56.950 position:50% align:middle Many educators have just this gift for teaching and love for it. 00:48:56.950 --> 00:49:01.760 position:50% align:middle I mean, there's passion and commitment involved, but you still have to put food on the table. 00:49:01.760 --> 00:49:03.060 position:50% align:middle You still have to make things happen. 00:49:03.060 --> 00:49:07.990 position:50% align:middle So pay is something okay to talk about, and I have to help...sometimes I have to help nurses 00:49:07.990 --> 00:49:11.580 position:50% align:middle help with that because we're very not self-serving on that. 00:49:11.580 --> 00:49:15.200 position:50% align:middle It's the physicians that are money grabbers, nurses are just angels. 00:49:15.200 --> 00:49:23.790 position:50% align:middle And so we have to work on that because we deserve to be rewarded and awarded for what we do as nurse educators. 00:49:23.790 --> 00:49:29.970 position:50% align:middle So I'm thinking of things like joint positions help a lot between universities and schools of nursing, 00:49:29.970 --> 00:49:35.880 position:50% align:middle and that goes back to my colleagues mentioning about clinical and academe working together. 00:49:35.880 --> 00:49:37.660 position:50% align:middle I think things can be figured out like that. 00:49:37.660 --> 00:49:43.760 position:50% align:middle I believe there should be partnerships between corporations in your community and schools of nursing 00:49:43.760 --> 00:49:49.200 position:50% align:middle about faculty and pay that they need to bring the kind of staff they need, and they need a 00:49:49.200 --> 00:49:50.500 position:50% align:middle good healthcare system. 00:49:50.500 --> 00:49:53.076 position:50% align:middle And without enough nurses, they're not going to have a good health. 00:49:53.076 --> 00:49:58.750 position:50% align:middle So you have to take it to your...sit down and have some conversations with some of those CEOs about the 00:49:58.750 --> 00:50:04.790 position:50% align:middle healthcare of their employees and how they could even feel better about some of the things they do, 00:50:04.790 --> 00:50:09.320 position:50% align:middle that is called business, but they need a clean mental state about it. 00:50:09.320 --> 00:50:14.260 position:50% align:middle So help them spend their money wisely on nurse educators. 00:50:14.260 --> 00:50:16.400 position:50% align:middle But we need to look at a number of ways. 00:50:16.400 --> 00:50:18.370 position:50% align:middle First, we have to acknowledge that this is an issue. 00:50:18.370 --> 00:50:23.370 position:50% align:middle And like I said, we have a hard time saying it out loud, "I charge." 00:50:23.370 --> 00:50:25.900 position:50% align:middle Work your mouth, "I charge." 00:50:25.900 --> 00:50:28.040 position:50% align:middle So nurses have to get over that. 00:50:28.040 --> 00:50:33.040 position:50% align:middle We have to start standing up for ourselves and standing up for each other and saying, "I deserve this." 00:50:33.040 --> 00:50:37.050 position:50% align:middle Educators are far behind even our nurses in doing that. 00:50:37.050 --> 00:50:40.790 position:50% align:middle And deans are just trying to make everything survive and get to the next level, 00:50:40.790 --> 00:50:45.730 position:50% align:middle and they got the provost and the president and colleagues in other areas who are being treated very 00:50:45.730 --> 00:50:47.690 position:50% align:middle differently than the nursing programs. 00:50:47.690 --> 00:50:52.260 position:50% align:middle So we have to provide some support from the outside for our deans of nursing too. 00:50:52.260 --> 00:50:56.380 position:50% align:middle It's not always just deans supporting staff. 00:50:56.380 --> 00:50:59.520 position:50% align:middle It's staff supporting deans, supporting the leadership also. 00:50:59.520 --> 00:51:01.726 position:50% align:middle It goes both ways. 00:51:01.726 --> 00:51:05.770 position:50% align:middle - So let me just say really quick before Eileen finishes off. 00:51:05.770 --> 00:51:10.800 position:50% align:middle One of the benefits of working for a women's university led by a chancellor, a provost, 00:51:10.800 --> 00:51:17.380 position:50% align:middle and provosts that were fantastically strong women at Texas Woman's University was differential. 00:51:17.380 --> 00:51:21.270 position:50% align:middle We solved the problem for faculty pay through differential tuition. 00:51:21.270 --> 00:51:23.990 position:50% align:middle Now, I'm told in Louisiana that that's never going to happen. 00:51:23.990 --> 00:51:27.890 position:50% align:middle You know, every time I bring it up at the legislature, they just look at me and say, "Yeah, 00:51:27.890 --> 00:51:28.760 position:50% align:middle that's not going to happen." 00:51:28.760 --> 00:51:31.080 position:50% align:middle Yeah, I said, "Well, yeah, since you told me about the compact, you know, 00:51:31.080 --> 00:51:32.410 position:50% align:middle we got that done in six months." 00:51:32.410 --> 00:51:34.130 position:50% align:middle So I don't believe anything they... 00:51:34.130 --> 00:51:35.140 position:50% align:middle They're men, I'm a woman. 00:51:35.140 --> 00:51:36.130 position:50% align:middle I just get things done. 00:51:36.130 --> 00:51:37.380 position:50% align:middle - Go on, girl. 00:51:37.380 --> 00:51:43.160 position:50% align:middle - But differential tuition, $25 for every NURS course at Texas Woman's University 00:51:43.160 --> 00:51:51.330 position:50% align:middle allowed us to meet and exceed the median for CCNE, you know, when they put out their salary booklet 00:51:51.330 --> 00:51:53.950 position:50% align:middle for all the different types of nursing programs. 00:51:53.950 --> 00:51:58.700 position:50% align:middle And in a university that, again, and that's what... 00:51:58.700 --> 00:52:03.670 position:50% align:middle It's a big issue, is that we're not paid as much as they can make in practice. 00:52:03.670 --> 00:52:11.040 position:50% align:middle But we solved that and made it much easier to attract younger faculty and to keep them in. 00:52:11.040 --> 00:52:14.290 position:50% align:middle So I just wish everybody had introduced differential tuition. 00:52:14.290 --> 00:52:16.670 position:50% align:middle - That sounds great. 00:52:16.670 --> 00:52:18.930 position:50% align:middle - It's a very complex issue. 00:52:18.930 --> 00:52:23.190 position:50% align:middle You know, higher ed is under a lot of strain these days. 00:52:23.190 --> 00:52:26.850 position:50% align:middle And nursing education, sort of, if you have a Venn diagram, 00:52:26.850 --> 00:52:32.290 position:50% align:middle and you've got health care and you've got higher education, nursing education sits right smack 00:52:32.290 --> 00:52:33.650 position:50% align:middle in the middle there. 00:52:33.650 --> 00:52:36.920 position:50% align:middle So I absolutely agree with my colleagues. 00:52:36.920 --> 00:52:45.650 position:50% align:middle But I do think we need to recognize that nursing is a bit of an outlier on an academic environment. 00:52:45.650 --> 00:52:51.780 position:50% align:middle The kinds of faculty that I have are faculty that need to be in the classroom and out in the clinical setting, 00:52:51.780 --> 00:52:53.240 position:50% align:middle maintaining their skills. 00:52:53.240 --> 00:52:56.820 position:50% align:middle In fact, it's a requirement in California. 00:52:56.820 --> 00:53:03.420 position:50% align:middle And so it's very different than what might be expected of an English professor or a chemistry professor, 00:53:03.420 --> 00:53:12.100 position:50% align:middle but those are very challenging arguments to make within the hierarchy of an academic environment because, 00:53:12.100 --> 00:53:15.030 position:50% align:middle you know, we're one school among many. 00:53:15.030 --> 00:53:18.070 position:50% align:middle And so, you know, there's competing pressures. 00:53:18.070 --> 00:53:26.160 position:50% align:middle So while we should absolutely continue to move in that direction, I think we can't just wait around for that. 00:53:26.160 --> 00:53:31.180 position:50% align:middle We have to be exploring, like Bev said, academic practice partnerships, 00:53:31.180 --> 00:53:39.350 position:50% align:middle thinking about other ways to provide opportunities for faculty to have time dedicated during the week that 00:53:39.350 --> 00:53:44.690 position:50% align:middle allow them to go ahead and work clinically if they so choose and, you know, 00:53:44.690 --> 00:53:49.130 position:50% align:middle not have that be penalized against them in terms of some of their other workload 00:53:49.130 --> 00:53:51.440 position:50% align:middle within the university setting. 00:53:51.440 --> 00:54:00.340 position:50% align:middle There's also opportunities to work with clinical agencies, and this actually has benefits of giving 00:54:00.340 --> 00:54:05.850 position:50% align:middle individuals who are burned out other opportunities where they can take a break from the clinical setting, 00:54:05.850 --> 00:54:10.010 position:50% align:middle be an instructor for a while or maybe one day a week. 00:54:10.010 --> 00:54:17.610 position:50% align:middle So there's a couple of different ideas that we should be working at while we're working on the pay equity 00:54:17.610 --> 00:54:19.270 position:50% align:middle issue as well. 00:54:19.270 --> 00:54:26.550 position:50% align:middle - So I want to end with each of you giving one final thought. 00:54:26.550 --> 00:54:33.390 position:50% align:middle If there is one thing you want our audience to remember, what would you like it to be? 00:54:33.390 --> 00:54:34.010 position:50% align:middle Lavonia? 00:54:34.010 --> 00:54:41.360 position:50% align:middle - I want us all to remember that the nurse comes to work as a whole person and that whatever we put 00:54:41.360 --> 00:54:46.390 position:50% align:middle in place needs to address her or him as a whole professional person. 00:54:46.390 --> 00:54:48.390 position:50% align:middle - Bev? 00:54:48.390 --> 00:54:53.340 position:50% align:middle - The goal in nursing is to make a difference in the world. 00:54:53.340 --> 00:55:01.790 position:50% align:middle It has a lot to do with healing and caring, and caring, the definition is promoting excellence. 00:55:01.790 --> 00:55:06.960 position:50% align:middle That's excellence, itself, in nursing education and building a strong and 00:55:06.960 --> 00:55:08.550 position:50% align:middle diverse nursing workforce. 00:55:08.550 --> 00:55:13.850 position:50% align:middle Caring is about that, and it's about making sure that we respond to the human 00:55:13.850 --> 00:55:16.220 position:50% align:middle condition in an appropriate way. 00:55:16.220 --> 00:55:22.180 position:50% align:middle So I'm so passionate about nursing and so honored to be a nurse. 00:55:22.180 --> 00:55:24.780 position:50% align:middle - Thank you. Karen? 00:55:24.780 --> 00:55:30.090 position:50% align:middle - You know, the one thing that I love about my profession is that it has given me the opportunity 00:55:30.090 --> 00:55:35.670 position:50% align:middle to do so many different things and an almost 50-year career. 00:55:35.670 --> 00:55:37.980 position:50% align:middle And I love being in academia. 00:55:37.980 --> 00:55:39.320 position:50% align:middle I love being in practice. 00:55:39.320 --> 00:55:41.089 position:50% align:middle I love being an APRN-CNS. 00:55:41.089 --> 00:55:43.880 position:50% align:middle Thank you so much for that. 00:55:43.880 --> 00:55:46.430 position:50% align:middle And I came to regulation at the end. 00:55:46.430 --> 00:55:51.340 position:50% align:middle I guess what I want people to know is we're not just about licensure and discipline. 00:55:51.340 --> 00:56:00.720 position:50% align:middle We're about working with our colleagues in practice and academia to make health care and the health care that 00:56:00.720 --> 00:56:07.250 position:50% align:middle we provide in this country and around the world good and to make the world a better place. 00:56:07.250 --> 00:56:08.920 position:50% align:middle - That's right. 00:56:08.920 --> 00:56:09.640 position:50% align:middle - Eileen? 00:56:09.640 --> 00:56:13.370 position:50% align:middle - I would say it takes a village to raise a new nurse. 00:56:13.370 --> 00:56:20.090 position:50% align:middle It takes practice, education, regulation, our clinical partners, you know, all working together, 00:56:20.090 --> 00:56:29.480 position:50% align:middle our communities, to invest in their education so that they can go out and serve the public in a safe and 00:56:29.480 --> 00:56:35.380 position:50% align:middle competent manner while not sacrificing their own well-being. 00:56:35.380 --> 00:56:44.790 position:50% align:middle - Well, I want to extend my heartfelt thanks to all of you for this enlightening and inspiring discussion. 00:56:44.790 --> 00:56:50.290 position:50% align:middle We certainly hope that all of you that have been listening have been taking to heart the many 00:56:50.290 --> 00:56:59.280 position:50% align:middle suggestions and ideas that have been addressed here and that a lot of it will become practice in institutions 00:56:59.280 --> 00:57:02.077 position:50% align:middle around the country. Thank you.