The foundation's gift will help, in part, fund start-up costs for a new Bachelor of Science in Nursing program.
Editor's note: This story has been updated to reflect the correct website of the IBC Foundation.
A $1 million gift to St. Mary’s University in San Antonio, Texas, not only will help fund start-up costs for a new Bachelor of Science in nursing program, but it will help close the critical gap in the regional healthcare system.
The four-year gift from the IBC Foundation also is earmarked to help fund construction of the new IBC Foundation Nursing Wing, according to the university.
St. Mary’s is among healthcare educators taking decisive steps in growing and strengthening the U.S. nursing workforce. Initiatives from other schools, for example, include simplifying the transfer of credits between higher education institutions, creating alliances with hospitals or health systems, and building more nursing schools.
St. Mary’s nursing program will be housed on the third floor of the state-of-the-art, 30,000-square-foot Blank Sheppard Innovation Center, which is under construction with planned completion in 2024, supporting research, innovation, and instruction in the School of Science, Engineering and Technology.
The 10,000-foot IBC Foundation Nursing Wing will include a flexible lab space, a seven-bed clinical skills lab, four simulation suites and faculty offices.
The nursing major is expected to begin enrolling students in fall 2024, pending approval by the Texas Board of Nursing and the Southern Association of Colleges and Schools Commission on Colleges (SACSCOC), according to the university.
The IBC Foundation gift will help fund:
Construction of the nursing wing, as well as IT and audio-visual infrastructure
Medical mannikins and other reality-enhancing technology and equipment
Additional equipment, furniture, and start-up supplies
"The generosity of the IBC Foundation has enabled St. Mary’s University with the exceptional opportunity to launch a nursing program in a space specifically designed for this specialized study," said Donna M. Badowski, DNP, vice dean and founding director of nursing. "We are all beyond grateful for this life-changing gift."
Graduates of the new nursing program will help to close critical gaps in the regional healthcare system.
Texas will need 50,000 more nurses by 2033, including 10,000 new nurses in Central and South Texas, according to the Texas Department of Health Services.
"Through this generous gift, the IBC Foundation will make possible many life-changing educational moments for St. Mary’s University students," said Thomas M. Mengler, JD, university president.
"Students learning in this new wing will benefit from in-depth training—replicating real-life healthcare scenarios—which they will rely on throughout their nursing careers," he said. "At St. Mary’s, we believe this IBC Foundation gift will literally save lives."
Editor's note: This story has been updated to reflect the correct website of the IBC Foundation.
Money, freedom, and flexibility rank high in their motivation for traveling.
Traveling, with its freedom, flexibility, and sense of adventure, can help nurses find satisfaction with their job and avoid burnout, a new survey reveals.
More than three-fourths (76%) of travel nurses surveyed June 21-29, 2023, for Nomad Health’s Job Satisfaction Indexreport being satisfied with their most recent travel job, compared to only half (51%) who report being satisfied with their last staff position.
Traveling helps nurses avoid the elements that contribute to burnout, such as long shifts, challenging patient-to-staff ratios, and hospital politics, according to Nomad Health, a digital marketplace for healthcare staffing.
Instead, nurses who repeatedly seek travel positions are motivated by:
Money, earning enough to meet financial goals: 76%
Freedom and flexibility: 67%
Sense of adventure: 32%
Work-life balance: 32%
Ability to focus on patient, not the politics: 26%
With the freedom and flexibility afforded by traveling, 41% of nurses surveyed stated they would never go back to a staff position. Others, however, choose to return to staff positions because they crave stability or have family responsibilities.
When Nomad Health queried travel nurses on travel assignment factors, pay rate was the top factor (26%), followed by location (20%), shift structure (11%), facility (11%), and contract length (10%).
That, most likely, is because Texas is a large, rapidly growing state, but it also is a "compact state," which allows travel nurses to obtain a multi-state license, speeding up the credentialing and employment process for travel nurses.
Nomad’s previous survey also looked at where travel nurses most wanted to work, based on states that they searched most.
California and Florida were the most popular, both with 6% of queries, followed by Texas with 5%; New York, North Carolina, and Georgia each received 4%; and Arizona, Colorado, Virginia, and Massachusetts each received 3%.
When it came to ranking facility assignment factors, flexible scheduling ranked first (14%), followed by support staff ratio (13%), and facility reputation (9%), according to Nomad.
That’s why Simpson and Vicki Stover Hertzberg, PhD, FASA, a professor and director of Emory’s Center for Data Science, helped create an online, self-paced data science certificate program—to help nurses use Big Data to solve problems in healthcare settings.
Big Data is a relatively new concept for nursing—it’s been around two, perhaps three years, Simpson says—but its capabilities are unlimited in developing patterns of patient care.
"To compare six patients and 10 patients and 30 patients and 400 patients is not a good indicator of evidence. You need large trillion data sets," Simpson says.
"Large data gives you patterns; you cannot get patterns out of small data sets," Simpson says. "So, if you're looking for whatever you're doing in nursing, whether it's getting a med, turning a patient, or deciding if it's the right room for them, you cannot gather evidence and research on small data sets today. You have to have large data sets to develop patterns of care."
For example, from Big Data, nurses know that new patients to a hospital who are over 65 and dehydrated will develop pressure ulcers, which can result in longer lengths of stay. Knowing that helps to develop a care plan.
"We're the only profession in the organization that is there 24 by 7—every other healthcare provider is an episodic engager with the patient—so we have to develop and understand care needs for our patients," he says. "We have to know what interventions we need to do for patients to decrease length of stay for the patient because our goal is to get a patient out of a hospital."
That’s not only for the patient’s sake but for the organization, as well.
If a patient is admitted with a pressure ulcer or develops one while hospitalized, it becomes the responsibility of the healthcare organization to discharge that patient with no pressure ulcer; otherwise, the hospital will not be reimbursed, Simpson notes.
Despite the benefits of Big Data, nurses tend to be uncomfortable with it for a couple of reasons.
"Evidence is hard to accept for change," he says.
Simpson referred to a recent announcement by a World Health Organization agency that artificial sweetener aspartame, used in low-calorie products such as Diet Coke, sugar-free gum, and tabletop sweeteners is "possibly carcinogenic to humans."
"I've had more people call me, asking, ‘Should I drink Diet Cokes or not?’" he says. "I say, ‘If you drink 20 a day you probably shouldn't drink it, but if you're drinking three or four, you're probably ok.’"
"How do you translate the evidence?" he says. "That's not a human behavior to follow the true evidence; people's inquisitions are not that strong."
The newness of Big Data is also a factor. "You have early adopters," he says, "and you have laggards and Big Data is a huge component."
Project NeLL
The new certificate program provides students with access to Emory's own vast stores of data—Project NeLL, the School of Nursing’s "pioneering" suite of apps that provides access to 2.7 million de-identified patient records and more than 37 trillion data points, providing information on diverse populations, countless conditions, and a wide spectrum of care.
Project NeLL, which stands for Nurse’s Electronic Learning Library, is singular in its presentation of data, Simpson says.
"There are other large data sets, but they don't have the clinical text data transcribed into natural languages that can be retrieved," Simpson says.
"For instance, MIMIC-III is a Massachusetts General data set which a lot of people use in research, but it is only data that is put in as data," he says. "NeLL looks at other types of data sets, so it has a lot of uniqueness to the marketplace."
Emory nursing students who used NeLL to complete capstones and dissertations discovered racial disparities in opioid administration for breast cancer patients, a cost value associated with nurse anesthetists compared to other provider types, and predictors of death among patients with pressure ulcers, according to Emory University.
The program
The new data science certificate program was conceived by Simpson and Hertzberg to move nurses forward in understanding Big Data and evidence and to advance Emory’s Doctorate in Nursing program to include a focus on evidence and systems work, he says.
"What we learned was not all nurses are interested in getting doctoral degrees," Simpson says. "They're looking at more scalable certificates as a way to advance their knowledge base and their criteria for work or being hired. We felt that more people wanted to understand informatics and Big Data before they decided whether they should go for degree granting in informatics."
Nurses completing the program will earn an Emory Nursing digital certificate and badge and receive continuing professional development contact hours.
‘New opportunity’
Getting comfortable with Big Data can only help nurses in their clinical practice.
"Every specialty in nursing has a component of informatics, and the weakness of those disciplines is the lack of informatics in their discipline," Simpson says.
Nurses need Big Data, Simpson says.
"Big Data is a new opportunity for the world at large, not just nursing," he says. "But for nursing to be successful in the future, we have to embrace it. We have to understand it and know how to use it."
$2.6M HRSA grant will help West Virginia's 'most vulnerable populations.'
A rural grant awarded to Shepherd University’s School of Nursing will boost the number of primary care nurse practitioners (NPs) and psychiatric mental health NPs to help support West Virginia’s “most vulnerable populations.”
The four-year, $2.6 million grant, given by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) provides Shepherd $649,998 a year—about $417,000 of which will cover yearly tuition and fees for 30 graduate and certificate students, according to the university.
Beginning in fall 2023, grant money will provide scholarships for students in the Doctor of Nursing Practice (DNP) program as well as programs offering post-graduate certificates for family nurse practitioners (FNP) and psychiatric mental health nurse practitioners (PMHMP).
"This grant will support nurse practitioners who are primary care providers in the region—and there is an inadequate number of providers at this point in time," said Sharon Mailey, PhD, RN, dean, College of Nursing, Education, and Health Sciences, and director, School of Nursing.
"We have many specialists, but we don’t have sufficient numbers of individuals at the primary care level who are facilitating access into the healthcare system for patients who have the most vulnerable needs," she said.
Indeed, the need for primary care advanced practice nurses (APRNs) in rural areas is great, as hospitals close and the number of physicians declines. Nearly 80% of U.S. rural counties are medical deserts, with no access to healthcare services, according to the National Rural Health Association.
Rural residents with mental healthcare needs are also struggling with the lack of providers. Nationwide, some 158 million people live in Mental Healthcare Health Professional Shortage Areas, according to the American Association of Nurse Practitioners.
"If you can be an FNP/PMHMP, it is ideal, because there is a backlog to refer your patients anywhere for mental health," said Kelly Watson Huffer, DNP, CRNP, CNE, associate professor of nursing education and grant project director. "There’s a six-month waitlist for most psychiatry and you have kids who need stimulant medication for ADHD and patients with depression and anxiety issues. If someone can serve in both roles in a primary care office, they are really facilitating getting their patients treated in a timely manner."
The grant will help Shepherd DNP and certificate students gain practical rural health experience at four federally qualified health centers and two mental health substance abuse disorder treatment centers.
"Doctoral education is expensive and time intensive. In addition, our students are working, and have families and other responsibilities," Watson Huffer said. "Taking the financial stress away is just one more thing to help them with their education."
The grant also strengthens healthcare in northeast West Virginia’s rural areas.
"Being able to support our students and West Virginia’s most vulnerable populations allows us to keep resources in our community," said Kayla Landsberger, project coordinator.
'Nurse leaders with healthcare economics and healthcare finance acumen are important to advocate for the profession.'
A new dual advanced degree program aims to empower nurses with the expertise to advance in executive leadership and health system administration.
Graduates of the unique program, offered by the East Carolina University College of Nursing, in partnership with the ECU College of Business, will receive both a Master of Science in Nursing and a Master of Business Administration (MSN-MBA), a robust combination of qualifications that will arm graduates in tackling long-term challenges in healthcare administration. The dual MSN-MBA program isn’t the first in the nation, but the pool of schools that offer a similar pairing is small.
"As we navigate unprecedented nursing shortages, nurse leaders with healthcare economics and healthcare finance acumen are important to advocate for the profession and to partner with healthcare administrators to properly assess the nursing needs of health systems, and to make fiscally responsible decisions regarding staffing and other financial investments," said Bimbola Akintade, dean of the College of Nursing and an MBA graduate.
"Bringing their clinical backgrounds and leadership knowledge to the table, they will improve communication of financial decisions that impact nursing practice and direct patient care between administrators and bedside nurses," he said. "In addition, this knowledge will help graduates of the dual MSN-MBA program contribute meaningfully to the nursing workforce development solutions that will positively impact the health and well-being of residents of our region and beyond."
"Nurse leaders control the largest part of a hospital labor budget, in some cases the largest part of the overall budget," Douglas writes. "The effectiveness of overseeing this responsibility can mean the difference between an organization’s financial stability and financial turmoil."
ECU students will focus on business during the first semester, then on nursing coursework during the second semester. The remaining year and a half will consist of a blend of the two, according to the university.
The purpose of offering the two degrees in tandem is to give students knowledge and skills to bridge the cultural gap between frontline nurses and hospital administration, who typically don’t speak the same language, said Thompson Forbes, PhD, MSN, NE-BC, ECU assistant professor of nursing and one of the program’s directors.
"We need to have leaders who can understand health system organizational theory, nursing theory, and nursing evidence-based practice, and then pair that with an understanding of finance, accounting, and marketing," Forbes said. "They will be better prepared to translate decisions that are made in the clinical environment to business environment and vice versa, so the systems can be more efficient."
Nursing will always be the largest line item on any healthcare system’s budget because they are the most patient-intensive workforce in hospitals, Forbes said.
"Instead of just striking numbers from a budget, there needs to be someone who can interpret and say, ‘We can handle this much efficiency gain on the business side, but that savings is going to result in a reduced level of quality of care at the bedside,’" Forbes said.
When conversations between the healthcare workforce and administration on how to balance patient care with keeping the lights on don’t happen, Forbes said distrust naturally festers. Nurse executives with business administration education can foster "an environment of understanding amongst everybody."
Mandating nurse staffing ratios is 'short-sighted and counterproductive,' AONL contends.
Though a handful of state legislatures are considering mandating nurse-to-patient staffing ratios, government mandates are not the answer to nurse staffing, the American Organization of Nursing Leadership (AONL) has declared.
"Staffing is a complex decision based on the experience and clinical expertise of the nurse, care team, resources, and patient needs," AONL said in a prepared statement. "Organizational leaders, nurse managers, and direct care nurses, not policymakers, should collaboratively align staffing with patient needs."
In January 2004, California became the first and only state, so far, to establish minimum RN-to-patient ratios in every hospital unit. Other states prioritize patient safety through different nurse staffing ratio rules. Just last month, New York set higher staffing ratios to hospitals’ critical care and intensive care units. It did not set minimum staffing levels for all units.
But that is for a hospital or health system to determine, according to AONL.
"Mandated nurse staffing standards remove real-time clinical judgment and flexibility from nurses. Government-mandated ratios do not account for an individual patient or the healthcare team’s needs in an ever-changing environment, nor do they account for the variability among healthcare organizations," it says. "Mandated approaches to staffing do not consider these differences and requires organizations to staff nurses to the number of patients rather than a patient’s needs."
Mandated ratios are typically based on traditional nursing care models, AONL said, which are becoming outdated and more nursing practices embrace innovation, advanced capabilities in technology, and collaborative interprofessional care teams.
Further, the nursing shortage has reached a crisis stage, some nursing organizations say. About 100,000 RNs left the workforce during the COVID-19 pandemic in the past two years due to stress, burnout, and retirement, and nearly 900,000 intend to leave the nursing workforce by 2027, according to the National Council of State Boards of Nursing and National Forum of State Nursing Workforce Centers
"Mandated staffing does not create more nurses or guarantee improvements in safety, patient outcomes, or ensure a positive practice environment. Mandatory ratios compound the strain healthcare systems are already facing, potentially forcing hospitals who do not have enough nurses to meet the nurse-to-patient ratio, to turn patients away or delay care, threatening the patient’s ability to access care in their community," according to AONL.
AONL supports the American Nurses Association Nurse Staffing Task Force’s definition of appropriate staffing, which reads, "Appropriate staffing is a dynamic process that aligns the number of nurses, their workload, expertise, and resources with patient needs in order to achieve quality patient outcomes within a healthy work environment."
It also supports most of the task force’s systematic recommendations, including reforming the work environment, innovating models of care, improving regulatory efficiency, and valuing the unique contribution of nursing.
"As an independent profession, nurses are best suited to determine staffing," according to AONL. "Asking policymakers to mandate nurse staffing ratios for our patients relinquishes nurses’ professional autonomy; it is short-sighted and counterproductive."
Bredimus, a contributor to the CNO Exchange Community*, spoke with HealthLeaders about how he and Midland Memorial approach practice redesign and how they’ve found success.
Kit Bredimus, chief nursing officer, Midland Memorial Hospital / Photo courtesy of Midland Memorial Hospital
This transcript has been lightly edited for clarity and brevity.
HealthLeaders: What is your definition of practice redesign?
Kit Bredimus: It’s really about who's delivering what aspect of care and by what means they are doing it, where it’s delivered and by whom. It’s important to understand that practice redesign is constantly occurring; it’s always happening because there are many factors that go into hospital acute-care operations.
COVID-19 changed a lot for us in practice redesign, but it was happening well before COVID; it just exacerbated with COVID. You always have to be thinking about redesign and evolution as far as the healthcare industry and who's delivering what aspects of care. Even if you think just a few years back, a lot of the things that we had nursing doing as the primary care model was what housekeeping does, what phlebotomy does, what personal care assistants do, what IT does.
There are a lot of different roles that we have delegated over the years to allow the nurse to step back and practice at the top of their licensure and scope in skills and assessment. But are they really able to do that right now? Are the models working?
HL: When is it necessary to re-engineer the way patients receive care?
Bredimus: It's necessary in the fact that resources are going to continue to dwindle as the nursing shortage is not going to get any better, so many organizations are continuing to look at new ways to take care of either the same number of patients or even more patients by maximizing nurses’ scope and skill by supplementing with different skill mixes and different modalities.
But it's going to be necessary as we continue to see the aging population hit our medical facilities. We are going to have to find ways to deliver care not only within the hospital, but also outside of the hospital, such as hospital at home or virtual nursing. There are going to be new care models that have to be put into place just to meet the demand.
HL: What does practice redesign look like in your organization in Midland?
Bredimus: We’ve done some things not considered innovative now, but they were cutting edge at the beginning. We utilize LVNs [licensed vocational nurses], but not in an assistive supportive role; we use LVNs for part of our primary care model, to have them taking patient assignments, taking fuller extent of their capacity here in Texas to evaluate patients and take care of patients. We’ve implemented and designed an LVN internship, residency, and fellowship program, recognizing that this entry to practice has not really been tapped here locally or in the region, as an opportunity to grow individuals in that space.
We put them on a path where we will pay them to get their RN through a transition program with a local community college partnership here, and that has been very successful. We had 15 individuals in our first cohort that we were able to upskill and get them onto the path to become an RN.
We are looking at our skill mix, as everyone in the country is looking at different skill mixes and how you can have unlicensed assistive personnel in the clinical environment. We redesigned some of our models where we're increasing our UAPs [unlicensed assistive personnel] and having them take on the care, feed, and activity roles where their sole focus is supplementing that aspect.
In addition, we are working further down the pipeline. We recognize that before COVID we were focusing on older adults—high school graduates, adults in the working world, or college kids trying to work toward the healthcare career. We've lowered our hiring limit to age 16. We are working with our local independent school district to create an Explorers program where not only do they get to come into the hospital and experience different areas of healthcare—different roles and disciplines—but also the ability to work as an unlicensed assistive personnel during their downtime that enables them for our employee benefits, such as tuition assistance.
We're getting these individuals plugged in earlier and getting them on a healthcare track so they're not waiting until they graduate to figure out what they want to do, and we as a hospital support them so that gives them a little bit of an edge when it comes to applying for whatever program they want to get into.
HL: What are key tips you would suggest in implementing practice redesign?
Bredimus: The primary focus for any leader planning a practice redesign is to have strong communication. You have to build in that feedback loop and make sure you've had that communication with the staff that are going to be involved with the change to get their buy-in. A leader needs to figure out what staff think is going to work and what's not going to work.
The other part is to empower them to make change. As you trial these things, it's important to hear from staff what's working well, what's not working well, and what they would like to see tweaked. Then, have planned stages where that feedback can be implemented, versus pushing it out from the top down. That has not been successful. I've been a victim of that before, where we recognize that something sounds like a great idea, but once we roll it out, it failed, so empowering the team to own the process and the change has been what’s really worked for us.
As an aside, it’s important to recognize that anytime you're talking about a practice redesign, there's not a lot of literature out there that says, “This is a tried-and-true model. Everyone should do it because it works every time,” because every situation, every organization, every community's going to be different, with different resources, constraints, and barriers. It’s important to keep that in the forefront of your mind whenever you're talking about any of these redesigns because a lot of them are unproven and you don't know if they're going to work for your organization until you try them.
That’s why it’s important to get the feedback of staff and key stakeholders—to make sure you are looking at all the variables that are specific to your unit, your area, your community.
* The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at https://www.linkedin.com/company/healthleaders-exchange/. To inquire about attending a HealthLeaders Exchange, email us at exchange@healthleadersmedia.com
Rhode Island RNs and licensed practical nurses will now be able to have one multistate license, with the ability to practice in person or via telehealth in both their own state and 38 others that have adopted the Nurse Licensure Compact (NLC).
Though Gov. Daniel J. McKee recently signed legislation making Rhode Island the 41st jurisdiction—along with 38 states, Guam, and the U.S. Virgin Islands—to enact the NLC, the state is awaiting implementation with no determined start date.
Implementation must be completed before its residents can apply for a multistate license, and before nurses in other NLC states who hold a multistate license will be able to practice in Rhode Island.
Rhode Island was part of the original NLC which has been operational for more than 20 years, but when the Enhanced Nurse Licensure Compact, a new and modernized version of the language was drafted and approved by boards of nursing in 2015, Rhode Island did not join.
That meant that Rhode Island nurses once again had the burden of holding and maintaining licenses for other states in which they wished to practice, and opportunities to be a travel nurse or remain competitive in a telehealth workforce became limited.
"Our state is grappling with a severe shortage of nurses. Returning to the compact is a way we can make it easier and more appealing for nurses to come here for a job, making it easier for our hospitals and health facilities to fill their staffing needs," said Sen. Joshua Miller, one of the NLC bill sponsors. "Rejoining the compact is good for our public health and safety."
Licensure requirements are aligned in NLC states, so all nurses applying for a multistate license are required to meet those same standards, including submission to a federal and state fingerprint-based criminal background check.
A multistate license eases cross-border practice for many types of nurses who routinely practice with patients in other states, including primary care nurses, case managers, transport nurses, school nurses, hospice nurses, and more. Military spouses who experience moves every few years also benefit greatly from the multistate license.
The NLC also benefits facilities that might have an acute shortage in one of their units to recruit a nurse for that unit or shift around their resources if they're an interstate facility and moves nurses between different states, according to Nicole Livanos, director of state affairs at the National Council of State Boards of Nursing (NCSBN).
Each addition to the NLC helps to strengthen the nursing workforce, she said.
"This sends a broader signal to the other states that are not yet in the NLC," Livanos said, "that the NLC can be part of broader workforce discussions in looking at how to shore up the existing nurse workforce, how to modernize the existing workforce, and how to make sure that your state remains competitive when recruiting nurses."
26% of patients wait two or more months to see a healthcare provider.
More than 40% of respondents have experienced “unreasonable wait times” wait times for healthcare, with more than 25% of those patients waiting more than two months for healthcare, according to a new survey released today by the American Association of Nurse Practitioners (AANP).
As a result, many went without needed care, including patients seeking critical mental health services, according to the survey, conducted in April 2023 of U.S. adults.
"These results are an eye-opening look at the state of access to care in our healthcare system," said AANP President Stephen Ferrara, DNP.
"A lack of timely access to care, particularly primary and preventive care, can lead to chronic conditions that put patients' lives in danger and increase costs," he said. "Delayed or deferred care can put an individual's health at greater risk for complications, which may also lead to a negative impact on mental health and lost wages for those patients. A decline in productivity for employers may also occur."
Other key findings from the survey include:
The increase in wait times extends across almost all major demographics—age, gender, education, and in rural/urban/suburban areas.
Among those with longer waits, nearly half gave up trying to get an appointment.
Those most likely to give up on seeing a provider include younger, urban, Hispanic, and mental healthcare patients.
Granting full practice authority (FPA) to NPs is one solution to eliminating long wait times, AANP has long championed.
FPA is the authorization of NPs to evaluate patients, diagnose, order, and interpret diagnostic tests, and initiate and manage treatments under the exclusive licensure authority of the state board of nursing.
This regulatory framework eliminates requirements for NPs to hold a state-mandated contract with a physician as a condition of state licensure and to provide patient care.
Momentum for FPA increased during the pandemic, when states temporarily suspended practice agreements and allowed NPs to practice at the top of their education, giving patients direct access to care.
"As a nation, we can solve the growing crisis in access to care by modernizing the outdated policies that sideline NPs from delivering care they are educated and clinically prepared to provide," said Jon Fanning, MS, CAE, CNED, the association’s CEO. "We can help shorten wait times and give patients timely access to the care they need by removing barriers to America's 355,000 NPs."
A holistic admissions process looks beyond grades to deliver a diversified student body.
Colleges and universities may be scrambling for new ways to uphold diversity after the U.S. Supreme Court’s recent decision to ban affirmative action, but the University of California, Davis, adopted a holistic admission process more than 25 years ago when California banned race-based admissions in 1996.
The court found it unconstitutional for colleges and universities to use race as a factor in student admissions, creating a particular challenge for the nursing profession, which seeks to better reflect its patient demographic. Indeed, a nursing workforce that mirrors its patient demographic makes healthcare more comfortable for every patient, several studies, including a Joint Commission report on cultural diversity, have shown.
But UC Davis has managed to accomplish that without affirmative action. Instead, its holistic admissions process looks beyond grades, says Jessica Draughon Moret, PhD, RN, an associate professor who chairs the Betty Irene Moore School of Nursing’s Recruitment, Admissions and Fellowship Committee.
"We are looking for unique experiences that will increase the diversity of our cohorts. We are looking for diversity of thought, in addition to diverse experiences. We weigh applications based on different life experiences," she says. "Then we also look at GPA, aptitude, essays, and letters of recommendation. We do look at all of that, but we also know those are not necessarily the best measure of program success."
The holistic review considers markers common for people from underserved backgrounds, such as rural versus urban environments and current or former military service experience.
Applicants answer questions regarding their socioeconomic background regarding:
Attending an under-resourced high school
A primary language other than English
Living in a medically underserved area
Being the first in their family to attend college, known as a first-generation student
When the School of Nursing launched in 2009, the founding faculty decided against requiring a Graduate Record Examination (GRE) score for admission, arguing that data from standardized tests is based on cultural bias and a barrier for underrepresented students, according to the university.
"We also look at the clinical and life experiences applicants have that align with our mission, such as commitment to service, cultural sensitivity, empathy, capacity for growth, emotional resilience, and interpersonal skills," says Teresa Thetford, director for the Physician Assistant (PA) program.
That approach resulted in the most diverse class of P.A.s in the history of the school last year, with more students older than 35, more men, and the largest group of Hispanic students yet.
To help attract a diverse pool of applicants, the school developed a series of videos advising prospective students on how to, in part, submit the strongest personal statement and letters of recommendation.
The admissions process and student success resources are working. For the past two years, according to the university, the class of students entering the entry-level nursing program mirrors the program’s applicant pool.
