352_Presentation-1

IMPROVING
RECRUITMENT AND
RETENTION OF PUBLIC
HEALTH NURSES
M. Bane, A. Bernard, M. Hrezi, E. Lee, V. Simpson
Gillings School of Global Public Health
University of North Carolina at Chapel Hill
Prepared for NENC Partnership for Public Health
20 April, 2015

Agenda
About Our Client
Public Health Nursing in NENC
Program Selection Criteria
Recommendation: Public Health Nursing
Pipeline
Questions

Agenda
• Northeastern North Carolina Partnership for Public Health
About Our Client
Recommendation: Public Health Nursing
Pipeline
Questions

Northeastern NC
Partnership for Public Health
About our client
Mission “address common local public health needs through the
sharing of resources and best practices regionally to achieve
greater efficiency and effectiveness.”
 Founded in 1999
 Activities: disease surveillance, heart disease and
stroke prevention, and healthy weight promotion
initiatives
 Dependent on PHNs to deliver such services

Agenda
About Our Client
• Trends
• Barriers to recruitment and retention
• Consequences of an inadequate workforce
Recommendation: Public Health Nursing Pipeline
Questions

Trends
Falling PHN Supply:
General
nursing
shortage
Fewer nurses
in Northeastern
NC vs NC
Slow and
unsteady growth
of supply in
Northeastern NC
Nurses not
entering the
public health
workforce
Rising PHN demand:
Health Risks
HIV/ AIDS rate in NENC
75% higher than NC
Above average obesity
rate in every county in
NENC
Demographics
38.3% Age 50+
16.2% Age 65+
Access
Rural location
19.8% Uninsured
(2014)

Barriers to maintaining workforce
 Aging workforce
 Insufficient public health funding
 Lack of public health awareness
 Incongruity between education training and job
demands
 Rural location
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
2000
2010
Age Distribution of Public
Health Registered Nurses in
2000 compared to 2010
Source: Characterization of the Public
Health Nurse Workforce, Robert Wood
Johnson Foundation. (2013)

Consequences of insufficient PHNs
 Decreased preventative care & health
promotion
 Increased burden on health system
 Lack of emergency preparedness
 ex. Inadequate response to natural disasters

Cost effective
Local
participation
Sustainable

Agenda
About Our Client
• Mentorship
• Employee Development
• Internships
Questions
} Grow Your Own

Mentorship
Employee
Development
Internships
Grow Your Own
Public Health Nursing Pipeline
Recommendation
 Immediate implementation to long-term planning
 Short-term resources to long-term investment
 Relatively prompt results to fostering future solutions

Mentorship
• North Carolina Accreditation
Learning Collaborative
Employee
Development
Internships
Grow Your Own
Nursing Workforce Initiatives

Mentorship
North Carolina Accreditation Learning Collaborative
Outcomes (NCALC)
 6-month pilot program in 2010
 Target: new PHNs
 Problem: PHN retention-issues in PH departments
Outcomes
 All mentees intended to stay in public health for at least 3 to 5
years
 3 of 4 stated intention to stay for 6+ years
 Perceived competence increase from 4.75 to 5.00
 All mentees and 3 of 4 mentors willing be future mentors
 Decreased job satisfaction from 4.63 to 4.35

Activities
• Mentor-mentee
pairing
• Training
• Remote and face-
to-face
communication
requirements
• Mentor training for
mentees
Recommendations
• One year, one-on-
one mentorship,
same activities
• Offer financial
incentives (grant
funded) or new title
(ex. Senior PHN)
Mentorship

 Benefits
 Shown to improve retention among new nurses
 Develop culture of support
 Foster non-financial reasons to stay
 Support integration of new graduates into work
environment
 Limitations
 Relatively time and labor intensive
 Increases administrative costs
 Some financial resources required
Mentorship

Mentorship
Employee Development
• Jewish Hospital Healthcare
Services
Internships
Grow Your Own
Recommendation

Employee-Based Program
Jewish Hospital Healthcare Services (JHHS)
 Started in 2002
 Target: current employees
 Problem: insufficient nursing workforce
Outcomes
 102 applicants; 32 accepted participants
 Average time at JHHS: 8.65 years
 Average age: 35.8 year old
 90% program retention

Activities
• Support employees with
full-time salary while
attending nursing
school part-time and
working part-time
• Work one year per
funded semester
Recommendations
• Implement same
program activities
• Survey for interest
within workforce
• Establish strong
relationship with
community college
• Apply for funding and/or
analyze financial
feasibility
• Integrate mentorship

 Benefits
 Guaranteed workforce
 Community-based
 90% retention
 Limitations
 Financial resources needed
 Willing, young yet experienced participants
 Time

Mentorship
Employee
Development
Internships
• Vermont Nurse
Internship Program
Grow Your Own
Nursing Workforce Initiatives

Vermont Nurse Internship Program
 10-week program Ongoing, started in 1999
 Target: Nursing students and graduates
 Problem: inadequate clinical training
Outcome:
 Shown to improve retention among new
nurses
 One agency maintained a 0% vacancy rate
for over 3 years
Internships

Activities
• Matches interns with
nurse preceptors
• Additional clinical
training
Recommendations
• Survey for interest
• Open to non-nursing
majors and high school
juniors and seniors
• Integrate community-
oriented activities
• Form partnerships with
local community
college and high
schools
Internships

 Benefits
 Improved retention
 Community oriented
 Limitations
 Increased administrative costs
 Time intensive
Internships

Mentorship
Employee
Development
Internships
Grow Your Own
Recommendation
 Immediate implementation to long-term planning
 Short-term resources to long-term investment
 Relatively prompt results to fostering future solutions
 Cost effective  Local Participation  Sustainable

Questions?
• Northeastern North Carolina Partnership for Public Health
About Our Client
• Trends: Falling Supply and Rising Demand
• Barrier: Aging workforce, Insufficient funding, Lack of awareness, Education-
work incongruity, Rural location
• Consequences of an inadequate workforce
• Cost effective, Local participation, Sustainable
• Mentorship
• Employee Development
• Internships
}Grow Your Own

References
Slide 4
About The NENCPPH. (n.d.). Retrieved April 19, 2015, from http://www.nencpph.net/about/
Slide 6
The Northeastern North Carolina Partnership for Public Health. (2012). Health in Northeastern North Carolina: Regional Assessment of a 15-County
Region, 1-94.
Slide 7
Washington State Nurses Association. (2011, June). Public Health and Public Health Nursing.Retrieved
from http://www.wsna.org/practice/publications/documents/Position%20Paper%20on%20Public%20Health%20r2.pdf
U.S. Bureau of Labor Statistics. (2014, January 8th). Registered Nurses: Occupational Outlook Handbook. Retrieved
from http://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
Slide 8
Diana McLawhorn, personal communication, October 6, 2014).
Robert Wood Johnson Foundation. (2008, September). Charting Nursing’s Future: Reports on Policies That Can Transform Patient Care. Retried
from http://www.rwjf.org/content/dam/farm/reports/issue_briefs/208/rwjf32665
Slide 14 & 15
The North Carolina Institute for Public Health (Jan 2010). Public Health Nurse Mentoring Pilot Program: Mini-Collaborative. Retrieved
from: http://nciph.sph.unc.edu/mlc/NurseMentoringPilotProgramManual.pdf
Slide 16
Davis, M. (2013) Improve the Retention of Public Health Nurses Through a Mentoring Program. Public Health Quality Improvement
Exchange. Retrieved from https://www.phqix.org/content/improve-retention-public-health-nurses-through-mentoring-program.
Slide 18, 19 & 20
Burge P., Dolan L., Price C., Kramer J., et al. (2004, June). ‘Grow Your Own’: A Responsible Approach to Addressing The Nursing Shortage. Nursing
Economics: The Journal for Health Care Leaders, 22(3), pp. 155-6.
Slide 22 & 23
Intern and Preceptor Development - Vermont Nurses in Partnership. (2009). Retrieved March 15, 2015, fromhttp://www.vnip.org/preceptor.html
Crimlisk, J., McNulty, M., & Fancione, D. (2002). New graduate RNs in a float pool. An inner-city hospital experience. Journal of Nursing
Administration, 32(4), 211-217.

Appendix A: Mentorship
The NC Accreditation Learning Collaborative (NCALC)
Statement of Need: Address retention
Desired Outcomes: Increase mentees who plan to remain in
public health nursing; increase knowledge base, competence, job
satisfaction, train future mentors
Targets: New PHNs (<2 years)
Activities: 6-month pilot program with 4 NC health depts., establish
mentor-mentee pairs
Outcomes: All mentees intend to remain in PHN for 3-5 years,
increased competence, all but one willing to serve as mentor in
future, fall in job satisfaction
Stage of Development: 1 March 2010 to November 2010
Appendix

Appendix B: Grow Your Own
Jewish Hospital Healthcare Services (JHHS)
Statement of need: Address nursing retention
Desired outcome: Ensure retention and support
Target: Current employees of JHHS
Activities: Current employees work part-time, receiving full-time
salary, and attend nursing school
 Agree to work as RN for a year for each semester of nursing school
tuition covered
Context: Depends on relatively young workforce
Outcomes: 102 applicants, 38 enrolled, 89.47% retention rate
Stage of Development: Currently unavailable
Appendix

Appendix C: Partnerships
The Vermont Nurse Internship Program (VNIP)
Statement of need: Address recruitment and retention
Desired Outcomes: Provide a more effective transition from
graduation into the workforce
Target: Undergraduate nursing and newly graduated students
Activities: 10-week program that includes lessons in standards of
care, managed care, cultural competence
Outcomes: One Vermont agency that implemented VNIP reduced
its vacancy from 20 % to 0%, maintained this vacancy rate for over
3 years
Stage of Development: Ongoing since 1999
Appendix

352_Presentation-1

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (15)

Similar to 352_Presentation-1

Similar to 352_Presentation-1 (20)

352_Presentation-1

Editor's Notes