We Need More Job Shadowing in Healthcare

We Need More Job Shadowing in Healthcare

Job shadowing is a long-standing tradition. High schools often have dedicated shadowing days, during which students can come and spend time with people working in careers that the students find interesting. While a few hours isn’t really enough to know if you like, love, or hate a job, it’s a start.

In healthcare, it can be especially important to spend time shadowing. In fact, PA schools want applicants to have hundreds of hours of documented shadowing time. I’m certain medical schools now want the same. I don’t know about other healthcare fields, such as dentistry, physical therapy, or pharmacy, but I suspect they want to see it as well.

We have created a system where shadowing is expected for acceptance in professional schools even as some hospitals make it very difficult (or impossible) to shadow. In some instances, it’s about concerns over privacy. In others, it’s simply that the number of people who desire to shadow is so large that it’s very difficult to get a time slot. And in others, it’s that there are medical, PA, or nurse practitioner students and residents rotating through the hospitals as part of their graduation requirements. In other words, it’s just dang crowded. As such, high school or even college students, trying to shadow, are at the bottom of the list.

In many career fields, it’s easy enough to shadow. If mom is an attorney, her son or daughter can sit in the courtroom or come to the office. If dad is a plumber, it’s easy enough to tag along and watch (or practice on projects at home). Teachers encourage students to shadow, and assorted business people do as well. Law enforcement often allows ride-along sessions. Even moms or dads in military careers have days when family can come on base and see what life is like in their jobs. I could go on, but the fact remains that from what I’ve seen, it’s much easier to shadow in other fields than in medicine. (If I’m wrong and this is a new trend everywhere, please leave a comment and educate me!)

The problem with medical careers that require graduate degrees is that the path to those schools is long, arduous, and expensive. And they require careful planning, sacrifice, and intentionality to create a resume and application that is more likely to stand out from the others. In this case, it would make so much more sense for shadowing opportunities to be much more available and easy to access.

It’s extraordinarily hard for a student to know if he wants to commit to 14 years of education based on a couple of hours walking around in a clinic. Admittedly, I have had some shadowers who probably got the message pretty quickly. Once I had a university student who followed me in the ED for four hours. At the end, he said, in a fatigued voice, “Don’t you guys ever sit down?” Not the perfect attitude if you really want to go into medicine. (Although maybe he ended up a radiologist with a nice chair in a dark room.)

We need to offer more shadowing, not less. Especially in an era of growing physician shortages in both primary care and specialties. We need to encourage students to pursue careers that have made our lives so rich and meaningful. And we need to urge hospitals, clinics, and offices to make those opportunities available as well.

If we want good healthcare; heck, if we want healthcare at all, we have to have physicians, PAs, and all the rest. And in order to have those essential persons, as it stands, they’ll have to shadow.

Every other job field seems to get it.

It’s time we do too.

Edwin Leap, MD, is an emergency physician. He practices full-time in a rural community hospital in South Carolina. He has spent many years practicing in rural and critical access facilities, including work as a locums provider for Weatherby Healthcare. He is a writer and blogger. He and his wife have four children. See more at edwinleap.com.

This post appeared on KevinMD.

UNLV to Develop Continuing Education Nursing Programs Through State Grant

UNLV to Develop Continuing Education Nursing Programs Through State Grant

The Nevada Governor’s Office of Economic Development (GOED) has rewarded the University of Nevada Las Vegas School of Nursing with a $900,000 grant. UNLV will put the grant toward expanding new advanced training opportunities and continuing education for nurses.

UNLV received the grant to develop nursing certificates designed to meet specific needs around the state, such as teaching, specialty care, and clinical research.

“We are excited to be able to expand the skills and competencies of Nevada nurses as clinical research nurses, genetics counselors, and clinical preceptors,” Angela Amar, professor and dean of the UNLV School of Nursing, shared with the UNLV News Center. “This funding allows us the opportunity to advance the health of Nevada citizens by increasing the capabilities of our nurses.”

The grant support, which originated from the GOED’s Workforce Innovations for a New Nevada program, is a continuation of UNLV’s plans in recent years to work on solving the state’s continually evolving medical needs. The UNLV School of Nursing has seen an admission increase of 50 percent since fall 2017 for BSN candidates. The school also has one of the top-ranked online master’s degree programs, and is also home to the Clinical Simulation Center of Las Vegas (CSCLV). The CSCLV, a technologically advanced educational facility, provides nursing and medical students opportunities to practice their skills through various simulations.

“At the UNLV School of Nursing, we educate nurses to provide the highest quality care for the citizens of Nevada,” Amar said. “The developing Las Vegas medical district and UNLV medical school make it important that nursing grows also. The increase in enrollment furthers our ability to meet the health care needs of our diverse population. With a critical need for highly trained nurses across our region and state, expanding our BSN class sizes will increase the number of graduates who can meet this demand.”

The planned certificate programs, which include Certified Nursing Assistant Instructors, Clinical Research Administrators, and Health Information Technology and Data Analytics, were developed in partnership with several health care organizations across the state, such as University Medical Center of Southern Nevada, and Comprehensive Cancer Centers of Nevada. These partners will help with job placement for all certification program participants.

The Valley Health System, University Medical Center of Southern Nevada, Comprehensive Cancer Centers of Nevada, and the Kenny Guinn Center for Policy Priorities. Health care employer partners, along with projected industry growth, will ensure successful placement of participants following their completion of the various programs, to ensure these nurses provide the best possible care to Nevada patients.

For more information about UNLV’s School of Nursing, click here.

Participate in our 2019 Nursing Career Survey!

Participate in our 2019 Nursing Career Survey!

Calling all nurses! Springer Publishing Company has launched the 2019 Nursing Career Survey, and we want to hear from you!

This study is designed for professional nurses and nursing students in every stage of their careers. Springer Publishing Company is surveying nurses to find out more about your professional paths, academic achievements, and leadership goals.

We are interested in learning about what steps you take and what tools you use to further your career, whether you’re just starting out or you’re thinking about pursuing a specialty. Your feedback will help us determine how we can better serve you and your needs in your nursing careers.

As always, there’s a perk for participating and helping Springer Publishing Company report the most up-to-date nursing career data. Survey participants will be entered to win one of five $25 Amazon gift cards!

Click here now to participate in the survey. We look forward to hearing your responses!

Nurse Residency Programs: Future for Post-Acute Care

Nurse Residency Programs: Future for Post-Acute Care

The New Jersey Action Coalition, in response to the Institute of Medicine’s recommendation to implement nurse residency programs across all practice settings, initiated a statewide program for new graduate RNs working in post-acute care (PAC) beginning in 2014. To date, more than 100 nurses and their experienced preceptors from more than 50 facilities in the state have completed this education program. The new book, Developing a Residency in Post-Acute Care, that I co-authored shares the experiences, program content and lessons learned from that innovative project.

How can this book help nurse leaders in post-acute settings to meet the challenges they presently face to provide safe, person-centered, evidence-based nursing care? It provides current, ready-to-use education for PAC nurses as well as other caregivers. Nurses in PAC strive to care for increasingly complex patients; adapt to new regulations and financial restrictions; and incorporate patient care technologies previously unknown outside of acute care. The rapid rate of change is unprecedented, requiring continual, stressful and swift improvements in knowledge and skill. Preventing rehospitalization alone requires a nursing staff with proficiency in assessment, early identification of deterioration, and appropriate intervention. Adding to this environment is high nurse turnover with vacancies expected to increase as experienced nurses retire. These events will create a practice gap that nurse leaders will have to fill, much of it with education to insure the competence and confidence of nursing staff.

Clinical safety and competence are always critically important; however, nurses must be knowledgeable and skilled in many areas in order to be effective. For example, teamwork and collaboration are essential to thriving in an interprofessional environment. Expertise in communication is required for all interactions with patients, families and colleagues; and as consumers develop greater expectations for care, communication becomes an indispensable skill. Regulatory expectations for nurses to participate in evaluating and implementing best practices as well as leading performance improvement projects requires education in these areas as well. These are among the topics detailed in Developing a Residency in Post-Acute Care.

The need to intensify nursing professional development in PAC is compounded by often limited resources. Nurse educators with a dedicated role are less common than in acute care, and responsibility for education often falls on someone with multiple jobs. Management, infection control and/or employee health are commonly combined functions, and these may take precedence over education. PAC care settings may not be able to afford subscriptions to print or online journals, and usually do not have access to medical libraries. Even with those resources, the time to research best practices or innovative solutions to problems probably does not exist in the extremely busy life of a PAC nurse leader. The Internet is a vast store of educational resources, but locating and evaluating options can be very time consuming. This book can dramatically reduce the amount of effort spent researching and preparing educational sessions by suggesting content, methods and literature/media sources.

With education come increased nurse confidence, greater accomplishment and the possibility of role expansion. With that, staff engagement and satisfaction increase, yielding the added benefits of improved retention, workplace stabilization, renewed professional energy and a more successful PAC setting.

This story was originally posted on MedPage Today.

Graduate Student Nurses Face Enrollment Concerns Over a Critical Shortage of Health Care Providers

Graduate Student Nurses Face Enrollment Concerns Over a Critical Shortage of Health Care Providers

The United States is facing a critical shortage in all health care professions. With the nation’s baby boomer population approaching retirement age, the issue is twofold: the aging population requires more care, and the nation’s physicians, nurses, and other health professionals are retiring.

Too Many Students, Not Enough Options

The solution to filling this gap is replacing the departing health care professionals with nursing graduates of all academic levels. However, many higher education institutions are turning away suitable candidates in droves. In 2016, nursing degree programs in the U.S. rejected 64,067 qualified applicants from baccalaureate and graduate nursing programs alike citing a lack of budget, faculty, clinical sites and preceptors, and classroom space.

Currently, there is a serious shortage of physicians, which continues to grow. By 2025, there will be a projected deficit of nearly 35,600 primary care doctors alone. Nursing schools are facing the struggle and strain to increase the capacity of existing nursing programs, and explore other avenues like online courses and accreditation.

Higher Education Means Higher Pay

Enrollment is increasing in nursing masters and doctoral programs across the country, and it’s no wonder that nurses are applying to graduate schools en masse. RNs realize there are significant perks to training and becoming an advanced practice registered nurse. Evidence shows that the quality of care by an advanced practice nurse is comparable to physicians, while often more affordable.

The full-time annual salary for a Nurse Practitioner (NP) averages $105,546. The high pay range of the NP may be partly to blame for the faculty shortage—higher compensation in the clinical setting is luring potential educators away from teaching.

Most vacant faculty positions require a terminal nursing degree. If more nurses pursue a doctoral degree, the faculty shortage will be alleviated. What will the outcomes of the nursing shortage be? Only time will tell.

Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University.    

War of Words for NPs: ‘Fellowship’ or ‘Residency’?

War of Words for NPs: ‘Fellowship’ or ‘Residency’?

When the first nurse practitioner residency programs began, the term “residency” left many in the nursing community unsettled.

“One of the concerns of residency programs and that terminology is the suggestion that nurse practitioners are not prepared upon graduation, which is not accurate at all,” Kitty Werner, MPA, executive director for the National Organization of Nurse Practitioner Faculties (NONPF), told MedPage Today.

In considering the language debate, Werner said, “[I]f people look at them [residencies or fellowships] closely they see how they are specific to their practice site, it’s much more like an intensive on-boarding experience for new graduates. Or it might be for existing nurse practitioners who transition to that particular practice environment, but they don’t replace formal educational preparation.”

The NONPF, as part of a broader statement on post-graduate education, declared that the term “residency” is “not an optimal description for NP post-graduate support” because it may be confused with medical residencies which are required for physicians to gain licensure. Four other major nursing groups signed the statement, which was later endorsed by the largest, the American Nurses Association.

“The residency in medicine fulfills the required clinical focus of a particular specialty. In NP preparation that clinical focus is embedded in the NP educational program centering on the population focus that is the center of NP practice emphasis (e.g., family, pediatrics, women’s health, etc.),” the statement read.

Even more confusing, some nursing programs use “residency” specifically for the clinical hours already included in their programs. The statement urged post-graduate support programs to keep things simple and call themselves “fellowships” instead.

Britney Broyhill, DNP, ACNP-BC, the director of the nurse practitioner program at Carolinas Healthcare in Charlotte, N.C., said she prefers the term “fellowship” since the programs are voluntary and offer advanced practice clinicians a chance “to go above and beyond their formal education and training in a subspecialty.”

But there are dissenters, among them Margaret Flinter, PhD, APRN, senior vice president and clinical director of the Community Health Center in Middletown, Conn., who founded the first nurse practitioner residency program and still prefers that name.

“My feeling is still — though I’m always open to the conversation — that this kind of broad-based, very intensive clinical training across the full gamut of primary care is best described as residency.”

She noted that the Department of Veterans Affairs also uses the term “residency.”

This story was originally posted on MedPage Today.

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