In Massachusetts, Future Health Care Needs Guide Nursing Education

The practice of nursing has been defined by change over the last decade. Innovations in technology and health care management have increased the demands made on nurses, and an aging baby boom generation is creating an urgent need for legions of new nurses with expanded skills. These nurses must provide the primary and preventive care, chronic care management and care coordination necessary to care for these older Americans, while keeping costs low and quality high. Beyond these national trends, Massachusetts also implemented health care reform in 2006, allowing an estimated 440,000 more citizens of the Bay State to get the health care they need. All these developments have resulted in a shortage of nurses: estimates project the state will need an additional 10,000 trained nurses by 2010, and 25,000 more by 2020 to help care for the 6.5 million people who call Massachusetts home.

To address the shortage and its consequences for health care consumers, a group of 32 veteran nurse executives, educators and health care experts came together in 2006 to map out a way forward for the Bay State, and, with support from the state’s Department of Higher Education, gathered in Worcester to forge a plan. The result was a report called Creativity and Connections: Building the Framework for the Future of Nursing Education and Practice.

Two years later, Massachusetts also became one of 30 states in which teams are working with the Center to Champion Nursing in America, an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation, to help build the nurse workforce of the future. Maureen Sroczynksi, RN, MS, who co-leads the Massachusetts team, was there at the 2006 summit and is also the Chief Nursing Consultant to the Massachusetts Department of Higher Education. Sroczynksi is delighted by all the collaboration in her state and says much of her job “is basically to facilitate the dialogue.”

The Department of Education houses the Massachusetts Nursing Initiative, which is tasked with alleviating the shortage of nurses and nurse educators and with addressing the increasing demands on nursing practice in modern health care delivery. So in addition to asking how Massachusetts can graduate more nurses to care for its citizens, they are also asking what kind of competencies nurses will need for their growing role in health care settings.

The answer to both questions is the Nurse of the Future Core Nursing Competencies©, Massachusetts’ comprehensive framework for training more and better prepared nurses. The competencies are a set of standards resulting from extensive research into the science and practice of contemporary nursing that provide a powerful framework around which much of the state’s Nursing Initiative is organized.

The key value of the competencies is that they drive outcome generated policies. As a template for what nurses need to know in the workplace, they are informing curricula for nursing students in some 30 programs throughout the Bay State and gearing their education towards the real world, real time demands of professional nurses. Also, because the Competencies create a more uniform curriculum across the state’s nursing programs, they are helping to increase graduation rates by accelerating education and streamlining transfers between schools as a nurse moves up through the educational system.

The Competencies are culled from the best practices developed by other states and institutions, including: the Institute of Medicine and the Quality and Safety Education for Nurses (QSEN) project at the University of North Carolina.

 
The American Organization of Nurse Executives:The Nurse of the Future Core Nursing Competencies©, is an outstanding example of how solving the nursing shortage is not only about quantity, but quality, and is the centerpiece of the state team’s work with the Center to Champion Nursing. As in Massachusetts, all the state teams are comprised of representatives from nursing education, state workforce offices, state departments of labor, consumers (often AARP state offices), local business, philanthropies, and others. Through strategic partnerships, they implement changes to nursing education, advocate for policy changes, and address faculty shortages, all to increase nursing school enrollment and bring more nurses into the workforce. The Center to Champion Nursing in America provides ongoing technical assistance to help teams accomplish these critical tasks and fosters collaborative learning experiences that link the teams and allow them to share best practices and lessons learned with their peers in other states.

Sroczynksi says that curriculum redesign at every level in Massachusetts is being driven by the competencies to meet the demands on – and for – nurses in her state. “Education and practice don’t always speak the same language,” she says, “but in Massachusetts, we are learning to. It’s the first time in my 40 years working in nursing that I’ve seen education and practice leaders so focused on these shared goals. It’s very exciting for me to be a part of this effort, here and nationwide.”