The ethical responsibility to manage pain and the suffering it causes. Silver Springs, MD: Author. Bosek chair , M. Turner, E. Attitudes of nurses toward patient-directed dying: A pilot study. Jannette, J. Advance practice registered nurse APRN intended actions toward patient-directed dying. Looking good or good nutrition? Rapid weight loss through enteral feedings: Ethical and clinical considerations: Ethical case.
Laramee, A. A comparison of nurse attitudes before implementation and 6 and 18 months after implementation of an electronic health record. Computers, Informatics, Nursing, 30 10 , Living kidney donor advocacy program: A quality improvement project. The ethical component of nursing education: Integrating ethics into clinical experiences. To establish uniform guidelines for educators, accreditation requirements should be evaluated and revised to allow simulation to fulfill the requirement for a standard number of clinical hours.
The use of simulation in relationship to the promotion of interprofessional education is discussed below. Increased attention is being focused on the dedicated education unit DEU as a viable alternative for expanding clinical education capacity Moscato et al. In this model, health care units are dedicated to the instruction of students from one program.
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Staff nurses who want to serve as clinical instructors are prepared to do so, and faculty expertise is used to support their development and comfort in this role. Since then, the University of Portland has helped at least a dozen other U. Early results suggest the DEU can dramatically increase capacity and have a positive effect on satisfaction among students and nursing staff. DEUs offer benefits for the nursing schools, the hospitals, the faculty, and the students. Because the hospital employs the clinical instructors, the nursing school can increase its enrollment without increasing costs.
The hospital benefits by training students it can hire after their graduation and licensure. Students benefit by having consistent clinical instructors each day, something not guaranteed under the traditional preceptorship model. As the case study in Box shows, the benefits of DEUs extend beyond the academic environment to the practice setting as well. A look at the way nursing students are educated at the prelicensure level 11 shows that most schools are not providing enough nurses with the required competencies in such areas as geriatrics and culturally relevant care to meet the changing health needs of the U.
The majority of nursing schools still educate students primarily for acute care rather than community settings, including public health and long-term care. Most curricula are organized around traditional medical specialties e. The intricacies of care coordination are not adequately addressed in most prelicensure programs.
Nursing students may gain exposure to leading health care disciplines and know something about basic health policy and available health and social service programs, such as Medicaid. Nursing curricula need to be reexamined and updated. They need to be adaptive enough to undergo continuous evaluation and improvement based on new evidence and a changing science base, changes and advances in technology, and changes in the needs of patients and the health care system.
Many nursing schools have dealt with the rapid growth of health research and knowledge by adding layers of content that require more instruction Ironside, For example, new competencies have been promulgated to address quality and patient safety goals Cronenwett et al. Greater emphasis on prevention, wellness, and improved health outcomes has led to new competency requirements as well Allan et al. These models, many of which could be focused in alternative settings such as schools and workplaces, will create new student placement options that will need to be tested for scalability and compared for effectiveness with more traditional care settings.
See also the discussion of competencies later in the chapter. The explosion of knowledge and decision-science technology also is changing the way health professionals access, process, and use information. No longer is rote memorization an option. There simply are not enough hours in the day or years in an undergraduate program to continue compressing all available information into the curriculum.
New approaches must be developed for evaluating curricula and presenting fundamental concepts that can be applied in many different situations rather than requiring students to memorize different lists of facts and information for each situation. Just as curricula must be assessed and rethought, so, too, must teaching—learning strategies.
Marcia Bosek, devyzuzyvoby.tk, RN | The Department of Nursing | The University of Vermont
Most nurse faculty initially learned to be nurses through highly structured curricula that were laden with content NLN Board of Governors, , and too few have received advanced formal preparation in curriculum development, instructional design, or performance assessment. Faculty, tending to teach as they were taught, focus on covering content Benner et al.
They also see curriculum-related requirements as a barrier to the creation of learning environments that are both engaging and student-centered Schaefer and Zygmont, ; Tanner, Even absent passage of the ACA, the need for APRNs, nurse faculty, and nurse researchers would have increased dramatically under any scenario Cronenwett, Not only must schools of nursing build their capacity to prepare more students at the graduate level, but they must do so in a way that fosters a unified, competency-based approach with the highest possible standards.
Therefore, building the science of nursing education research, or how best to teach students, is an important emphasis for the field of nursing education. For APRNs, graduate education should ensure that they can contribute to primary care and help respond to shortages, especially for those populations who are most underserved.
For nurse researchers, a focus on fundamental improvements in the delivery of nursing care to improve patient safety and quality is key. A PhD in nursing is a research-oriented degree designed to educate nurses in a wide range of scientific areas that may include clinical science, social science, policy, and education. Traditionally, PhD-educated nurses teach in university settings and conduct research to expand knowledge and improve care, although they can also work in clinical settings and assume leadership and administrative roles in health care systems and academic settings. The DNP is the complement to other practice doctorates, such as the MD, PharmD, doctorate of physical therapy, and others that require highly rigorous clinical training.
Nurses with DNPs are clinical scholars who have the capacity to translate research, shape systems of care, potentiate individual care into care needed to serve populations, and ask the clinical questions that influence organizational-level research to improve performance using informatics and quality improvement models. The DNP is a relatively new degree that offers nurses an opportunity to become practice scholars in such areas as clinical practice, leadership, quality improvement, and health policy.
Schools of nursing have been developing DNP programs since , but only in the last 5 years have the numbers of graduates approached a substantial level Raines, Between and the number of programs offering the degree increased by nearly 40 percent, as is shown in Figure At this point, more evidence is needed to examine the impact DNP nurses will have on patient outcomes, costs, quality of care, and access in clinical settings. It is also difficult to discern how DNP nurses could affect the provision of nursing education and whether they will play a significant role in easing faculty shortages.
While the DNP provides a promising opportunity to advance the nursing profession, and some nursing organizations are promoting this degree as the next step for APRNs, the committee cannot comment directly on the potential role of DNP nurses because of the current lack of evidence on outcomes. Growth trends in different nursing programs. Although 13 percent of nurses hold a graduate degree, fewer than 1 percent 28, nurses have a doctoral degree in nursing or a nursing-related field, the qualification needed to conduct independent research HRSA, b.
In fact, only students graduated with a PhD in nursing in , a number that has remained constant for the past decade AACN, a. As noted, key roles for PhD nurses include teaching future generations of nurses and conducting research that becomes the basis for improvements in nursing practice. As the need for nursing education and research and for nurses to engage with interprofessional research teams has grown, the numbers of nurses with a PhD in nursing or a related field have not kept pace see Figure for trends in the various nursing programs.
The main reasons for this lag are 1 an inadequate pool of nurses with advanced nursing degrees to draw upon, 2 faculty salaries and benefits that are not comparable to those of nurses with advanced nursing degrees working in clinical settings, and 3 a culture that promotes obtaining clinical experience prior to continuing graduate education.
To gain certification in one of these advanced practice areas, nurses must take specialized courses in addition to a basic core curriculum. Nurses who receive certification, including those serving in all advanced practice roles, provide added assurance to the public that they have acquired the specialized professional development, training, and competencies required to provide safe, quality care for specific patient populations. Certification is time-limited, and maintenance of certification requires ongoing acquisition of both knowledge and experience in practice.
These requirements must be fulfilled within the 5 years preceding submission of the renewal application ANCC, b. CRNAs are recertified every 2 years and must be substantially engaged in the practice of nurse anesthesia during those years, in addition to completing continuing education credits NBCRNA, As the health care system grows in complexity, expectations are that APRNs will have competence in expanding areas such as technology, genetics, quality improvement, and geriatrics.
Coursework and clinical experience requirements are increasing to keep pace with these changes. As discussed above, DNP programs allow nurses to hone their expertise in roles related to nurse executive practice, health policy, informatics, and other practice specialties. Graduate-level education produces nurses who can assume roles in advanced practice, leadership, teaching, and research.
For the latter role, a doctoral degree is required, yet as noted above, fewer than 1 percent of nurses have achieved this level of education. This number is insufficient to meet the crucial need for research in two key areas: nursing education and nursing science. At no time in recent history has there been a greater need for research on nursing education.
As health care reform progresses, basic and advanced nursing practices are being defined by the new competencies alluded to above and discussed in the next section, yet virtually no evidence exists to support the teaching approaches used in nursing education. The paucity of evidence in nursing education and pedagogy calls for additional research and funding to ascertain the efficiency and effectiveness of approaches to nursing education, advancing evidence-based teaching and interprofessional knowledge. Chapter 7 outlines specific research priorities that could shape improvements to nursing education.
The expansion of knowledge about the science of nursing is key to providing better patient care, improving health, and evaluating outcomes. Nurse scientists are a critical link in the discovery and translation of knowledge that can be generated by nurses and other health scientists. To carry out this crucial work, a sustainable supply of and support for nurse scientists will be necessary IOM, The research conducted by nurse scientists has led to many fundamental improvements in the provision of care.
Advances have been realized, for example, in the prevention of pressure ulcers; the reduction of high blood pressure among African American males; and the models described elsewhere in this report for providing transitional care after hospital discharge and for promoting health and well-being among young, disadvantaged mothers and their newborns.
Evaluating these and other factors will be essential to achieving the transformation of the nursing profession that this report argues is essential to a transformed health care system. Competencies that are well known to the nursing profession, such as care management and coordination, patient education, public health intervention, and transitional care, are likely to dominate in a reformed health care system.
A review of medical school education found that evidence in favor of competency-based education is limited but growing Carraccio et al. Nursing schools also have embraced the notion of competency-based education, as noted earlier in the chapter in the case study on the Oregon Consortium for Nursing Education Box In addition, Western Governors University uses competency-based education exclusively, allowing nursing students to move through their program of study at their own pace. Mastery of the competency is achieved to the satisfaction of the faculty without the normal time-bound semester structure IOM, The value of competency-based education in nursing is that it can be strongly linked to clinically based performance expectations.
Numerous sets of core competencies for nursing education are available from a variety of sources. It has proven difficult to establish a single set of competencies that cover all clinical situations, across all settings, for all levels of students. The competencies in these reports focus on aspects of professional behavior e.
While students appear to gradu ate with ample factual knowledge of these types of core competencies, however, they often appear to have little sense of how the competencies can be applied or integrated into real-world practice situations Benner et al. Imparting emerging competencies, such as quality improvement and systems thinking, is also key to developing a more highly educated workforce.
Doing so will require performing a thorough evaluation and redesign of educational content, not just adding content to existing curricula. An exploration of the educational changes required to teach all the emerging competencies required to meet the needs of diverse patient populations is beyond the scope of this report.
Defining an agreed-upon set of core competencies across health professions could lead to better communication and coordination among disciplines see the discussion of the Interprofessional Education Collaborative below for an example of one such effort. Additionally, the committee supports the development of a unified set of core competencies across the nursing profession and believes it would help provide direction for standards across nursing education.
Defining these core competencies must be a collaborative effort among nurse educators, professional organizations, and health care organizations and providers. This effort should be ongoing and should inform regular updates of nursing curricula to ensure that graduates at all levels are prepared to meet the current and future health needs of the population.
Changes in the way competencies are assessed are also needed. Steps are already being taken to establish competency-based assessments in medical education. The NCSBN has considered various challenges related to competency assessment and is considering approaches to ensure that RNs can demonstrate competence in the full range of areas that are required for the practice of nursing.
A competency-based approach to education strives to make the competencies for a particular course explicit to students and requires them to demonstrate mastery of those competencies Harden, Performance-based assessment then shows whether students have both a theoretical grasp of what they have learned and the ability to apply that knowledge in a real-world or realistically simulated situation. The transition-to-practice or nurse residency programs discussed in Chapter 3 could offer an extended opportunity to reinforce and test core competencies in real-world settings that are both safe and monitored.
Many professions, such as nursing, that depend heavily on knowledge are becoming increasingly technical and complex The Lewin Group, No individual can know all there is to know about providing safe and effective care, which is why nurses must be integral members of teams that include other health professionals. Nor can a single initial degree provide a nurse with all she or he will need to know over an entire career.
Creating an expectation and culture of lifelong learning for nurses is therefore essential. Nurses, physicians, and other health professionals have long depended on continuing education programs to maintain and develop new competencies over the course of their careers. Likewise, the NCSBN has found that there is no clear link between continuing education requirements and continued competency.
Therefore, building the capacity for lifelong learning—which encompasses both continuing competence and advanced degrees—requires ingenuity on the part of employers, businesses, schools, community and government leaders, and philanthropies. The case study in Box describes a program that extends the careers of nurses by training them to transition from the acute care to the community setting.
The importance of interprofessional collaboration and education has been recognized since the s Alberto and Herth, What is new is the introduction of simulation and web-based learning—solutions that can be used to can break down traditional barriers to learning together, such as the conflicting schedules of medical and APRN students or their lack of joint clinical learning opportunities. Simulation technology offers a safe environment in which to learn and make mistakes , while web-based learning makes schedule conflicts more manageable and content more repeatable.
If all nursing and medical students are educated in aspects of interprofessional collaboration, such as knowledge of professional roles and responsibilities, effective communication, conflict resolution, and shared decision making, and are exposed to working with other health professional students through simulation and web-based training, they may be more likely to engage in collaboration in future work settings. England, Canada, and the United States have made strides to improve interprofessional education by bringing students together from academic health science universities and medical centers e.
It is expected that graduates of programs with interprofessional education will be ready to work effectively in patient-centered teams where miscommunication and undermining behaviors are minimized or eliminated, resulting in safer, more effective care and greater clinician and patient satisfaction. Interprofessional education is thought to foster collaboration in implementing policies and improving services, prepare students to solve problems that exceed the capacity of any one profession, improve future job satisfaction, create a more flexible workforce, modify negative attitudes and perceptions, and remedy failures of trust and communication Barr, These organizations are committed to fulfilling the social contract that every nursing, pharmacy, dental, public health, and medical graduate is proficient in the core competencies required for interprofessional, team-based care, including preventive, acute, chronic, and catastrophic care.
The collaborative is also committed to facilitating the identification, development, and deployment of the resources essential to achieving this vision. As a first step, the collaborative is developing a shared and mutually endorsed set of core competencies that will frame the education of the six represented health professions. Efforts have been made to evaluate the effectiveness of interprofessional education in improving outcomes, including increased student satisfaction, modified negative stereotypes of other disciplines, increased collaborative behavior, and improved patient outcomes.
However, the effect of interprofessional education is not easily verified since control group designs are expensive, reliable measures are few, and time lapses can be long between interprofessional education and the behavior of graduates. Barr and colleagues reviewed evaluations of interprofessional education in published reports and found support for three outcomes: interprofessional education creates positive interaction among students and faculty; encourages collaboration between professions; and results in improvements in aspects of patient care, such as more targeted health promotion advice, higher immunization rates, and reduced blood pressure for patients with chronic heart disease.
Reeves and colleagues reviewed six later studies of varying designs. Four of the studies found that interprofessional education improved aspects of how clinicians worked together, while the remaining two found that it had no effect Reeves et al. Although empirical evidence is mixed, widespread theoretical agreement and anecdotal evidence suggest that students who demonstrate teamwork skills in the simulation laboratory or in a clinical education environment with patients will apply those skills beyond the confines of their academic programs.
Chapter 3 highlighted a variety of challenges facing the nursing profession in meeting the changing needs of patients and the health care system. A major challenge for the nursing workforce is the underrepresentation of racial and ethnic minority groups and men in the profession. To better meet the current and future health needs of the public and to provide more culturally relevant care, the nursing workforce will need to grow more diverse.
This is a crucial concern that needs to be addressed across all levels of nursing education. Although the composition of the nursing student body is more racially and ethnically diverse than that of the current workforce, diversity continues to be a challenge. Their underrepresentation is greatest for pathways associated with higher levels of education. In academic year —, for example, ethnic minority groups made up Even less evidence of diversity is present among nurses in faculty positions AACN, b.
The committee believes the implementation of these recommendations holds promise for ensuring a more diverse health care workforce in the future. Mentoring programs that support minority nursing students are another promising approach. One example of such a program is the National Coalition of Ethnic Minority Nursing Associations, a group made up of five ethnic minority nursing associations that aims to build the cadre and preparation of ethnic minority nurses and promote equity in health care across ethnic minority populations NCEMNA, This program is described at greater length in Chapter 5.
Another example of a successful program that has promoted racial and ethnic diversity is the ANA Minority Fellowship Program, 22 started in under the leadership of Dr. Hattie Bessent. This program has played a crucial role in supporting minority nurses with predoctoral and postdoctoral fellowships to advance research and clinical practice Minority Fellowship Program, Programs to recruit and retain more individuals from racial and ethnic minority groups in nursing education programs are needed.
A necessary first step toward accomplishing this goal is to create policies that increase the overall educational attainment of ethnic minorities Coffman et al. As noted in Chapter 3 , the nursing workforce historically has been composed predominantly of women. While the number of men who become nurses has grown dramatically in the last two decades, men still make up just 7 percent of all RNs HRSA, b.
While most disciplines within the health professional workforce have become more gender balanced, the same has not been true for nursing. For example, in nearly half of medical school graduates were female The Kaiser Family Foundation— statehealthfacts. Stereotypes, academic acceptance, and role support are challenges for men entering the nursing profession. These barriers must be overcome if men are to be recruited in larger numbers to help offset the shortage of nurses and fill advanced and expanded nursing roles.
Compounding the gender diversity problem of the nursing profession is the fact that fewer men in general are enrolling in higher education programs Mather and Adams, While more men are being drawn to nursing, especially as a second career, the profession needs to continue efforts to recruit men; their unique perspectives and skills are important to the profession and will help contribute additional diversity to the workforce.
One professional organization that works to encourage men to join the nursing profession and supports men who do so is the American Assembly for Men in Nursing AAMN. This chapter has outlined a number of challenges facing nursing education. These challenges have been the subject of much documentation, analysis, and debate Benner et al. Various approaches to responding to these challenges and transforming curricula have been proposed, and several are being tested.
The committee reviewed the literature on educational capacity and redesign, heard testimony about various challenges and potential solutions at the public forum in Houston, and chose a number of exemplars for closer examination. Three of these models are described in this section.
The committee found that each of these models provided important insight into creative approaches to maximizing faculty resources, encouraging the establishment and funding of new faculty positions, maximizing the effectiveness of clinical education, and redesigning nursing curricula.
VANA also was aimed at encouraging interprofessional programs and increasing the retention and recruitment of VA nurses. Fifteen geographically and demographically diverse pilot sites were selected to participate in VANA based on the strength of their proposals. Each funded VANA partnership is required to have a rigorous evaluation plan to measure outcomes. Outcomes are expected to include increased staff, patient, student, and faculty satisfaction; greater scholarly output; enhanced professional development; better continuity and coordination of care; more reliance on evidence-based practice; and enhanced interprofessional learning.
Each selected school is also expected to increase enrollment by at least 20 students a year. The program has already resulted in 2, new students, with receiving the majority of their clinical rotation experiences at the VA. The number of nursing school faculty has increased by and the number of VA faculty by In addition to the new nurses and faculty, educational innovations have encompassed curriculum revision, including quality and safety standards; DEUs described earlier in Box ; and a postgraduate baccalaureate nurse residency see Chapter 3.
Other changes include interprofessional simulation training and the development of evidence-based practice committees and programs. Beyond these specific changes and accomplishments, the VANA faculty has worked to develop the program into a single community of learning and to prepare students in a genuinely collaborative practice environment with clinically proficient staff and educators.
The Carondolet Health Network of Tucson, Arizona, is an example of how employers can offer educational benefits that improve both patient outcomes and the bottom line. After Carondelet became part of Ascension Health in , the Tucson organization embarked on a strategic plan to recruit and retain more nurses. Arizona faces some of the severest nursing shortages in the nation, and most nurses prefer to live and work in higher-paying markets, such as Phoenix or southern California.
When Carondelet instituted an on-site BSN program, which it subsidized in exchange for a 2-year work commitment, the response was dramatic. Instead of an anticipated class size of 20 nurses in the first semester of the program, it enrolled Of interest, it was the business case—the opportunity to decrease the amount of money the organization was spending on costly temporary nurses—that tipped the balance in favor of action The Lewin Group, Across the state, HEET-funded programs support industry-based reform of the education system and include preparation and completion of nursing career ladder programs.
HEET seeks to develop educational opportunities that support both employer needs and the career aspirations of health care workers. It features cohort-based programs, distance learning, worksite classes, use of a simulation laboratory for nursing prerequisites, case management, tutoring support for those reentering academia, and nontraditional scheduling of classes to enable working adults to attend and address employee barriers to education.
HEET participants represent a pool of potential nurses who are more diverse than the current nursing workforce. Providing on-site classes at hospitals appears to support the participation of working adults who are enrolled in nursing school while continuing to work at least part time.
Workers participating in the HEET program have had lower attrition rates and higher rates of course completion compared with community college students in nursing career tracks. The curriculum also blends academic preparation with health care career education, thereby opening the doors of college to workers who might not otherwise enroll or succeed Moss and Weinstein, The future of access to basic primary care and nursing education will depend on increasing the number of BSN-prepared nurses.
The committee believes that increasing the proportion of the nursing workforce with a BSN from the current 50 percent to 80 percent by is bold but achievable. Achieving this target will help meet future demand for nurses qualified for advanced practice positions and possessing competencies in such areas as community care, public health, health policy, evidence-based practice, research, and leadership.
The committee concludes further that the number of nurses holding a doctorate must be increased to produce a greater pool of nurses prepared to assume faculty and research positions. The committee believes a target of doubling the number of nurses with a doctorate by would meet this need and is achievable.
To achieve these targets, however, will require overcoming a number of barriers. The numbers of educators and clinical placements are insufficient for all the qualified applicants who wish to enter nursing school. There also is a shortage of faculty to teach nurses at all levels. Incentives for nurses at any level to pursue further education are few, and there are active disincentives against advanced education.
Nurses and physicians—not to mention pharmacists and social workers—typically are not educated together and yet are increasingly required to cooperate and collaborate more closely in the delivery of care. To address these barriers, innovative new programs to attract nursing faculty and provide a wider range of clinical education placements must clear long-stand ing bottlenecks. To this end, market-based salary adjustments must be made for faculty, and more scholarships must be provided to help nursing students advance their education.
Accrediting and certifying organizations must mandate demonstrated mastery of clinical skills, managerial competencies, and professional development at all levels. Mandated skills, competencies, and professional development milestones must be updated on a more timely basis to keep pace with the rapidly changing demands of health care.
All health professionals should receive more of their education in concert with students from other disciplines. Efforts also must be made to increase the diversity of the nursing workforce. The nursing profession must adopt a framework of continuous lifelong learning that includes basic education, academic progression, and continuing competencies.
Ethical Component of Nursing Education: Integrating Ethics into Clinical Experiences / Edition 1
More nurses must receive a solid education in how to manage complex conditions and coordinate care with multiple health professionals. They must demonstrate new competencies in systems thinking, quality improvement, and care management and a basic understanding of health care policy.
Graduate-level nurses must develop an even deeper understanding of care coordination, quality improvement, systems thinking, and policy. The committee emphasizes further that, as discussed in Chapter 2 , the ACA is likely to accelerate the shift in care from the hospital to the community setting. This transition will have a particularly strong impact on nurses, more than 60 percent of whom are currently employed in hospitals HRSA, b.
Nurses may turn to already available positions in primary or chronic care or in public or community health, or they may pursue entirely new careers in emerging fields that they help create. Continuing and graduate education programs must support the transition to a future that rewards flexibility. In addition, the curriculum at many nursing schools, which places heavy emphasis on preparing students for employment in the acute care setting, will need to be rethought Benner et al.
While titles for LPNs and LVNs vary from state to state, their responsibilities and education are relatively consistent. Available evidence is based on evaluation of BSN programs and curricula. Evidence was not available for ADN or diploma programs. Some faculty development programs and training opportunities are offered through universities and professional organizations, such as the AACN and the NLN.
Additionally, the NLN offers a certification program for nurse educators, who can publically confirm knowledge in the areas of pedagogy, learning, and the complex encounter between educator and student. This certification program can provide a basis for innovation and the continuous quality improvement of nursing education.
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National Center for Biotechnology Information , U. Search term. Overview of Current Undergraduate Education Educational Pathways Nursing is unique among the health care professions in the United States in that it has multiple educational pathways leading to an entry-level license to practice see the annexes to Chapter 1 and Appendix E.
Costs of Nursing Education Although a limited number of educational grants and scholarships are available, most of individuals seeking nursing education must finance their own education at any level of preparation. Why More BSN-Prepared Nurses Are Needed The qualifications and level of education required for entry into the nursing profession have been widely debated by nurses, nursing organizations, academics, and a host of other stakeholders for more than 40 years NLN, The Role of Community Colleges Community colleges play a key role in attracting students to the nursing education pipeline.
Barriers to Meeting Undergraduate Educational Needs Although the committee believes the capacity needed to ensure a nursing workforce that is 80 percent BSN-prepared by can be attained using the approaches outlined above, getting there will not be easy. Aging and Shortage of Nursing Faculty There are not enough nursing faculty to teach the current number of nursing students, let alone the number of qualified applicants who wish to pursue nursing.
FIGURE Distribution of the registered nurse population by highest nursing or nursing-related educational preparation, — NOTES: The totals in each bar may not equal the estimated numbers for RNs in each survey year because of incomplete information more Insufficient Clinical Placement Opportunities As nursing education has moved out of hospital-based programs and into mainstream colleges and universities, integrating opportunities for clinical experience into coursework has become more difficult Cronenwett, Need for Updated and Adaptive Curricula A look at the way nursing students are educated at the prelicensure level 11 shows that most schools are not providing enough nurses with the required competencies in such areas as geriatrics and culturally relevant care to meet the changing health needs of the U.
Research Roles Graduate-level education produces nurses who can assume roles in advanced practice, leadership, teaching, and research. Research on Nursing Education At no time in recent history has there been a greater need for research on nursing education. Research on Nursing Science The expansion of knowledge about the science of nursing is key to providing better patient care, improving health, and evaluating outcomes.
Defining Core Competencies The value of competency-based education in nursing is that it can be strongly linked to clinically based performance expectations. Assessing Competencies Changes in the way competencies are assessed are also needed. Lifelong Learning and Continuing Competence Many professions, such as nursing, that depend heavily on knowledge are becoming increasingly technical and complex The Lewin Group, From Continuing Education to Continuing Competence Nurses, physicians, and other health professionals have long depended on continuing education programs to maintain and develop new competencies over the course of their careers.
Interprofessional Education The importance of interprofessional collaboration and education has been recognized since the s Alberto and Herth, Racial and Ethnic Diversity Although the composition of the nursing student body is more racially and ethnically diverse than that of the current workforce, diversity continues to be a challenge. Gender Diversity As noted in Chapter 3 , the nursing workforce historically has been composed predominantly of women. Carondolet Health Network The Carondolet Health Network of Tucson, Arizona, is an example of how employers can offer educational benefits that improve both patient outcomes and the bottom line.
Enrollment and graduations in bac calaureate and graduate programs in nursing, Enrollment and graduations in baccalaureate and graduate programs in nursing, The essentials of baccalaureate education for professional nursing practice.
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The Ethical Component of Nursing Education: Integrating Ethics Into Clinical Experience
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