This article describes a successful collaborative endeavor by organizations within Texas to address the nursing shortage. As one of the first states to address the nursing shortage from a legislative perspective, passage of the Nursing Shortage Reduction Act of 2001 focused on bolstering the nursing education pipeline. Specifically addressed are the strategic planning process for development and passage of this important legislation, the content of the legislation, and a 2-year summary of the impact of the legislation on the Texas nursing educational infrastructure.
The nursing shortage is negatively affecting the quality, effectiveness, and timeliness of patient care, which warrants a transformation of the nursing work environment. The Nurse-Friendly (NF) Hospital Project assisted 30 rural or small hospitals implement 12 NF criteria into hospital policies to create a positive work environment. The NF criteria represent organizational attributes necessary for ensuring quality patient care, positive work environment, professional development, and nurse satisfaction. The authors discuss nurses' perception of presence of NF criteria before and after they were incorporated at each hospital and the implementation outcomes.
The nursing shortage has resulted in patients seeing fewer registered nurses (RNs) at the bedside in this time of high acuity and high use of health care facilities. A possible solution to the shortage is to improve staffing in hospitals to make them more nurse-friendly. A further benefit is the improvement of safety standards when full nursing staff complements are available. This article describes a collaborative initiative to implement health policy to improve the work environment by incorporating the American Nurses Association (ANA) staffing principles into state rules and regulations. The process described is one that used the political and regulatory arenas to bring together historically competing groups to work toward a mutually acceptable policy initiative that actually increased nurses’ ability to influence staffing in hospitals in the State of Texas. The process of mediation and collaboration is translatable into many health policy and political areas in which a win-win solution benefits everyone.
The evolving contexts in which nursing care is provided and the complexity of clients being served are raising new questions about the nature of nursing practice, the ways in which nurses can best be prepared for such practice settings, and how current staff can continually update their knowledge, skills, and abilities to provide competent care. It is imperative that the profession be forward looking as it reassesses the implications of assuring the public of a competent nursing work force. The mandate to prepare nurses differently to practice competently in future health care systems also suggests a different system for competency assessment. This article provides an overview of international, national, and state perspectives and approaches in addressing the issue of assuring competency from a public policy perspective, including one state's experience to date.
The present shortage of nurses in the United States is expected to continue. Nurse shortage, the nature of the work environment, and employers' expectations and attitudes, among other factors, influence both nurse retention and quality of patient care. The Nurse-Friendly Hospital Project was designed to improve nurses' work environment in rural and small hospitals in Texas. Findings demonstrate improvements in nurse retention, nurse staffing, and quality of care.
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