When I grow up
Nurse recruiters set their sights on a younger audience to bring the next generation into the profession

By David Ferris
February 19, 2001
Photo: www.sc.edu/nursing/cic/kidsclub/kidsclubindex.html

One day soon, children across North Carolina might be led in this chorus, sung to the tune of "Back At One" by R&B singer Brian McKnight. The song asks children to imagine a career in nursing. Simple enough. But can something as humble as a song help solve the nation’s nursing shortage?

Youth recruiters are betting on it. As the severity of the nursing gap sets in, nursing schools and hospitals have realized they need to boost the image of nursing among elementary, middle and high school students today if there are to be enough nurses tomorrow. Educators are encouraging children to handle stethoscopes, doodle in coloring books, learn first aid and follow nurses on their rounds.

"People go into nursing either because they want to help people or want the power to change people’s lives," said Dennis Sherrod, Ed.D., RN, associate director of the North Carolina Center for Nursing, which consulted 200 children through focus groups to come up with a video, a poster, a public service announcement and the song above.

"We have nurses out there working under dire conditions. It can’t just be fluff," he said.

Television programs, newspapers and movies put nurses in a poor light—if they mention nurses at all, educators say—whereas generations past might have been inspired by the biographies of wartime nurses such as Clara Barton or Edith Cavell.

Nursing recruiters must persuade children who’ve heard about poor salaries that the actual compensation isn’t bad and improves over time, that the work is rewarding even if it is difficult and that there’s a lot more to it than assisting a physician.

Recruiters are frustrated that parents, teachers and particularly guidance counselors push bright students with an interest in health toward careers in medicine. Recruiters say they have had only limited success persuading such youths to consider nursing.

"Nursing is not seen as a profession; it is seen as a service job," said Melodie Chenevert, RN, a nursing author and speaker. "It’s where you go if you aren’t bright enough for one of the glamour professions."

Most recruitment drives are comprised of one or two paid staff members and a large cadre of volunteers. The Robert Wood Johnson Foundation has given 20 such collaborative projects as much as $150,000 each. Most of the projects haven’t been around long enough to measure results.

Educators are addressing the problem in several ways:

Job shadowing
t’s a truism, recruiters say: The child most likely to go into nursing is one who has a relative in the profession or who has seen a nurse in action during a stay in the hospital. The next best thing is to simulate that exposure by letting a student tag along for a day.

At Nursing 2000, a recruiting effort in central Indiana, not just any high school student can get into the "Day in the Life of a Nurse" program. Good marks in math and science are required. Each year, 500 children follow a nurse around for the day at 22 hospitals in and around Indianapolis, said executive director Barbara Mitchell, MSN, RN.

The follow-up surveys are telling: Of the 30 percent who respond, more than half say they plan to go into nursing.

At Moravian College in Bethlehem, Pa., at least 50 shadow graduates have gone on to nursing school, said Janet Sipple, Ed.D., RN, chairwoman of the department of nursing.

While some programs allow a student to observe any nursing field, others steer children away from areas like ER and surgery, where a messy situation might erupt and disturb the child.

Show and tell
A visit to a classroom or career fair, or a class field trip to a hospital or nursing school, are among a recruiter’s most common tools.

At the University of Colorado Health Sciences Center in Denver, volunteer nurses bring a stick to class. On it, they mount a succession of paper cutouts of nurses—military, pediatric, triage—and speak from behind it in different voices, to show the variety of work that nurses perform, said Marie Miller, Ph.D., RN, executive director of the Colorado Alliance of Nursing Workforce Development Opportunities.

In South Carolina, visits by the South Carolina Colleagues in Caring project feature a short skit in which a nurse (played by a nurse) and a little girl (played by a nursing student in pigtails and overalls) discuss the ins and outs of nursing while the nurse treats the girl’s injured finger, said Renatta Loquist, MN, RN, FAAN, the project director.

Most recruiters take advantage of health care’s arsenal of cool gizmos children love to get their hands on.

Once a year, Nursing 2000 sets up nursing information tables throughout the Children’s Museum of Indianapolis with displays to hook children—such as a mannequin that, when probed, reveals a body cavity full of erasers or candy.

"It’s a way to make visual something that would otherwise be uninteresting to them," Mitchell said.

Others go high-tech. At the University of Mary Hardin-Baylor in Belton, Texas, visiting students use a video game-like console to simulate an intravenous injection, said Grace Labaj, Ph.D., RN, the school’s acting dean. At the University of Colorado Health Sciences Center, students watch video displays to learn how a baby’s face might be disfigured if it were born with fetal alcohol syndrome.

As seen on …
It comes as no surprise that children respond well to colorful pictures, both moving and still.

Promotional videos. With tight, fast editing and the latest music, nursing videos are growing in popularity. Several organizations offer theirs for sale and other consortiums are creating their own.

North Carolina’s Center for Nursing is making a video in which a girl goes on a quest to learn about nursing and finds multiracial nurses of both genders engaged in different specialties, from flight to surgical, Sherrod said.

In California, the California Strategic Planning Committee for Nursing is developing a video to recruit minority children. The videos eventually will be distributed across the state, said Ellen Lewis, MSN, RN, the program administrator.

Public service announcements. The North Carolina Center for Nursing has established a 30-second public service announcement that is being played on as many as 10 television stations across the state.

Coloring books. A longtime favorite of the Crayola set, these books are gaining popularity as an inexpensive way to interest children in nursing early on.

Chenevert, the author, has sold 25,000 copies of her coloring book What Do Nurses Do? in the past six months—as many as she has sold in the previous 10 years.

"We’re hoping it goes home with the kids and they are shared with their brothers and sisters and even their parents, who might be young enough to be making their own career decisions," Chenevert said.

Posters. Tacked up in the school library or in the pediatric ward, posters with messages such as "Nursing is Amazing" are one of the simplest and most effective ways to get children’s attention, educators say.

Web sites. A Web site can offer children unlimited information about nursing. If it requires membership to enter, it also can be a way to create a database of interested children who can be approached with further mention as they get older.

Let children participate
Many opportunities exist to turn children from spectators into participants in health care activities that might lead to an interest in nursing.

In North Carolina, Sherrod is designing a nursing merit badge for the state’s Girl Scouts, which they can earn by shadowing a nurse, becoming certified in CPR or scheduling a week of healthy meals. He plans to approach the Boy Scouts, the YWCA, YMCA and 4-H with the same idea.

Day camps also are popular. At the Moravian College nurse camp in Pennsylvania, 60 middle school students have the chance to get certified in baby-sitting or first aid, Sipple said.

Biased gatekeepers
The greatest obstacle to nurse recruitment has a name, educators say, and it is "guidance counselor." These advisers may have the same prejudice as others against nursing, but wield greater power as gatekeepers.

High school and middle school career advisers are so indifferent, Sherrod said, that he avoids them and sends his recruitment posters to the school librarian instead.

Wooing counselors is so important to the College of Nursing at Kent State University in Ohio that recruiters visit with a counselor first and with students if there’s time. "Every single visit we do—and we do more than 200 visits a year—is with counselors," said Assistant Dean Connie Stopper, RN.

Cheerleading
Educators say the unbeatable recruitment tool is a nurse who is enthusiastic about the profession. Unfortunately, they add, those are hard to come by these days.

Worries about staffing ratios, managed care and the profession’s reputation erode nurses’ desire to recommend the profession to young people—including their own children.

Educators tell children about nursing’s living wages, its intellectual and physical challenges and the satisfaction nurses find in helping others. Sherrod of the North Carolina Center for Nursing has developed guidelines for nurses called "Talk with Kids about Nursing!" at www.ga.unc.edu /NCCN/recruitment/Licensed%20Nurses/talkwithkids.htm.

"I tell stories about the people who come mid-career ... looking for more meaningful work," Sipple said. "They tell me they will die if they have to be a stockbroker anymore. I tell those [stories] to the kids who want to make a lot of money."

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