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When Dennis Sherrod, Ed.D., RN, began planning a campaign to entice young people into nursing three years ago, he wanted something exciting and powerful, something that would project nurses as smart, independent thinkers, capable of a myriad of exciting feats, from breathing life into a newborn to relieving an aging person's pain. It would have posters. It would have a Web site. And, naturally, it would have a video.

Although his creative energies were fired up, Sherrod, associate director for recruitment and retention at the North Carolina Center for Nursing, was not starting out cold. He was plugged in to a network called Colleagues in Caring, a nursing workforce development project that allows different regions to share ideas and information about attracting, educating, retaining and keeping track of nurses.

Colleagues in Caring was started in 1996 with funds from the Robert Wood Johnson Foundation. Its original purpose was to coordinate nursing education programs, making it easier for students to move from an LVN or AD program into an RN or BSN program.

But with guidelines from the foundation, a broader mission quickly evolved, said Rebecca Rice, Ed.D., MPH, RN, deputy director for Colleagues in Caring's national office in Washington, D.C.

Through its regional sites, Colleagues in Caring would gather data to document the state of the nursing workforce and would work to develop an adequate supply of nurses by improving education, recruitment and work environment. The new mission soon proved timely.

"Lo and behold, it wasn't too long into the project that the nursing shortage started," Rice said.

Colleagues in Caring includes 40 regional sites in 40 states. Half are independently funded. Most regional programs include some aspect of workforce data collection, educational mobility, scholarship, recruitment and workplace improvement. Each has its own way of running its program, with successful and not-so-successful experiences, which it readily shares with others.

The collaboration between Sherrod in Raleigh, N.C., and Barbara Mitchell, MSN, RN, in Indianapolis offers a good example of how the exchange works.

Ten years ago Mitchell, executive director of central Indiana's Nursing 2000, a nonprofit educational program to promote nursing careers, created "A Day in the Life of A Nurse."

The program allows high school students to spend time with a nurse at work. Surveys of participants showed that nearly 60 percent of respondents went into nursing programs. To complement the program, Mitchell created a Web site and a video.

Sherrod learned of Mitchell's work when Nursing 2000 joined Colleagues in Caring as a nonfunded member. Using her experiences and examples, as well as information from his own student focus groups, Sherrod created a Web site aimed at high school, middle school and elementary school students. He recently produced a video to show how nurses make a difference in people's lives.

Just as Sherrod borrowed from Indiana, Colleagues in Caring sites in Mississippi, Missouri, Arizona and other areas are incorporating aspects of North Carolina's recruitment campaign into their programs.

Sherrod, Mitchell and other site directors eagerly list other sources of inspiration: Mississippi's competency model, which matches nursing degrees with expected levels of performance; California's expertise in data collection; Kansas City's design for continuation of funding; and Pennsylvania's brochure for high school students.

Collaboration between regional sites, often by e-mail, is sometimes so fast and furious, regional directors don't always know who originated what. Ann McNamara, Ph.D., RN, project director for Arizona Colleagues in Caring, said she's traded a lot of information with the Kansas City site in setting up a separate institute to provide continuing support for her program. "I'm not sure if we gave the idea to them or they gave it to us," she said.

Under rules laid out by the Robert Wood Johnson Foundation, each project must have input from every aspect of nursing. South Dakota's 40-member consortium, for example, includes representatives from community colleges and universities, hospitals and nursing homes, nursing organizations, home health agencies, government agencies, and mental health and consumer groups.

Recently, members attended a retreat in Sioux Falls, S.D., where they discussed the role of nurses in four future health care scenarios, ranging from high-tech health care delivered at a grocery store to a barter economy, where patients exchanged vegetables for care.

Before Colleagues in Caring, members of the different groups rarely spoke to each other, let alone discussed the future, said Marge Hegge, Ed.D., RN, project director of the South Dakota consortium.

"We have few resources here in South Dakota," she said. "This has given us the luxury of getting together face to face and talking about our issues. The payoff has been a trust level that we haven't had in this state for a long time. It's lifted us all beyond our own levels and our own areas."

Such cooperation may not be possible on a national level, Rice said, which is why she believes Colleagues in Caring works best as a collection of regional sites with her office providing a framework. National organizations usually have a specific mission, she said. Local and regional organizations have closer ties to the community and are more willing to put aside differences.

Resources and regulations also vary from state to state. Some, such as Arizona, have legislation mandating articulation between two- and four-year higher education programs. Others, such as North Carolina, have state-established nursing centers. Some, such as California, have extensive data collection systems.

California's experience shows why data collection is such an important part of Colleagues in Caring's mission.

With information collected through the California Strategic Planning Committee for Nursing/Colleagues in Caring project, the state now knows that many nurses with inactive licenses cannot return to work, that California's nurses and nurse educators are older than those in the rest of the country, and that while enrollment in nursing programs reflects the state's population, the graduates do not, said project director Ellen Lewis, MSN, RN.

But regional data can't always be used on the national level, Rice said. Different sites collect information in different ways, partly because of local laws and available funding. One of Rice's goals is to establish a uniform set of information that all sites would provide to a national database.

Policy-makers already use information from individual sites. Recently, the General Accounting Office asked regional Colleagues in Caring programs for data on the supply and demand of nurses in their areas. Lewis said she has provided California's data to national lawmakers and to policy groups in other states. Many sites regularly supply information to their state legislatures.

Translating information into action can be a slow process, Lewis said. Her organization worked hard to get the state to allocate $15 million to expand nursing education programs, only to see the funds evaporate this year because of California's energy crisis.

"I'm amazed that the need has been detailed, but there just doesn't seem to be a response from the state Legislature," she said.

The slow pace of politics can make it difficult to measure the effects of Colleagues in Caring's work so far.

Rice emphasizes the importance of the process, of communication, networking and building on each other's information-like Sherrod's video, which took on a life of its own after he told the producer he wanted it to show the emotion pervasive in nursing.

"Then you need a song," the producer said. "OK," Sherrod responded. "Write me one."

The result, "Imagine the Difference," plays at the end of the 20-minute video. It has brought tears to the eyes of some listeners. Sherrod plans to have radio stations across North Carolina play the song as a public service announcement.

Mitchell in Indiana, for one, can't wait to see the new video. "It will be more current than ours, more updated," she said. "And that's great."